International Journal of Environmental Research and Public Health

386 KiB

Open AccessArticle

Pre-Hospital ECG E-Transmission for Patients with Suspected Myocardial Infarction in the Highlands of Scotland

by Gordon F. Rushworth, Charlie Bloe, H. Lesley Diack, Rachel Reilly, Calum Murray, Derek Stewart and Stephen J. Leslie

Int. J. Environ. Res. Public Health 2014, 11(2), 2346-2360; https://doi.org/10.3390/ijerph110202346 - 21 Feb 2014

Cited by 10 | Viewed by 7860

Abstract

Patients with ST elevation myocardial infarction (STEMI) require prompt treatment, best done by primary percutaneous coronary intervention (PPCI). However, for patients unable to receive PPCI, immediate pre-hospital thrombolysis (PHT) is the best alternative. Evidence indicates that diagnostic and management support for staff increases [...] Read more.

Patients with ST elevation myocardial infarction (STEMI) require prompt treatment, best done by primary percutaneous coronary intervention (PPCI). However, for patients unable to receive PPCI, immediate pre-hospital thrombolysis (PHT) is the best alternative. Evidence indicates that diagnostic and management support for staff increases the use of PHT. This study aimed to describe the patient demographics and management of patients, to determine any potential inter-area differences in referral rates to the ECG e-transmission service and to explore the views and experiences of key staff involved in ECG e-transmission within NHS Highland. Data from 2,025 patient episodes of ECG e-transmission identified a statistically significant geographical variation in ECG e-transmission and PHT delivery. Scottish Ambulance Service (SAS) staff were more likely than GPs to deliver PHT overall, however, GPs were more likely to deliver in remote areas. Interviews with six Cardiac Care Unit (CCU) nurses and six SAS staff highlighted their positive views of ECG e-transmission, citing perceived benefits to patients and interprofessional relationships. Poor access to network signal was noted to be a barrier to engaging in the system. This study has demonstrated that a specialist triage service based on e-transmission of ECGs in patients with suspected STEMI can be implemented in a diverse geographical setting. Work is needed to ensure equity of the service for all patients. Full article

(This article belongs to the Special Issue Advances in Telehealthcare)

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Open AccessReview

Potential for Improved Glycemic Control with Dietary Momordica charantia in Patients with Insulin Resistance and Pre-Diabetes

by Jimmy T. Efird, Yuk Ming Choi, Stephen W. Davies, Sanjay Mehra, Ethan J. Anderson and Lalage A. Katunga

Int. J. Environ. Res. Public Health 2014, 11(2), 2328-2345; https://doi.org/10.3390/ijerph110202328 - 21 Feb 2014

Cited by 52 | Viewed by 17862

Abstract

Bitter Melon (Momordica charantia) is a widely used traditional remedy for hyperglycemia. While the medicinal properties of this plant have been studied extensively using in vitro and animal models, the clinical efficacy and safety in humans is largely unknown. This review discusses [...] Read more.

Bitter Melon (Momordica charantia) is a widely used traditional remedy for hyperglycemia. While the medicinal properties of this plant have been studied extensively using in vitro and animal models, the clinical efficacy and safety in humans is largely unknown. This review discusses the benefits and limitations of bitter melon supplementation in the context of epidemic levels of insulin resistance and pre-diabetes throughout the world. Full article

(This article belongs to the Special Issue IJERPH: 10th Anniversary)

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Open AccessArticle

The Relation between Scores on Noise Annoyance and Noise Disturbed Sleep in a Public Health Survey

by Frits Van den Berg, Claudia Verhagen and Daan Uitenbroek

Int. J. Environ. Res. Public Health 2014, 11(2), 2314-2327; https://doi.org/10.3390/ijerph110202314 - 21 Feb 2014

Cited by 27 | Viewed by 7191

Abstract

The relation between responses to survey questions on noise annoyance and self-reported sleep disturbance has been analysed to gain insight in its dependency on noise source or noise type and on individual characteristics. The results show a high correlation between responses (scores 0–10) [...] Read more.

The relation between responses to survey questions on noise annoyance and self-reported sleep disturbance has been analysed to gain insight in its dependency on noise source or noise type and on individual characteristics. The results show a high correlation between responses (scores 0–10) with Pearson’s correlation coefficient close to 0.8 for respondents who report hearing the source. At the same level of annoyance, scooters and neighbours are associated with more sleep disturbance, air and road traffic with less. The relation between Annoyance (A) and Sleep Disturbance (SD) is also significantly related to age, the use of sleeping drugs, and living alone. However, the differences in the A-SD relations with respect to source and characteristic are small. Noise-related sleep disturbance is associated more strongly to noise annoyance than it is to noise exposure. For transportation noise both scores are more often equal when the annoyance score is 7 or higher; this change in scoring behaviour could be an indication for a change to severe annoyance. Full article

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Open AccessArticle

Environmental Arsenic Exposure and Microbiota in Induced Sputum

by Allison G. White, George S. Watts, Zhenqiang Lu, Maria M. Meza-Montenegro, Eric A. Lutz, Philip Harber and Jefferey L. Burgess

Int. J. Environ. Res. Public Health 2014, 11(2), 2299-2313; https://doi.org/10.3390/ijerph110202299 - 21 Feb 2014

Cited by 11 | Viewed by 7721

Abstract

Arsenic exposure from drinking water is associated with adverse respiratory outcomes, but it is unknown whether arsenic affects pulmonary microbiota. This exploratory study assessed the effect of exposure to arsenic in drinking water on bacterial diversity in the respiratory tract of non-smokers. Induced [...] Read more.

Arsenic exposure from drinking water is associated with adverse respiratory outcomes, but it is unknown whether arsenic affects pulmonary microbiota. This exploratory study assessed the effect of exposure to arsenic in drinking water on bacterial diversity in the respiratory tract of non-smokers. Induced sputum was collected from 10 subjects with moderate mean household water arsenic concentration (21.1 ± 6.4 ppb) and 10 subjects with low household water arsenic (2.4 ± 0.8 ppb). To assess microbiota in sputum, the V6 hypervariable region amplicons of bacterial 16s rRNA genes were sequenced using the Ion Torrent Personal Genome Machine. Microbial community differences between arsenic exposure groups were evaluated using QIIME and Metastats. A total of 3,920,441 sequence reads, ranging from 37,935 to 508,787 per sample for 316 chips after QIIME quality filtering, were taxonomically classified into 142 individual genera and five phyla. Firmicutes (22%), Proteobacteria (17%) and Bacteriodetes (12%) were the main phyla in all samples, with Neisseriaceae (15%), Prevotellaceae (12%) and Veillonellacea (7%) being most common at the genus level. Some genera, including Gemella, Lactobacillales, Streptococcus, Neisseria and Pasteurellaceae were elevated in the moderate arsenic exposure group, while Rothia, Prevotella, Prevotellaceae Fusobacterium and Neisseriaceae were decreased, although none of these differences was statistically significant. Future studies with more participants and a greater range of arsenic exposure are needed to further elucidate the effects of drinking water arsenic consumption on respiratory microbiota. Full article

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Open AccessArticle

Assessment of Unsuspected Exposure to Drugs of Abuse in Children from a Mediterranean City by Hair Testing

by Simona Pichini, Oscar Garcia-Algar, Airam Alvarez, Massimo Gottardi, Emilia Marchei, Fiorenza Svaizer, Manuela Pellegrini, Maria Concetta Rotolo and Roberta Pacifici

Int. J. Environ. Res. Public Health 2014, 11(2), 2288-2298; https://doi.org/10.3390/ijerph110202288 - 21 Feb 2014

Cited by 15 | Viewed by 6839

Abstract

Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and [...] Read more.

Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15–3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (D9-THC concentration range 0.05–0.54 ng/mg hair), with four samples positive to codeine (0.1–0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child’s health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions. Full article

(This article belongs to the Special Issue IJERPH: 10th Anniversary)

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Open AccessArticle

Monitoring the Transmission of Schistosoma japonicum in Potential Risk Regions of China, 2008 – 2012

by Hui Dang, Jing Xu, Shi-Zhu Li, Zhi-Guo Cao, Yi-Xin Huang, Cheng-Guo Wu, Zu-Wu Tu and Xiao-Nong Zhou

Int. J. Environ. Res. Public Health 2014, 11(2), 2278-2287; https://doi.org/10.3390/ijerph110202278 - 21 Feb 2014

Cited by 22 | Viewed by 8576

Abstract

Schistosomiasis japonica, caused by Schistosoma japonicum infection, remains a major public health concern in China, and the geographical distribution of this neglected tropical disease is limited to regions where Oncomelania hupensis, the intermediate host of the causative parasite, is detected. The purpose [...] Read more.

Schistosomiasis japonica, caused by Schistosoma japonicum infection, remains a major public health concern in China, and the geographical distribution of this neglected tropical disease is limited to regions where Oncomelania hupensis, the intermediate host of the causative parasite, is detected. The purpose of this study was to monitor the transmission of S. japonicum in potential risk regions of China during the period from 2008 through 2012. To monitor the transmission, 10 fixed surveillance sites and 30 mobile sentinel sites were selected in 10 counties of four provinces, namely Anhui, Jiangsu, Chongqing and Hubei. There were 8, 9, 6, 2 and 3 cases infected with S. japonicum detected in the 30 mobile sentinel sites during the 5-year study period, while 27 subjects were positive for the antibody-based serum test in the 10 fixed sentinel sites; however, no infection was found. In addition, neither local nor imported livestock were found to be infected. No O. hupensis snails were detected in either the fixed surveillance or the mobile sentinel sites; however, the snail host was found to survive and reproduce at Chaohu Lake, inferring the potential of transmission of the disease. It is suggested that the continuous surveillance of schistosomiasis japonica should be carried out in both the endemic foci and potential risk regions of China, and an active, sensitive system to respond the potential risk of transmission seems justified. Full article

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Open AccessArticle

Evaluation of Health Care System Reform in Hubei Province, China

by Shuping Sang, Zhenkun Wang and Chuanhua Yu

Int. J. Environ. Res. Public Health 2014, 11(2), 2262-2277; https://doi.org/10.3390/ijerph110202262 - 21 Feb 2014

Cited by 14 | Viewed by 8690

Abstract

This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based [...] Read more.

This study established a set of indicators for and evaluated the effects of health care system reform in Hubei Province (China) from 2009 to 2011 with the purpose of providing guidance to policy-makers regarding health care system reform. The resulting indicators are based on the “Result Chain” logic model and include the following four domains: Inputs and Processes, Outputs, Outcomes and Impact. Health care system reform was evaluated using the weighted TOPSIS and weighted Rank Sum Ratio methods. Ultimately, the study established a set of indicators including four grade-1 indicators, 16 grade-2 indicators and 76 grade-3 indicators. The effects of the reforms increased year by year from 2009 to 2011 in Hubei Province. The health status of urban and rural populations and the accessibility, equity and quality of health services in Hubei Province were improved after the reforms. This sub-national case can be considered an example of a useful approach to the evaluation of the effects of health care system reform, one that could potentially be applied in other provinces or nationally. Full article

(This article belongs to the Special Issue Public Health Informatics)

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Open AccessArticle

Exploring Powered Wheelchair Users and Their Caregivers’ Perspectives on Potential Intelligent Power Wheelchair Use: A Qualitative Study

by Dahlia Kairy, Paula W. Rushton, Philippe Archambault, Evelina Pituch, Caryne Torkia, Anas El Fathi, Paula Stone, François Routhier, Robert Forget, Louise Demers, Joelle Pineau and Richard Gourdeau

Int. J. Environ. Res. Public Health 2014, 11(2), 2244-2261; https://doi.org/10.3390/ijerph110202244 - 21 Feb 2014

Cited by 37 | Viewed by 9442

Abstract

Power wheelchairs (PWCs) can have a positive impact on user well-being, self-esteem, pain, activity and participation. Newly developed intelligent power wheelchairs (IPWs), allowing autonomous or collaboratively-controlled navigation, could enhance mobility of individuals not able to use, or having difficulty using, standard PWCs. The [...] Read more.

Power wheelchairs (PWCs) can have a positive impact on user well-being, self-esteem, pain, activity and participation. Newly developed intelligent power wheelchairs (IPWs), allowing autonomous or collaboratively-controlled navigation, could enhance mobility of individuals not able to use, or having difficulty using, standard PWCs. The objective of this study was to explore the perspectives of PWC users (PWUs) and their caregivers regarding if and how IPWs could impact on current challenges faced by PWUs, as well as inform current development of IPWs. A qualitative exploratory study using individual interviews was conducted with PWUs (n = 12) and caregivers (n = 4). A semi-structured interview guide and video were used to facilitate informed discussion regarding IPWs. Thematic analysis revealed three main themes: (1) “challenging situations that may be overcome by an IPW” described how the IPW features of obstacle avoidance, path following, and target following could alleviate PWUs’ identified mobility difficulties; (2) “cautious optimism concerning IPW use revealed participants” addresses concerns regarding using an IPW as well as technological suggestions; (3) “defining the potential IPW user” revealed characteristics of PWUs that would benefit from IPW use. Findings indicate how IPW use may help overcome PWC difficulties and confirm the importance of user input in the ongoing development of IPWs. Full article

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Open AccessArticle

Pupillometry in Chinese Female Patients with Depression: A Pilot Study

by Jikun Wang, Yaodong Fan, Xudong Zhao and Nanhui Chen

Int. J. Environ. Res. Public Health 2014, 11(2), 2236-2243; https://doi.org/10.3390/ijerph110202236 - 21 Feb 2014

Cited by 13 | Viewed by 5711

Abstract

The pupillary responses to light in patients with depression and normal controls were evaluated among Chinese females. Four parameters related to the pupil were assessed using a video-based pupillometer. The results showed that there were significant differences in the pupil area in the [...] Read more.

The pupillary responses to light in patients with depression and normal controls were evaluated among Chinese females. Four parameters related to the pupil were assessed using a video-based pupillometer. The results showed that there were significant differences in the pupil area in the darkness and the pupil area at the peak of constriction between depressed patients and normal controls. Full article

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Open AccessArticle

Indicators for Tracking European Vulnerabilities to the Risks of Infectious Disease Transmission due to Climate Change

by Jonathan E. Suk, Kristie L. Ebi, David Vose, Willy Wint, Neil Alexander, Koen Mintiens and Jan C. Semenza

Int. J. Environ. Res. Public Health 2014, 11(2), 2218-2235; https://doi.org/10.3390/ijerph110202218 - 21 Feb 2014

Cited by 19 | Viewed by 10441

Abstract

A wide range of infectious diseases may change their geographic range, seasonality and incidence due to climate change, but there is limited research exploring health vulnerabilities to climate change. In order to address this gap, pan-European vulnerability indices were developed for 2035 and [...] Read more.

A wide range of infectious diseases may change their geographic range, seasonality and incidence due to climate change, but there is limited research exploring health vulnerabilities to climate change. In order to address this gap, pan-European vulnerability indices were developed for 2035 and 2055, based upon the definition vulnerability = impact/adaptive capacity. Future impacts were projected based upon changes in temperature and precipitation patterns, whilst adaptive capacity was developed from the results of a previous pan-European study. The results were plotted via ArcGIS^TM to EU regional (NUTS2) levels for 2035 and 2055 and ranked according to quintiles. The models demonstrate regional variations with respect to projected climate-related infectious disease challenges that they will face, and with respect to projected vulnerabilities after accounting for regional adaptive capacities. Regions with higher adaptive capacities, such as in Scandinavia and central Europe, will likely be better able to offset any climate change impacts and are thus generally less vulnerable than areas with lower adaptive capacities. The indices developed here provide public health planners with information to guide prioritisation of activities aimed at strengthening regional preparedness for the health impacts of climate change. There are, however, many limitations and uncertainties when modeling health vulnerabilities. To further advance the field, the importance of variables such as coping capacity and governance should be better accounted for, and there is the need to systematically collect and analyse the interlinkages between the numerous and ever-expanding environmental, socioeconomic, demographic and epidemiologic datasets so as to promote the public health capacity to detect, forecast, and prepare for the health threats due to climate change. Full article

(This article belongs to the Special Issue Climate Change and Human Health)

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Open AccessCommentary

Recent Evidence Regarding Triclosan and Cancer Risk

by Michael T. Dinwiddie, Paul D. Terry and Jiangang Chen

Int. J. Environ. Res. Public Health 2014, 11(2), 2209-2217; https://doi.org/10.3390/ijerph110202209 - 21 Feb 2014

Cited by 69 | Viewed by 15368

Abstract

Triclosan is a broad-spectrum antibacterial commonly used in cosmetics, dentifrices, and other consumer products. The compound’s widespread use in consumer products and its detection in breast milk, urine, and serum have raised concerns regarding its potential association with various human health outcomes. Recent [...] Read more.

Triclosan is a broad-spectrum antibacterial commonly used in cosmetics, dentifrices, and other consumer products. The compound’s widespread use in consumer products and its detection in breast milk, urine, and serum have raised concerns regarding its potential association with various human health outcomes. Recent evidence suggests that triclosan may play a role in cancer development, perhaps through its estrogenicity or ability to inhibit fatty acid synthesis. Our aims here are to review studies of human exposure levels, to evaluate the results of studies examining the effects of triclosan on cancer development, and to suggest possible directions for future research. Full article

(This article belongs to the Special Issue Endocrine Disruptors and Human Health)

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Open AccessArticle

Risk Factors of CVD Mortality among the Elderly in Beijing, 1992 – 2009: An 18-year Cohort Study

by Tao Zhou, Xia Li, Zhe Tang, Changchun Xie, Lixin Tao, Lei Pan, Da Huo, Fei Sun, Yanxia Luo, Wei Wang, Aoshuang Yan and Xiuhua Guo

Int. J. Environ. Res. Public Health 2014, 11(2), 2193-2208; https://doi.org/10.3390/ijerph110202193 - 21 Feb 2014

Cited by 10 | Viewed by 7477

Abstract

Few researchers have examined the effects of multiple risk factors of cardiovascular disease (CVD) mortality simultaneously. This study was to determine the associations of combined lifestyle and other factors with CVD mortality among the elderly (n = 3,257), in Beijing, China, through data [...] Read more.

Few researchers have examined the effects of multiple risk factors of cardiovascular disease (CVD) mortality simultaneously. This study was to determine the associations of combined lifestyle and other factors with CVD mortality among the elderly (n = 3,257), in Beijing, China, through data mining of the Beijing Longitudinal Study of Aging (BLSA). BLSA is a representative cohort study from 1992 to 2009, hosted by Xuan Wu Hospital. Competing risk survival analysis was conducted to explore the association between risk factors and CVD mortality. The factors focused mainly on lifestyle, physical condition, and the model was adjusted for age and gender. There were 273 of the 1,068 recorded deaths caused by CVD among the 2010 participants. Living in a suburban area (HR = 0.614, 95% CI: 0.410-0.921) was associated with lower CVD mortality. Increasing age (66–75: HR = 1.511, 95% CI: 1.111–2.055; ≥76: HR = 1.847, 95% CI: 1.256–2.717), high blood pressure (HR = 1.407, 95% CI: 1.031–1.920), frequent consumption of meat (HR = 1.559, 95% CI: 1.079–2.254) and physical inactivity (p = 0.046) were associated with higher CVD mortality. The study provides an instructional foundation for the control and prevention of CVD in Beijing, China. Full article

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Open AccessArticle

by Elizabeth Christenson, Mark Elliott, Ovik Banerjee, Laura Hamrick and Jamie Bartram

Int. J. Environ. Res. Public Health 2014, 11(2), 2169-2192; https://doi.org/10.3390/ijerph110202169 - 21 Feb 2014

Cited by 37 | Viewed by 16834

Abstract

Global climate change (GCC) has led to increased focus on the occurrence of, and preparation for, climate-related extremes and hazards. Population exposure, the relative likelihood that a person in a given location was exposed to a given hazard event(s) in a given period [...] Read more.

Global climate change (GCC) has led to increased focus on the occurrence of, and preparation for, climate-related extremes and hazards. Population exposure, the relative likelihood that a person in a given location was exposed to a given hazard event(s) in a given period of time, was the outcome for this analysis. Our objectives were to develop a method for estimating the population exposure at the country level to the climate-related hazards cyclone, drought, and flood; develop a method that readily allows the addition of better datasets to an automated model; differentiate population exposure of urban and rural populations; and calculate and present the results of exposure scores and ranking of countries based on the country-wide, urban, and rural population exposures to cyclone, drought, and flood. Gridded global datasets on cyclone, drought and flood occurrence as well as population density were combined and analysis was carried out using ArcGIS. Results presented include global maps of ranked country-level population exposure to cyclone, drought, flood and multiple hazards. Analyses by geography and human development index (HDI) are also included. The results and analyses of this exposure assessment have implications for country-level adaptation. It can also be used to help prioritize aid decisions and allocation of adaptation resources between countries and within a country. This model is designed to allow flexibility in applying cyclone, drought and flood exposure to a range of outcomes and adaptation measures. Full article

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Open AccessArticle

Assessing and Mapping Spatial Associations among Oral Cancer Mortality Rates, Concentrations of Heavy Metals in Soil, and Land Use Types Based on Multiple Scale Data

by Wei-Chih Lin, Yu-Pin Lin, Yung-Chieh Wang, Tsun-Kuo Chang and Li-Chi Chiang

Int. J. Environ. Res. Public Health 2014, 11(2), 2148-2168; https://doi.org/10.3390/ijerph110202148 - 21 Feb 2014

Cited by 21 | Viewed by 8996

Abstract

In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the [...] Read more.

In this study, a deconvolution procedure was used to create a variogram of oral cancer (OC) rates. Based on the variogram, area-to-point (ATP) Poisson kriging and p-field simulation were used to downscale and simulate, respectively, the OC rate data for Taiwan from the district scale to a 1 km × 1 km grid scale. Local cluster analysis (LCA) of OC mortality rates was then performed to identify OC mortality rate hot spots based on the downscaled and the p-field-simulated OC mortality maps. The relationship between OC mortality and land use was studied by overlapping the maps of the downscaled OC mortality, the LCA results, and the land uses. One thousand simulations were performed to quantify local and spatial uncertainties in the LCA to identify OC mortality hot spots. The scatter plots and Spearman’s rank correlation yielded the relationship between OC mortality and concentrations of the seven metals in the 1 km cell grid. The correlation analysis results for the 1 km scale revealed a weak correlation between OC mortality rate and concentrations of the seven studied heavy metals in soil. Accordingly, the heavy metal concentrations in soil are not major determinants of OC mortality rates at the 1 km scale at which soils were sampled. The LCA statistical results for local indicator of spatial association (LISA) revealed that the sites with high probability of high-high (high value surrounded by high values) OC mortality at the 1 km grid scale were clustered in southern, eastern, and mid-western Taiwan. The number of such sites was also significantly higher on agricultural land and in urban regions than on land with other uses. The proposed approach can be used to downscale and evaluate uncertainty in mortality data from a coarse scale to a fine scale at which useful additional information can be obtained for assessing and managing land use and risk. Full article

(This article belongs to the Special Issue Assessment, Management, and Policy-Making for Environmental Pollution Related to Land Use and Land Cover)

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Open AccessHypothesis

Glyphosate, Hard Water and Nephrotoxic Metals: Are They the Culprits Behind the Epidemic of Chronic Kidney Disease of Unknown Etiology in Sri Lanka?

by Channa Jayasumana, Sarath Gunatilake and Priyantha Senanayake

Int. J. Environ. Res. Public Health 2014, 11(2), 2125-2147; https://doi.org/10.3390/ijerph110202125 - 20 Feb 2014

Cited by 225 | Viewed by 110402

Abstract

The current chronic kidney disease epidemic, the major health issue in the rice paddy farming areas in Sri Lanka has been the subject of many scientific and political debates over the last decade. Although there is no agreement among scientists about the etiology [...] Read more.

The current chronic kidney disease epidemic, the major health issue in the rice paddy farming areas in Sri Lanka has been the subject of many scientific and political debates over the last decade. Although there is no agreement among scientists about the etiology of the disease, a majority of them has concluded that this is a toxic nephropathy. None of the hypotheses put forward so far could explain coherently the totality of clinical, biochemical, histopathological findings, and the unique geographical distribution of the disease and its appearance in the mid-1990s. A strong association between the consumption of hard water and the occurrence of this special kidney disease has been observed, but the relationship has not been explained consistently. Here, we have hypothesized the association of using glyphosate, the most widely used herbicide in the disease endemic area and its unique metal chelating properties. The possible role played by glyphosate-metal complexes in this epidemic has not been given any serious consideration by investigators for the last two decades. Furthermore, it may explain similar kidney disease epidemics observed in Andra Pradesh (India) and Central America. Although glyphosate alone does not cause an epidemic of chronic kidney disease, it seems to have acquired the ability to destroy the renal tissues of thousands of farmers when it forms complexes with a localized geo environmental factor (hardness) and nephrotoxic metals. Full article

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Open AccessArticle

Effects of Age, Season, Gender and Urban-Rural Status on Time-Activity: Canadian Human Activity Pattern Survey 2 (CHAPS 2)

by Carlyn J. Matz, David M. Stieb, Karelyn Davis, Marika Egyed, Andreas Rose, Benedito Chou and Orly Brion

Int. J. Environ. Res. Public Health 2014, 11(2), 2108-2124; https://doi.org/10.3390/ijerph110202108 - 19 Feb 2014

Cited by 240 | Viewed by 12744

Abstract

Estimation of population exposure is a main component of human health risk assessment for environmental contaminants. Population-level exposure assessments require time-activity pattern distributions in relation to microenvironments where people spend their time. Societal trends may have influenced time-activity patterns since previous Canadian data [...] Read more.

Estimation of population exposure is a main component of human health risk assessment for environmental contaminants. Population-level exposure assessments require time-activity pattern distributions in relation to microenvironments where people spend their time. Societal trends may have influenced time-activity patterns since previous Canadian data were collected 15 years ago. The Canadian Human Activity Pattern Survey 2 (CHAPS 2) was a national survey conducted in 2010–2011 to collect time-activity information from Canadians of all ages. Five urban and two rural locations were sampled using telephone surveys. Infants and children, key groups in risk assessment activities, were over-sampled. Survey participants (n = 5,011) provided time-activity information in 24-hour recall diaries and responded to supplemental questionnaires concerning potential exposures to specific pollutants, dwelling characteristics, and socio-economic factors. Results indicated that a majority of the time was spent indoors (88.9%), most of which was indoors at home, with limited time spent outdoors (5.8%) or in a vehicle (5.3%). Season, age, gender and rurality were significant predictors of time activity patterns. Compared to earlier data, adults reported spending more time indoors at home and adolescents reported spending less time outdoors, which could be indicative of broader societal trends. These findings have potentially important implications for assessment of exposure and risk. The CHAPS 2 data also provide much larger sample sizes to allow for improved precision and are more representative of infants, children and rural residents. Full article

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Open AccessReview

Ketogenic Diet for Obesity: Friend or Foe?

by Antonio Paoli

Int. J. Environ. Res. Public Health 2014, 11(2), 2092-2107; https://doi.org/10.3390/ijerph110202092 - 19 Feb 2014

Cited by 222 | Viewed by 124723

Abstract

Obesity is reaching epidemic proportions and is a strong risk factor for a number of cardiovascular and metabolic disorders such as hypertension, type 2 diabetes, dyslipidemia, atherosclerosis, and also certain types of cancers. Despite the constant recommendations of health care organizations regarding the [...] Read more.

Obesity is reaching epidemic proportions and is a strong risk factor for a number of cardiovascular and metabolic disorders such as hypertension, type 2 diabetes, dyslipidemia, atherosclerosis, and also certain types of cancers. Despite the constant recommendations of health care organizations regarding the importance of weight control, this goal often fails. Genetic predisposition in combination with inactive lifestyles and high caloric intake leads to excessive weight gain. Even though there may be agreement about the concept that lifestyle changes affecting dietary habits and physical activity are essential to promote weight loss and weight control, the ideal amount and type of exercise and also the ideal diet are still under debate. For many years, nutritional intervention studies have been focused on reducing dietary fat with little positive results over the long-term. One of the most studied strategies in the recent years for weight loss is the ketogenic diet. Many studies have shown that this kind of nutritional approach has a solid physiological and biochemical basis and is able to induce effective weight loss along with improvement in several cardiovascular risk parameters. This review discusses the physiological basis of ketogenic diets and the rationale for their use in obesity, discussing the strengths and the weaknesses of these diets together with cautions that should be used in obese patients. Full article

(This article belongs to the Special Issue Lifestyle Intervention for Chronic Diseases Prevention)

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Open AccessArticle

Casual Dock Work: Profile of Diseases and Injuries and Perception of Influence on Health

by Marta Regina Cezar-Vaz, Marlise Capa Verde De Almeida, Clarice Alves Bonow, Laurelize Pereira Rocha, Anelise Miritz Borges and Diéssica Roggia Piexak

Int. J. Environ. Res. Public Health 2014, 11(2), 2077-2091; https://doi.org/10.3390/ijerph110202077 - 19 Feb 2014

Cited by 12 | Viewed by 7167

Abstract

The present study aimed to identify the profile of diseases and injuries that affect casual dock workers and identify casual dock workers’ perceptions of positive and negative work influences on their health. This study consisted of two phases. The first phase was a [...] Read more.

The present study aimed to identify the profile of diseases and injuries that affect casual dock workers and identify casual dock workers’ perceptions of positive and negative work influences on their health. This study consisted of two phases. The first phase was a quantitative study composed of a retrospective analysis, conducted with 953 medical records. The second phase of the research is a non-random sample with 51 casual dock workers. Data analysis was performed with SPSS 19.0. The average age of the casual dock workers was 48.7. Concerning working time, the majority had more than 19.6 years of dock work experience. In the first phase, 527 pathologic diagnoses were identified. The diagnoses that affected the musculoskeletal system (15.8%, N = 152; p < 0.01) were highlighted. Consequences to physical health produced by accidents stood out, with fracture registration predominating (12.8%, N = 122; p < 0.05). Significant differences were found for positive work influence on the cardiovascular system and family health. It was concluded that the diagnoses obtained are related to the influence of dock work perception and have motivated an introduction of preventive measures. Full article

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Open AccessArticle

Effect of Different Disinfection Protocols on Microbial and Biofilm Contamination of Dental Unit Waterlines in Community Dental Practices

by Laura Dallolio, Amalia Scuderi, Maria S. Rini, Sabrina Valente, Patrizia Farruggia, Maria A. Bucci Sabattini, Gianandrea Pasquinelli, Anna Acacci, Greta Roncarati and Erica Leoni

Int. J. Environ. Res. Public Health 2014, 11(2), 2064-2076; https://doi.org/10.3390/ijerph110202064 - 18 Feb 2014

Cited by 34 | Viewed by 9363

Abstract

Output water from dental unit waterlines (DUWLs) may be a potential source of infection for both dental healthcare staff and patients. This study compared the efficacy of different disinfection methods with regard to the water quality and the presence of biofilm in DUWLs. [...] Read more.

Output water from dental unit waterlines (DUWLs) may be a potential source of infection for both dental healthcare staff and patients. This study compared the efficacy of different disinfection methods with regard to the water quality and the presence of biofilm in DUWLs. Five dental units operating in a public dental health care setting were selected. The control dental unit had no disinfection system; two were disinfected intermittently with peracetic acid/hydrogen peroxide 0.26% and two underwent continuous disinfection with hydrogen peroxide/silver ions (0.02%) and stabilized chlorine dioxide (0.22%), respectively. After three months of applying the disinfection protocols, continuous disinfection systems were more effective than intermittent systems in reducing the microbial contamination of the water, allowing compliance with the CDC guidelines and the European Council regulatory thresholds for drinking water. P. aeruginosa, Legionella spp, sulphite-reducing Clostridium spores, S. aureus and β-haemolytic streptococci were also absent from units treated with continuous disinfection. The biofilm covering the DUWLs was more extensive, thicker and more friable in the intermittent disinfection dental units than in those with continuous disinfection. Overall, the findings showed that the products used for continuous disinfection of dental unit waterlines showed statistically better results than the intermittent treatment products under the study conditions. Full article

(This article belongs to the Special Issue IJERPH: 10th Anniversary)

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Open AccessArticle

A Prospective Cohort Study of Alcohol Exposure in Early and Late Pregnancy within an Urban Population in Ireland

by Deirdre J. Murphy, Clare Dunney, Aoife Mullally, Nita Adnan, Tom Fahey and Joe Barry

Int. J. Environ. Res. Public Health 2014, 11(2), 2049-2063; https://doi.org/10.3390/ijerph110202049 - 17 Feb 2014

Cited by 10 | Viewed by 6898

Abstract

Most studies of alcohol consumption in pregnancy have looked at one time point only, often relying on recall. The aim of this longitudinal study was to determine whether alcohol consumption changes in early and late pregnancy and whether this affects perinatal outcomes. We [...] Read more.

Most studies of alcohol consumption in pregnancy have looked at one time point only, often relying on recall. The aim of this longitudinal study was to determine whether alcohol consumption changes in early and late pregnancy and whether this affects perinatal outcomes. We performed a prospective cohort study, conducted from November 2010 to December 2011 at a teaching hospital in the Republic of Ireland. Of the 907 women with a singleton pregnancy who booked for antenatal care and delivered at the hospital, 185 (20%) abstained from alcohol in the first trimester but drank in the third trimester, 105 (12%) consumed alcohol in the first and third trimesters, and the remaining 617 (68%) consumed no alcohol in pregnancy. Factors associated with continuing to drink in pregnancy included older maternal age (30–39 years), Irish nationality, private healthcare, smoking, and a history of illicit drug use. Compared to pre-pregnancy, alcohol consumption in pregnancy was markedly reduced, with the majority of drinkers consuming ≤ 5 units per week (92% in first trimester, 72–75% in third trimester). Perhaps because of this, perinatal outcomes were similar for non-drinkers, women who abstained from alcohol in the first trimester, and women who drank in the first and third trimester of pregnancy. Most women moderate their alcohol consumption in pregnancy, especially in the first trimester, and have perinatal outcomes similar to those who abstain. Full article

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Open AccessArticle

Risk Assessment of the Schmutzdecke of Biosand Filters: Identification of an Opportunistic Pathogen in Schmutzdecke Developed by an Unsafe Water Source

by Hyun Gyu Hwang, Min Seo Kim, Soo Min Shin and Cher Won Hwang

Int. J. Environ. Res. Public Health 2014, 11(2), 2033-2048; https://doi.org/10.3390/ijerph110202033 - 14 Feb 2014

Cited by 21 | Viewed by 9826

Abstract

The biosand filter (BSF) is widely applied in developing counties as an appropriate technology-based product for supplying “safe” water. Biosand filters exhibit relatively high purifying efficiency because of the schmutzdecke (biofilm) embedded in them. However, schmutzdecke should be cleaned or discarded on a [...] Read more.

The biosand filter (BSF) is widely applied in developing counties as an appropriate technology-based product for supplying “safe” water. Biosand filters exhibit relatively high purifying efficiency because of the schmutzdecke (biofilm) embedded in them. However, schmutzdecke should be cleaned or discarded on a regular basis to maintain the purifying efficiency of the BSF. Due to its role in BSFs, the purifying function of schmutzdecke, rather than its potential risk when not properly discarded, has so far been the primary focus of research. This study aims to provide a risk assessment of schmutzdecke in an attempt to draw attention to a wholly new angle of schmutzdecke usage. We conducted 16S rRNA gene sequencing and phylogenetic analysis to identify opportunistic pathogens in schmutzdecke developed using water from the Hyung-San River. The results reveal that the schmutzdecke derived from this water source contains diverse and relatively high portions of opportunistic pathogen strains; 55% of all isolates collected from schmutzdecke were identified as opportunistic pathogens. Moreover, the diversity of microorganisms is increased in the schmutzdecke compared to its water source in terms of diversity of genus, phylum and opportunistic pathogen strain. As a whole, our study indicates a potential risk associated with schmutzdecke and the necessity of a solid guideline for the after-treatment of discarded schmutzdecke. Full article

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Open AccessArticle

Extreme Precipitation and Beach Closures in the Great Lakes Region: Evaluating Risk among the Elderly

by Kathleen F. Bush, Cheryl L. Fossani, Shi Li, Bhramar Mukherjee, Carina J. Gronlund and Marie S. O'Neill

Int. J. Environ. Res. Public Health 2014, 11(2), 2014-2032; https://doi.org/10.3390/ijerph110202014 - 14 Feb 2014

Cited by 11 | Viewed by 7637

Abstract

As a result of climate change, extreme precipitation events are expected to increase in frequency and intensity. Runoff from these extreme events poses threats to water quality and human health. We investigated the impact of extreme precipitation and beach closings on the risk [...] Read more.

As a result of climate change, extreme precipitation events are expected to increase in frequency and intensity. Runoff from these extreme events poses threats to water quality and human health. We investigated the impact of extreme precipitation and beach closings on the risk of gastrointestinal illness (GI)-related hospital admissions among individuals 65 and older in 12 Great Lakes cities from 2000 to 2006. Poisson regression models were fit in each city, controlling for temperature and long-term time trends. City-specific estimates were combined to form an overall regional risk estimate. Approximately 40,000 GI-related hospital admissions and over 100 beach closure days were recorded from May through September during the study period. Extreme precipitation (≥90th percentile) occurring the previous day (lag 1) is significantly associated with beach closures in 8 of the 12 cities (p < 0.05). However, no association was observed between beach closures and GI-related hospital admissions. These results support previous work linking extreme precipitation to compromised recreational water quality. Full article

(This article belongs to the Special Issue Climate Change and Human Health)

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Open AccessArticle

Beginning A Patient-Centered Approach in the Design of A Diabetes Prevention Program

by Richard W.Seidel, Kimberlee A. Pardo, Paul A.Estabrooks, WenYou, Sarah S. Wall, Brenda M.Davy and Fabio A.Almeida

Int. J. Environ. Res. Public Health 2014, 11(2), 2003-2013; https://doi.org/10.3390/ijerph110202003 - 14 Feb 2014

Cited by 6 | Viewed by 6588

Abstract

Objective: The purpose of this study was to identify patient preferences for different components of a local diabetes prevention program that would improve reach. A secondary purpose was to determine if patient characteristics were related to program preferences. Methods: Participants were identified through [...] Read more.

Objective: The purpose of this study was to identify patient preferences for different components of a local diabetes prevention program that would improve reach. A secondary purpose was to determine if patient characteristics were related to program preferences. Methods: Participants were identified through electronic medical records from two family medicine clinics in Virginia. Participants completed a mailed survey addressing demographics, economic status, risk factors for diabetes, and preferences regarding diabetes prevention interventions—delivery mode, program length, and duration. Results: Twenty-nine percent of eligible participants responded (n = 142); 83% of participants were at risk for diabetes and 82% had a household income <$20,000. When presented with the choice between a class-based vs. a technology-based program, 83% preferred a technology-based program. Whites were less likely to choose the technology-based program, with no significant differences based on age, education, income, or gender. Conclusions: Contrary to beliefs that lower income individuals may not use technology-based interventions, lower socioeconomic patients indicated a preference for a technology- and telephone-supported diabetes prevention program over in-person class approaches. Findings provide formative data to support the design of a patient-centered, technology-enhanced diabetes prevention program in a real-world setting, thereby increasing potential participation and reach. Full article

(This article belongs to the Special Issue Diabetes Prevention: Challenges and Opportunities)

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Open AccessArticle

Beliefs and Knowledge about Vaccination against AH1N1pdm09 Infection and Uptake Factors among Chinese Parents

by Cynthia Sau Ting Wu, Enid Wai Yung Kwong, Ho Ting Wong, Suet Hang Lo and Anthony Siu Wo Wong

Int. J. Environ. Res. Public Health 2014, 11(2), 1989-2002; https://doi.org/10.3390/ijerph110201989 - 14 Feb 2014

Cited by 9 | Viewed by 6243

Abstract

Vaccination against AH1N1pdm09 infection (human swine infection, HSI) is an effective measure of preventing pandemic infection, especially for high-risk groups like children between the ages of 6 months and 6 years. This study used a cross-sectional correlation design and aimed to identify predicting [...] Read more.

Vaccination against AH1N1pdm09 infection (human swine infection, HSI) is an effective measure of preventing pandemic infection, especially for high-risk groups like children between the ages of 6 months and 6 years. This study used a cross-sectional correlation design and aimed to identify predicting factors of parental acceptance of the HSI vaccine (HSIV) and uptake of the vaccination by their preschool-aged children in Hong Kong. A total of 250 parents were recruited from four randomly selected kindergartens. A self-administered questionnaire based on the health belief framework was used for data collection. The results showed that a number of factors significantly affected the tendency toward new vaccination uptake; these factors included parental age, HSI vaccination history of the children in their family, preferable price of the vaccine, perceived severity, perceived benefits, perceived barriers, and motivating factors for taking new vaccines. Using these factors, a logistic regression model with a high Nagelkerke R² of 0.63 was generated to explain vaccination acceptance. A strong correlation between parental acceptance of new vaccinations and the motivating factors of vaccination uptake was found, which indicates the importance of involving parents in policy implementation for any new vaccination schemes. Overall, in order to fight against pandemics and enhance vaccination acceptance, it is essential for the government to understand the above factors determining parental acceptance of new vaccinations for their preschool-aged children. Full article

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Open AccessArticle

Strategies to Reduce the Harmful Effects of Extreme Heat Events: A Four-City Study

by Jalonne L. White-Newsome, Sabrina McCormick, Natalie Sampson, Miatta A. Buxton, Marie S. O'Neill, Carina J. Gronlund, Linda Catalano, Kathryn C. Conlon and Edith A. Parker

Int. J. Environ. Res. Public Health 2014, 11(2), 1960-1988; https://doi.org/10.3390/ijerph110201960 - 13 Feb 2014

Cited by 40 | Viewed by 11500

Abstract

Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted [...] Read more.

Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted 73 semi-structured interviews with government and non-governmental organization leaders representing public health, general social services, emergency management, meteorology, and the environmental planning sectors in Detroit, MI; New York City, NY; Philadelphia, PA and Phoenix, AZ—cities selected for their diverse demographics, climates, and climate adaptation strategies. We identified activities these leaders used to reduce the harmful effects of heat for residents in their city, as well as the obstacles they faced and the approaches they used to evaluate these efforts. Local leaders provided a description of how local context (e.g., climate, governance and city structure) impacted heat preparedness. Despite the differences among study cities, political will and resource access were critical to driving heat-health related programming. Upon completion of our interviews, we convened leaders in each city to discuss these findings and their ongoing efforts through day-long workshops. Our findings and the recommendations that emerged from these workshops could inform other local or national efforts towards preventing heat-related morbidity and mortality. Full article

(This article belongs to the Special Issue Climate Change and Human Health)

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Open AccessArticle

Effect of Ambient Temperature on Australian Northern Territory Public Hospital Admissions for Cardiovascular Disease among Indigenous and Non-Indigenous Populations

by Leanne Webb, Hilary Bambrick, Peter Tait, Donna Green and Lisa Alexander

Int. J. Environ. Res. Public Health 2014, 11(2), 1942-1959; https://doi.org/10.3390/ijerph110201942 - 13 Feb 2014

Cited by 41 | Viewed by 10011

Abstract

Hospitalisations are associated with ambient temperature, but little is known about responses in population sub-groups. In this study, heat responses for Indigenous and non-Indigenous people in two age groups were examined for two categories of cardiac diseases using daily hospital admissions from five [...] Read more.

Hospitalisations are associated with ambient temperature, but little is known about responses in population sub-groups. In this study, heat responses for Indigenous and non-Indigenous people in two age groups were examined for two categories of cardiac diseases using daily hospital admissions from five Northern Territory hospitals (1992–2011). Admission rates during the hottest five per cent of days and the coolest five per cent of days were compared with rates at other times. Among 25–64 year olds, the Indigenous female population was more adversely affected by very hot days than the non-Indigenous female population, with admission rates for ischaemic heart disease (IHD) increasing by 32%. People older than 65 were more sensitive to cold, with non-Indigenous male admissions for heart failure increasing by 64%, and for IHD by 29%. For older Indigenous males, IHD admissions increased by 52% during cold conditions. For older non-Indigenous females, increases in admissions for heart failure were around 50% on these cold days, and 64% for older Indigenous females. We conclude that under projected climate change conditions, admissions for IHD amongst younger Indigenous people would increase in hot conditions, while admissions among elderly people during cold weather may be reduced. The responses to temperature, while showing significant relationships across the Northern Territory, may vary by region. These variations were not explored in this assessment. Full article

(This article belongs to the Special Issue Climate Change and Human Health)

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Open AccessArticle

Global Trade, Local Impacts: Lessons from California on Health Impacts and Environmental Justice Concerns for Residents Living near Freight Rail Yards

by Andrea Hricko, Glovioell Rowland, Sandrah Eckel, Angelo Logan, Maryam Taher and John Wilson

Int. J. Environ. Res. Public Health 2014, 11(2), 1914-1941; https://doi.org/10.3390/ijerph110201914 - 10 Feb 2014

Cited by 26 | Viewed by 15119

Abstract

Global trade has increased nearly 100-fold since 1950, according to the World Trade Organization. Today, major changes in trade are occurring with the advent of mega-ships that can transport thousands more containers than cargo ships now in use. Because global trade is expected [...] Read more.

Global trade has increased nearly 100-fold since 1950, according to the World Trade Organization. Today, major changes in trade are occurring with the advent of mega-ships that can transport thousands more containers than cargo ships now in use. Because global trade is expected to increase dramatically, the railroad industry—in the U.S. alone—has invested more than $5 billion a year over the past decade to expand rail yards and enhance rail routes to transport goods from ports to retail destinations. This article describes cancer risks for residents living in close proximity to rail yards with emissions of diesel particulate matter pollution from locomotives, trucks and yard equipment. The article examines the demographics (income, race/ethnicity) of populations living in the highest estimated cancer risk zones near 18 major rail yards in California, concluding that the majority are over-represented by either lower-income or minority residents (or both). The authors also describe a review of the news media and environmental impact reports to determine if rail yards are still being constructed or expanded in close proximity to homes and schools or in working class/working poor communities of color. The paper suggests policy efforts that might provide more public health protection and result in more “environmentally just” siting of rail yards. The authors conclude that diesel pollution from rail yards, which creates significant diesel cancer risks for those living near the facilities, is an often overlooked public health, health disparities and environmental justice issue in the U.S. The conclusions are relevant to other countries where international trade is increasing and large new intermodal rail facilities are being considered. Full article

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

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Effects of Dietary Selenium on Histopathological Changes and T Cells of Spleen in Broilers Exposed to Aflatoxin B₁

by Kejie Chen, Xi Peng, Jing Fang, Hengmin Cui, Zhicai Zuo, Junliang Deng, Zhengli Chen, Yi Geng, Weimin Lai, Li Tang and Qingqiu Yang

Int. J. Environ. Res. Public Health 2014, 11(2), 1904-1913; https://doi.org/10.3390/ijerph110201904 - 10 Feb 2014

Cited by 47 | Viewed by 6911

Abstract

Aflatoxin B₁ (AFB₁), which causes hepatocellular carcinoma and immune-suppression, is commonly found in feedstuffs. To evaluate the ability of selenium (Se) to counteract the deleterious effects of AFB₁, two hundred 1-day-old male avian broilers, divided into five groups, [...] Read more.

Aflatoxin B₁ (AFB₁), which causes hepatocellular carcinoma and immune-suppression, is commonly found in feedstuffs. To evaluate the ability of selenium (Se) to counteract the deleterious effects of AFB₁, two hundred 1-day-old male avian broilers, divided into five groups, were fed with basal diet (control group), 0.3 mg/kg AFB₁ (AFB₁ group), 0.3 mg/kg AFB₁+0.2 mg/kg Se (+Se group I), 0.3 mg/kg AFB₁+0.4 mg/kg Se (+Se group II) and 0.3 mg/kg AFB₁+0.6 mg/kg Se (+Se group III), respectively. Compared with control group, the relative weight of spleen in the AFB₁ group was decreased at 21 days of age. The relative weight of spleen in the three +Se groups was higher than that in the AFB₁ group. By pathological observation, the major spleen lesions included congestion in red pulp and vacuoles appeared in the lymphatic nodules and periarterial lymphatic sheath in the AFB₁ group. In +Se groups II and III, the incidence of major splenic lesions was decreased. The percentages of CD₃⁺, CD₃⁺CD₄⁺ and CD₃⁺CD₈⁺ T cells in the AFB₁ group were lower than those in control group from 7 to 21 days of age, while there was a marked increase in the three +Se groups compared to the AFB₁ group. The results indicated that sodium selenite could improve the cellular immune function impaired by AFB₁through increasing the relative weight of spleen and percentages of splenic T cell subsets, and alleviating histopathological spleen damage. Full article

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Correlates of the Intention to Implement a Tailored Physical Activity Intervention: Perceptions of Intermediaries

by Denise Peels, Aart Mudde, Catherine Bolman, Rianne Golsteijn, Hein De Vries and Lilian Lechner

Int. J. Environ. Res. Public Health 2014, 11(2), 1885-1903; https://doi.org/10.3390/ijerph110201885 - 10 Feb 2014

Cited by 7 | Viewed by 7177

Abstract

The public health impact of health behaviour interventions is highly dependent on large-scale implementation. Intermediaries—intervention providers—determine to a large extent whether an intervention reaches the target population, and hence its impact on public health. A cross-sectional study was performed to identify the correlates [...] Read more.

The public health impact of health behaviour interventions is highly dependent on large-scale implementation. Intermediaries—intervention providers—determine to a large extent whether an intervention reaches the target population, and hence its impact on public health. A cross-sectional study was performed to identify the correlates of intermediaries’ intention to implement a computer-tailored physical activity intervention. According to theory, potential correlates are intervention characteristics, organisational characteristics, socio-political characteristics and intermediary characteristics. This study investigated whether intermediary characteristics mediated the association between the intervention, organisational and socio-political characteristics and intention to implement the intervention. Results showed that intervention characteristics (i.e., observability (B = 0.53; p = 0.006); relative advantage (B = 0.79; p = 0.020); complexity (B = 0.80; p < 0.001); compatibility (B = 0.70; p < 0.001)), organisational characteristics (i.e., type of organization (B = 0.38; p = 0.002); perceived task responsibility (B = 0.66; p ≤ 0.001); capacity (B = 0.83; p < 0.001)), and the social support received by intermediary organisations (B = 0.81; p < 0.001) were associated with intention to implement the intervention. These factors should thus be targeted by an implementation strategy. Since self-efficacy and social norms perceived by the intermediary organisations partially mediated the effects of other variables on intention to implement the intervention (varying between 29% and 84%), these factors should be targeted to optimise the effectiveness of the implementation strategy. Full article

(This article belongs to the Special Issue Health Behaviors and Public Health)

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Perceptions of Community Health Workers (CHWs/PS) in the U.S.-Mexico Border HEART CVD Study

by Hector G. Balcazar, Sherrie Wise, Alisha Redelfs, E. Lee Rosenthal, Hendrik D. De Heer, Ximena Burgos and Maria Duarte-Gardea

Int. J. Environ. Res. Public Health 2014, 11(2), 1873-1884; https://doi.org/10.3390/ijerph110201873 - 10 Feb 2014

Cited by 8 | Viewed by 6604

Abstract

Although prior research has shown that Community Health Workers/Promotores de Salud (CHW/PS) can facilitate access to care, little is known about how CHW/PS are perceived in their community. The current study reports the findings of a randomized telephone survey conducted in a high-risk [...] Read more.

Although prior research has shown that Community Health Workers/Promotores de Salud (CHW/PS) can facilitate access to care, little is known about how CHW/PS are perceived in their community. The current study reports the findings of a randomized telephone survey conducted in a high-risk urban community environment along the U.S.-Mexico border. In preparation for a community-based CHW/PS intervention called the HEART ecological study, the survey aimed to assess perceptions of CHW/PS, availability and utilization of community resources (recreational and nutrition related) and health behaviors and intentions. A total of 7,155 calls were placed to complete 444 surveys in three zip codes in El Paso, Texas. Results showed that participants felt that healthful community resources were available, but utilization was low and variable: 35% reported going to a park, 20% reported having taken a health class, few reported using a gym (12%), recreation center (8%), or YMCA/YWCA (0.9%). Awareness and utilization of CHW/PS services were low: 20% of respondents had heard of CHW/PS, with 8% reporting previous exposure to CHW/PS services. Upon review of a definition of CHW/PS, respondents expressed positive views of CHW/PS and their value in the healthcare system. Respondents who had previous contact with a CHW/PS reported a significantly more positive perception of the usefulness of CHW/PS (p = 0.006), were more likely to see CHW/PS as an important link between providers and patients (p = 0.008), and were more likely to ask a CHW/PS for help (p = 0.009). Participants who utilized CHW/PS services also had significantly healthier intentions to reduce fast food intake. Future research is needed to evaluate if CHW/PS can facilitate utilization of available community resources such as recreational facilities among Hispanic border residents at risk for CVD. Full article

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Int. J. Environ. Res. Public Health, Volume 11, Issue 2 (February 2014) – 71 articles , Pages 1195-2360

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