International Journal of Environmental Research and Public Health

1288 KiB

Open AccessArticle

Ambient Air Pollution and Risk for Ischemic Stroke: A Short-Term Exposure Assessment in South China

by Pi Guo, Yulin Wang, Wenru Feng, Jiagang Wu, Chuanxi Fu, Hai Deng, Jun Huang, Li Wang, Murui Zheng and Huazhang Liu

Int. J. Environ. Res. Public Health 2017, 14(9), 1091; https://doi.org/10.3390/ijerph14091091 - 20 Sep 2017

Cited by 47 | Viewed by 6219

Abstract

Data on the association between air pollution and risk of ischemic stroke in China are still limited. This study aimed to investigate the association between short-term exposure to ambient air pollution and risk of ischemic strokes in Guangzhou, the most densely-populated city in [...] Read more.

Data on the association between air pollution and risk of ischemic stroke in China are still limited. This study aimed to investigate the association between short-term exposure to ambient air pollution and risk of ischemic strokes in Guangzhou, the most densely-populated city in south China, using a large-scale multicenter database of stroke hospital admissions. Daily counts of ischemic stroke admissions over the study years 2013–2015 were obtained from the Guangzhou Cardiovascular and Cerebrovascular Disease Event Surveillance System. Daily particulate matter <2.5 μm in diameter (PM_2.5), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), and meteorological data were collected. The associations between air pollutants and hospital admissions for stroke were examined using relative risks (RRs) and their corresponding 95% confidence intervals (CIs) based on time-series Poisson regression models, adjusting for temperature, public holiday, day of week, and temporal trends in stroke. Ischemic stroke admissions increased from 27,532 to 35,279 through 2013 to 2015, increasing by 28.14%. Parameter estimates for NO₂ exposure were robust regardless of the model used. The association between same-day NO₂ (RR = 1.0509, 95% CI: 1.0353–1.0668) exposure and stroke risk was significant when accounting for other air pollutants, day of the week, public holidays, temperature, and temporal trends in stroke events. Overall, we observed a borderline significant association between NO₂ exposure modeled as an averaged lag effect and ischemic stroke risk. This study provides data on air pollution exposures and stroke risk, and contributes to better planning of clinical services and emergency contingency response for stroke. Full article

(This article belongs to the Section Environmental Health)

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2757 KiB

Open AccessArticle

Joint Decisions on Production and Pricing with Strategic Consumers for Green Crowdfunding Products

by Yuting Chen, Rong Zhang and Bin Liu

Int. J. Environ. Res. Public Health 2017, 14(9), 1090; https://doi.org/10.3390/ijerph14091090 - 20 Sep 2017

Cited by 18 | Viewed by 4986

Abstract

Green crowdfunding is developing as a novel and popular transaction method, which can largely improve the efficiency of raising initial funds and selling innovative green products or services. In this paper, we explore the creator’s joint decisions regarding green crowdfunding products of different [...] Read more.

Green crowdfunding is developing as a novel and popular transaction method, which can largely improve the efficiency of raising initial funds and selling innovative green products or services. In this paper, we explore the creator’s joint decisions regarding green crowdfunding products of different quality levels that can sufficiently satisfy consumer preferences. Firstly, considering the characteristics of a green crowdfunding product, we present four pricing strategies when substitutes exist. Then we propose the optimal pricing strategies to maximize the total profit for the creator under different circumstances, facing strategic and myopic consumers. Finally, for the heterogeneity of consumer valuations, we compare the total profits of the four pricing strategies under different values of the substitution coefficient to obtain the optimal pricing and product strategies under the coexistence of strategic and myopic consumers. According to the result, we find that when the fraction of high-type consumers and the gap between high and low valuations is big, or when they are both small, traditional single pricing shows its benefit. However, when the green crowdfunding products are better than their substitute, a line of green products is more likely to be optimal. Full article

(This article belongs to the Special Issue Green Environment, Green Operations and Sustainability)

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Open AccessArticle

Socio-Demographic and Lifestyle Factors Predict 5-Year Changes in Adiposity among a Group of Black South African Adults

by Cornelie Nienaber-Rousseau, Olusola F. Sotunde, Patricia O. Ukegbu, P. Hermanus Myburgh, Hattie H. Wright, Lize Havemann-Nel, Sarah J. Moss, Iolanthé M. Kruger and H. Salomé Kruger

Int. J. Environ. Res. Public Health 2017, 14(9), 1089; https://doi.org/10.3390/ijerph14091089 - 20 Sep 2017

Cited by 17 | Viewed by 5645

Abstract

The rising prevalence of obesity and excessive adiposity are global public health concerns. Understanding determinants of changes in adiposity over time is critical for informing effective evidence-based prevention or treatment. However, limited information is available to achieve this objective. Cultural, demographic, environmental, and [...] Read more.

The rising prevalence of obesity and excessive adiposity are global public health concerns. Understanding determinants of changes in adiposity over time is critical for informing effective evidence-based prevention or treatment. However, limited information is available to achieve this objective. Cultural, demographic, environmental, and behavioral factors including socio-economic status (SES) likely account for obesity development. To this end, we related these variables to anthropometric measures in 1058 black adult Tswana-speaking South Africans who were HIV negative in a prospective study over five years. Body mass index (BMI) and waist circumference increased in both sexes, whereas triceps skinfold thickness remained the same. Over the five years, women moved to higher BMI categories and more were diagnosed with central obesity. Age correlated negatively, whereas SES, physical activity, energy, and fat intake correlated positively with adiposity markers in women. In men, SES, marital status, physical activity, and being urban predicted increases in adiposity. For women, SES and urbanicity increased, whereas menopause and smoking decreased adiposity. Among men, smokers had less change in BMI than those that never smoked over five years. Our findings suggest that interventions, focusing on the urban living, the married and those with the highest SES—the high-risk groups identified herein—are of primary importance to contain morbidity and premature mortality due to obesity in black South Africans. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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215 KiB

Open AccessEditorial

Environmental Influences on Maternal and Child Health

by Katherine P. Theall and Carolyn C. Johnson

Int. J. Environ. Res. Public Health 2017, 14(9), 1088; https://doi.org/10.3390/ijerph14091088 - 20 Sep 2017

Cited by 3 | Viewed by 4772

Abstract

This Special Issue of IJERPH focuses on maternal and child health (MCH), with research that highlights the role of environmental influences on MCH across a range of settings.[...] Full article

(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)

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Open AccessFeature PaperArticle

Comparison of Physiological and Psychological Relaxation Using Measurements of Heart Rate Variability, Prefrontal Cortex Activity, and Subjective Indexes after Completing Tasks with and without Foliage Plants

by Sin-Ae Park, Chorong Song, Yun-Ah Oh, Yoshifumi Miyazaki and Ki-Cheol Son

Int. J. Environ. Res. Public Health 2017, 14(9), 1087; https://doi.org/10.3390/ijerph14091087 - 20 Sep 2017

Cited by 51 | Viewed by 7664

Abstract

The objective of this study was to compare physiological and psychological relaxation by assessing heart rate variability (HRV), prefrontal cortex activity, and subjective indexes while subjects performed a task with and without foliage plants. In a crossover experimental design, 24 university students performed [...] Read more.

The objective of this study was to compare physiological and psychological relaxation by assessing heart rate variability (HRV), prefrontal cortex activity, and subjective indexes while subjects performed a task with and without foliage plants. In a crossover experimental design, 24 university students performed a task transferring pots with and without a foliage plant for 3 min. HRV and oxyhemoglobin (oxy-Hb) concentration in the prefrontal cortex were continuously measured. Immediately thereafter, subjective evaluation of emotions was performed using a modified semantic differential (SD) method and a profile of mood state questionnaire (POMS). Results showed that the natural logarithmic (ln) ratio of low frequency/high frequency, as an estimate of sympathetic nerve activity, was significantly lower while performing the task with foliage plants for the average 3 min measurement interval. Oxy-Hb concentration in the left prefrontal cortex showed a tendency to decrease in the 2–3 min interval in the task with foliage plants compared to the task without plants. Moreover, significant psychological relaxation according to POMS score and SD was demonstrated when the task involved foliage plants. In conclusion, the task involving foliage plants led to more physiological and psychological relaxation compared with the task without foliage plants. Full article

(This article belongs to the Special Issue Evidence-Based Nature Therapy: Advances in Physiological Evaluation)

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737 KiB

Open AccessArticle

Timeliness of Childhood Primary Immunization and Risk Factors Related with Delays: Evidence from the 2014 Zhejiang Provincial Vaccination Coverage Survey

by Yu Hu, Qian Li and Yaping Chen

Int. J. Environ. Res. Public Health 2017, 14(9), 1086; https://doi.org/10.3390/ijerph14091086 - 20 Sep 2017

Cited by 25 | Viewed by 5510

Abstract

Background: this study aimed to assess both immunization coverage and timeliness, as well as reasons for non-vaccination, and identity the risk factors of delayed immunization, for the vaccines scheduled during the first year of life, in Zhejiang province, east China. Methods: A cluster [...] Read more.

Background: this study aimed to assess both immunization coverage and timeliness, as well as reasons for non-vaccination, and identity the risk factors of delayed immunization, for the vaccines scheduled during the first year of life, in Zhejiang province, east China. Methods: A cluster survey among children aged 24–35 months was conducted. Demographic information and socio-economic characteristics of the selected child, the mother, and the household were collected. Immunization data were transcribed from immunization cards. Timeliness was assessed with Kaplan–Meier analysis for each vaccine given before 12 months of age, based on the time frame stipulated by the expanded program on immunization of China. Cox proportional hazard regression was applied to identify risk factors of delayed immunization. Results: A total of 2772 eligible children were surveyed. The age-appropriate coverage ranged from 25.4% (95% CI: 23.7–27.0%) for Bacillus Calmette–Guerin (BCG) to 91.3% (95% CI: 90.2–92.3%) for the first dose of oral poliomyelitis vaccine (OPV1). The most frequent reason for non-vaccination was parent’s fear of adverse events of immunization. Delayed immunizations were associated with mother having a lower education level, mother having a job, delivery at home, increasing number of children per household, and having a lower household income. Conclusions: Although the timeliness of immunization has improved since 2011, necessary steps are still needed to achieve further improvement. Timeliness of immunization should be considered as another important indicator of expanded program on immunization (EPI) performance. Future interventions on vaccination coverage should take into consideration demographic and socio-economic risk factors identified in this study. The importance of adhering to the recommended schedule should be explained to parents. Full article

(This article belongs to the Section Global Health)

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Open AccessArticle

Association between Emotional Symptoms and Job Demands in an Asian Electronics Factory

by Wei-Lieh Huang, Yue Leon Guo, Pau-Chung Chen, Jui Wang and Po-Ching Chu

Int. J. Environ. Res. Public Health 2017, 14(9), 1085; https://doi.org/10.3390/ijerph14091085 - 19 Sep 2017

Cited by 5 | Viewed by 3936

Abstract

Various work-related issues including mental health have been described for the electronic industry. Although East Asian countries play important roles in the electronics industry, the association between job demands and emotional symptoms has been rarely examined. The present study recruited 603 workers from [...] Read more.

Various work-related issues including mental health have been described for the electronic industry. Although East Asian countries play important roles in the electronics industry, the association between job demands and emotional symptoms has been rarely examined. The present study recruited 603 workers from either office or clean room environments in an electronics factory in Taiwan. Their personal factors, work-related factors, and emotional symptoms were assessed by a self-administered questionnaire. The symptoms of depression and hostility were reported in 24.88% and 24.38% of the subjects, respectively, while 14.93% reported both. A multivariate analysis showed that, overall, women workers were more likely to have emotional symptoms than male workers (odds ration (OR) = 1.50, 95% CI = 1.02–2.18). Among clean room workers, working under high pressure (OR = 1.84, 95% CI = 1.05–3.21), conflicting demands (OR = 2.15, 95% CI = 1.30–3.57), and social isolation at work (OR = 2.99, 95% CI = 1.23–7.30) were associated with emotional symptoms. The findings suggest that in the Asian electronics industry, for women, working under high pressure, conflicting demands, and social isolation at work are risk factors for emotional symptoms, especially for clean room workers. Further large-scale, longitudinal studies are necessary to confirm and prevent the mental health problems in this fast-evolving, highly competitive industry. Full article

(This article belongs to the Section Occupational Safety and Health)

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Open AccessArticle

Dental Environmental Noise Evaluation and Health Risk Model Construction to Dental Professionals

by Kuen Wai Ma, Hai Ming Wong and Cheuk Ming Mak

Int. J. Environ. Res. Public Health 2017, 14(9), 1084; https://doi.org/10.3390/ijerph14091084 - 19 Sep 2017

Cited by 37 | Viewed by 7096

Abstract

Occupational noise is unavoidably produced from dental equipment, building facilities, and human voices in the dental environment. The purpose of this study was to investigate the effect of occupational noise exposure on the dental professionals’ health condition. The psychoacoustics approach noise exposure assessment [...] Read more.

Occupational noise is unavoidably produced from dental equipment, building facilities, and human voices in the dental environment. The purpose of this study was to investigate the effect of occupational noise exposure on the dental professionals’ health condition. The psychoacoustics approach noise exposure assessment followed by the health risk assessment was carried on at the paediatric dentistry clinic and the dental laboratory in the Prince Philip Dental Hospital of Hong Kong. The A-weighted equivalent sound level, total loudness, and sharpness values were statistically significantly higher for the noise at the laboratory than that at the clinic. The degree of perceived influences and sharpness of noise were found to have the impacts on the dental professionals’ working performance and health. Moreover, the risk of having a bad hearing state would a have 26% and 31% higher chance for a unit increment of the short-term and long-term impact scores, respectively. The dental professionals with the service length more than 10 years and the daily working hours of more than eight showed the highest risk to their hearing state. The worse the hearing state was, the worse the health state was found for the dental professionals. Also, the risk of dissatisfaction would be increased by 4.41 and 1.22 times for those who worked at the laboratory and a unit increment of the long-term impact score. The constructed health risk mode with the scientific and statistical evidence is hence important for the future noise management of environmental improvement. Full article

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Open AccessFeature PaperArticle

Green Space and Depression during Pregnancy: Results from the Growing Up in New Zealand Study

by Vikram Nichani, Kim Dirks, Bruce Burns, Amy Bird and Cameron Grant

Int. J. Environ. Res. Public Health 2017, 14(9), 1083; https://doi.org/10.3390/ijerph14091083 - 18 Sep 2017

Cited by 23 | Viewed by 7209

Abstract

Background: Antenatal depression is an important contributor to poor maternal health experienced by some women. This study aimed to determine whether exposure to green space during pregnancy is associated with less depression, and whether this association is moderated by relevant factors, such [...] Read more.

Background: Antenatal depression is an important contributor to poor maternal health experienced by some women. This study aimed to determine whether exposure to green space during pregnancy is associated with less depression, and whether this association is moderated by relevant factors, such as age, education, self-identified ethnicity, physical activity, residential rurality, and socioeconomic status. Methods: Health data were sourced from the cohort study “Growing Up in New Zealand” comprised of 6772 participants. Green space was estimated based on the proportion of green space within the Census Area Unit. Adjusted logistic mixed effect models were used to investigate the association between green space and antenatal depression after controlling for confounding variables. Results: Maternal exposure to green space were not associated with lower odds of antenatal depression. Indications of effect modifications due to relevant factors were not observed. Conclusions: This study did not determine an association between access to green space (measured based on the distance to the nearest green space) and antenatal depression. Therefore, a link between green space and antenatal depression was not established. For that reason, ensuring residential areas contain adequate green space may or may not be helpful in preventing antenatal depression and adverse health outcomes associated with this depression. More studies focusing on pregnant women in a range of social contexts, and considering both exposure and access to green space, are warranted to determine the relationships between green space and antenatal depression. Full article

(This article belongs to the Special Issue Frontiers in Mental Health and the Environment)

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Open AccessFeature PaperArticle

Mothers’ Perceived Neighbourhood Environment and Outdoor Play of 2- to 3.5-Year-Old Children: Findings from the Healthy Beginnings Trial

by Huilan Xu, Li Ming Wen, Louise L. Hardy and Chris Rissel

Int. J. Environ. Res. Public Health 2017, 14(9), 1082; https://doi.org/10.3390/ijerph14091082 - 18 Sep 2017

Cited by 20 | Viewed by 5359

Abstract

Background: This study aims to investigate whether mothers’ perceived neighbourhood environment is associated with outdoor playtime of 2- to 3.5-year-old children. Methods: Cross-sectional analyses were conducted using data from the Healthy Beginnings Trial (HBT). Data on children’s outdoor playtime and mothers’ perceived neighbourhood [...] Read more.

Background: This study aims to investigate whether mothers’ perceived neighbourhood environment is associated with outdoor playtime of 2- to 3.5-year-old children. Methods: Cross-sectional analyses were conducted using data from the Healthy Beginnings Trial (HBT). Data on children’s outdoor playtime and mothers’ perceived neighbourhood environment were collected through face-to-face interviews with mothers when their children were 2 and 3.5 years old. Walk score was obtained from a publicly available website and population density data were obtained from Australian Census data. Multiple logistic regression models were built to investigate these associations. Results: A total of 497 and 415 mother-child dyads were retained at 2 years and 3.5 years. After adjusting for intervention group allocation and other confounding factors, at 2 years, mothers’ perceptions that ‘the neighbourhood is a good place to bring up children’, ‘it is safe to play outside during the day’, and ‘there are good parks or playgrounds in neighbourhood’ were positively associated with children’s outdoor playtime. At 3.5 years, living in a free-standing house was associated with more children’s outdoor playtime. Conclusions: Children may benefit from living in a neighbourhood that supports active lifestyle. Improving social and physical environments in neighbourhoods could be an important strategy for improving young children’s physical activity. Full article

(This article belongs to the Special Issue The Impacts of Physical Activity on Chronic Disease Prevention and Population Health)

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Open AccessArticle

China’s Air Quality and Respiratory Disease Mortality Based on the Spatial Panel Model

by Qilong Cao, Ying Liang and Xueting Niu

Int. J. Environ. Res. Public Health 2017, 14(9), 1081; https://doi.org/10.3390/ijerph14091081 - 18 Sep 2017

Cited by 30 | Viewed by 6526

Abstract

Background: Air pollution has become an important factor restricting China’s economic development and has subsequently brought a series of social problems, including the impact of air pollution on the health of residents, which is a topical issue in China. Methods: Taking [...] Read more.

Background: Air pollution has become an important factor restricting China’s economic development and has subsequently brought a series of social problems, including the impact of air pollution on the health of residents, which is a topical issue in China. Methods: Taking into account this spatial imbalance, the paper is based on the spatial panel data model PM_2.5. Respiratory disease mortality in 31 Chinese provinces from 2004 to 2008 is taken as the main variable to study the spatial effect and impact of air quality and respiratory disease mortality on a large scale. Results: It was found that there is a spatial correlation between the mortality of respiratory diseases in Chinese provinces. The spatial correlation can be explained by the spatial effect of PM_2.5 pollutions in the control of other variables. Conclusions: Compared with the traditional non-spatial model, the spatial model is better for describing the spatial relationship between variables, ensuring the conclusions are scientific and can measure the spatial effect between variables. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Depression and Risk of Unintentional Injury in Rural Communities—A Longitudinal Analysis of the Australian Rural Mental Health Study

by Kerry J. Inder, Elizabeth G. Holliday, Tonelle E. Handley, Lyn J. Fragar, Tony Lower, Angela Booth, Terry J. Lewin and Brian J. Kelly

Int. J. Environ. Res. Public Health 2017, 14(9), 1080; https://doi.org/10.3390/ijerph14091080 - 18 Sep 2017

Cited by 8 | Viewed by 6419

Abstract

Limited longitudinal research has examined relationships between depression and injury, particularly in rural contexts. This paper reports cross-sectional and longitudinal analyses from the Australian Rural Mental Health Study (ARMHS) exploring relationships between “probable depression” episodes and unintentional injury. Participants completed four surveys over [...] Read more.

Limited longitudinal research has examined relationships between depression and injury, particularly in rural contexts. This paper reports cross-sectional and longitudinal analyses from the Australian Rural Mental Health Study (ARMHS) exploring relationships between “probable depression” episodes and unintentional injury. Participants completed four surveys over five years. Multivariate logistic regressions were employed to assess the causal effect of prior depression episodes on subsequent injury risk. Of 2621 baseline participants, 23.3% experienced a probable depression episode recently and 15.9% reported a serious injury during the previous 12 months. Factors associated with a 12-month injury at baseline included male gender, being unemployed or unable to work, being involved in a serious incident, hazardous alcohol use, and having experienced a recent depression episode. Longitudinal analyses revealed that probable depression was significantly associated with subsequent unintentional injury (OR 1.68, 99%CI 1.20–2.35), as was male gender (OR 1.39, 99%CI 1.06–1.82), while alcohol consumption did not mediate these relationships. Campaigns to reduce the impact of mental illness should consider unintentional injuries as a contributor, while injury prevention initiatives may benefit from addressing mental health issues. Such strategies are particularly important in rural and remote areas where injuries are more common and mental health services are less readily available. Full article

(This article belongs to the Section Health Behavior, Chronic Disease and Health Promotion)

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Open AccessReview

Mini-Review: The Contribution of Intermediate Phenotypes to GxE Effects on Disorders of Body Composition in the New OMICS Era

by Edna J. Nava-Gonzalez, Esther C. Gallegos-Cabriales, Irene Leal-Berumen and Raul A. Bastarrachea

Int. J. Environ. Res. Public Health 2017, 14(9), 1079; https://doi.org/10.3390/ijerph14091079 - 17 Sep 2017

Cited by 3 | Viewed by 9083

Abstract

Studies of gene-environment (GxE) interactions describe how genetic and environmental factors influence the risk of developing disease. Intermediate (molecular or clinical) phenotypes (IPs) are traits or metabolic biomarkers that mediate the effects of gene-environment influences on risk behaviors. Functional systems genomics discovery offers [...] Read more.

Studies of gene-environment (GxE) interactions describe how genetic and environmental factors influence the risk of developing disease. Intermediate (molecular or clinical) phenotypes (IPs) are traits or metabolic biomarkers that mediate the effects of gene-environment influences on risk behaviors. Functional systems genomics discovery offers mechanistic insights into how DNA variations affect IPs in order to detect genetic causality for a given disease. Disorders of body composition include obesity (OB), Type 2 diabetes (T2D), and osteoporosis (OSTP). These pathologies are examples of how a GxE interaction contributes to their development. IPs as surrogates for inherited genotypes play a key role in models of genetic and environmental interactions in health outcomes. Such predictive models may unravel relevant genomic and molecular pathways for preventive and therapeutic interventions for OB, T2D, and OSTP. Annotation strategies for genomes, in contrast to phenomes, are well advanced. They generally do not measure specific aspects of the environment. Therefore, the concepts of deep phenotyping and the exposome generate new avenues to exploit with high-resolution technologies for analyzing this sophisticated phenome. With the successful characterization of phenomes, exposomes, and genomes, environmental and genetic determinants of chronic diseases can be united with multi-OMICS studies that better examine GxE interactions. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Linguistic Multi-Attribute Group Decision Making with Risk Preferences and Its Use in Low-Carbon Tourism Destination Selection

by Hui Lin and Zhou-Jing Wang

Int. J. Environ. Res. Public Health 2017, 14(9), 1078; https://doi.org/10.3390/ijerph14091078 - 17 Sep 2017

Cited by 22 | Viewed by 4852

Abstract

Low-carbon tourism plays an important role in carbon emission reduction and environmental protection. Low-carbon tourism destination selection often involves multiple conflicting and incommensurate attributes or criteria and can be modelled as a multi-attribute decision-making problem. This paper develops a framework to solve multi-attribute [...] Read more.

Low-carbon tourism plays an important role in carbon emission reduction and environmental protection. Low-carbon tourism destination selection often involves multiple conflicting and incommensurate attributes or criteria and can be modelled as a multi-attribute decision-making problem. This paper develops a framework to solve multi-attribute group decision-making problems, where attribute evaluation values are provided as linguistic terms and the attribute weight information is incomplete. In order to obtain a group risk preference captured by a linguistic term set with triangular fuzzy semantic information, a nonlinear programming model is established on the basis of individual risk preferences. We first convert individual linguistic-term-based decision matrices to their respective triangular fuzzy decision matrices, which are then aggregated into a group triangular fuzzy decision matrix. Based on this group decision matrix and the incomplete attribute weight information, a linear program is developed to find an optimal attribute weight vector. A detailed procedure is devised for tackling linguistic multi-attribute group decision making problems. A low-carbon tourism destination selection case study is offered to illustrate how to use the developed group decision-making model in practice. Full article

(This article belongs to the Special Issue Decision Models in Green Growth and Sustainable Development)

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Open AccessArticle

Mother’s IPV, Child Maltreatment Type and the Presence of PTSD in Children and Adolescents

by Maravillas Castro, Mavi Alcántara-López, Antonia Martínez, Visitación Fernández, Julio Sánchez-Meca and Concepción López-Soler

Int. J. Environ. Res. Public Health 2017, 14(9), 1077; https://doi.org/10.3390/ijerph14091077 - 17 Sep 2017

Cited by 21 | Viewed by 6937

Abstract

This correlational cross-sectional study was designed to investigate whether the intimate partner violence (IPV) suffered by mothers (physical and psychological maltreatment), child eyewitness of psychological and physical maltreatment suffered by the mother, the neglect suffered by children, and the maltreatment (physical and psychological) [...] Read more.

This correlational cross-sectional study was designed to investigate whether the intimate partner violence (IPV) suffered by mothers (physical and psychological maltreatment), child eyewitness of psychological and physical maltreatment suffered by the mother, the neglect suffered by children, and the maltreatment (physical and psychological) directly suffered by children are statistically associated to post-traumatic stress disorder (PTSD) symptoms exhibited by the child. In addition, the prevalence of child PTSD was estimated, as well as the concordance between the PTSD symptoms assessed by the Child PTSD Symptom Scale (CPSS) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for child PTSD. The sample consisted of 152 Spanish children aged 8 to 17 and their mothers, who were recruited from Centers of Specialized Assistance for Women Victims of IPV. PTSD prevalence was 20.4%. The results of a canonical correlation analysis showed that the two types of maltreatment with the largest contribution to the canonical variable were physical maltreatment directly suffered by the child, and child eyewitness of physical maltreatment suffered by the mother. The potential developmental pathway of PTSD when both children and mothers suffer severe maltreatment needs to be examined, and this will contribute to the choice of the most effective type of specialized intervention. Full article

(This article belongs to the Special Issue Youth Violence as a Public Health Issue)

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Open AccessArticle

Poverty Dynamics and Academic Trajectories of Children of Immigrants

by Liwei Zhang and Wen-Jui Han

Int. J. Environ. Res. Public Health 2017, 14(9), 1076; https://doi.org/10.3390/ijerph14091076 - 16 Sep 2017

Cited by 4 | Viewed by 6569

Abstract

Using Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999 (ECLS-K), we investigated the relationship between poverty and academic trajectories for children in immigrant families in the United States. We used family socioeconomic status (SES) which considers parental education, parental occupation, and family income [...] Read more.

Using Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999 (ECLS-K), we investigated the relationship between poverty and academic trajectories for children in immigrant families in the United States. We used family socioeconomic status (SES) which considers parental education, parental occupation, and family income to define poverty in correspondence with the U.S. federal poverty threshold. Three dimensions of poverty were examined including depth (i.e., not-poor, near-poor, poor or extreme poor), stability (i.e., continuously or intermittently), and duration (i.e., for how many times in poverty). Our results indicated that living in poverty, particularly when it was extreme, volatile, and for long spell could compromise children’s reading and math achievements during the first nine schooling years. Children of immigrants were doing as well as, if not better than, children of native-borns in certain areas (i.e., math) or in facing of certain pattern of poverty (i.e., long-spell). However, deep poverty and volatile changes in family SES could compromise academic achievements for children of immigrants throughout their first nine years of schooling, a period holds important key to their future success. Implications to practice and policy as well as future directions were discussed. Full article

(This article belongs to the Special Issue Poverty and Child Well-Being)

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Open AccessArticle

Food Shopping and Acquisition Behaviors in Relation to BMI among Residents of Low-Income Communities in South Carolina

by Angela D. Liese, Xiaonan Ma, Brent Hutto, Patricia A. Sharpe, Bethany A. Bell and Sara Wilcox

Int. J. Environ. Res. Public Health 2017, 14(9), 1075; https://doi.org/10.3390/ijerph14091075 - 16 Sep 2017

Cited by 23 | Viewed by 7728

Abstract

Low-income areas in which residents have poor access to healthy foods have been referred to as “food deserts.” It is thought that improving food access may help curb the obesity epidemic. Little is known about where residents of food deserts shop and if [...] Read more.

Low-income areas in which residents have poor access to healthy foods have been referred to as “food deserts.” It is thought that improving food access may help curb the obesity epidemic. Little is known about where residents of food deserts shop and if shopping habits are associated with body mass index (BMI). We evaluated the association of food shopping and acquisition (e.g., obtaining food from church, food pantries, etc.) with BMI among 459 residents of low-income communities from two South Carolina counties, 81% of whom lived in United States Department of Agriculture-designated food deserts. Participants were interviewed about food shopping and acquisition and perceptions of their food environment, and weight and height were measured. Distances to food retail outlets were determined. Multivariable linear regression analysis was employed. Our study sample comprising largely African-American women had an average BMI of 32.5 kg/m². The vast majority of study participants shopped at supermarkets (61%) or supercenters/warehouse clubs (27%). Shopping at a supercenter or warehouse club as one’s primary store was significantly associated with a 2.6 kg/m² higher BMI compared to shopping at a supermarket, independent of demographics, socioeconomics, physical activity, and all other food shopping/acquisition behaviors. Persons who reported shopping at a small grocery store or a convenience or dollar store as their tertiary store had a 2.6 kg/m² lower BMI. Respondents who perceived lack of access to adequate food shopping in their neighborhoods as a problem had higher BMI. Living in a food desert census tract was not significantly associated with BMI. Other shopping attributes, including distance to utilized and nearest grocery stores, were not independently associated with BMI. These findings call into question the idea that poor spatial access to grocery stores is a key underlying factor affecting the obesity epidemic. Future research should consider assessing foods purchased and dietary intake within a comprehensive study of food shopping behaviors and health outcomes among persons living in food deserts. Full article

(This article belongs to the Special Issue Food Environment, Diet, and Health)

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Open AccessArticle

Stress Exposure and Physical, Mental, and Behavioral Health among American Indian Adults with Type 2 Diabetes

by Melissa L. Walls, Kelley J. Sittner, Benjamin D. Aronson, Angie K. Forsberg, Les B. Whitbeck and Mustafa Al’Absi

Int. J. Environ. Res. Public Health 2017, 14(9), 1074; https://doi.org/10.3390/ijerph14091074 - 16 Sep 2017

Cited by 23 | Viewed by 7663

Abstract

American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and [...] Read more.

American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after accounting for participant age, gender, and income. Fewer stressors were linked to physical health. We also document a dose–response relationship between stress accumulation and worse health. Findings underscore the importance of considering a broad range of stressors for comprehensive assessment of stress burden and diabetes. Policies and practices aimed at reducing stress exposure and promoting tools for stress management may be mechanisms for optimal health for AI diabetes patients. Full article

(This article belongs to the Collection Health Care and Diabetes)

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Open AccessArticle

Relationships of Sexual Dysfunction with Depression and Acceptance of Illness in Women and Men with Type 2 Diabetes Mellitus

by Ewelina Bąk, Czeslaw Marcisz, Sylwia Krzemińska, Dorota Dobrzyn-Matusiak, Agnieszka Foltyn and Agnieszka Drosdzol-Cop

Int. J. Environ. Res. Public Health 2017, 14(9), 1073; https://doi.org/10.3390/ijerph14091073 - 16 Sep 2017

Cited by 49 | Viewed by 6661

Abstract

An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index, [...] Read more.

An increased prevalence of sexual disorders has been reported in patients with type 2 diabetes. The aim of this study is the assessment of the influence of the psychical condition, the concentration of glycated hemoglobin, the duration of diabetes, the body mass index, the age, and the subjective acceptance of the illness on sexual disorders occurring in women and men with type 2 diabetes. The study enrolled 215 patients (114 women and 101 men) with type 2 diabetes and 183 controls. Sexuality was determined in all of the studied subjects using: the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. The occurrence of depression symptoms was determined using the Beck Depression Inventory (BDI), whereas the acceptance of the illness in diabetic patients using the Acceptance of Illness Scale (AIS). A sexual dysfunction was found in 68% of the studied diabetic women and 17% of controls. The point values of all the examined FSFI domains were significantly lower in women with diabetes than in controls (p < 0.001). Erectile disorders occurred in 82% of the studied men with diabetes and in 41% of the controls (p < 0.001). The point values of all the domains of FSFI and IIEF demonstrated a significantly negative correlation with the total BDI score, which was higher in patients with diabetes than in patients without diabetes, and a positive correlation with the total AIS score (p < 0.001). The occurrence of sexual dysfunction in patients with diabetes correlated with the age and the duration of diabetes. We conclude that sexual disorders in patients with type 2 diabetes demonstrate the correlation with the occurrence of depression and the acceptance of their illness. Sexual disorders in diabetic patients occur more frequently in older patients and in those with a longer duration of diabetes. Full article

(This article belongs to the Collection Health Care and Diabetes)

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Open AccessArticle

Smoothed Temporal Atlases of Age-Gender All-Cause Mortality in South Africa

by Samuel O. M Manda and Nada Abdelatif

Int. J. Environ. Res. Public Health 2017, 14(9), 1072; https://doi.org/10.3390/ijerph14091072 - 15 Sep 2017

Cited by 4 | Viewed by 4443

Abstract

Most mortality maps in South Africa and most contried of the sub-Saharan region are static, showing aggregated count data over years or at specific years. Lack of space and temporral dynamanics in these maps may adversely impact on their use and application for [...] Read more.

Most mortality maps in South Africa and most contried of the sub-Saharan region are static, showing aggregated count data over years or at specific years. Lack of space and temporral dynamanics in these maps may adversely impact on their use and application for vigorous public health policy decisions and interventions. This study aims at describing and modeling sub-national distributions of age–gender specific all-cause mortality and their temporal evolutions from 1997 to 2013 in South Africa. Mortality information that included year, age, gender, and municipality administrative division were obtained from Statistics South Africa for the period. Individual mortality level data were grouped by three ages groups (0–14, 15–64, and 65 and over) and gender (male, female) and aggregated at each of the 234 municipalities in the country. The six age-gender all-cause mortality rates may be related due to shared common social deprivation, health and demographic risk factors. We undertake a joint analysis of the spatial-temporal variation of the six age-gender mortality risks. This is done within a shared component spatial model construction where age-gender common and specific spatial and temporal trends are estiamted using a hierarchical Bayesian spatial model. The results show municipal and temporal differentials in mortality risk profiles between age and gender groupings. High rates were seen in 2005, especially for the 15–64 years age group for both males and females. The dynamic geographical and time distributions of subnational age-gender all-cause mortality contribute to a better understanding of the temporal evolvement and geographical variations in the relationship between demographic composition and burden of diseases in South Africa. This provides useful information for effective monitoring and evaluation of public health policies and programmes targeting mortality reduction across time and sub-populations in the country. Full article

(This article belongs to the Special Issue Spatial Modelling for Public Health Research)

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Open AccessReply

Response to Elwood, M. et al., Comment on: Maternal Exposure to Domestic Hair Cosmetics and Occupational Endocrine Disruptors Is Associated with a Higher Risk of Hypospadias in the Offspring. Int. J. Environ. Res. Public Health 2017, 14, 27

by Elodie Haraux, Karine Braun, Philippe Buisson, Erwan Stéphan-Blanchard, Camille Devauchelle, Jannick Ricard, Bernard Boudailliez, Pierre Tourneux, Richard Gouron and Karen Chardon

Int. J. Environ. Res. Public Health 2017, 14(9), 1071; https://doi.org/10.3390/ijerph14091071 - 15 Sep 2017

Cited by 4 | Viewed by 3621

Abstract

Dear Editor, Thank you for inviting us to reply to a “Comment” paper to our published paper “Maternal Exposure to Domestic Hair Cosmetics and Occupational Endocrine Disruptors Is Associated with a Higher Risk of Hypospadias in the Offspring” (Authors: Elodie Haraux, Karine Braun, [...] Read more.

Dear Editor, Thank you for inviting us to reply to a “Comment” paper to our published paper “Maternal Exposure to Domestic Hair Cosmetics and Occupational Endocrine Disruptors Is Associated with a Higher Risk of Hypospadias in the Offspring” (Authors: Elodie Haraux, Karine Braun, Philippe Buisson, Erwan Stéphan-Blanchard, Jannick Ricard, Camille Devauchelle, Bernard Boudailliez, Pierre Tourneux, Richard Gouron, Karen Chardon).[...] Full article

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Open AccessArticle

Phylogenetic Analysis and Antimicrobial Profiles of Cultured Emerging Opportunistic Pathogens (Phyla Actinobacteria and Proteobacteria) Identified in Hot Springs

by Jocelyn Leonie Jardine, Akebe Luther King Abia, Vuyo Mavumengwana and Eunice Ubomba-Jaswa

Int. J. Environ. Res. Public Health 2017, 14(9), 1070; https://doi.org/10.3390/ijerph14091070 - 15 Sep 2017

Cited by 24 | Viewed by 6655

Abstract

Hot spring water may harbour emerging waterborne opportunistic pathogens that can cause infections in humans. We have investigated the diversity and antimicrobial resistance of culturable emerging and opportunistic bacterial pathogens, in water and sediment of hot springs located in Limpopo, South Africa. Aerobic [...] Read more.

Hot spring water may harbour emerging waterborne opportunistic pathogens that can cause infections in humans. We have investigated the diversity and antimicrobial resistance of culturable emerging and opportunistic bacterial pathogens, in water and sediment of hot springs located in Limpopo, South Africa. Aerobic bacteria were cultured and identified using 16S ribosomal DNA (rDNA) gene sequencing. The presence of Legionella spp. was investigated using real-time polymerase chain reaction. Isolates were tested for resistance to ten antibiotics representing six different classes: β-lactam (carbenicillin), aminoglycosides (gentamycin, kanamycin, streptomycin), tetracycline, amphenicols (chloramphenicol, ceftriaxone), sulphonamides (co-trimoxazole) and quinolones (nalidixic acid, norfloxacin). Gram-positive Kocuria sp. and Arthrobacter sp. and gram-negative Cupriavidus sp., Ralstonia sp., Cronobacter sp., Tepidimonas sp., Hafnia sp. and Sphingomonas sp. were isolated, all recognised as emerging food-borne pathogens. Legionella spp. was not detected throughout the study. Isolates of Kocuria, Arthrobacter and Hafnia and an unknown species of the class Gammaproteobacteria were resistant to two antibiotics in different combinations of carbenicillin, ceftriaxone, nalidixic acid and chloramphenicol. Cronobacter sp. was sensitive to all ten antibiotics. This study suggests that hot springs are potential reservoirs for emerging opportunistic pathogens, including multiple antibiotic resistant strains, and highlights the presence of unknown populations of emerging and potential waterborne opportunistic pathogens in the environment. Full article

(This article belongs to the Special Issue Emerging Infectious Disease (EID) Research, Management and Response)

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Open AccessArticle

Gender Differences in Problematic Alcohol Consumption in University Professors

by Pablo Ruisoto, Silvia L. Vaca, José J. López-Goñi, Raúl Cacho and Iván Fernández-Suárez

Int. J. Environ. Res. Public Health 2017, 14(9), 1069; https://doi.org/10.3390/ijerph14091069 - 15 Sep 2017

Cited by 13 | Viewed by 4917

Abstract

The role of job satisfaction and other psychosocial variables in problematic alcohol consumption within professional settings remains understudied. The aim of this study is to assess the level of problematic alcohol consumption among male and female university professors and associated psychosocial variables. A [...] Read more.

The role of job satisfaction and other psychosocial variables in problematic alcohol consumption within professional settings remains understudied. The aim of this study is to assess the level of problematic alcohol consumption among male and female university professors and associated psychosocial variables. A total of 360 professors (183 men and 177 women) of a large private university in Ecuador were surveyed using standardized instruments for the following psychosocial measures: alcohol consumption, job satisfaction, psychological stress, psychological flexibility, social support and resilience. Problematic alcohol consumption was found in 13.1% of participants, although this was significantly higher (χ² = 15.6; d.f. = 2, p < 0.001) in men (19.1%) than women (6.8%). Problematic alcohol consumption was reported in men with higher perceived stress and job satisfaction. However, 83.3% of women with problematic alcohol use reported lower job satisfaction and higher psychological inflexibility. Results suggest that job satisfaction itself did not prevent problematic alcohol consumption in men; stress was associated with problematic consumption in men and psychological inflexibility in women. Findings from this study support the need to assess aspects of alcohol consumption and problematic behavior differently among men and women. Intervention strategies aimed at preventing or reducing problematic alcohol consumption in university professors must be different for men and women. Full article

(This article belongs to the Section Occupational Safety and Health)

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Screening for Autochthonous Phytoextractors in a Heavy Metal Contaminated Coal Mining Area

by Kuangjia Li, Zijian Lun, Lin Zhao, Qilong Zhu, Yansheng Gu and Manzhou Li

Int. J. Environ. Res. Public Health 2017, 14(9), 1068; https://doi.org/10.3390/ijerph14091068 - 15 Sep 2017

Cited by 15 | Viewed by 4427

Abstract

In order to protect public health and crops from soil heavy metal (HM) contamination at a coal mining area in Henan, central China, HM pollution investigation and screening of autochthonous HM phytoextractors were conducted. The concentrations of cadmium (Cd), lead (Pb), copper (Cu) [...] Read more.

In order to protect public health and crops from soil heavy metal (HM) contamination at a coal mining area in Henan, central China, HM pollution investigation and screening of autochthonous HM phytoextractors were conducted. The concentrations of cadmium (Cd), lead (Pb), copper (Cu) and zinc (Zn) in surface soils exceeded the corresponding local background values and the China National Standard (CNS). The maximum potential ecological risk (RI) was 627.30, indicating very high ecological risk. The monomial risk of Cd contributed the most to the RI, varying from 85.48% to 96.48%. The plant community structure in the study area was simple, and was composed of 24 families, 37 genera and 40 species. B. pilosa, A. roxburghiana, A. argyi, A. hispidus were found to be the most dominant species at considerable risk sites. Based on the comprehensive analysis of Cd concentration, bioconcentration factor, translocation factor and adaptability factor, B. pilosa and A. argyi had potential for phytoextraction at considerable risk sites. A. roxburghiana had potential for Cd phytoextraction at moderately risk sites and A. hispidus seemed suitable for phytostabilization. The results could contribute to the phytoremediation of the similar sites. Full article

(This article belongs to the Section Environmental Science and Engineering)

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Open AccessArticle

Perception of Radiation Risk as a Predictor of Mid-Term Mental Health after a Nuclear Disaster: The Fukushima Health Management Survey

by Itaru Miura, Masato Nagai, Masaharu Maeda, Mayumi Harigane, Senta Fujii, Misari Oe, Hirooki Yabe, Yuriko Suzuki, Hideto Takahashi, Tetsuya Ohira, Seiji Yasumura and Masafumi Abe

Int. J. Environ. Res. Public Health 2017, 14(9), 1067; https://doi.org/10.3390/ijerph14091067 - 15 Sep 2017

Cited by 33 | Viewed by 6537

Abstract

Predictive factors including risk perception for mid-term mental health after a nuclear disaster remain unknown. The purpose of this study was to examine the association between perceived radiation risk and other factors at baseline and mid-term mental health after the Fukushima Daiichi nuclear [...] Read more.

Predictive factors including risk perception for mid-term mental health after a nuclear disaster remain unknown. The purpose of this study was to examine the association between perceived radiation risk and other factors at baseline and mid-term mental health after the Fukushima Daiichi nuclear disaster of 2011 in Japan. A mail-based questionnaire survey was conducted in January 2012 and January 2013. Mental health status was assessed using the K6 scale. Psychological distress over the 2-year period was categorized into the following four groups: chronic, recovered, resistant, or worsened. Most participants (80.3%) were resistant to the disaster. A positive association was found between the radiation risk perception regarding immediate effects and the worsened group in women. Baseline post-traumatic stress disorder (PTSD) or a history of psychiatric disease predicted being in the chronic or worsened group in mid-term course. These results suggest that evacuees who believed that their health was substantially affected by the nuclear disaster were at an increased risk of having poor mid-term mental health in women. Careful assessment of risk perception after a nuclear disaster, including the presence of PTSD or a history of psychiatric disease, is needed for appropriate interventions. Full article

(This article belongs to the Special Issue Public Health Preparedness for and Response to Nuclear Disasters)

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New Methods to Address Old Challenges: The Use of Administrative Data for Longitudinal Replication Studies of Child Maltreatment

by Emily Hurren, Anna Stewart and Susan Dennison

Int. J. Environ. Res. Public Health 2017, 14(9), 1066; https://doi.org/10.3390/ijerph14091066 - 15 Sep 2017

Cited by 17 | Viewed by 4492

Abstract

Administrative data are crucial to the “big data” revolution of social science and have played an important role in the development of child maltreatment research. These data are also of value to administrators, policy makers, and clinicians. The focus of this paper is [...] Read more.

Administrative data are crucial to the “big data” revolution of social science and have played an important role in the development of child maltreatment research. These data are also of value to administrators, policy makers, and clinicians. The focus of this paper is the use of administrative data to produce and replicate longitudinal studies of child maltreatment. Child protection administrative data have several advantages. They are often population-based, and allow longitudinal examination of child maltreatment and complex multi-level analyses. They also allow comparison across subgroups and minority groups, remove burden from individuals to disclose traumatic experiences, and can be less biased than retrospective recall. Finally, they can be linked to data from other agencies to explore comorbidity and outcomes, and are comparatively cost and time effective. The benefits and challenges associated with the use of administrative data for longitudinal child maltreatment research become magnified when these data are used to produce replications. Techniques to address challenges and support future replication efforts include developing a biographical understanding of the systems from which the data are drawn, using multiple data sources to contextualize the data and research results, recognizing and adopting various approaches to replication, and documenting all data coding and manipulation processes. These techniques are illustrated in this paper via a case study of previous replication work. Full article

(This article belongs to the Special Issue Using Big Data to Advance Knowledge in Child Maltreatment)

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Open AccessArticle

Use of Principal Components Analysis and Kriging to Predict Groundwater-Sourced Rural Drinking Water Quality in Saskatchewan

by Lianne McLeod, Lalita Bharadwaj, Tasha Epp and Cheryl L. Waldner

Int. J. Environ. Res. Public Health 2017, 14(9), 1065; https://doi.org/10.3390/ijerph14091065 - 15 Sep 2017

Cited by 25 | Viewed by 6218

Abstract

Groundwater drinking water supply surveillance data were accessed to summarize water quality delivered as public and private water supplies in southern Saskatchewan as part of an exposure assessment for epidemiologic analyses of associations between water quality and type 2 diabetes or cardiovascular disease. [...] Read more.

Groundwater drinking water supply surveillance data were accessed to summarize water quality delivered as public and private water supplies in southern Saskatchewan as part of an exposure assessment for epidemiologic analyses of associations between water quality and type 2 diabetes or cardiovascular disease. Arsenic in drinking water has been linked to a variety of chronic diseases and previous studies have identified multiple wells with arsenic above the drinking water standard of 0.01 mg/L; therefore, arsenic concentrations were of specific interest. Principal components analysis was applied to obtain principal component (PC) scores to summarize mixtures of correlated parameters identified as health standards and those identified as aesthetic objectives in the Saskatchewan Drinking Water Quality Standards and Objective. Ordinary, universal, and empirical Bayesian kriging were used to interpolate arsenic concentrations and PC scores in southern Saskatchewan, and the results were compared. Empirical Bayesian kriging performed best across all analyses, based on having the greatest number of variables for which the root mean square error was lowest. While all of the kriging methods appeared to underestimate high values of arsenic and PC scores, empirical Bayesian kriging was chosen to summarize large scale geographic trends in groundwater-sourced drinking water quality and assess exposure to mixtures of trace metals and ions. Full article

(This article belongs to the Section Environmental Health)

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Public Health Network Structure and Collaboration Effectiveness during the 2015 MERS Outbreak in South Korea: An Institutional Collective Action Framework

by KyungWoo Kim, Simon A. Andrew and Kyujin Jung

Int. J. Environ. Res. Public Health 2017, 14(9), 1064; https://doi.org/10.3390/ijerph14091064 - 15 Sep 2017

Cited by 19 | Viewed by 6056

Abstract

Following the 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea, this research aims to examine the structural effect of public health network explaining collaboration effectiveness, which is defined as joint efforts to improve quality of service provision, cost savings, and coordination. [...] Read more.

Following the 2015 Middle East Respiratory Syndrome (MERS) outbreak in South Korea, this research aims to examine the structural effect of public health network explaining collaboration effectiveness, which is defined as joint efforts to improve quality of service provision, cost savings, and coordination. We tested the bonding and bridging effects on collaboration effectiveness during the MERS outbreak response by utilizing an institutional collective action framework. The analysis results of 114 organizations responding during the crisis show a significant association between the bonding effect and the effectiveness of collaboration, as well as a positive association between risk communication in disseminating public health information and the effectiveness of collaboration. Full article

(This article belongs to the Section Health Economics)

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Open AccessArticle

Disaster Governance for Community Resilience in Coastal Towns: Chilean Case Studies

by Paula Villagra and Carolina Quintana

Int. J. Environ. Res. Public Health 2017, 14(9), 1063; https://doi.org/10.3390/ijerph14091063 - 14 Sep 2017

Cited by 26 | Viewed by 6307

Abstract

This study aimed to further our understanding of a characteristic of Community Resilience known as Disaster Governance. Three attributes of Disaster Governance—redundancy, diversity, and overlap—were studied in four coastal towns in southern Chile that are at risk of tsunamis. Overall, we explored how [...] Read more.

This study aimed to further our understanding of a characteristic of Community Resilience known as Disaster Governance. Three attributes of Disaster Governance—redundancy, diversity, and overlap—were studied in four coastal towns in southern Chile that are at risk of tsunamis. Overall, we explored how different spatial structures of human settlements influence Disaster Governance. Using the Projective Mapping Technique, the distribution of emergency institutions (N = 32) and uses given to specific sites (e.g., for refuge, sanitary purposes and medical attention) were mapped. Content and GIS analyses (Directional Distribution and Kernel Density Index) were used to explore the dispersion and concentration of institutions and uses in each town. Disaster Governance was found to be highly influenced by decisions taken during regional, urban, and emergency planning. Governance is better in towns of higher order in the communal hierarchical structure. Most of the emergency institutions were found to be located in central and urban areas, which, in turn, assures more redundancy, overlap, and diversity in governance in the event of a tsunami. Lack of flexibility of emergency plans also limits governance in rural and indigenous areas. While the spatial relationships found in this study indicate that urban sectors have better Disaster Governance than rural and indigenous sectors, the influence of resource availability after tsunamis, the role and responsibility of different levels of governments, and the politics of disaster also play an important role in Disaster Governance for determining Community Resilience. These findings shed light on emergency planning and aspects of the Disaster Management cycle. Full article

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

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Hospital Costs of Foreign Non-Resident Patients: A Comparative Analysis in Catalonia, Spain

by Elena Arroyo-Borrell, Gemma Renart-Vicens, Marc Saez and Marc Carreras

Int. J. Environ. Res. Public Health 2017, 14(9), 1062; https://doi.org/10.3390/ijerph14091062 - 14 Sep 2017

Cited by 1 | Viewed by 3582

Abstract

Although patient mobility has increased over the world, in Europe there is a lack of empirical studies. The aim of the study was to compare foreign non-resident patients versus domestic patients for the particular Catalan case, focusing on patient characteristics, hospitalisation costs and [...] Read more.

Although patient mobility has increased over the world, in Europe there is a lack of empirical studies. The aim of the study was to compare foreign non-resident patients versus domestic patients for the particular Catalan case, focusing on patient characteristics, hospitalisation costs and differences in costs depending on the typology of the hospital they are treated. We used data from the 2012 Minimum Basic Data Set-Acute Care hospitals (CMBD-HA) in Catalonia. We matched two case-control groups: first, foreign non-resident patients versus domestic patients and, second, foreign non-resident patients treated by Regional Public Hospitals versus other type of hospitals. Hospitalisation costs were modelled using a GLM Gamma with a log-link. Our results show that foreign non-resident patients were significantly less costly than domestic patients (12% cheaper). Our findings also suggested differences in the characteristics of foreign non-resident patients using Regional Public Hospitals or other kinds of hospitals although we did not observe significant differences in the healthcare costs. Nevertheless, women, 15–24 and 35–44 years old patients and the days of stay were less costly in Regional Public Hospitals. In general, acute hospitalizations of foreign non-resident patients while they are on holiday cost substantially less than domestic patients. The typology of hospital is not found to be a relevant factor influencing costs. Full article

(This article belongs to the Section Health Economics)

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Int. J. Environ. Res. Public Health, Volume 14, Issue 9 (September 2017) – 143 articles

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