International Journal of Environmental Research and Public Health

16 pages, 375 KiB

Open AccessArticle

Public Perceptions of Contentious Risk: The Case of Rubber Granulate in the Netherlands

by Marion de Vries, Liesbeth Claassen, Marcel Mennen, Aura Timen, Margreet J. M. te Wierik and Danielle R. M. Timmermans

Int. J. Environ. Res. Public Health 2019, 16(12), 2250; https://doi.org/10.3390/ijerph16122250 - 25 Jun 2019

Cited by 7 | Viewed by 3349

Abstract

This paper reports on the perceptions of risk related to practicing sports on fields containing rubber granulate infill, and preferences for mitigation measures, among people with and without offspring exposed to rubber granulate. Two repeated surveys were conducted among members of the general [...] Read more.

This paper reports on the perceptions of risk related to practicing sports on fields containing rubber granulate infill, and preferences for mitigation measures, among people with and without offspring exposed to rubber granulate. Two repeated surveys were conducted among members of the general population and parents of children aged under 18, in the middle of a dynamic public discussion about the potential health risks of exposure to rubber granulate. The first survey (N = 1033) was administered in December 2016 at a time characterized by considerable public uncertainty and contrasting opinions in the public risk debate. The second survey (N = 782) was conducted in January 2017 after the publication of a risk assessment report, which concluded that practicing sport on fields containing rubber granulate is safe. Multilevel analyses were performed to study changes in perceptions of risk and mitigation preferences in the time between the two surveys, the influence of being familiar with new information following the risk assessment report, and the differences in the perceptions of risk and mitigation preferences between groups with and without offspring exposed to rubber granulate. The results of this study show that, initially, a substantial proportion of the Dutch public perceived practicing sports on fields containing rubber granulate as a potential health threat to children. Over time, after publication of a new risk assessment study stating that practicing sports on fields containing rubber granulate is safe, perceived risk and preferences for mitigation of this risk decreased, especially among those who were familiar with the new information. Parents of children under the age of 18, in particular those with children who were exposed to rubber granulate, were more likely to perceive the risk as higher and to prefer a stricter mitigation policy. These insights may be important to inform public health communication strategies with respect to the timing and tailoring of risk messages to various groups. Full article

10 pages, 336 KiB

Open AccessArticle

Prevalence of Burnout among Primary Health Care Staff and Its Predictors: A Study in Iran

by Ehsan Zarei, Fariba Ahmadi, Muhammad Safdar Sial, Jinsoo Hwang, Phung Anh Thu and Sardar Muhammad Usman

Int. J. Environ. Res. Public Health 2019, 16(12), 2249; https://doi.org/10.3390/ijerph16122249 - 25 Jun 2019

Cited by 39 | Viewed by 6055

Abstract

Burnout, which is an emerging challenge in health systems, is very common among primary health care (PHC) workers. The aim of this study was to investigate the level of burnout among PHC workers, and its predictive factors, in a region in the west [...] Read more.

Burnout, which is an emerging challenge in health systems, is very common among primary health care (PHC) workers. The aim of this study was to investigate the level of burnout among PHC workers, and its predictive factors, in a region in the west of Iran. In this cross-sectional study, all the health network staff (n = 539) were enrolled. The data collection instrument was the Maslach Burnout Inventory (MBI), which consists of 22 items and the three subscales of emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). High scores in EE and DP and low scores in PA are indicative of high burnout. Logistic regression was used to determine the predictors of high burnout. The data were analyzed using SPSS version 16. The findings showed that 90.5% of the staff had high DP, 55.3% had high EE, and 98.9% had low PA scores. Also, 52.9% (277 people) of the staff suffered from high burnout. Single people (OR = 3.33), less experienced employees (OR = 9.09), people aged over 35 years (OR = 2.35), physicians (OR = 1.72), and staff with permanent employment (OR = 5.0) were more likely to suffer high levels of burnout. We conclude that burnout is a common problem in PHC workers. Less experienced, younger, single employees and physicians were more at risk of suffering from high burnout. Preventive measures, such as strengthening social skills, communication competencies, and coping strategies, and reduction of risk factors such as job stress, are suggested for reducing employees’ risk of burnout. Full article

(This article belongs to the Special Issue Patient Satisfaction with Health Services)

11 pages, 488 KiB

Open AccessArticle

Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

by Cheng-Jei Lin, Sarah Chua, Sheng-Ying Chung, Chi-Ling Hang and Tzu-Hsien Tsai

Int. J. Environ. Res. Public Health 2019, 16(12), 2248; https://doi.org/10.3390/ijerph16122248 - 25 Jun 2019

Cited by 12 | Viewed by 3790

Abstract

Infective endocarditis (IE) is a severe disease with a hospital mortality rate of 17–25%. Early identification of IE patients with high risk of mortality may improve their clinical outcomes. Patients with diabetes mellitus (DM) who develop infective diseases are associated with worse outcomes. [...] Read more.

Infective endocarditis (IE) is a severe disease with a hospital mortality rate of 17–25%. Early identification of IE patients with high risk of mortality may improve their clinical outcomes. Patients with diabetes mellitus (DM) who develop infective diseases are associated with worse outcomes. This study aimed to define the impact of DM on long-term mortality in IE patients. A total of 412 patients with definite IE from February 1999 to June 2012 were enrolled in this observational study and divided into 2 groups: group 1, patients with DM (n = 72) and group 2, patients without DM (n = 340). The overall in-hospital mortality rate for both groups combined was 20.2% and was higher in group 1 than in group 2 (41.7% vs. 16.5%, p < 0.01). Compared to patients without DM, patients with DM were older and associated with higher incidence of chronic diseases, less drug abuse, higher creatinine levels, and increased risk of Staphylococcus aureus infection (all p < 0.05). Moreover, they were more likely to have atypical clinical presentation and were associated with longer IE diagnosis time (all p < 0.05). In multivariable analysis, DM is an independent and significant predictor of mortality. The prognosis of IE patients with DM is still poor. Early identification and more aggressive treatment may be considered in IE patients with DM. Full article

(This article belongs to the Section Infectious Disease Epidemiology)

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17 pages, 1753 KiB

Open AccessPerspective

Introducing Care 4.0: An Integrated Care Paradigm Built on Industry 4.0 Capabilities

by Chaloner Chute and Tara French

Int. J. Environ. Res. Public Health 2019, 16(12), 2247; https://doi.org/10.3390/ijerph16122247 - 25 Jun 2019

Cited by 73 | Viewed by 9585

Abstract

Western developed health and care policy is shifting from a patriarchal medical model to a co-managed and integrated approach. Meanwhile, the fourth industrial revolution (Industry 4.0) is transforming manufacturing in line with the digital consumer revolution. Digital health and care initiatives are beginning [...] Read more.

Western developed health and care policy is shifting from a patriarchal medical model to a co-managed and integrated approach. Meanwhile, the fourth industrial revolution (Industry 4.0) is transforming manufacturing in line with the digital consumer revolution. Digital health and care initiatives are beginning to use some of the same capabilities to optimize healthcare provision. However, this is usually limited to self-management as part of an organization-centric delivery model. True co-management and integration with other organizations and people is difficult because it requires formal care organizations to share control and extend trust. Through a co-design lens, this paper discusses a more person-centered application of Industry 4.0 capabilities for care. It introduces ‘Care 4.0’, a new paradigm that could change the way people develop digital health and care services, focusing on trusted, integrated networks of organizations, people and technologies. These networks and tools would help people co-manage and use their own assets, in the context of their own care circle and community. It would enable personalized services that are more responsive to care needs and aspirations, offering preventative approaches that ultimately create a more flexible and sustainable set of integrated health and social care services that support meaningful engagement and interactions. Full article

(This article belongs to the Special Issue Global Advances in Telehealth Practice)

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13 pages, 2211 KiB

Open AccessArticle

Gentrification and Displacement in the San Francisco Bay Area: A Comparison of Measurement Approaches

by Mahasin S. Mujahid, Elizabeth Kelley Sohn, Jacob Izenberg, Xing Gao, Melody E. Tulier, Matthew M. Lee and Irene H. Yen

Int. J. Environ. Res. Public Health 2019, 16(12), 2246; https://doi.org/10.3390/ijerph16122246 - 25 Jun 2019

Cited by 43 | Viewed by 15764

Abstract

Gentrification may play an important role in influencing health outcomes, but few studies have examined these associations. One major barrier to producing empirical evidence to establish this link is that there is little consensus on how to measure gentrification. To address this barrier, [...] Read more.

Gentrification may play an important role in influencing health outcomes, but few studies have examined these associations. One major barrier to producing empirical evidence to establish this link is that there is little consensus on how to measure gentrification. To address this barrier, we compared three gentrification classification methodologies in relation to their ability to identify neighborhood gentrification in nine San Francisco Bay Area counties: the Freeman method, the Landis method, and the Urban Displacement Project (UDP) Regional Early Warning System. In the 1580 census tracts, 43% of the population had a bachelor’s degree or higher. The average median household income was $79,671 in 2013. A comparison of gentrification methodologies revealed that the Landis and Freeman methodologies characterized the vast majority of census tracts as stable, and only 5.2% and 6.1% of tracts as gentrifying. UDP characterized 46.7% of tracts at risk, undergoing, or experiencing advanced stages of gentrification and displacement. There was substantial variation in the geographic location of tracts identified as gentrifying across methods. Given the variation in characterizations of gentrification across measures, studies evaluating associations between gentrification and health should consider using multiple measures of gentrification to examine the robustness of the study findings across measures. Full article

(This article belongs to the Special Issue Neighborhood Environmental Influences on Health and Well-Being)

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20 pages, 1034 KiB

Open AccessArticle

The Use of a Quasi-Experimental Study on the Mortality Effect of a Heat Wave Warning System in Korea

by Seulkee Heo, Amruta Nori-Sarma, Kwonsang Lee, Tarik Benmarhnia, Francesca Dominici and Michelle L. Bell

Int. J. Environ. Res. Public Health 2019, 16(12), 2245; https://doi.org/10.3390/ijerph16122245 - 25 Jun 2019

Cited by 17 | Viewed by 6260

Abstract

Many cities and countries have implemented heat wave warning systems to combat the health effects of extreme heat. Little is known about whether these systems actually reduce heat-related morbidity and mortality. We examined the effectiveness of heat wave alerts and health plans in [...] Read more.

Many cities and countries have implemented heat wave warning systems to combat the health effects of extreme heat. Little is known about whether these systems actually reduce heat-related morbidity and mortality. We examined the effectiveness of heat wave alerts and health plans in reducing the mortality risk of heat waves in Korea by utilizing the discrepancy between the alerts and the monitored temperature. A difference-in-differences analysis combined with propensity score weighting was used. Mortality, weather monitoring, and heat wave alert announcement data were collected for 7 major cities during 2009–2014. Results showed evidence of risk reduction among people aged 19–64 without education (−0.144 deaths/1,000,000 people, 95% CI: −0.227, −0.061) and children aged 0–19 (−0.555 deaths/1,000,000 people, 95% CI: −0.993, −0.117). Decreased cardiovascular and respiratory mortality was found in several subgroups including single persons, widowed people, blue-collar workers, people with no education or the highest level of education (university or higher). No evidence was found for decreased all-cause mortality in the population (1.687 deaths/1,000,000 people per day; 95% CI: 1.118, 2.255). In conclusion, heat wave alerts may reduce mortality for several causes and subpopulations of age and socio-economic status. Further work needs to examine the pathways through which the alerts impact subpopulations differently. Full article

(This article belongs to the Special Issue Extreme Weather Events and Health)

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24 pages, 1627 KiB

Open AccessReview

The Distribution of Available Prevention and Management Interventions for Fetal Alcohol Spectrum Disorder (2007 to 2017): Implications for Collaborative Actions

by Babatope O. Adebiyi, Ferdinand C. Mukumbang and Charlene Erasmus

Int. J. Environ. Res. Public Health 2019, 16(12), 2244; https://doi.org/10.3390/ijerph16122244 - 25 Jun 2019

Cited by 14 | Viewed by 7558

Abstract

The global prevalence of Fetal Alcohol Spectrum Disorder (FASD) remains high despite the various preventive and management interventions that have been designed and implemented to tackle the issue in various settings. The aim of the scoping review is to identify and classify prevention [...] Read more.

The global prevalence of Fetal Alcohol Spectrum Disorder (FASD) remains high despite the various preventive and management interventions that have been designed and implemented to tackle the issue in various settings. The aim of the scoping review is to identify and classify prevention and management interventions of FASD reported globally across the life span and to map the concentration of these interventions across the globe. We searched some selected databases with predefined terms. Framework and narrative approaches were used to synthesize and report on the findings. Thirty-two prevention intervention studies and 41 management interventions studies were identified. All the interventions were reported to be effective or showed promising outcomes for the prevention and management of FASD, except four. Although Europe and Africa have a relatively higher prevalence of FASD, the lowest number of interventions to address FASD were identified in these regions. Most of the interventions for FASD were reported in North America with comparatively lower FASD prevalence. The uneven distribution of interventions designed for FASD vis-à-vis the burden of FASD in the different regions calls for a concerted effort for knowledge and intervention sharing to enhance the design of contextually sensitive preventive and management policy in the different regions. Full article

(This article belongs to the Special Issue Fetal Alcohol Spectrum Disorder (FASD))

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10 pages, 638 KiB

Open AccessArticle

Effectiveness of Enzyme Dentifrices on Oral Health in Orthodontic Patients: A Randomized Controlled Trial

by Hsin-Chung Cheng, Hao-Ting Hu and Ya-Chu Chang

Int. J. Environ. Res. Public Health 2019, 16(12), 2243; https://doi.org/10.3390/ijerph16122243 - 25 Jun 2019

Cited by 7 | Viewed by 3836

Abstract

Plaque accumulation and white spot lesions are common adverse effects of fixed orthodontic appliance use. This study compared the effects between enzyme-containing and conventional dentifrices on orthodontic patients. This double-blind randomized controlled trial included 42 orthodontic patients (25 women and 17 men: 22.7 [...] Read more.

Plaque accumulation and white spot lesions are common adverse effects of fixed orthodontic appliance use. This study compared the effects between enzyme-containing and conventional dentifrices on orthodontic patients. This double-blind randomized controlled trial included 42 orthodontic patients (25 women and 17 men: 22.7 ± 4.2 years) from Taipei Medical University Hospital between 2017 and 2018. The patients were randomly divided into three groups and assigned to dentifrice use during the first 3 months of the orthodontic treatment: group 1 used dentifrices containing enzymes including amyloglucosidase and glucose oxidase, group 2 used dentifrices containing 1450 ppm fluoride, and group 3 used natural dentifrices containing no chemical agent. White spot lesion index (WSL), gingival bleeding index (GBI), and visible plaque index (VPI) were recorded and analyzed. WSL, GBI, and VPI values exhibited no significant difference among the three groups. WSL increased significantly in group 3, GBI decreased significantly in all groups, and VPI decreased significantly in groups 1 and 2. No significant difference was observed between the use of enzyme-containing and conventional dentifrices after fixed orthodontic appliance placement. Full article

(This article belongs to the Special Issue Oral Health of Children, Adolescents, Young Adults and Special Needs Population)

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12 pages, 2563 KiB

Open AccessArticle

Effects of Lanthanum on the Photosystem II Energy Fluxes and Antioxidant System of Chlorella Vulgaris and Phaeodactylum Tricornutum

by Dong Sun, Ning He, Qi Chen and Shunshan Duan

Int. J. Environ. Res. Public Health 2019, 16(12), 2242; https://doi.org/10.3390/ijerph16122242 - 25 Jun 2019

Cited by 20 | Viewed by 3485

Abstract

The rare earth elements are widely used in agricultural and light industry development. They promote the growth of crop seedlings, enhance root development and change the metal properties. Due to the large amount of rare earth minerals mined in China, rare earth elements [...] Read more.

The rare earth elements are widely used in agricultural and light industry development. They promote the growth of crop seedlings, enhance root development and change the metal properties. Due to the large amount of rare earth minerals mined in China, rare earth elements have been detected in both coastal and estuary areas. They cause pollution and threaten the health of aquatic organisms and human beings. This study investigates the effects of lanthanum on two marine bait algae, and analyzes the changes in the photosynthetic and antioxidant systems of the two algae. The results show that rare earth elements have significant inhibitory effects upon the two algae. The OJIP kinetic curve value decreases with an increasing concentration of La(NO₃)₃ ·6H₂O. The parameters of the fluorescence value were analyzed. The ABS/RC increases and the DI₀/RC decreases during the first 24 h after exposure. The effects on the photosynthetic and antioxidant systems at low concentrations (both EC₁₀ and EC₂₀) show that the TR₀/ABS increases, and the ET₀/RC, ABS/RC, and DI₀/RC has a decreasing trend after 30 min. However, after 24 h, normal levels were restored. In addition, the study finds that the TR₀/ABS increases after 24 h, leading to an increase in reactive oxygen species. The antioxidant system analysis also confirms the increase in the activities of antioxidant enzymes, such as SOD and GSH. The experiment is expected to support the marine pollution of rare earths and the theoretical data of the impact on marine primary producers. Full article

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

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Graphical abstract

12 pages, 309 KiB

Open AccessArticle

Exploring Generational Differences of British Ethnic Minorities in Smoking Behavior, Frequency of Alcohol Consumption, and Dietary Style

by Senhu Wang and Shuanglong Li

Int. J. Environ. Res. Public Health 2019, 16(12), 2241; https://doi.org/10.3390/ijerph16122241 - 25 Jun 2019

Cited by 15 | Viewed by 4145

Abstract

Background: This article explores ethnic minority generational differences in smoking behavior, frequency of alcohol consumption, and dietary style in Britain, and whether these differences can be explained by generational differences in socioeconomic status and ethnic identity. Method: Multivariate analyses using wave 2 (2010–2012) [...] Read more.

Background: This article explores ethnic minority generational differences in smoking behavior, frequency of alcohol consumption, and dietary style in Britain, and whether these differences can be explained by generational differences in socioeconomic status and ethnic identity. Method: Multivariate analyses using wave 2 (2010–2012) and wave 5 (2013–2015) of the United Kingdom Household Longitudinal Study on smoking behavior, frequency of alcohol consumption, and dietary style from 59,189 White British, 1690 Indians, 960 Pakistanis, 555 Bangladeshis, 1060 Black Caribbeans, and 1059 Black Africans, adjusted for demographic characteristics, socioeconomic status and ethnic identity. Results: While we find little evidence for generational differences in dietary style, second-generation Indians, Pakistanis, and Black Caribbeans have a significantly higher probability of smoking than the first-generation, and all second-generation minorities are significantly more likely to consume alcohol than their first-generation counterparts. Such generational differences in alcohol consumption are partly explained by second-generation minorities’ weakened ethnic identity and higher socioeconomic status. Conclusions: This study facilitates a better understanding of minority generational differences in health behaviors and the role of socioeconomic status and ethnic identity, highlighting the need for future policy interventions to target certain second-generation ethnic minorities who have adopted certain host society unhealthy lifestyles. Full article

(This article belongs to the Special Issue Health of Marginalized People)

32 pages, 1940 KiB

Open AccessArticle

Environmental Assessment and Evaluation of Oxidative Stress and Genotoxicity Biomarkers Related to Chronic Occupational Exposure to Benzene

by Isabele C. Costa-Amaral, Leandro V. B. Carvalho, Marcus Vinicius C. Santos, Daniel Valente, Angélica C. Pereira, Victor O. Figueiredo, Juliana Mendonça de Souza, Vinicio S. Castro, Maria de Fátima Trancoso, Antônio Sérgio A. Fonseca, Vanessa G. Milagres, Michele P. R. Mendes, Maria José N. Paiva, Leiliane C. André, Renato M. Borges, Marco Antônio C. Menezes, Sérgio R. Alves, Eline S. Gonçalves, Herbert Ary Sisenando, Jamila A. Perini, Mônica S. Oliveira, Maria Juliana Moura-Correa, Liliane R. Teixeira, Andrew R. Collins, Rita de Cássia O. C. Mattos, Paula N. Sarcinelli and Ariane L. Larentis Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2019, 16(12), 2240; https://doi.org/10.3390/ijerph16122240 - 25 Jun 2019

Cited by 27 | Viewed by 5924

Abstract

Environmental and occupational exposure to benzene from fuels is a major cause for concern for national and international authorities, as benzene is a known carcinogen in humans and there is no safe limit for exposure to carcinogens. The objective of this study was [...] Read more.

Environmental and occupational exposure to benzene from fuels is a major cause for concern for national and international authorities, as benzene is a known carcinogen in humans and there is no safe limit for exposure to carcinogens. The objective of this study was to evaluate the genotoxic effects of chronic occupational exposure to benzene among two groups of workers: filling station workers (Group I) and security guards working at vehicles entrances (Group II), both on the same busy highway in Rio de Janeiro, Brazil. Sociodemographic data on the workers were evaluated; the concentration of benzene/toluene (B/T) in atmospheric air and individual trans,trans-muconic acid (ttMA) and S-phenylmercapturic acid (S-PMA) were measured; oxidative stress was analyzed by catalase (CAT), glutathione S-transferase (GST), superoxide dismutase (SOD), thiol groups (THIOL) and malondialdehyde (MDA); genotoxicity was measured by metaphases with chromosomal abnormalities (MCA) and nuclear abnormalities, comet assay using the enzyme formamidopyrimidine DNA glycosylase (C-FPG), and methylation of repetitive element LINE-1, CDKN2B and KLF6 genes. Eighty-six workers participated: 51 from Group I and 35 from Group II. The B/T ratio was similar for both groups, but Group I had greater oscillation of benzene concentrations because of their work activities. No differences in ttMA and S-PMA, and no clinical changes were found between both groups, but linearity was observed between leukocyte count and ttMA; and 15% of workers had leukocyte counts less than 4.5 × 10⁹ cells L⁻¹, demanding close worker’s attention. No differences were observed between the two groups for THIOL, MDA, MCA, or nuclear abnormalities. A multiple linear relationship was obtained for the biomarkers MCA and C-FPG. A significant correlation was found between length of time in current job and the biomarkers C-FPG, MCA, GST, and MDA. Although both populations had chronic exposure to benzene, the filling station workers were exposed to higher concentrations of benzene during their work activities, indicating an increased risk of DNA damage. Full article

(This article belongs to the Special Issue Environmental and Occupational Exposure to Benzene and Oxidative Damage)

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17 pages, 3082 KiB

Open AccessArticle

Performance of Anaerobic Digestion of Chicken Manure Under Gradually Elevated Organic Loading Rates

by Fei Wang, Mengfu Pei, Ling Qiu, Yiqing Yao, Congguang Zhang and Hong Qiang

Int. J. Environ. Res. Public Health 2019, 16(12), 2239; https://doi.org/10.3390/ijerph16122239 - 25 Jun 2019

Cited by 37 | Viewed by 5211

Abstract

Poultry manure is the main source of agricultural and rural non-point source pollution, and its effective disposal through anaerobic digestion (AD) is of great significance; meanwhile, the high nitrogen content of chicken manure makes it a typical feedstock for anaerobic digestion. The performance [...] Read more.

Poultry manure is the main source of agricultural and rural non-point source pollution, and its effective disposal through anaerobic digestion (AD) is of great significance; meanwhile, the high nitrogen content of chicken manure makes it a typical feedstock for anaerobic digestion. The performance of chicken-manure-based AD at gradient organic loading rates (OLRs) in a continuous stirred tank reactor (CSTR) was investigated herein. The whole AD process was divided into five stages according to different OLRs, and it lasted for 150 days. The results showed that the biogas yield increased with increasing OLR, which was based on the volatile solids (VS), before reaching up to 11.5 g VS/(L·d), while the methane content was kept relatively stable and maintained at approximately 60%. However, when the VS was further increased to 11.5 g VS/(L·d), the total ammonia nitrogen (TAN), pH, and alkalinity (CaCO₃) rose to 2560 mg·L⁻¹, 8.2, and 15,000 mg·L⁻¹, respectively, while the volumetric biogas production rate (VBPR), methane content, and VS removal efficiency decreased to 0.30 L·(L·d)⁻¹, 45%, and 40%, respectively. Therefore, the AD performance immediately deteriorated and ammonia inhibition occurred. Further analysis demonstrated that the microbial biomass yield and concentrations dropped dramatically in this period. These results indicated that the AD stayed steady when the OLR was lower than 11.5 g VS/(L·d); this also provides valuable information for improving the efficiency and stability of AD of a nitrogen-rich substrate. Full article

(This article belongs to the Special Issue Advances in Anaerobic Digestion)

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13 pages, 319 KiB

Open AccessArticle

Mercury Exposure in Mother-Children Pairs in A Seafood Eating Population: Body Burden and Related Factors

by Shamshad Karatela, Neil Ward and Janis Paterson

Int. J. Environ. Res. Public Health 2019, 16(12), 2238; https://doi.org/10.3390/ijerph16122238 - 25 Jun 2019

Cited by 11 | Viewed by 4131

Abstract

Background: Mercury is a neurotoxin that affects neurodevelopment in children; however, its association at the lowest concentration is not clear. The main objective of this study is to measure and evaluate mercury concentrations in mother–child pairs and its association demographics, lifestyle, and dietary [...] Read more.

Background: Mercury is a neurotoxin that affects neurodevelopment in children; however, its association at the lowest concentration is not clear. The main objective of this study is to measure and evaluate mercury concentrations in mother–child pairs and its association demographics, lifestyle, and dietary factors within the Pacific Island Families living in Auckland, New Zealand. Methods: Mercury exposure was assessed in a sub-sample of mother–child pairs who were a part of the Pacific Island Families birth cohort, in Auckland, New Zealand at the 6-year phase. Hair samples were collected from both mothers and their children to determine mercury concentrations. Total mercury was measured using inductively coupled plasma mass spectrometry for hair samples. An interviewer-based reliable food frequency questionnaire (FFQ) examined the frequency of seafood by all the participants. Other variables such as sociodemographic (ethnicity and gender), lifestyle factors (income, education, and smoking status) and health outcomes (child behaviour and obesity) were also collected. Results: In this study, 41% of both mothers and their children had mercury concentrations above the US Environmental Protection Agency (EPA) recommended value of 1 µg/g. Most of the participants ate fish 3 or more times a week. A significant correlation was observed between mother and child hair mercury concentrations (Spearman Rho 0.79 (95% confidence interval (CI): 0.65, 0.88)). Conclusions: Mercury levels in children can be affected by their mothers’ levels due to similar eating patterns. Full article

(This article belongs to the Special Issue Environmental and Social Influences on Cognitive Development and Function)

19 pages, 675 KiB

Open AccessArticle

Age Group Differences in Household Accident Risk Perceptions and Intentions to Reduce Hazards

by James Morgan, John Reidy and Tahira Probst

Int. J. Environ. Res. Public Health 2019, 16(12), 2237; https://doi.org/10.3390/ijerph16122237 - 25 Jun 2019

Cited by 16 | Viewed by 5204

Abstract

Very little is known about the extent to which seemingly vulnerable younger and older adults appraise household risks and relatedly whether safety information focused on raising risk awareness influences intentions to reduce hazards in the home. The present study assessed age differences in [...] Read more.

Very little is known about the extent to which seemingly vulnerable younger and older adults appraise household risks and relatedly whether safety information focused on raising risk awareness influences intentions to reduce hazards in the home. The present study assessed age differences in accident experience, risk attitudes, household accident risk perceptions, comparative optimism, personal control, efficacy judgements, and intentions to remove household hazards. It also examined the predictors of these intentions. Thirty-eight younger adults (aged 18 to 25) and forty older adults (aged 65 to 87) completed study booklets containing all measures. There were significant age group differences for all accident experience and risk-related variables. Younger adults experienced more accidents, had riskier attitudes, and had significantly lower cognitive risk perceptions (i.e., they were less likely to be injured due to a household accident). They also had lower affective risk perceptions (i.e., they were less worried) about their accident risk and perceived more personal control over the risk compared with older adults. Young adults were comparatively optimistic about their risk while older adults were pessimistic. Older adults had higher response efficacy and intentions to reduce hazards in the home. Only worry, response efficacy, and risk attitudes predicted intention, however, these relationships were not moderated by age or efficacy appraisal. Although tentative theoretical and practical implications are presented, further research is required in order to better understand the objective and subjective risk associated with household accidents, and to determine the factors that may improve safety, particularly for those most vulnerable. Full article

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12 pages, 339 KiB

Open AccessArticle

Evaluation of the Effectiveness of a Nursing/Physiotherapy Program in Chronic Patients

by Remedios López-Liria, Francisco Antonio Vega-Ramírez, José Manuel Aguilar-Parra, David Padilla-Góngora, Rubén Trigueros-Ramos and Patricia Rocamora-Pérez

Int. J. Environ. Res. Public Health 2019, 16(12), 2236; https://doi.org/10.3390/ijerph16122236 - 25 Jun 2019

Cited by 5 | Viewed by 3649

Abstract

This study aimed to evaluate the functional impact of a shared intervention model by the mobile physiotherapy and rehabilitation team (MPRT) and primary care case management nurses (PCCMNs) on chronic patients. This was a prospective, observational study involving 1086 patients (mean age, 80 [...] Read more.

This study aimed to evaluate the functional impact of a shared intervention model by the mobile physiotherapy and rehabilitation team (MPRT) and primary care case management nurses (PCCMNs) on chronic patients. This was a prospective, observational study involving 1086 patients (mean age, 80 years; 63.7% females) in the province of Almeria, which was conducted between 2004 and 2018. Most of the registered diseases included cerebrovascular and neurological diseases (56.7%), osteoarticular diseases (45.3%), diabetes mellitus (25.7%), cardiovascular diseases (25.5%), and chronic respiratory diseases. The study included a home care intervention by the MPRT and PCCMNs and included the following main outcome measures: age, sex, main caregiver, disabling process (ICD-9), type and number of inclusion categories for chronic disease, initial and final Barthel index (BI), treatment or intervention on the patient (techniques), objectives, and number of sessions. The main techniques used were kinesiotherapy (44.6%) and caregiver training (23%), along with technical aid. An equation predicting the patients’ final BI, according to the initial BI, was constructed using multiple linear regression modelling. A marked improvement in functional capacity was found after an average of 10 physiotherapy sessions. A lower patient age was correlated with a higher functional capacity, both initial and final BI, as well as a greater number of sessions. Full article

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

11 pages, 297 KiB

Open AccessArticle

Normative Data on Grip Strength in a Population-Based Study with Adjusting Confounding Factors: Sixth Korea National Health and Nutrition Examination Survey (2014–2015)

by Seong Hoon Lim, Yeo Hyung Kim and Jung Soo Lee

Int. J. Environ. Res. Public Health 2019, 16(12), 2235; https://doi.org/10.3390/ijerph16122235 - 25 Jun 2019

Cited by 25 | Viewed by 4465

Abstract

Background: We investigated population-based data on grip strength, analyzed for demographic factors, and proposed a formula to estimate grip strength that could be generalized to a population with different anthropometric and background characteristics. Methods: This study used a complex, stratified, multistage probability [...] Read more.

Background: We investigated population-based data on grip strength, analyzed for demographic factors, and proposed a formula to estimate grip strength that could be generalized to a population with different anthropometric and background characteristics. Methods: This study used a complex, stratified, multistage probability cluster survey with a representative sample of the population. Select household Korean participants (n = 6577) over age 10 who were able to perform daily tasks without issue were included. Grip strength was measured in both hands, alternately, three times using a digital grip strength dynamometer. Results: There was a curvilinear relationship between grip strength and age, and grip strength was higher in males than females (p = 0.001). Hand preference significantly affected grip strength (p = 0.001). Weight and height were positively correlated with strength in both hands (p = 0.001), but waist circumference was negatively correlated with strength in both hands (p = 0.001). The intensity of occupational labor did significantly affect grip strength in both hands (p = 0.001). The formulas for estimating grip strength of each hand are presented as main results. Conclusions: To determine normative data on grip strength, we may consider factors such as occupations with different physical demands, underlying medical conditions, anthropometric characteristics, and unmodifiable factors such as age and sex. Full article

(This article belongs to the Special Issue Physical Activity and Health)

21 pages, 2357 KiB

Open AccessArticle

Sustainability Indicators Concerning Waste Management for Implementation of the Circular Economy Model on the University of Lome (Togo) Campus

by Lucía Salguero-Puerta, Juan Carlos Leyva-Díaz, Francisco Joaquín Cortés-García and Valentín Molina-Moreno

Int. J. Environ. Res. Public Health 2019, 16(12), 2234; https://doi.org/10.3390/ijerph16122234 - 25 Jun 2019

Cited by 68 | Viewed by 8445

Abstract

The circular economy aims to reduce the volume of waste generated in the world, transforming it into resources. The concept of indicator of circular economy was introduced to evaluate the improvement obtained regarding efficiency in terms of reduction, reuse and recycling of waste [...] Read more.

The circular economy aims to reduce the volume of waste generated in the world, transforming it into resources. The concept of indicator of circular economy was introduced to evaluate the improvement obtained regarding efficiency in terms of reduction, reuse and recycling of waste generated on the campus of the University of Lome (Togo). These indicators showed that 59.5% of the waste generated on the campus in 2018 could be introduced into the circular economy paradigm through composting, and 27.0% of the energy consumed could be replaced by clean energy obtained from biogas. The entire plastic fraction can be introduced into the circular economy paradigm by reusing plastic bottles and selling the rest in the port of the city. Thus, the income obtained could range from €15.5/day in 2018 to €34.5/day in 2027. Concerning old tires, 1.5% of the rubber needed to pave the entire roadway of the campus could be replaced by the waste generated by the tires currently existing there. Consequently, waste management on the campus could be controlled thanks to these indicators, and this could serve as a model for the rest of the country. Full article

(This article belongs to the Special Issue Circular Economy from Process to Policy)

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11 pages, 617 KiB

Open AccessArticle

What Frequency of Technical Activity Is Needed to Improve Results? New Approach to Analysis of Match Status in Professional Soccer

by Marek Konefał, Paweł Chmura, Kacper Rybka, Jan Chmura, Maciej Huzarski and Marcin Andrzejewski

Int. J. Environ. Res. Public Health 2019, 16(12), 2233; https://doi.org/10.3390/ijerph16122233 - 25 Jun 2019

Cited by 14 | Viewed by 4114

Abstract

The aim of the research detailed here has been to assess the frequency with which football players engage in technical activity of various different types, in relation to seven phases of a game associated with changes in match status. To this end, 2016–2017 [...] Read more.

The aim of the research detailed here has been to assess the frequency with which football players engage in technical activity of various different types, in relation to seven phases of a game associated with changes in match status. To this end, 2016–2017 domestic-season matches in Germany’s Bundesliga were analyzed, the relevant data being retrieved using an Opta Sportsdata Company system. Technical activity taken into consideration included shots, passes, ball possession, dribbles, and tackles. It was found that there was a large impact of frequency of shots on target (H = 466.999(6); p = 0.001) in relation to the different match-status phases. Furthermore, moderate effect sizes were then obtained for frequency of shots (H = 187.073(6); p = 0.001), frequency of passes (H = 133.547(6); p = 0.001), and percentage of ball possession (H = 123.401(6); p = 0.001). The implication would be that a team trying to change the match score of a game experienced at a given moment in a more favorable direction will need to raise the frequency and accuracy of passes, the percentage of ball possession, and the percentage of tackles ending in success. The maintenance of a winning match status requires a high frequency of occurrence of shots and shots on target as well as greater frequency and effectiveness of dribbling. The main finding from our work is that consideration of the consequences of a game presented in relation to seven potential phases to match status can point to a novel approach to analysis. Full article

(This article belongs to the Special Issue Health, Exercise and Sports Performance)

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18 pages, 1725 KiB

Open AccessArticle

The Effect of Environmental Performance on Employment: Evidence from China’s Manufacturing Industries

by Wei Shan and Jingyi Wang

Int. J. Environ. Res. Public Health 2019, 16(12), 2232; https://doi.org/10.3390/ijerph16122232 - 25 Jun 2019

Cited by 22 | Viewed by 4138

Abstract

This research aims to explore the interaction between environmental performance and employment China’s manufacturing industries. Based on the environmental performance of 32 industries in China’s manufacturing industry during 2006–2015, a panel vector autoregressive model was constructed to study the interaction between industry output [...] Read more.

This research aims to explore the interaction between environmental performance and employment China’s manufacturing industries. Based on the environmental performance of 32 industries in China’s manufacturing industry during 2006–2015, a panel vector autoregressive model was constructed to study the interaction between industry output and employment in clean industries and dirty industries. The dynamic impact and internal transmission mechanism between environmental performance is analyzed. The study found that in the early stage, due to the reduction of production scale, there was a weak and short-term negative correlation effect on employment, and the mutual promotion relationship between economic benefits and employment was unsustainable. In return, employment affects environmental performance, but the effect differs due to the different forms of environmental performance. For dirty industries, the impact of environmental performance on employment through technical effects is more significant and, thus, a win–win situation of ecological environment and employment stability will be achieved. This research has practical significance regarding how to scientifically and effectively carry out environmental regulation and green management. Full article

(This article belongs to the Special Issue Rethinking Work in the Digital Era to Protect the Environment and Promote Health)

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13 pages, 595 KiB

Open AccessArticle

Relationship between Parental Socialization, Emotional Symptoms, and Academic Performance during Adolescence: The Influence of Parents’ and Teenagers’ Gender

by Paola Bully, Joana Jaureguizar, Elena Bernaras and Iratxe Redondo

Int. J. Environ. Res. Public Health 2019, 16(12), 2231; https://doi.org/10.3390/ijerph16122231 - 25 Jun 2019

Cited by 15 | Viewed by 8584

Abstract

Scientific interest in students’ emotional and psychosocial experiences has been increasing in the last years due to their influence on students’ learning processes and academic performance. The present manuscript tries to go further in the study of the relationship between perceived parenting socialization [...] Read more.

Scientific interest in students’ emotional and psychosocial experiences has been increasing in the last years due to their influence on students’ learning processes and academic performance. The present manuscript tries to go further in the study of the relationship between perceived parenting socialization and academic performance by analyzing not only their direct effects, but also by testing their indirect influence through other variables such as students’ psychological and school maladjustment, especially focusing on gender differences (both of students and parents). The sample comprised 823 students (416 males and 407 females) from the Basque Country (Spain), with ages ranging between 12 and 16 years (M = 13.7, SD = 1.2). Students completed a sociodemographic data form, the PARQ-Control questionnaire, and the BASC-S3 test. Teachers answered an ad hoc question on each student’s academic performance. The data showed that, both for males and females, the same structure of parent–teenager relationship predicted teenagers’ academic performance, via psychological and school maladjustment. However, the intensity of the relationship between parental acceptance and teenagers’ results in all the other factors differed depending on teenagers’ gender. Fathers’ influence was greater in males, and mothers’ influence was higher in females. This study is considered a starting point for a theoretical model predicting academic performance and psychological and school maladjustment among teenagers. Full article

(This article belongs to the Special Issue Parental Socialization Styles in 21st Century and Adolescent Health and Well-being)

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10 pages, 666 KiB

Open AccessArticle

by Jia-Hung Chen, Chien-Tai Hong, Dean Wu, Wen-Chou Chi, Chia-Feng Yen, Hua-Fang Liao, Lung Chan and Tsan-Hon Liou

Int. J. Environ. Res. Public Health 2019, 16(12), 2230; https://doi.org/10.3390/ijerph16122230 - 24 Jun 2019

Cited by 13 | Viewed by 4750

Abstract

Dementia is a common nonmotor condition among people with moderate or advanced Parkinson’s disease (PD). Undoubtedly, profound motor symptoms cause remarkable impairment in daily activities; however, dementia-related disabilities have not been thoroughly investigated, especially not with consideration of differences according to sex. The [...] Read more.

Dementia is a common nonmotor condition among people with moderate or advanced Parkinson’s disease (PD). Undoubtedly, profound motor symptoms cause remarkable impairment in daily activities; however, dementia-related disabilities have not been thoroughly investigated, especially not with consideration of differences according to sex. The present study used the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) to compare the functional disability between men and women with PD (PwP) with and without dementia. This study employed a registry of disability evaluation and functional assessment using the Taiwan Data Bank of Persons with Disability between July 2012 and October 2018. To investigate dementia-related disability in PwP, 1:1 matching by age and Hoehn-Yahr stage was conducted, which resulted in the inclusion of 1605 study participants in each group. The present study demonstrated that among the six major domains of WHODAS 2.0, the section of “Getting alone with others” was significantly worse in both genders of PwP with dementia; however, a greater disability in fulfilling activities of daily living was only noted in male PwP with dementia but not in their female counterparts. Neither the inability to provide self-care nor participation were significantly different between the sexes. Our findings suggested that deteriorating social relationships were a dementia-related disability in all PwP at the moderate and advanced disease stages. Regarding the performance of activities of daily living, deterioration was related to dementia only in male PwP. Such disabilities could indicate cognitive impairment in people with moderate or advanced PD and could be used as an indicator for the early detection of dementia in PwP by healthcare professionals through the easier functional assessment of the WHODAS 2.0. Full article

(This article belongs to the Special Issue Disabilities, Health and Well-being)

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13 pages, 1586 KiB

Open AccessArticle

The Potential Psychological Mechanism of Subjective Well-Being in Migrant Workers: A Structural Equation Models Analysis

by Hao Chen, Lei Wang, Yanxia Wei, Bo Ye, Junming Dai, Junling Gao, Fan Wang and Hua Fu

Int. J. Environ. Res. Public Health 2019, 16(12), 2229; https://doi.org/10.3390/ijerph16122229 - 24 Jun 2019

Cited by 11 | Viewed by 4091

Abstract

Objective: The aim of this study was to identify the potential psychological mechanism of well-being in migrants in Shanghai, China. Methods: A cross-sectional study was conducted in 2018. First, a literature review was conducted to understand the salutogenesis of migrants in [...] Read more.

Objective: The aim of this study was to identify the potential psychological mechanism of well-being in migrants in Shanghai, China. Methods: A cross-sectional study was conducted in 2018. First, a literature review was conducted to understand the salutogenesis of migrants in China. Then, 2573 random participants were recruited from six workplaces and public places in six districts of Shanghai. The Chinese versions of the Patient Health Questionnaire-9 (PHQ-9), the Personal Wellbeing Index (PWI), and the Sense of Coherence (SOC) Scale were used to evaluate the depression, subjective well-being (SWB), and SOC of migrants. The t-test, ANOVA, and multiple linear regression and structural equation models (SEM) were used to analyze the correlations and paths among generalized resistant resources (GRRs), SOC, PHQ, and SWB. Results: The subjects were aged between 18 and 58 (mean, 28.17; SD, 6.99). SOC showed a positive correlation with SWB (r = 0.46, p < 0.001) and a negative correlation to PHQ (r = −0.53, p < 0.001). After controlling for the demographic characteristics, we found that PHQ, SOC (comprehensibility, manageability, meaningfulness), and GRRs (income ratio, marital status) contributed 33.3% of the variance in SWB, and their linear regression coefficients were: −0.32 (p < 0.001), 0.09 (p < 0.001), 0.09 (p < 0.001), 0.15 (p < 0.001), 0.06 (p < 0.05), and 0.16 (p < 0.05), respectively. These findings not only confirmed the direct association among SOC, PHQ and SWB, but also verified two underlying mechanisms regarding the mediating effect of SOC by using SEM: (1) GRRs (income ratio, marital status) are positively associated with a higher SOC, which further contributes to favorable SWB; and (2) PHQ is negatively associated with poor SWB indirectly via SOC. Conclusion: Migrant workers with low SOC and high PHQ are vulnerable to poor well-being levels. Meanwhile, GRRs (income ratio, marital status) may strengthen the SOC level, and can be regarded as the basis of intervention. Further investigation may be needed to focus on external psychological support factors. Full article

(This article belongs to the Special Issue Understanding Psychosocial Wellbeing in the Context of Complex and Multidimensional Problems)

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12 pages, 1612 KiB

Open AccessArticle

Effect of an Oral Health Programme on Oral Health, Oral Intake, and Nutrition in Patients with Stroke and Dysphagia in Taiwan: A Randomised Controlled Trial

by Hsiao-Jung Chen, Jean-Lon Chen, Chung-Yao Chen, Megan Lee, Wei-Han Chang and Tzu-Ting Huang

Int. J. Environ. Res. Public Health 2019, 16(12), 2228; https://doi.org/10.3390/ijerph16122228 - 24 Jun 2019

Cited by 26 | Viewed by 10910

Abstract

No previous studies have evaluated an oral health programme, before swallowing therapy, in patients with stroke and dysphagia in Taiwan. This randomised controlled trial evaluated the effect of an oral health programme (i.e., sputum assessment, Bass method-based tooth brushing, and tooth coating with [...] Read more.

No previous studies have evaluated an oral health programme, before swallowing therapy, in patients with stroke and dysphagia in Taiwan. This randomised controlled trial evaluated the effect of an oral health programme (i.e., sputum assessment, Bass method-based tooth brushing, and tooth coating with fluoride toothpaste) before swallowing therapy. Sixty-six patients with stroke (23 female, 43 male) in our rehabilitation ward, who underwent nasogastric tube insertion, were assigned randomly to an oral care group (n = 33) and a control group (n = 33). Demographic data, oral health assessment, Functional Oral Intake Scale (FOIS) scores, Mini-Nutritional Assessment-Short Form (MNA-SF) scores, and nasogastric tube removal rates were compared between groups. We evaluated outcomes using generalised estimating equation analysis. Three weeks post-implementation, the oral care group had significant oral health improvements relative to the control group (95% CI =−2.69 to −1.25, Wald χ² = 29.02, p < 0.001). There was no difference in the FOIS (95% CI = −0.16 to 0.89, Wald χ² = 1.86, p > 0.05), MNA-SF (95% CI =−0.35 to 0.53, Wald χ² =−0.17, p > 0.05), and nasogastric tube removal (p > 0.05) between groups. The oral care group had a higher, but non-significant FOIS score (3.94 vs 3.52) (p > 0.05). Routine oral health programmes implemented during stroke rehabilitation in patients with dysphagia may promote oral health and maintain oral intake. Full article

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23 pages, 15204 KiB

Open AccessArticle

Spatio-Temporal Characterization Analysis and Water Quality Assessment of the South-to-North Water Diversion Project of China

by Xizhi Nong, Dongguo Shao, Yi Xiao and Hua Zhong

Int. J. Environ. Res. Public Health 2019, 16(12), 2227; https://doi.org/10.3390/ijerph16122227 - 24 Jun 2019

Cited by 35 | Viewed by 4309

Abstract

In this article, a data matrix of 20 indicators (6960 observations) was obtained from 29 water quality monitoring stations of the Middle Route (MR) of the South-to-North Water Diversion Project of China (SNWDPC). Multivariate statistical techniques including analysis of variance (ANOVA), correlation analysis [...] Read more.

In this article, a data matrix of 20 indicators (6960 observations) was obtained from 29 water quality monitoring stations of the Middle Route (MR) of the South-to-North Water Diversion Project of China (SNWDPC). Multivariate statistical techniques including analysis of variance (ANOVA), correlation analysis (CA), and principal component analysis (PCA) were applied to understand and identify the interrelationships between the different indicators and the most contributive sources of anthropogenic and natural impacts on water quality. The water quality index (WQI) was used to assess the classification and variation of water quality. The distributions of the indicators revealed that six heavy-metal indicators including arsenic (As), mercury (Hg), cadmium (Cd), chromium (Cr), selenium (Se), and lead (Pb) were within the Class I standard, while the As, Pb, and Cd displayed spatial variation. Moreover, some physicochemical indicators such as dissolved oxygen, 5-day biochemical oxygen demand (as BOD₅), and total phosphorus (TP) had spatio-temporal variability. The correlation analysis result demonstrated that As, Hg, Cd, Cr, Se, Pb, copper (Cu), and zinc (Zn) had high correlation coefficients. The PCA result extracted three principal components (PC) accounting for 82.67% of the total variance, while the first PC was indicative of the mixed sources of anthropogenic and natural contributions, the second and the third PCs were mainly controlled by human activities and natural sources, respectively. The calculation results of the WQI showed an excellent water quality of the MR of the SNWDPC where the values of the stations ranged from 10.49 to 17.93, while Hg was the key indicator to determine the WQI > 20 of six stations, which indicated that the Hg can be the main potential threat to water quality and human health in this project. The result suggests that special attention should be paid to the monitoring of Hg, and the investigation and supervision within the areas of high-density human activities in this project should be taken to control the impacts of urban and industrial production and risk sources on water quality. Full article

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

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15 pages, 816 KiB

Open AccessArticle

Evaluating the Environmental Performance and Operational Efficiency of Container Ports: An Application to the Maritime Silk Road

by Gang Dong, Jing Zhu, Jin Li, Handong Wang and Yuvraj Gajpal

Int. J. Environ. Res. Public Health 2019, 16(12), 2226; https://doi.org/10.3390/ijerph16122226 - 24 Jun 2019

Cited by 41 | Viewed by 6394

Abstract

A major goal for port authorities, operators, and investors is to achieve efficient operations and effective environmental protection. This is because the environmental performance of a container port is important for its competitiveness and sustainable development. However, the container ports along the Maritime [...] Read more.

A major goal for port authorities, operators, and investors is to achieve efficient operations and effective environmental protection. This is because the environmental performance of a container port is important for its competitiveness and sustainable development. However, the container ports along the Maritime Silk Road (MSR) have caused numerous problems with the rapid development, among which the most significant problem is environmental pollution. In this paper, we aim to measure and compare the environmental performance and operational efficiency of ten major container ports along the MSR, including the ports of Shanghai, Hong Kong, Singapore, Kelang, Laem Chabang, Colombo, Dubai, Barcelona, Antwerp, and Hamburg. We develop an improved, inseparable data envelopment analysis (DEA) model with slack-based measures (SBMs) to evaluate and compare the environmental performance and operational efficiency, and we incorporate the desirable output of container throughput as well as the undesirable output of CO₂ emission. Our results show that. Overall. these container ports perform better in terms of operational efficiency than environmental performance. We also provide insights for management and policy makers for container ports with different levels of operational efficiency and environmental performance. Full article

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

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20 pages, 2366 KiB

Open AccessArticle

Landscape Grain Effect in Yancheng Coastal Wetland and Its Response to Landscape Changes

by Peng Tian, Luodan Cao, Jialin Li, Ruiliang Pu, Xiaoli Shi, Lijia Wang, Ruiqing Liu, Hao Xu, Chen Tong, Zijing Zhou and Shuyao Shao

Int. J. Environ. Res. Public Health 2019, 16(12), 2225; https://doi.org/10.3390/ijerph16122225 - 24 Jun 2019

Cited by 36 | Viewed by 4586

Abstract

The landscape grain effect reflects the spatial heterogeneity of a landscape and it is used as a research core of landscape ecology. The landscape grain effect can be used to not only explore spatiotemporal variation characteristics of a landscape pattern, but also to [...] Read more.

The landscape grain effect reflects the spatial heterogeneity of a landscape and it is used as a research core of landscape ecology. The landscape grain effect can be used to not only explore spatiotemporal variation characteristics of a landscape pattern, but also to disclose variation laws of ecological structures and functions of landscapes. In this study, the sensitivity of landscape pattern indexes to grain sizes 50–1000 m was studied based on landscape data in Yancheng Coastal Wetland acquired in 1991, 2000, 2008, and 2017. Response of the grain effect to landscape changes was analyzed and an optimal grain size for analysis in the study area was determined. Results indicated that: (1) among 27 indexes (12 in a class level and 15 in a landscape level), eight indexes were highly sensitive to grains, ten indexes presented moderate sensitivity, eight indexes presented low sensitivity, and one was unresponsive. It was shown that the area-margin index and the shape index were more sensitive to the different grain sizes. The aggregation index had some differences in the grain size change, and the diversity index had a low response degree to the grain size. (2) Landscape indexes showed six different responses to different grains, including slow reduced response, fast reduced and then slow reduced response, monotonically increased response, fluctuating reduced response, up-down responses, and stable response, which indicated that the landscape index was closely related to the spatial grain. (3) From 1991 to 2017, variation curves of the landscape grain size of different landscape types could be divided into four types: fluctuation rising type, fluctuation type, monotonous decreasing type, and monotonous rising type. Different grain size curves had different interpretations of landscape changes, but in general, Yancheng Coastal Wetland’s landscape tended to be fragmented and complicated, internal connectivity was weakened, and dominant landscape area was reduced. Natural wetlands were more sensitive to grain size effects than artificial wetlands. (4) The landscape index at the 50 m grain size had a strong response to different grain size changes, and the loss of landscape information was the smallest. Therefore, it was determined that the optimal landscape grain size in the study area was 50 m. Full article

(This article belongs to the Special Issue Strategic Management toward a Sustainable Urbanization by Balancing the Utilization of Land and/or Water Resources)

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15 pages, 360 KiB

Open AccessArticle

Assessing the Importance of Health in Choosing a Restaurant: An Empirical Study from Romania

by Gabriela O. Chiciudean, Rezhen Harun, Iulia C. Muresan, Felix H. Arion, Daniel I. Chiciudean, Garofita L. Ilies and Diana E. Dumitras

Int. J. Environ. Res. Public Health 2019, 16(12), 2224; https://doi.org/10.3390/ijerph16122224 - 24 Jun 2019

Cited by 15 | Viewed by 5062

Abstract

In the context of a spectacular growth of the Romanian restaurant market, it has become a necessity for managers to analyze the decision-making process related to restaurant selection toward obtaining a competitive advantage, which can be achieved through better segmentation and adequate targeting. [...] Read more.

In the context of a spectacular growth of the Romanian restaurant market, it has become a necessity for managers to analyze the decision-making process related to restaurant selection toward obtaining a competitive advantage, which can be achieved through better segmentation and adequate targeting. The main objectives involved the identification of the main factors that influence restaurant selection by evaluating the role that health concerns play in this process and identifying consumers’ restaurant profiles. A survey was conducted using face-to-face interviews as the contact method, in order to identify the main factors considered important for consumers in the city of Cluj-Napoca in the decision-making process related to restaurant selection. Principal component analysis (PCA) was conducted to group the attributes. The non-hierarchical cluster analysis through the use of the k-means method was used to define different groups within the sample and identify common features. Results suggest that the analyzed restaurant market is dominated by three segments of consumers, of which the largest is represented by “health seekers”: a group of young women with medium and low incomes. As such, the possibility of consuming healthy meals within a restaurant is the most important factor for them during the decision-making process for restaurant selection. The present study has important managerial implications. Restaurant managers should admit that this process represents the starting point in designing restaurant concepts, as this type of information is fundamental for management decisions. On the other hand, the study offers important information regarding consumer perception of food, which has recently changed significantly, especially in the segment of young consumers to whom health is very important. Full article

11 pages, 304 KiB

Open AccessArticle

The Association between Organizational Justice and Psychological Well-Being by Regular Exercise in Korean Employees

by Hanul Park, Kang-Sook Lee, Yong-Jun Park, Dong-Joon Lee and Hyun-Kyung Lee

Int. J. Environ. Res. Public Health 2019, 16(12), 2223; https://doi.org/10.3390/ijerph16122223 - 24 Jun 2019

Cited by 4 | Viewed by 3616

Abstract

Many studies have shown that organizational justice (OJ) is related to psychological determinants of employees’ physical and mental health in the workplace, and these health outcomes also lead to the psychological well-being (PW) of employees. Additionally, physical activity is one of the most [...] Read more.

Many studies have shown that organizational justice (OJ) is related to psychological determinants of employees’ physical and mental health in the workplace, and these health outcomes also lead to the psychological well-being (PW) of employees. Additionally, physical activity is one of the most important issues related to health in the workplace. This study compared the level of perceived OJ according to sociodemographic and lifestyle factors and examined the association between OJ and PW by regular exercise (hours per week) in Korean employees. This study used cross-sectional data obtained from 494 subjects in South Korea. Self-administered questionnaires comprising OJ, PW, and lifestyle factors (e.g., smoking, drinking, sleeping, and exercise) were completed by employees in April 2017. Multiple logistic regression analyses were conducted to estimate the association of procedural justice (PJ) and interactional justice (IJ) with the prevalence odds ratios and 95% confidence intervals of the high risk to PW. After the adjustment of sociodemographic characteristics and lifestyle factors, the main effects of PJ and IJ on the high risk to PW were significantly observed, and when these values were stratified by a regular exercise category, the lowest odds ratio was observed in a group that exercised for 1–2 h (hours per week). Organizations must encourage trust and consideration between employees and supervisors and carry out efforts to improve their environment, such as making the decision-making process fairer and encouraging employees to exercise regularly. This intervention may help prevent a high risk to PW. Full article

(This article belongs to the Special Issue Workplace Health and Wellbeing 2019)

14 pages, 1564 KiB

Open AccessArticle

Environmental Assessment of a Hybrid Solar-Biomass Energy Supplying System: A Case Study

by Congguang Zhang, Jiaming Sun, Jieying Ma, Fuqing Xu and Ling Qiu

Int. J. Environ. Res. Public Health 2019, 16(12), 2222; https://doi.org/10.3390/ijerph16122222 - 24 Jun 2019

Cited by 14 | Viewed by 5483

Abstract

Local energy supply by renewable energy, such as solar energy and biomass, using distributed energy systems plays an important role in global energy structure. This study investigated the environmental performance of a hybrid solar-biomass energy supplying system by life-cycle assessment method. The results [...] Read more.

Local energy supply by renewable energy, such as solar energy and biomass, using distributed energy systems plays an important role in global energy structure. This study investigated the environmental performance of a hybrid solar-biomass energy supplying system by life-cycle assessment method. The results showed that in terms of environmental and energy impacts, the construction stage and the disassembly and recycling stage of the system contribute little to the whole life-cycle environmental impacts. According to the results of most of the selected impact categories, the solar subsystem contributed the most environmental emissions during construction stage, followed by the two anaerobic reactors; therefore, the excessive pursuit of high solar energy proportion can correspondingly lead to even more serious environmental problems. The integrated energy supplying system significantly reduces non-renewable energy consumption, climate change impacts, acidification as well as eutrophication effects due to the replacement of alternatives such as lignite coal, and from fertilizer production. The present hybrid solar-biomass energy supplying system not only produces clean thermal energy but also reduces the disposal of organic wastes and produces valuable agricultural products. Full article

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

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19 pages, 424 KiB

Open AccessArticle

New Insights in Computational Methods for Pharmacovigilance: E-Synthesis, a Bayesian Framework for Causal Assessment

by Francesco De Pretis and Barbara Osimani

Int. J. Environ. Res. Public Health 2019, 16(12), 2221; https://doi.org/10.3390/ijerph16122221 - 24 Jun 2019

Cited by 9 | Viewed by 4976

Abstract

Today’s surge of big data coming from multiple sources is raising the stakes that pharmacovigilance has to win, making evidence synthesis a more and more robust approach in the field. In this scenario, many scholars believe that new computational methods derived from data [...] Read more.

Today’s surge of big data coming from multiple sources is raising the stakes that pharmacovigilance has to win, making evidence synthesis a more and more robust approach in the field. In this scenario, many scholars believe that new computational methods derived from data mining will effectively enhance the detection of early warning signals for adverse drug reactions, solving the gauntlets that post-marketing surveillance requires. This article highlights the need for a philosophical approach in order to fully realize a pharmacovigilance 2.0 revolution. A state of the art on evidence synthesis is presented, followed by the illustration of E-Synthesis, a Bayesian framework for causal assessment. Computational results regarding dose-response evidence are shown at the end of this article. Full article

(This article belongs to the Special Issue Societal Side Effects: The Wider Impact of Pharmaceuticals on Society)

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