International Journal of Environmental Research and Public Health

11 pages, 325 KiB

Open AccessArticle

Shift Work Including Night Work and Long Working Hours in Industrial Plants Increases the Risk of Atherosclerosis

by Marit Skogstad, Asgeir Mamen, Lars-Kristian Lunde, Bente Ulvestad, Dagfinn Matre, Hans Christian D. Aass, Reidun Øvstebø, Pia Nielsen, Kari N. Samuelsen, Øivind Skare and Per Anton Sirnes

Int. J. Environ. Res. Public Health 2019, 16(3), 521; https://doi.org/10.3390/ijerph16030521 - 12 Feb 2019

Cited by 45 | Viewed by 6817

Abstract

There is an abundance of literature reporting an association between shift work and cardiovascular disease (CVD). Few studies have examined early manifestation of CVD using advanced modern methodology. We established a group of 65 shift workers and 29 day workers (controls) in two [...] Read more.

There is an abundance of literature reporting an association between shift work and cardiovascular disease (CVD). Few studies have examined early manifestation of CVD using advanced modern methodology. We established a group of 65 shift workers and 29 day workers (controls) in two industrial plants. For the shift workers, the shift schedule includes rotating shifts with day, evening and nightshifts, some day and nightshifts lasting for 12 h. The current paper describes cross-sectional data in a study running for three years. We collected background data by questionnaire and measured blood pressure, heart rate, lipids, glycosylated hemoglobin (HbA1c) and C-reactive protein (CRP). We examined arterial stiffness (central blood pressure, augmentation pressure and index, and pulse wave velocity) by the use of SphygmoCor^® (AtCor Medical Pty Ltd, Sydney, Australia) and the carotid arteries by ultrasound. We assessed VO_2max by bicycle ergometry. We applied linear and logistic regression to evaluate associations between total number of years in shift work and cardiovascular outcome measures. The day workers were older and had more pronounced arterial stiffness compared to the shift workers. Number of years as a shift worker was associated with increased carotid intima media thickness (max IMT) (B = 0.015, p = 0.009) and an elevated CRP (B = 0.06, p = 0.03). Within the normal range for this age group, VO_2max was 41 (9) ml/kg/min. Rotating shift work including day and night shifts lasting up to 12 h and evening shifts are associated with CVD-risk factors. This could imply an increased risk for coronary heart disease and stroke among these workers. Therefore, preventive measures should be considered for these groups of workers in order to prevent such diseases. Full article

(This article belongs to the Special Issue Occupational Epidemiology)

16 pages, 2249 KiB

Open AccessArticle

Characterization and Source Identification of Polybrominated Diphenyl Ethers (PBDEs) in Air in Xi’an: Based on a Five-Year Study

by Lei Ye, Chengzhong Zhang, Deming Han and Zheng Ji

Int. J. Environ. Res. Public Health 2019, 16(3), 520; https://doi.org/10.3390/ijerph16030520 - 12 Feb 2019

Cited by 4 | Viewed by 3533

Abstract

In order to assess polybrominated diphenyl ether (PBDE) atmospheric pollution levels in Xi’an, air samples were collected using a large flow air sampler from July 2008 to April 2013. In total, 134 samples were collected and 12 PBDE congeners were detected. Total PBDE [...] Read more.

In order to assess polybrominated diphenyl ether (PBDE) atmospheric pollution levels in Xi’an, air samples were collected using a large flow air sampler from July 2008 to April 2013. In total, 134 samples were collected and 12 PBDE congeners were detected. Total PBDE concentrations (both gaseous and particulate phase) were 36.38–1054 pg/m³, with an average of 253.2 ± 198.4 pg/m³. BDE-209 was identified as the main PBDE component, with a corresponding concentration of 0.00–1041 pg/m³, accounting for 89.4% of total PBDEs. Principal component analysis results showed that PBDEs in Xi’an’s atmosphere mainly originated from commercial products containing penta-BDE, octa-BDE, and deca-BDE. The relative natural logarithm for partial pressure (RP) of PBDEs (gaseous phase) was calculated using the Clausius–Clapeyron equation. The gas flow trajectories at high, middle, and low RP values were analyzed by applying the backward trajectory model. These data indicated that the difference between trajectory distribution and concentration load on trajectories was huge under different RP values. PBDE concentrations (gaseous phase) weighted trajectory showed that the central and southwestern parts of Henan Province and the northwestern area of Hubei Province exhibited the darkest colors, and the daily average concentration contribution of PBDEs to the receiving point was >9 pg/m³, which indicates that these areas might be the main potential source areas of PBDEs in Xi’an’s atmosphere. Full article

(This article belongs to the Special Issue Air Quality Monitoring and Assessment)

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12 pages, 737 KiB

Open AccessArticle

Measuring the Burden of Disease Due to Preterm Birth Complications in Korea Using Disability-Adjusted Life Years (DALY)

by Hyun Joo Kim, Min-Woo Jo, Seok-Hwan Bae, Seok-Jun Yoon and Jin Yong Lee

Int. J. Environ. Res. Public Health 2019, 16(3), 519; https://doi.org/10.3390/ijerph16030519 - 12 Feb 2019

Cited by 7 | Viewed by 4340

Abstract

The premature birth rate in Korea has increased from 13.5% in 2008 to 15.7% in 2013. The complications of premature birth are a major determinant of neonatal mortality and morbidities. The purpose of this study was to estimate the burden of premature birth [...] Read more.

The premature birth rate in Korea has increased from 13.5% in 2008 to 15.7% in 2013. The complications of premature birth are a major determinant of neonatal mortality and morbidities. The purpose of this study was to estimate the burden of premature birth in Korea using disability-adjusted life years (DALY). DALY consists of years of life lost (YLL) and years lost due to disability (YLD). In this study, preterm birth complications refer to nine diseases: P07, P22, P25, P26, P27, P28, P52, P77, P612, and H351 (International Classification of Diseases—10th Revision). YLL was calculated using mortality data from the 2012 National Health Insurance Data. YLD is a function of the prevalence, disability weight (DW), and duration of each complication. DW was determined by the Korean Disability Weight Study for National Burden of Disease in Korea 2013/2015. The burden of premature birth in Korea is 79,574 DALY (YLL: 43,725; YLD: 35,849). The burden for men (DALY: 43,603; YLL: 24,004; YLD: 19,599) is higher than that of women (DALY: 35,970; YLL: 19,720; YLD: 16,250). This study could provide essential data for evaluating the effects of policies intended to reduce preterm birth. Full article

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14 pages, 317 KiB

Open AccessArticle

Impact of Adolescents’ Screen Time and Nocturnal Mobile Phone-Related Awakenings on Sleep and General Health Symptoms: A Prospective Cohort Study

by Milena Foerster, Andrea Henneke, Shala Chetty-Mhlanga and Martin Röösli

Int. J. Environ. Res. Public Health 2019, 16(3), 518; https://doi.org/10.3390/ijerph16030518 - 12 Feb 2019

Cited by 72 | Viewed by 17661

Abstract

Nocturnal media use has been linked to adolescents’ sleeping problems in cross-sectional studies which do not address reverse causality. To prospectively assess the new occurrence of sleep problems or health symptoms in relation to electronic media use and nocturnal mobile phone use, we [...] Read more.

Nocturnal media use has been linked to adolescents’ sleeping problems in cross-sectional studies which do not address reverse causality. To prospectively assess the new occurrence of sleep problems or health symptoms in relation to electronic media use and nocturnal mobile phone use, we used data from the longitudinal Swiss HERMES (Health Effects Related to Mobile phone usE in adolescentS) cohort on 843 children from 7th to 9th grade. Logistic regression models were fitted and adjusted for relevant confounders. Adolescents reporting at baseline and follow-up at least one nocturnal awakenings from their own mobile phone per month were more likely to have developed restless sleep (Odds Ratio (OR): 5.66, 95% Confidence Interval: 2.24–14.26) and problems falling asleep (3.51, 1.05–11.74) within one year compared to adolescents without nocturnal awakenings. A similar pattern was observed for developing symptoms, although somewhat less pronounced in terms of the magnitude of the odds ratios. With respect to high screen time at baseline and follow-up, associations were observed for falling asleep (2.41, 1.41–4.13), exhaustibility (1.76, 1.02–3.03), lack of energy (1.76, 1.04–2.96) and lack of concentration (2.90, 1.55–5.42). Our results suggest a detrimental effect of screen time and mobile phone-related awakenings on sleep problems and related health symptoms. However, the results should be interpreted cautiously with respect to adolescents’ natural changes in circadian rhythm, which may coincidence with an increase in mobile phone and media use. Full article

9 pages, 755 KiB

Open AccessArticle

Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial

by Jing Liu, Albert Yeung, Tao Xiao, Xiaopei Tian, Zhaowei Kong, Liye Zou and Xueqiang Wang

Int. J. Environ. Res. Public Health 2019, 16(3), 517; https://doi.org/10.3390/ijerph16030517 - 12 Feb 2019

Cited by 53 | Viewed by 8283

Abstract

Tai Chi (TC) can be considered safe and effective intervention to improve pain and pain-related functional disability. However, it is unclear that whether aging individuals with Chronic Non-Specific Low Back Pain (CNS-LBP) can achieve positive results. This study, therefore, attempted to explore the [...] Read more.

Tai Chi (TC) can be considered safe and effective intervention to improve pain and pain-related functional disability. However, it is unclear that whether aging individuals with Chronic Non-Specific Low Back Pain (CNS-LBP) can achieve positive results. This study, therefore, attempted to explore the effects of TC on pain and functional disability in CNS-LBP patients aged 50 years old or above. Forty-three individuals (aged 50 years old or above) with CNS-LBP were randomly assigned into three groups: Chen-Style TC group (n = 15), Core Stabilization training (CST) group (n = 15), and control group (n = 13). Participants in the TC group participated in Chen-style TC training program (three 60-min sessions per week for 12 weeks), individuals in CST group received 12-week Core Stabilization exercise on the Swiss ball, whereas individuals in the control group maintained their unaltered lifestyle. Pain intensity as primary outcome was measured using the Visual Analogue Scale (VAS), A BiodexSystem 3 isokinetic dynamometer was used to measure knee and ankle joint position sense (JPS) as secondary outcomes at baseline and after the 12-week intervention. TC and CST have significant effects in VAS for CNS-LBP patients (p< 0.01, TC group OR CST group versus control group in mean of the post-minus-pre assessment). However, the feature of joint position sense (JPS) of ankle inversion, ankle eversion and knee flexion did not occur, it showed no significant effects with TC and CST. TC was found to reduce pain, but not improve lower limb proprioception in patients with CNS-LBP. Future research with larger sample sizes will be needed to achieve more definitive findings on the effects of TC on both pain and lower limb proprioception in this population. Full article

(This article belongs to the Special Issue Mindfulness-Based Practice for Health Benefits)

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11 pages, 302 KiB

Open AccessFeature PaperArticle

“In Initiative Overload”: Australian Perspectives on Promoting Physical Activity in the Workplace from Diverse Industries

by Josephine Y. Chau, Lina Engelen, Tracy Kolbe-Alexander, Sarah Young, Heidi Olsen, Nicholas Gilson, Nicola W. Burton, Adrian E. Bauman and Wendy J. Brown

Int. J. Environ. Res. Public Health 2019, 16(3), 516; https://doi.org/10.3390/ijerph16030516 - 12 Feb 2019

Cited by 16 | Viewed by 6374

Abstract

Introduction: With two thirds of adults in paid employment and one third physically inactive, workplaces are an important setting for promoting more physical activity. We explored the attitudes and practices of employees and managers from different industries towards sitting and moving at [...] Read more.

Introduction: With two thirds of adults in paid employment and one third physically inactive, workplaces are an important setting for promoting more physical activity. We explored the attitudes and practices of employees and managers from different industries towards sitting and moving at work, to inform the development of acceptable solutions for encouraging businesses to adopt activity-promoting workplaces. Method: We conducted focus groups with employees and structured interviews with upper/middle managers from 12 organisations in a range of industries (e.g., education, healthcare, manufacturing, construction, insurance, mining). Topics focused on past and current workplace health and wellness initiatives, workplace culture and environment related to physical activity, responsibility for employee physical activity patterns at work, and enablers of/barriers to activity promoting workplaces. Results: Physical activity was not an explicit priority in existing occupational health and wellness initiatives. Instead, there was a strong focus on education about preventing and managing injuries, such as manual handling among non-office workers and desk-based ergonomics for office workers. Physical activity was viewed as a strategy for maintaining work ability and preventing injury, particularly in blue-collar staff, rather than for chronic disease prevention. Managers noted structural/organisational barriers/enablers to promoting physical activity at work (e.g., regulations, costs, competing concerns), while employees tended to focus on individual constraints such as time and geographic location. The issues of "initiative overload" and making physical activity a part of “business as usual” emerged as strong themes from employees and managers. Conclusions: While there is stakeholder enthusiasm for creating activity-promoting workplaces, multi-level support is needed to make physical activity an integral part of day-to-day business. The synergism between occupational health and safety priorities could be leveraged to facilitate the creation of activity-promoting workplaces. Full article

(This article belongs to the Special Issue Occupational Sedentary Behaviour)

15 pages, 5320 KiB

Open AccessFeature PaperArticle

The Use of Geonarratives to Add Context to Fine Scale Geospatial Research

by Jayakrishnan Ajayakumar, Andrew Curtis, Steve Smith and Jacqueline Curtis

Int. J. Environ. Res. Public Health 2019, 16(3), 515; https://doi.org/10.3390/ijerph16030515 - 12 Feb 2019

Cited by 17 | Viewed by 4490

Abstract

There has been a move towards using mixed method approaches in geospatial research to gain context in understanding health related social patterns and processes. The central premise is that official data is often too reductionist and misses’ nuances that can help explain causality. [...] Read more.

There has been a move towards using mixed method approaches in geospatial research to gain context in understanding health related social patterns and processes. The central premise is that official data is often too reductionist and misses’ nuances that can help explain causality. One example is the geonarrative, a spatially relevant commentary or interview that can be mapped by content and/or location. While there have been several examples of geonarratives being used by researchers, there is no commonly available software that can easily transfer the associated text into spatial data. Having a standardized software platform is vital if these methods are to be used across different disciplines. This paper presents an overview of a solution, Wordmapper (WM), which is a standalone software developed to process geonarratives from a transcription and associated global positioning system (GPS) path. Apart from querying textual narrative data, Wordmapper facilitates qualitative coding which could be used to extract latent contextual information from the narratives. In order to improve interoperability, Wordmapper provides spatialized narrative data in formats, such as ESRI shape files, Keyhole Markup Language (KML), and Comma Separated Values (CSV). A case study based on five different spatial video geonarratives (SVG) collected to assess the human impacts following the 2011 Joplin, Missouri are used for illustration. Full article

(This article belongs to the Special Issue The Next Frontier in Health Geography: Context and Implications for Interventions)

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15 pages, 335 KiB

Open AccessArticle

Development and Validation of the Vending Evaluation for Nutrient-Density (VEND)ing Audit

by Tanya M. Horacek, Elif Dede Yildirim, Melissa Matthews Schreiber, Carol Byrd-Bredbenner, Sarah Colby, Adrienne A. White, Karla P. Shelnutt, Melissa D. Olfert, Anne E. Mathews, Kristin Riggsbee, Lisa Franzen-Castle, Jesse Stabile Morrell and Kendra Kattelmann

Int. J. Environ. Res. Public Health 2019, 16(3), 514; https://doi.org/10.3390/ijerph16030514 - 12 Feb 2019

Cited by 10 | Viewed by 5516

Abstract

Background: This paper describes the development and validation of the Vending Evaluation for Nutrient-Density (VEND)ing audit to comprehensively evaluate vended products based upon healthfulness, price and promotion, and machine accessibility. Methods: A novel vending nutrient-density score was created to determine the healthfulness of [...] Read more.

Background: This paper describes the development and validation of the Vending Evaluation for Nutrient-Density (VEND)ing audit to comprehensively evaluate vended products based upon healthfulness, price and promotion, and machine accessibility. Methods: A novel vending nutrient-density score was created to determine the healthfulness of vended snack/beverage products. Field tested in United States colleges, VENDing audit (∑nutrient-density + 10 × % healthy products) and Support sub-scores (price + promotion + accessibility) were calculated for snack/beverage machines. Higher scores indicate more healthful vending options and supports for choosing healthfully. Nutrition Environment Measures Survey-Vending (NEMS-V) was used to validate the nutrient-density score for a sub-sample of machines. Sensitivity and specificity were computed by comparing the number of healthy snacks/beverages determined by NEMS-V and the VENDing nutrient-density scores. Results: Researchers conducted the VENDing audit on 228 snack/beverage vending machines at 9 universities within the United States and used both VENDing and NEMS-V on 33 snack and 52 beverage vending machines. Mean VENDing audit scores were 4.5 ± 2.0 (2.6, 3.4) and 2.6 ± 2.0 (0, 12) for snack/beverage machines, respectively. The number of products considered healthy assessed with both the VENDing nutrient-density scores and the NEMS-V were positively correlated for beverages (r = 0.687, p < 0.001) and snacks (r = 0.366, p < 0.05). The sensitivity was excellent for beverages (0.83) and moderate for snacks (0.69); while the specificity was moderate for both beverages (0.66) and snacks (0.50). Conclusions: The VENDing audit uses unique, valid, and reliable nutrient-density scoring to evaluate snacks/beverages along a continuum of healthful criteria and comprehensively evaluates the full vending environment. Full article

(This article belongs to the Special Issue Built Environments, Food Environments, and Public Health)

53 pages, 8395 KiB

Open AccessArticle

Advanced Hepatitis C Virus Replication PDE Models within a Realistic Intracellular Geometric Environment

by Markus M. Knodel, Paul Targett-Adams, Alfio Grillo, Eva Herrmann and Gabriel Wittum

Int. J. Environ. Res. Public Health 2019, 16(3), 513; https://doi.org/10.3390/ijerph16030513 - 12 Feb 2019

Cited by 6 | Viewed by 4213

Abstract

The hepatitis C virus (HCV) RNA replication cycle is a dynamic intracellular process occurring in three-dimensional space (3D), which is difficult both to capture experimentally and to visualize conceptually. HCV-generated replication factories are housed within virus-induced intracellular structures termed membranous webs (MW), which [...] Read more.

The hepatitis C virus (HCV) RNA replication cycle is a dynamic intracellular process occurring in three-dimensional space (3D), which is difficult both to capture experimentally and to visualize conceptually. HCV-generated replication factories are housed within virus-induced intracellular structures termed membranous webs (MW), which are derived from the Endoplasmatic Reticulum (ER). Recently, we published 3D spatiotemporal resolved diffusion–reaction models of the HCV RNA replication cycle by means of surface partial differential equation (sPDE) descriptions. We distinguished between the basic components of the HCV RNA replication cycle, namely HCV RNA, non-structural viral proteins (NSPs), and a host factor. In particular, we evaluated the sPDE models upon realistic reconstructed intracellular compartments (ER/MW). In this paper, we propose a significant extension of the model based upon two additional parameters: different aggregate states of HCV RNA and NSPs, and population dynamics inspired diffusion and reaction coefficients instead of multilinear ones. The combination of both aspects enables realistic modeling of viral replication at all scales. Specifically, we describe a replication complex state consisting of HCV RNA together with a defined amount of NSPs. As a result of the combination of spatial resolution and different aggregate states, the new model mimics a cis requirement for HCV RNA replication. We used heuristic parameters for our simulations, which were run only on a subsection of the ER. Nevertheless, this was sufficient to allow the fitting of core aspects of virus reproduction, at least qualitatively. Our findings should help stimulate new model approaches and experimental directions for virology. Full article

(This article belongs to the Special Issue Spatio-Temporal Analysis of Infectious Diseases)

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15 pages, 1161 KiB

Open AccessArticle

Conventional Rehabilitation Therapy Versus Telerehabilitation in Cardiac Patients: A Comparison of Motivation, Psychological Distress, and Quality of Life

by Helle Spindler, Kasper Leerskov, Katrine Joensson, Gitte Nielsen, Jan Jesper Andreasen and Birthe Dinesen

Int. J. Environ. Res. Public Health 2019, 16(3), 512; https://doi.org/10.3390/ijerph16030512 - 12 Feb 2019

Cited by 39 | Viewed by 6850

Abstract

Telerehabilitation (TR) has gained attention as a promising rehabilitation format. Our study examined how patients responded to TR and whether it provided adequate support for their lifestyle changes and self-care efforts when compared to conventional rehabilitation (CR). Cardiac patients (n = 136) [...] Read more.

Telerehabilitation (TR) has gained attention as a promising rehabilitation format. Our study examined how patients responded to TR and whether it provided adequate support for their lifestyle changes and self-care efforts when compared to conventional rehabilitation (CR). Cardiac patients (n = 136) were randomly assigned to a TR or CR group. The TR group was provided with relevant health care technology for a period of three months, and both groups filled in questionnaires on their motivation for lifestyle changes and self-care psychological distress, and quality of life at 0, 3, 6, and 12 months. Patients in both groups were found to be equally motivated for lifestyle changes and self-care (p < 0.05) and they experienced similar levels of psychological distress and quality of life. TR is comparable to conventional rehabilitation in motivating patients, preventing psychological distress and improving quality of life. Although we observed an initial increase in autonomous motivation in the telerehabilitation group, this positive difference in motivation does not last over time. As such, neither rehabilitation format seems able to ensure long-term motivation. Therefore, TR may serve as a viable replacement for conventional rehabilitation when considered relevant. Further research is needed to enhance long-term motivation, and maybe telerehabilitation can help to achieve this. Full article

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

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18 pages, 6915 KiB

Open AccessArticle

Quantitative Evaluation of the Eco-Environment in a Coalfield Based on Multi-Temporal Remote Sensing Imagery: A Case Study of Yuxian, China

by Xue Wang, Kun Tan, Kailei Xu, Yu Chen and Jianwei Ding

Int. J. Environ. Res. Public Health 2019, 16(3), 511; https://doi.org/10.3390/ijerph16030511 - 12 Feb 2019

Cited by 10 | Viewed by 3621

Abstract

With the exploitation of coalfields, the eco-environment around the coalfields can become badly damaged. To address this issue, “mine greening” has been proposed by the Ministry of Land and Resources of China. The sustainable development of mine environments has now become one of [...] Read more.

With the exploitation of coalfields, the eco-environment around the coalfields can become badly damaged. To address this issue, “mine greening” has been proposed by the Ministry of Land and Resources of China. The sustainable development of mine environments has now become one of the most prominent issues in China. In this study, we aimed to make use of Landsat 7 ETM+ and Landsat 8 OLI images obtained between 2005 and 2016 to analyze the eco-environment in a coalfield. Land cover was implemented as the basic evaluation factor to establish the evaluation model for the eco-environment. Analysis and investigation of the eco-environment in the Yuxian coalfield was conducted using a novel evaluation model, based on the biological abundance index, vegetation coverage index, water density index, and natural geographical factors. The weight of each indicator was determined by an analytic hierarchy process. Meanwhile, we also used the classic ecological footprint to calculate the ecological carrying capacity in order to verify the effectiveness of the evaluation model. Results showed that the eco-environment index illustrated a slowly increasing tendency over the study period, and the ecological quality could be considered as “good”. The results of the evaluation model showed a strong correlation with the ecological carrying capacity with a correlation coefficient of 0.9734. In conclusion, the evaluation method is a supplement to the time-series quantitative evaluation of the eco-environment, and also helps us to explore the eco-environment in the mining area. Full article

(This article belongs to the Special Issue Anthropocene Challenges: Exploitation of Resources vs. Preservation of Natural Systems)

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11 pages, 1804 KiB

Open AccessArticle

Study on Analysis and Sedimentation of Alumina Nanoparticles

by Xuehong Zheng, Yuehan Li, Ding Chen, Airong Zheng and Qikang Que

Int. J. Environ. Res. Public Health 2019, 16(3), 510; https://doi.org/10.3390/ijerph16030510 - 12 Feb 2019

Cited by 9 | Viewed by 3354

Abstract

Dispersion and aggregation behavior of nanoparticles in aquatic environment may be affected by pH, salinity, and dissolved organic matter, which would change its ecological risk. Effects of time, power and temperature on the alumina nanoparticles (nano-Al₂O₃) ultrasonic dispersion in [...] Read more.

Dispersion and aggregation behavior of nanoparticles in aquatic environment may be affected by pH, salinity, and dissolved organic matter, which would change its ecological risk. Effects of time, power and temperature on the alumina nanoparticles (nano-Al₂O₃) ultrasonic dispersion in water were discussed. Al₂O₃ had a best ultrasonic dispersion for 30 min at 105 W and 30 °C. The concentration of Al₂O₃ could be measured by ultraviolet (UV) spectrophotometer, and the method was efficient and accurate. Furthermore, the sedimentation rate of Al₂O₃ was related to pH, salinity, and its concentration in the artificial seawater. When pH was 7.31, approaching the isoelectric point of Al₂O₃, they aggregated and settled fastest. Settlement coefficient (k) of Al₂O₃ increased by 3 and 2.7 times while the salinity and its concentration increased. The sedimentation rate was higher in natural seawater than that in artificial seawater. All results indicated that nano-Al₂O₃ would be removed in aquatic environment. Full article

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12 pages, 310 KiB

Open AccessArticle

Associations of Serum 25-Hydroxyvitamin D with Physical Performance and Bone Health in Overweight and Obese Older Adults

by Melissa Dang, Cat Shore-Lorenti, Lachlan B. McMillan, Jakub Mesinovic, Alan Hayes, Peter R. Ebeling and David Scott

Int. J. Environ. Res. Public Health 2019, 16(3), 509; https://doi.org/10.3390/ijerph16030509 - 12 Feb 2019

Cited by 14 | Viewed by 3882

Abstract

Low vitamin D status commonly accompanies obesity, and both vitamin D deficiency and obesity have been associated with falls and fracture risk in older adults. We aimed to determine the associations of serum 25-hydroxyvitamin D (25(OH)D) concentrations with physical performance and bone health [...] Read more.

Low vitamin D status commonly accompanies obesity, and both vitamin D deficiency and obesity have been associated with falls and fracture risk in older adults. We aimed to determine the associations of serum 25-hydroxyvitamin D (25(OH)D) concentrations with physical performance and bone health in community-dwelling, overweight and obese older men and women. Serum 25(OH)D concentrations were measured in 84 participants with body mass index ≥25 kg/m² (mean ± SD age 62.4 ± 7.9 years; 55% women). Physical function was determined by short physical performance battery, hand grip and quadriceps strength, and stair climb power tests. Body composition and bone structure were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. Mean ± SD 25(OH)D was 49.6 ± 17.7 nmol/L, and 50% of participants had low 25(OH)D (<50 nmol/L) levels. 25(OH)D concentrations were positively associated with quadricep strength and stair climb power in women (B = 0.15; 95% CI 0.02–0.27 kg and B = 1.07; 95% CI 0.12–2.03 W, respectively) but not in men. There were no associations between 25(OH)D and bone parameters in either sex after multivariable adjustment (all p > 0.05). Lower 25(OH)D concentrations are associated with poorer quadricep strength and muscle power in overweight and obese older women but not men. Full article

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

24 pages, 763 KiB

Open AccessArticle

Promoting Healthcare Sustainability in Developing Countries: Analysis of Knowledge Management Drivers in Public and Private Hospitals of Pakistan

by Jawad Karamat, Tong Shurong, Naveed Ahmad, Sana Afridi, Shahbaz Khan and Kashif Mahmood

Int. J. Environ. Res. Public Health 2019, 16(3), 508; https://doi.org/10.3390/ijerph16030508 - 12 Feb 2019

Cited by 43 | Viewed by 6584

Abstract

Investing in a sustainable future has no alternative; the healthcare sector in developing countries has failed to achieve sustainability objectives. Knowledge management (KM) is a concrete application of sustainability in healthcare, as organizations (hospitals) that manage their knowledge assets will gain sustainable competitive [...] Read more.

Investing in a sustainable future has no alternative; the healthcare sector in developing countries has failed to achieve sustainability objectives. Knowledge management (KM) is a concrete application of sustainability in healthcare, as organizations (hospitals) that manage their knowledge assets will gain sustainable competitive advantage. Several organizations in developed countries are moving towards the adoption of knowledge management so that they can manage their knowledge well and improve their performance. Due to the effective implementation of KM in developed countries, developing countries are also considering adopting KM in their healthcare. In this study, an attempt has been made to identify the drivers of KM adoption in public and private hospitals of Pakistan. With the help of an extensive literature review and expert opinion, the drivers were identified and a hierarchical structure was developed. Nineteen drivers were identified and screened out by experts. The experts identified the contextual relationships between the drivers during a brainstorming session. The hierarchical model of the drivers for KM in the healthcare of Pakistan was eventually developed using interpretive structural modeling (ISM). The structure has 10 levels, in which “developed competitive advantage” formed the foundation of the structure and “job creation” and “improvement in the reputation of healthcare” formed the topmost level. The “Matrices d’Impacts Croises Multiplication Appliqué a un Classement” (MICMAC) analysis classified the drivers by categorizing them according to their driving and dependence powers. One driver is identified as autonomous, six drivers as dependent, seven drivers as linkage, and five drivers as independent. The analysis of KM drivers will provide a good understanding of the interdependence and interactions between them and support the effect adoption of KM in developing countries especially in Pakistan. Full article

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13 pages, 1430 KiB

Open AccessArticle

Parental Psychological Control and Emotional and Behavioral Disorders among Spanish Adolescents

by Benito León-del-Barco, Santiago Mendo-Lázaro, María I. Polo-del-Río and Víctor M. López-Ramos

Int. J. Environ. Res. Public Health 2019, 16(3), 507; https://doi.org/10.3390/ijerph16030507 - 12 Feb 2019

Cited by 39 | Viewed by 7291

Abstract

There is no denying the fundamental role played by parents in the psychosocial development of their children—either as a liability or as protection against mental health disorders. This study seeks to ascertain, by means of odds ratio statistics (OR), the correlation between parental [...] Read more.

There is no denying the fundamental role played by parents in the psychosocial development of their children—either as a liability or as protection against mental health disorders. This study seeks to ascertain, by means of odds ratio statistics (OR), the correlation between parental psychological control and emotional and behavioral disorders. A total of 762 students took part in this study, with an average age of 12.23 years—53.8% of whom were girls and 46.2% were boys. Children and adolescents reported their parental psychological control and their emotional and behavioral disorders (i.e., emotional and behavioral problems, internalizing and externalizing problems). Minors who perceive their psychological control as high are 6 times more likely to suffer from internalizing disorders and 4.8 times more likely to develop externalizing disorders. Furthermore, the probability of suffering externalizing disorders is higher among males who perceive a high degree of psychological control. This study breaks new ground on the importance of perceived psychological control—considered as a negative form of control by parents—in the emotional and behavioral disorders among children and adolescents. 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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16 pages, 714 KiB

Open AccessArticle

Enteric Pathogen Diversity in Infant Foods in Low-Income Neighborhoods of Kisumu, Kenya

by Kevin Tsai, Sheillah Simiyu, Jane Mumma, Rose Evalyne Aseyo, Oliver Cumming, Robert Dreibelbis and Kelly K. Baker

Int. J. Environ. Res. Public Health 2019, 16(3), 506; https://doi.org/10.3390/ijerph16030506 - 12 Feb 2019

Cited by 25 | Viewed by 4495

Abstract

Pediatric diarrheal disease remains the second most common cause of preventable illness and death among children under the age of five, especially in low and middle-income countries (LMICs). However, there is limited information regarding the role of food in pathogen transmission in LMICs. [...] Read more.

Pediatric diarrheal disease remains the second most common cause of preventable illness and death among children under the age of five, especially in low and middle-income countries (LMICs). However, there is limited information regarding the role of food in pathogen transmission in LMICs. For this study, we examined the frequency of enteric pathogen occurrence and co-occurrence in 127 infant weaning foods in Kisumu, Kenya, using a multi-pathogen PCR diagnostic tool, and assessed household food hygiene risk factors for contamination. Bacterial, viral, and protozoan enteric pathogen DNA and RNA were detected in 62% of the infant weaning food samples collected, with 37% of foods containing more than one pathogen type. Multivariable generalized linear mixed model analysis indicated type of infant food best explained the presence and diversity of enteric pathogens in infant food, while most household food hygiene risk factors considered in this study were not significantly associated with pathogen contamination. Specifically, cow’s milk was significantly more likely to contain a pathogen (adjusted risk ratio = 14.4; 95% confidence interval (CI) 1.78–116.1) and more likely to have higher number of enteric pathogen species (adjusted risk ratio = 2.35; 95% CI 1.67–3.29) than porridge. Our study demonstrates that infants in this low-income urban setting are frequently exposed to diarrhoeagenic pathogens in food and suggests that interventions are needed to prevent foodborne transmission of pathogens to infants. Full article

(This article belongs to the Special Issue New Directions in Water, Sanitation and Hygiene Research)

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17 pages, 2469 KiB

Open AccessArticle

Removal of Paracetamol Using Effective Advanced Oxidation Processes

by Francesca Audino, Jorge Mario Toro Santamaria, Luis J. del Valle Mendoza, Moisès Graells and Montserrat Pérez-Moya

Int. J. Environ. Res. Public Health 2019, 16(3), 505; https://doi.org/10.3390/ijerph16030505 - 11 Feb 2019

Cited by 27 | Viewed by 4454

Abstract

Fenton, photo-Fenton, and photo-induced oxidation, were investigated and compared for the treatment of 0.26 mmol L⁻¹ of paracetamol (PCT) in a deionised water matrix, during a reaction span of 120.0 min. Low and high Fenton reagent loads were studied. Particularly, the initial [...] Read more.

Fenton, photo-Fenton, and photo-induced oxidation, were investigated and compared for the treatment of 0.26 mmol L⁻¹ of paracetamol (PCT) in a deionised water matrix, during a reaction span of 120.0 min. Low and high Fenton reagent loads were studied. Particularly, the initial concentration of Fe²⁺ was varied between 0.09 and 0.18 mmol L⁻¹ while the initial concentration of H₂O₂ was varied between 2.78 and 11.12 mmol L⁻¹. The quantitative performance of these treatments was evaluated by: (i) measuring PCT concentration; (ii) measuring and modelling TOC conversion, as a means characterizing sample mineralization; and (iii) measuring cytotoxicity to assess the safe application of each treatment. In all cases, organic matter mineralization was always partial, but PCT concentration fell below the detection limit within 2.5 and 20.0 min. The adopted semi-empirical model revealed that photo induced oxidation is the only treatment attaining total organic matter mineralization (

ξ^{MAX} =

100% in 200.0 min) at the expense of the lowest kinetic constant (k = 0.007 min⁻¹). Conversely, photo-Fenton treatment using high Fenton reagent loads gave a compromise solution (

ξ^{MAX} =

73% and k = 0.032 min⁻¹). Finally, cytotoxicity assays proved the safe application of photo-induced oxidation and of photo-Fenton treatments using high concentrations of Fenton reagents. Full article

(This article belongs to the Special Issue Advanced Oxidation Processes (AOPs) for Water Treatment)

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21 pages, 1587 KiB

Open AccessArticle

Repeated Measures Regression in Laboratory, Clinical and Environmental Research: Common Misconceptions in the Matter of Different Within- and Between-Subject Slopes

by Donald R. Hoover, Qiuhu Shi, Igor Burstyn and Kathryn Anastos

Int. J. Environ. Res. Public Health 2019, 16(3), 504; https://doi.org/10.3390/ijerph16030504 - 11 Feb 2019

Cited by 9 | Viewed by 3502

Abstract

When using repeated measures linear regression models to make causal inference in laboratory, clinical and environmental research, it is typically assumed that the within-subject association of differences (or changes) in predictor variable values across replicates is the same as the between-subject association of [...] Read more.

When using repeated measures linear regression models to make causal inference in laboratory, clinical and environmental research, it is typically assumed that the within-subject association of differences (or changes) in predictor variable values across replicates is the same as the between-subject association of differences in those predictor variable values. However, this is often false. For example, with body weight as the predictor variable and blood cholesterol (which increases with higher body fat) as the outcome: (i) a 10-lb. weight increase in the same adult affects more greatly an increase in cholesterol in that adult than does (ii) one adult weighing 10 lbs. more than a second indicate higher cholesterol in the heavier adult. A 10-lb. weight gain in the first adult more likely reflects a build-up of body fat in that person, while a second person being 10 lbs. heavier than the first could be influenced by other factors, such as the second person being taller. Hence, to make causal inferences, different within- and between-subject slopes should be separately modeled. A related misconception commonly made using generalized estimation equations (GEE) and mixed models on repeated measures (i.e., for fitting cross-sectional regression) is that the working correlation structure only influences variance of the parameter estimates. However, only independence working correlation guarantees that the modeled parameters have interpretability. We illustrate this with an example where changing the working correlation from independence to equicorrelation qualitatively biases parameters of GEE models and show that this happens because within- and between-subject slopes for the outcomes regressed on the predictor variables differ. We then systematically describe several common mechanisms that cause within- and between-subject slopes to differ: change effects, lag/reverse-lag and spillover causality, shared within-subject measurement bias or confounding, and predictor variable measurement error. The misconceptions we describe should be better publicized. Repeated measures analyses should compare within- and between-subject slopes of predictors and when they do differ, investigate the causal reasons for this. Full article

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11 pages, 329 KiB

Open AccessArticle

Dose-Dependent Toxic Effect of Cotinine-Verified Tobacco Smoking on Systemic Inflammation in Apparently Healthy Men and Women: A Nationwide Population-Based Study

by Won-Jun Choi, Ji-Won Lee, A Ra Cho and Yong-Jae Lee

Int. J. Environ. Res. Public Health 2019, 16(3), 503; https://doi.org/10.3390/ijerph16030503 - 11 Feb 2019

Cited by 15 | Viewed by 3211

Abstract

Chronic exposure to tobacco smoke leads to chronic low-grade systemic inflammation; however, little is known about the dose-dependent toxic effect of objective tobacco smoking on systemic inflammation. We examined the dose-dependent toxic effect of cotinine-verified tobacco smoking on leukocyte count in a representative [...] Read more.

Chronic exposure to tobacco smoke leads to chronic low-grade systemic inflammation; however, little is known about the dose-dependent toxic effect of objective tobacco smoking on systemic inflammation. We examined the dose-dependent toxic effect of cotinine-verified tobacco smoking on leukocyte count in a representative sample of Korean adults, including 8655 men and 10,432 women aged 19–65 years from the Korean National Health and Nutrition Examination Survey. The participants were categorized into five groups by the level of urine cotinine (Ucot) as follows: A non-smoker group (<50.00 ng/mL) and four quartile groups for smokers for both men and women. The odds ratios (ORs) and 95% confidence intervals (CIs) for sex-specific high leukocyte count (≥75th percentile) were calculated across five groups of Ucot concentrations using multiple logistic regression analyses. The mean values of leukocyte count gradually increased according to the grade of Ucot concentration in both sexes. The ORs (95% CIs) for high leukocyte count in the 4th Ucot quartile concentrations versus the non-smokers were 4.09 (3.39–4.94) for men and 3.91 (2.82–5.41) for women after adjusting for confounding variables. The present study confirmed the dose-response toxic effect of tobacco smoking on chronic low-grade systemic inflammation. Full article

(This article belongs to the Section Global Health)

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13 pages, 344 KiB

Open AccessArticle

Social Norms Influencing the Local Food Environment as Perceived by Residents and Food Traders: The Heart Healthy Hoods Project

by María Sandín Vázquez, Jesús Rivera, Paloma Conde, Marta Gutiérrez, Julia Díez, Joel Gittelsohn and Manuel Franco

Int. J. Environ. Res. Public Health 2019, 16(3), 502; https://doi.org/10.3390/ijerph16030502 - 11 Feb 2019

Cited by 10 | Viewed by 4371

Abstract

Exploring subjective elements of the food environment remains key to understand why and how residents purchase food. Our aim was to explore and describe the social norms relating to the local food environment and food purchasing behaviors, as perceived by residents and food [...] Read more.

Exploring subjective elements of the food environment remains key to understand why and how residents purchase food. Our aim was to explore and describe the social norms relating to the local food environment and food purchasing behaviors, as perceived by residents and food traders in Madrid, Spain. This qualitative study took place in a middle socioeconomic status neighborhood of Madrid between January 2015 and May 2016. We conducted 35 semi-structured interviews. We used stratified purposive sampling to recruit residents, neighborhood workers (N = 20) and food traders (N = 15) representing different levels of involvement with food purchasing behaviors. We analyzed these data using an interpretative phenomenological analysis approach. Participants highlighted social aspects of the food environment in relation to food purchasing behaviors. First, interpersonal and relational food environment elements were emphasized, including trust and tradition. Participants also identified generational demographic trends in relation to changes in the way residents purchased food: the new pace of life and the lack of time to buy fresh food and to cook at home. All these elements were influenced by the economic crisis. Food environment interventions aiming to improve food purchasing behaviors and residents’ diets should consider intermediate social aspects of the food environment like trust and tradition and the fast pace of life of younger generations. Full article

(This article belongs to the Special Issue Environmental Influences on Food Behaviour)

18 pages, 333 KiB

Open AccessArticle

Prevalence of Dietary Behavior and Determinants of Quality of Diet among Beneficiaries of Government Welfare Assistance in Poland

by Sylwia Kałucka, Dorota Kaleta and Teresa Makowiec-Dabrowska

Int. J. Environ. Res. Public Health 2019, 16(3), 501; https://doi.org/10.3390/ijerph16030501 - 11 Feb 2019

Cited by 13 | Viewed by 3387

Abstract

Diet, as a modifiable factor for good health maintenance, reduces the risk of numerous non-communicable chronic diseases and prevents premature death. The aim of the study was to examine the prevalence of a dietary behavior and to find out what the determinants of [...] Read more.

Diet, as a modifiable factor for good health maintenance, reduces the risk of numerous non-communicable chronic diseases and prevents premature death. The aim of the study was to examine the prevalence of a dietary behavior and to find out what the determinants of diet quality among the low socio-economic status population are. The studied sample consisted of 1710 respondents. Only 3% of the beneficiaries had healthy dietary habits. Unhealthy dietary habits dominated in all the study group regardless of the subjects’ level of education (p < 0.001). Higher odds of unhealthy dietary habits were reported among the respondents with primary, vocational, and secondary education than among the respondents with high education (for the primary education OR = 11.10; 95% CI: 5.86–21.01; p ≤ 0.001; for vocational education OR = 10.54; 95% CI: 5.79–19.18; p ≤ 0.001 and for secondary education OR = 5.83; 95% CI: 3.48–9.79; p ≤ 0.001). The unhealthy dietary behavior prevalence among beneficiaries of government welfare assistance in Poland is much higher than in the general population. Since only educational level is a determinant which is significantly correlated with the unhealthy dietary behavior, promotion of a healthy diet among disadvantaged individuals should be focused on this factor. Full article

(This article belongs to the Special Issue Nutrition, Diets and Public Health)

17 pages, 3683 KiB

Open AccessArticle

Forecast and Analysis on Reducing China’s CO₂ Emissions from Lime Industrial Process

by Qing Tong, Sheng Zhou, Yuefeng Guo, Yang Zhang and Xinyang Wei

Int. J. Environ. Res. Public Health 2019, 16(3), 500; https://doi.org/10.3390/ijerph16030500 - 11 Feb 2019

Cited by 8 | Viewed by 4218

Abstract

China greenhouse gas inventories show that CO₂ emissions from the lime industrial process are large scales and closely related to the development of its downstream industries. Therefore, there is high importance to analyze and forecast on reducing China’s CO2 emissions from lime [...] Read more.

China greenhouse gas inventories show that CO₂ emissions from the lime industrial process are large scales and closely related to the development of its downstream industries. Therefore, there is high importance to analyze and forecast on reducing China’s CO2 emissions from lime industrial process. The aims of this paper are to make up the research gaps in China and provide a quantitative reference for related authorities to formulate relevant policies. The prediction method in this paper is consistent with the published national inventory, which is an activity data based method to predict carbon dioxide emissions from the industrial process of four categories of lime products. Three future scenarios are assumed. The business as usual scenario (BAU) is a frozen scenario. There are two emission reduction scenarios (ERS and SRS) assumed under different emission reduction strength considering combined industrial process CO₂ emission reduction approaches from both the production side and the consumption side. The results show that between 2020 and 2050, China’s lime industrial process has an increasingly significant CO₂ emission reduction potential, enabling both emission intensity reductions and total emission reductions to be achieved simultaneously. Based on the simulation results from emission reduction scenarios, compared with 2012 level, in 2050, the emission intensity can be reduced by 13–27%, the total lime production can be reduced by 49–78%, and the CO₂ emissions in the lime industrial process can be reduced by 57–85%. Full article

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

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11 pages, 272 KiB

Open AccessArticle

Exploring Drug-Related Problems in Diabetic Patients during Ramadan Fasting in Saudi Arabia: A Mixed-Methods Study

by Waleed Saleh Alluqmani, Mohammed Misri Alotaibi, Waleed Jamal Almalki, Abdulrahman Althaqafi, Hamed Abdullah Alawi, Fahad Althobiani, Amjad Abdullah Albishi, Amjad Ahmad Madkhali, Layal Yahia Baunes, Razan Ibrahim Alhazmi, Elaf Mohammed Doman, Anwar Hussain Alhazmi, Majid Ali and Ejaz Cheema

Int. J. Environ. Res. Public Health 2019, 16(3), 499; https://doi.org/10.3390/ijerph16030499 - 11 Feb 2019

Cited by 9 | Viewed by 4453

Abstract

This study aimed to identify any drug-related problems (DRPs) in diabetic patients during Ramadan fasting in Saudi Arabia. The study used a mixed-methods approach consisting of two phases and was conducted in Makkah, Saudi Arabia from December 2017 to March 2018. The first [...] Read more.

This study aimed to identify any drug-related problems (DRPs) in diabetic patients during Ramadan fasting in Saudi Arabia. The study used a mixed-methods approach consisting of two phases and was conducted in Makkah, Saudi Arabia from December 2017 to March 2018. The first phase of the study involved qualitative semi-structured individual interviews with diabetic patients. A 13-item questionnaire was used in the second phase to further identify DRPs in the wider population. The data was mainly presented as frequencies and percentages. Inferential statistics was performed using Statistical Package for Social Sciences (SPSS) version 21 to compare relevant variables/questions using the chi-square test. Twenty patients (10 male, 10 female) attended face-to-face interviews during the first phase of the study while 95 (40 male, 55 female) completed the questionnaire in the second phase of the study. Two possible risk factors for DRPs were identified from the qualitative data: patient-related factors, including changes in their medicine intake during fasting, and healthcare professionals-related factors, including lack of advice from healthcare professionals regarding fasting. The quantitative results indicated that 52 (54%) of the 95 participants who observed fasting reported to have changed the way they were taking their medicines. Furthermore, 41% of the participants experienced general healthcare problems such as hypoglycemia, hyperglycemia, fatigue, excessive sweating, and gastrointestinal disturbances. Healthcare professionals need to educate patients who are at risk of DRPs by providing structured education and counseling. Full article

(This article belongs to the Special Issue Community Health Intervention to Reduce Chronic Disease)

14 pages, 1697 KiB

Open AccessArticle

Effect of Liming with Various Water Regimes on Both Immobilization of Cadmium and Improvement of Bacterial Communities in Contaminated Paddy: A Field Experiment

by Lei Shi, Zhaohui Guo, Fang Liang, Xiyuan Xiao, Chi Peng, Peng Zeng, Wenli Feng and Hongzhen Ran

Int. J. Environ. Res. Public Health 2019, 16(3), 498; https://doi.org/10.3390/ijerph16030498 - 11 Feb 2019

Cited by 20 | Viewed by 3682

Abstract

Cadmium (Cd) in paddy soil is one of the most harmful potentially toxic elements threatening human health. In order to study the effect of lime combined with intermittent and flooding conditions on the soil pH, Cd availability and its accumulation in tissues at [...] Read more.

Cadmium (Cd) in paddy soil is one of the most harmful potentially toxic elements threatening human health. In order to study the effect of lime combined with intermittent and flooding conditions on the soil pH, Cd availability and its accumulation in tissues at the tillering, filling and maturity stages of rice, as well as enzyme activity and the microbial community in contaminated soil, a field experiment was conducted. The results showed that liming under flooding conditions is a more suitable strategy for in situ remediation of Cd-contaminated paddy soil than intermittent conditions. The availability of Cd in soils was closely related to the duration of flooding. Liming was an effective way at reducing available Cd in flooding soil because it promotes the transformation of Cd in soil from acid-extractable to reducible fraction or residual fraction during the reproductive growth period of rice. Compared with control, after liming, the concentration of Cd in brown rice was reduced by 34.9% under intermittent condition while reduced by 55.8% under flooding condition. Meanwhile, phosphatase, urease, and invertase activities in soil increased by 116.7%, 61.4% and 28.8%, and 41.3%, 46.5% and 20.8%, respectively. The high urease activity in tested soils could be used to assess soil recovery with liming for the remediation of contaminated soil. Soil microbial diversity was determined by the activities of soil acid phosphatase, urease and available Cd by redundancy analysis (RDA). The results indicated that the problem of Cd-contaminated paddy soil could achieve risk control of agricultural planting by chemical treatment such as lime, combined with various water regimes. Full article

(This article belongs to the Special Issue Studies on Heavy Metals and Health)

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17 pages, 4730 KiB

Open AccessArticle

Spatiotemporal Prediction of Increasing Winter Perceived Temperature across a Sub-Tropical City for Sustainable Planning and Climate Change Mitigation

by Hung Chak Ho, Sawaid Abbas, Jinxin Yang, Rui Zhu and Man Sing Wong

Int. J. Environ. Res. Public Health 2019, 16(3), 497; https://doi.org/10.3390/ijerph16030497 - 11 Feb 2019

Cited by 6 | Viewed by 3993

Abstract

Climate variability has been documented as being key to influencing human wellbeing across cities as it is linked to mortality and illness due to changes in the perceived weather cycle. Many studies have investigated the impact of summer temperature on human health and [...] Read more.

Climate variability has been documented as being key to influencing human wellbeing across cities as it is linked to mortality and illness due to changes in the perceived weather cycle. Many studies have investigated the impact of summer temperature on human health and have proposed mitigation strategies for summer heat waves. However, sub-tropical cities are still experiencing winter temperature variations. Increasing winter perceived temperature through the decades may soon affect city wellbeing, due to a larger temperature change between normal winter days and extreme cold events, which may cause higher health risk due to lack of adaptation and self-preparedness. Therefore, winter perceived temperature should also be considered and integrated in urban sustainable planning. This study has integrated the increasing winter perceived temperature as a factor for developing spatiotemporal protocols for mitigating the adverse impact of climate change. Land surface temperature (LST) derived from satellite images and building data extracted from aerial photographs were used to simulate the adjusted wind chill equivalent temperature (AWCET) particularly for sub-tropical scenarios between 1990 and 2010 of the Kowloon Peninsula, Hong Kong. Compared with perceived temperature based on the representative station located at the headquarters of the Hong Kong Observatory, the temperature of half the study area in the Kowloon Peninsula has raised by 1.5 °C. The areas with less green space and less public open space in 2010 show higher relative temperatures. Socioeconomically deprived areas (e.g., areas with lower median monthly income) may suffer more from this scenario, but not all types of socioeconomic disparities are associated with poor sustainable planning. Based on our results and the “no-one left behind” guideline from the United Nations, climate change mitigation should be conducted by targeting socioeconomic neighborhoods more than just aging communities. Full article

(This article belongs to the Special Issue Urban Environmental Quality)

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10 pages, 1140 KiB

Open AccessArticle

3D Printed Temporary Veneer Restoring Autotransplanted Teeth in Children: Design and Concept Validation Ex Vivo

by Ali Al-Rimawi, Mostafa EzEldeen, Danilo Schneider, Constantinus Politis and Reinhilde Jacobs

Int. J. Environ. Res. Public Health 2019, 16(3), 496; https://doi.org/10.3390/ijerph16030496 - 11 Feb 2019

Cited by 16 | Viewed by 5169

Abstract

(1) Background: Three-dimensional printing is progressing rapidly and is applied in many fields of dentistry. Tooth autotransplantation offers a viable biological approach to tooth replacement in children and adolescents. Restoring or reshaping the transplanted tooth to the anterior maxilla should be done as [...] Read more.

(1) Background: Three-dimensional printing is progressing rapidly and is applied in many fields of dentistry. Tooth autotransplantation offers a viable biological approach to tooth replacement in children and adolescents. Restoring or reshaping the transplanted tooth to the anterior maxilla should be done as soon as possible for psychological and aesthetic reasons. However, to avoid interfering with the natural healing process, reshaping of transplanted teeth is usually delayed three to four months after transplantation. This delay creates a need for simple indirect temporary aesthetic restoration for autotransplanted teeth. The aim of this study was to develop and validate a digital solution for temporary restoration of autotransplanted teeth using 3D printing. (2) Methods: Four dry human skulls and four dry human mandibles were scanned using cone beam computed tomography to create 3D models for 15 premolars. Digital impression of the maxillary arch of one of the skulls was captured by intra oral scanner. The digital work flow for the design and fabrication of temporary veneers is presented. The seating and adaptation of the 3D printed veneers were evaluated using stereomicroscopy and micro-computed tomography. (3) Results: Evaluation of the veneer seating using stereomicroscopy showed that the mean marginal gap at all of the sides was below the cut-off value of 200 µm. The overall mean marginal gap was 99.9 ± 50.7 µm (median: 87.8 (IQR 64.2–133 µm)). The internal adaptation evaluation using micro-computed tomography showed an average median gap thickness of 152.5 ± 47.7 (IQR 129–149.3 µm). (4) Conclusions: The present concept of using temporary veneers that are designed and fabricated with CAD/CAM (computer-aided design/computer-aided manufacturing) technology using a DLP (digital light processing) printer may present a viable treatment option for restoration of autotransplanted teeth. Full article

(This article belongs to the Special Issue Digital Dentistry: The Evolution of Dental Care)

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14 pages, 329 KiB

Open AccessArticle

The Effect of Cross-Level Interaction between Community Factors and Social Capital among Individuals on Physical Activity: Considering Gender Difference

by Hee-Jung Jun and Seoyeon Park

Int. J. Environ. Res. Public Health 2019, 16(3), 495; https://doi.org/10.3390/ijerph16030495 - 11 Feb 2019

Cited by 6 | Viewed by 3491

Abstract

This study examines the effect of cross-level interaction between community physical environment and social capital among individuals on physical activity by considering gender difference. In this regard, we ask two research questions: (1) What is the effect of cross-level interaction between community factors [...] Read more.

This study examines the effect of cross-level interaction between community physical environment and social capital among individuals on physical activity by considering gender difference. In this regard, we ask two research questions: (1) What is the effect of cross-level interaction between community factors and social capital among individuals on physical activity? (2) Is there gender difference in the effect of the cross-level interaction? To examine the research questions, this study used the 2015 Korea Community Health Survey and used multi-level analyses. The empirical analyses show that while there are both positive and negative cross-level interaction effects between physical activity-supportive community environment and social capital among individuals on physical activity, the positive cross-level interaction effect is more pronounced for women than for men. These findings suggest that local efforts to improve public health should take into account the cross-level interaction effect between community physical environment and social capital among individuals as well as gender difference. Full article

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

15 pages, 879 KiB

Open AccessArticle

Understanding the Intrinsic and Extrinsic Motivations Associated with Community Gardening to Improve Environmental Public Health Prevention and Intervention

by Monica D. Ramirez-Andreotta, Abigail Tapper, Diamond Clough, Jennifer S. Carrera and Shana Sandhaus

Int. J. Environ. Res. Public Health 2019, 16(3), 494; https://doi.org/10.3390/ijerph16030494 - 11 Feb 2019

Cited by 20 | Viewed by 6107

Abstract

Considering that community members continue to garden in and near environments impacted by pollutants known to negatively impact human health, this paper seeks to characterize the intrinsic and extrinsic motivations of a gardener and elucidate their perception of soil quality and environmental responsibility, [...] Read more.

Considering that community members continue to garden in and near environments impacted by pollutants known to negatively impact human health, this paper seeks to characterize the intrinsic and extrinsic motivations of a gardener and elucidate their perception of soil quality and environmental responsibility, awareness of past land use, and gardening behavior. Via semi-structured interviews with community gardeners in the Boston area (N = 17), multifactorial motivations associated with gardening as well as ongoing environmental health challenges were reported. Gardeners are knowledgeable about their garden’s historical past and are concerned with soil quality, theft, trash maintenance, animal waste, and loss of produce from foraging animals. Study findings directly inform the field of environmental health exposure assessments by reporting gardening duration, activities that can lead to incidental soil ingestion, and consumption patterns of locally grown produce. This information combined with an understanding of a gardener’s intrinsic and extrinsic motivations can be used to develop urban agricultural infrastructure and management strategies, educational programming, and place-based environmental public health interventions. Full article

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15 pages, 2834 KiB

Open AccessArticle

Spatial Equity of Multilevel Healthcare in the Metropolis of Chengdu, China: A New Assessment Approach

by Shaoyao Zhang, Xueqian Song, Yongping Wei and Wei Deng

Int. J. Environ. Res. Public Health 2019, 16(3), 493; https://doi.org/10.3390/ijerph16030493 - 10 Feb 2019

Cited by 29 | Viewed by 5922

Abstract

The spatial equity of the healthcare system is an important factor in assessing how the different medical service demands of residents are met by different levels of medical institutions. However, previous studies have not paid sufficient attention to multilevel healthcare accessibility based on [...] Read more.

The spatial equity of the healthcare system is an important factor in assessing how the different medical service demands of residents are met by different levels of medical institutions. However, previous studies have not paid sufficient attention to multilevel healthcare accessibility based on both the divergence of hierarchical healthcare supplies and variations in residents’ behavioral preferences for different types of healthcare. This study aims to propose a demand-driven “2R grid-to-level” (2R-GTL) method of analyzing the spatial equity in access to a multilevel healthcare system in Chengdu. Gridded populations, real-time travel distances and residents’ spatial behavioral preferences were used to generate a dynamic and accurate healthcare accessibility assessment. The results indicate that significant differences exist in the spatial accessibility to different levels of healthcare. Approximately 90% of the total population living in 57% of the total area in the city can access all three levels of healthcare within an acceptable travel distance, whereas multilevel healthcare shortage zones cover 42% of the total area and 12% of the population. A lack of primary healthcare is the most serious problem in these healthcare shortage zones. These results support the systematic monitoring of multilevel healthcare accessibility by decision-makers. The method proposed in this research could be improved by introducing nonspatial factors, private healthcare providers and other cultural contexts and time periods. Full article

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17 pages, 2025 KiB

Open AccessArticle

Analysis of Obesity among Malaysian University Students: A Combination Study with the Application of Bayesian Structural Equation Modelling and Pearson Correlation

by Che Wan Jasimah Wan Mohamed Radzi, Hashem Salarzadeh Jenatabadi, Ayed R. A. Alanzi, Mohd Istajib Mokhtar, Mohd Zufri Mamat and Nor Aishah Abdullah

Int. J. Environ. Res. Public Health 2019, 16(3), 492; https://doi.org/10.3390/ijerph16030492 - 10 Feb 2019

Cited by 38 | Viewed by 9569

Abstract

In obesity modelling studies, researchers have been seeking to identify the effective indicators of obesity by using appropriate statistical or mathematical techniques. The main objective of the present study is addressed in three stages. First, a new framework for modelling obesity in university [...] Read more.

In obesity modelling studies, researchers have been seeking to identify the effective indicators of obesity by using appropriate statistical or mathematical techniques. The main objective of the present study is addressed in three stages. First, a new framework for modelling obesity in university students is introduced. The second stage involves data analysis based on Bayesian Structural Equation Modelling (BSEM) for estimating the Body Mass Index (BMI) (representative of the obesity level) of students at three university levels: Bachelor, Master and PhD. In the third stage, the highest significant correlation is determined between the BMI and other variables in the research model that were found significant through the second phase. The data for this study were collected from students at selected Malaysian universities. The results indicate that unhealthy food intake (fast food and soft drinks), social media use and stress exhibit the highest weightage contributing to overweight and obesity issues for Malaysian university students. Full article

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