International Journal of Environmental Research and Public Health

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Open AccessArticle

Changes in Soil Microbial Community and Its Effect on Carbon Sequestration Following Afforestation on the Loess Plateau, China

by Yun Xiang, Man Cheng, Yimei Huang, Shaoshan An and Frédéric Darboux

Int. J. Environ. Res. Public Health 2017, 14(8), 948; https://doi.org/10.3390/ijerph14080948 - 22 Aug 2017

Cited by 15 | Viewed by 4037

Abstract

Afforestation plays an important role in soil protection and ecological restoration. The objective of this study is to understand the effect of afforestation on soil carbon and soil microbial communities in the Loess Plateau of China. We measured two chemically-separated carbon fractions (i.e., [...] Read more.

Afforestation plays an important role in soil protection and ecological restoration. The objective of this study is to understand the effect of afforestation on soil carbon and soil microbial communities in the Loess Plateau of China. We measured two chemically-separated carbon fractions (i.e., humic acid, HA, and fulvic acid, FA) and soil microbial communities within shrublands (18-year-old Caragana korshinskii Kom (shrubland I) and 28-year-old Caragana korshinskii Kom (shrubland II)) and cropland. The size and structure of the soil microbial community was measured by phospholipid fatty acid (PLFA) analysis. The analysis of C-fractions indicated that at a depth of 0–20 cm, FA-C concentration in shrubland I and shrubland II were 1.7 times that of cropland, while HA-C had similar values across all three sites. Total PLFAs, G⁺ (Gram positive) bacterial, G⁻ (Gram negative) bacterial, and actinobacterial PLFAs were highest in shrubland II, followed by shrubland I and finally cropland. Fungal PLFAs were significantly higher in shrubland II compared to the other sites. Additionally, we found a high degree of synergy between main microbial groups (apart from fungi) with FA-C. We concluded that planting C. korshinskii in abandoned cropland could alter the size and structure of soil microbial community, with these changes being closely related to carbon sequestration and humus formation. Full article

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

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Open AccessArticle

Surface Sampling Collection and Culture Methods for Escherichia coli in Household Environments with High Fecal Contamination

by Natalie G. Exum, Margaret N. Kosek, Meghan F. Davis and Kellogg J. Schwab

Int. J. Environ. Res. Public Health 2017, 14(8), 947; https://doi.org/10.3390/ijerph14080947 - 22 Aug 2017

Cited by 4 | Viewed by 4368

Abstract

Empiric quantification of environmental fecal contamination is an important step toward understanding the impact that water, sanitation, and hygiene interventions have on reducing enteric infections. There is a need to standardize the methods used for surface sampling in field studies that examine fecal [...] Read more.

Empiric quantification of environmental fecal contamination is an important step toward understanding the impact that water, sanitation, and hygiene interventions have on reducing enteric infections. There is a need to standardize the methods used for surface sampling in field studies that examine fecal contamination in low-income settings. The dry cloth method presented in this manuscript improves upon the more commonly used swabbing technique that has been shown in the literature to have a low sampling efficiency. The recovery efficiency of a dry electrostatic cloth sampling method was evaluated using Escherichia coli and then applied to household surfaces in Iquitos, Peru, where there is high fecal contamination and enteric infection. Side-by-side measurements were taken from various floor locations within a household at the same time over a three-month period to compare for consistency of quantification of E. coli bacteria. The dry cloth sampling method in the laboratory setting showed 105% (95% Confidence Interval: 98%, 113%) E. coli recovery efficiency off of the cloths. The field application demonstrated strong agreement of side-by-side results (Pearson correlation coefficient for dirt surfaces was 0.83 (p < 0.0001) and 0.91 (p < 0.0001) for cement surfaces) and moderate agreement for results between entrance and kitchen samples (Pearson (0.53, p < 0.0001) and weighted Kappa statistic (0.54, p < 0.0001)). Our findings suggest that this method can be utilized in households with high bacterial loads using either continuous (quantitative) or categorical (semi-quantitative) data. The standardization of this low-cost, dry electrostatic cloth sampling method can be used to measure differences between households in intervention and non-intervention arms of randomized trials. Full article

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

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Open AccessArticle

Perceived Injury Risk among Junior Cricketers: A Cross Sectional Survey

by Prasanna J. Gamage, Lauren V. Fortington and Caroline F. Finch

Int. J. Environ. Res. Public Health 2017, 14(8), 946; https://doi.org/10.3390/ijerph14080946 - 22 Aug 2017

Cited by 8 | Viewed by 5720

Abstract

Understanding how junior athletes perceive injury risks when participating in sport and the environment they play in is an important component of injury prevention. This study investigates how Sri Lankan junior cricketers (n = 365, aged 11–14 years, boys) perceive injury risks [...] Read more.

Understanding how junior athletes perceive injury risks when participating in sport and the environment they play in is an important component of injury prevention. This study investigates how Sri Lankan junior cricketers (n = 365, aged 11–14 years, boys) perceive injury risks associated with playing cricket. The study used a Sri Lankan modification of an Australian junior cricket injury risk perception survey that considered playing cricket versus other sports, different cricket playing positions and roles, and different ground conditions. The risk of playing cricket was considered to be greater than that for cycling, but lower than that for rugby and soccer. Fast-bowlers, batters facing fast-bowlers, fielding close in the field, and wicket-keeping without a helmet were perceived to pose greater risks of injury than other scenarios. Playing on hard, bumpy and/or wet ground conditions were perceived to have a high risk opposed to playing on a grass field. Fielding in the outfield and wicket-keeping to fast-bowlers whilst wearing a helmet were perceived as low risk actions. The risk perceptions of junior cricketers identified in this study, do not necessarily reflect the true injury risk in some instances. This information will inform the development of injury prevention education interventions to address these risk perceptions in junior cricketers. Full article

(This article belongs to the Special Issue Child Injury Prevention 2017)

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Open AccessFeature PaperArticle

“You Think You’re Helping Them, But They’re Helping You Too”: Experiences of Scottish Male Young Offenders Participating in a Dog Training Program

by Rebecca J. Leonardi, Hannah M. Buchanan-Smith, Gill McIvor and Sarah-Jane Vick

Int. J. Environ. Res. Public Health 2017, 14(8), 945; https://doi.org/10.3390/ijerph14080945 - 22 Aug 2017

Cited by 27 | Viewed by 8727

Abstract

Interaction with animals can be beneficial to humans and animal-assisted interventions (AAIs) are increasingly popular in a range of contexts. Dog training programs (DTPs) are the most popular form of AAI in custodial contexts; prisoners often have multiple needs and DTPs seem to [...] Read more.

Interaction with animals can be beneficial to humans and animal-assisted interventions (AAIs) are increasingly popular in a range of contexts. Dog training programs (DTPs) are the most popular form of AAI in custodial contexts; prisoners often have multiple needs and DTPs seem to facilitate a diverse range of positive outcomes, including improvements in well-being, behavior, and offending behavior. However, evidence on the efficacy of prison-based DTPs is still limited and these evaluations often lack detail or methodological rigor. We examined the experiences of male young offenders (N = 70) using thematic analysis of semi-structured interviews conducted following completion of a DTP. The themes that emerged indicated a broad range of inter-related experiences and positive outcomes. The most prevalent theme related to their experiences with Dogs (including feelings and attitudes), and there were perceived improvements categorized as: Positive Effects (including mood and well-being), Motivation, Charitable Purpose, Self-Efficacy, Improved Skills, Impulsivity, and Emotional Management. These themes mapped well onto outcomes previously identified in research on DTPs, and to the program’s core aims of improving behavior, educational engagement, employability, and well-being. The diversity and nature of these themes indicates that DTPs have considerable potential to engage and benefit those individuals with multiple needs, such as young offenders, and ultimately to achieve positive long-term outcomes with significant social, health, and economic impact. Full article

(This article belongs to the Special Issue Animal Assisted Interventions and Activities for Health and Wellbeing)

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Open AccessArticle

Biometeorological Assessment of Mortality Related to Extreme Temperatures in Helsinki Region, Finland, 1972–2014

by Reija Ruuhela, Kirsti Jylhä, Timo Lanki, Pekka Tiittanen and Andreas Matzarakis

Int. J. Environ. Res. Public Health 2017, 14(8), 944; https://doi.org/10.3390/ijerph14080944 - 22 Aug 2017

Cited by 43 | Viewed by 6501

Abstract

Climate change is expected to increase heat-related and decrease cold-related mortality. The extent of acclimatization of the population to gradually-changing thermal conditions is not well understood. We aimed to define the relationship between mortality and temperature extremes in different age groups in the [...] Read more.

Climate change is expected to increase heat-related and decrease cold-related mortality. The extent of acclimatization of the population to gradually-changing thermal conditions is not well understood. We aimed to define the relationship between mortality and temperature extremes in different age groups in the Helsinki-Uusimaa hospital district in Southern Finland, and changes in sensitivity of the population to temperature extremes over the period of 1972–2014. Time series of mortality were made stationary with a method that utilizes 365-day Gaussian smoothing, removes trends and seasonality, and gives relative mortality as the result. We used generalized additive models to examine the association of relative mortality to physiologically equivalent temperature (PET) and to air temperature in the 43-year study period and in two 21-year long sub-periods (1972–1992 and 1994–2014). We calculated the mean values of relative mortality in percentile-based categories of thermal indices. Relative mortality increases more in the hot than in the cold tail of the thermal distribution. The increase is strongest among those aged 75 years and older, but is somewhat elevated even among those younger than 65 years. Above the 99th percentile of the PET distribution, the all-aged relative mortality decreased in time from 18.3 to 8.6%. Among those ≥75 years old, the decrease in relative mortality between the sub-periods were found to be above the 90th percentile. The dependence of relative mortality on cold extremes was negligible, except among those ≥75 years old, in the latter period. Thus, heat-related mortality is also remarkable in Finland, but the sensitivity to heat stress has decreased over the decades. Full article

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

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Open AccessArticle

Further Evidence of a Specific Psychopathology of Addiction. Differentiation from Other Psychiatric Psychopathological Dimensions (Such as Obesity)

by Angelo G.I. Maremmani, Luca Cerniglia, Silvia Cimino, Silvia Bacciardi, Luca Rovai, Alessandro Pallucchini, Vincenza Spera, Giulio Perugi and Icro Maremmani

Int. J. Environ. Res. Public Health 2017, 14(8), 943; https://doi.org/10.3390/ijerph14080943 - 21 Aug 2017

Cited by 36 | Viewed by 4305

Abstract

Introduction: In this study, we used a symptomatology checklist (SCL-90) to substantiate the hypothesis that Substance Use Disorder (SUD) has its own five-dimensional psychopathology. The aim of the present study was to test whether this psychopathology can be differentiated from other psychiatric [...] Read more.

Introduction: In this study, we used a symptomatology checklist (SCL-90) to substantiate the hypothesis that Substance Use Disorder (SUD) has its own five-dimensional psychopathology. The aim of the present study was to test whether this psychopathology can be differentiated from other psychiatric psychopathological dimensions (such as obesity). Methods: The severity and frequency of each of the five dimensions were investigated, at univariate and multivariate levels, by comparing 972 Heroin Use Disorder (HUD) patients (83.5% male, mean age 30.12 ± 6.6, range: 16–59) and 106 obese individuals (50.0% male, mean age 37.59 ± 7.6, range: 24–52). The correlations between the Body Mass Index (BMI) of obese individuals with these psychopathological dimensions were also studied. Results: Obese individuals showed higher SCL-90 total scores, global severity index scores, number of items rated positively, and positive symptoms distress index scores than HUD patients. The severity of all psychopathological dimensions was significantly higher in obese individuals. Discriminant analysis showed that Panic-Anxiety and Violence-Suicide severity were more frequent in obese patients, sufficiently so to allow differentiation between HUD (lower severity) and obese individuals (greater severity). At the reclassification level, 70.8% of obese individuals in the sample were reclassified as HUD patients. Psychopathological subtypes characterized by Panic-Anxiety and Violence-Suicide typology were more frequent in obese patients and sufficiently so as to discriminate between groups. Of obese patients, 47.2% were reclassified as HUD patients. The severity of the Worthlessness-Being Trapped dimension was sufficient to predict the BMI of obese individuals. Conclusions: Our results suggest that the five-factor psychopathology found in HUD can discriminate between HUD and obese patients, but that there is an area of overlap between the forms of psychopathology found in SUD and those found in obese patients. Full article

(This article belongs to the Section Global Health)

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Open AccessReview

Trapped in Statelessness: Rohingya Refugees in Bangladesh

by Abul Hasnat Milton, Mijanur Rahman, Sumaira Hussain, Charulata Jindal, Sushmita Choudhury, Shahnaz Akter, Shahana Ferdousi, Tafzila Akter Mouly, John Hall and Jimmy T. Efird

Int. J. Environ. Res. Public Health 2017, 14(8), 942; https://doi.org/10.3390/ijerph14080942 - 21 Aug 2017

Cited by 87 | Viewed by 28860

Abstract

The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar [...] Read more.

The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar (Burma) to neighboring countries. This article addresses the Rohingya refugee crisis in Bangladesh, with special emphasis on the living conditions of this vulnerable population. We reviewed several documents on Rohingya refugees, visited a registered refugee camp (Teknaf), collected case reports, and conducted a series of meetings with stakeholders in the Cox’s Bazar district of Bangladesh. A total of 33,131 registered Rohingya refugees are living in two registered camps in Cox’s Bazar, and up to 80,000 additional refugees are housed in nearby makeshift camps. Overall, the living conditions of Rohingya refugees inside the overcrowded camps remain dismal. Mental health is poor, proper hygiene conditions are lacking, malnutrition is endemic, and physical/sexual abuse is high. A concerted diplomatic effort involving Bangladesh and Myanmar, and international mediators such as the Organization of Islamic Countries and the United Nations, is urgently required to effectively address this complex situation. Full article

(This article belongs to the Special Issue Refugee Health)

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Open AccessArticle

Grip Strength and Its Relationship to Police Recruit Task Performance and Injury Risk: A Retrospective Cohort Study

by Robin Orr, Rodney Pope, Michael Stierli and Benjamin Hinton

Int. J. Environ. Res. Public Health 2017, 14(8), 941; https://doi.org/10.3390/ijerph14080941 - 21 Aug 2017

Cited by 65 | Viewed by 6604

Abstract

Suitable grip strength is a police occupational requirement. The aim of this study was to investigate the association between grip strength, task performance and injury risk in a police population. Retrospective data of police recruits (n = 169) who had undergone basic recruit [...] Read more.

Suitable grip strength is a police occupational requirement. The aim of this study was to investigate the association between grip strength, task performance and injury risk in a police population. Retrospective data of police recruits (n = 169) who had undergone basic recruit training were provided, including handgrip strength results, occupational task performance measures (consisting of police task simulations [SIM], tactical options [TACOPS] and marksmanship assessments) and injury records. Left hand grip strength (41.91 ± 8.29 kg) measures showed a stronger correlation than right hand grip strength (42.15 ± 8.53 kg) with all outcome measures. Recruits whose grip strength scores were lower were significantly more susceptible to failing the TACOPS occupational task assessment than those with greater grip strength scores, with significant (p ≤ 0.003) weak to moderate, positive correlations found between grip strength and TACOPS performance. A significant (p < 0.0001) correlation was found between grip strength, most notably of the left hand, and marksmanship performance, with those performing better in marksmanship having higher grip strength. Left hand grip strength was significantly associated with injury risk (r = −0.181, p = 0.018) but right hand grip strength was not. A positive association exists between handgrip strength and police recruit task performance (notably TACOPS and marksmanship) with recruits who scored poorly on grip strength being at greatest risk of occupational assessment task failure. Full article

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

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Open AccessArticle

Assessment of Urban Ecosystem Health Based on Matter Element Analysis: A Case Study of 13 Cities in Jiangsu Province, China

by Xuefeng Xie and Lijie Pu

Int. J. Environ. Res. Public Health 2017, 14(8), 940; https://doi.org/10.3390/ijerph14080940 - 21 Aug 2017

Cited by 25 | Viewed by 4539

Abstract

Urban public health is an important global issue and receives public concern. The urban ecosystem health (UEH) indicator system was constructed with 27 assessment indicators selected from vigor, organization, resilience, service function, and population health, then the matter element analysis (MEA) and analytic [...] Read more.

Urban public health is an important global issue and receives public concern. The urban ecosystem health (UEH) indicator system was constructed with 27 assessment indicators selected from vigor, organization, resilience, service function, and population health, then the matter element analysis (MEA) and analytic hierarchy process (AHP) weighting method were used to assess the UEH of each city in Jiangsu Province during the period of 2000–2014. The results show that the overall ecosystem health status of each city shows continuous improvement. The UEH status of each city gradually transferred from poor, general, and medium condition to good and excellent condition. From the perspective of spatial distribution, the city’s UEH showing a steady status after increasing for 10 years, and their spatial variations have gradually reduced. The UEH status in Southern Jiangsu and Central Jiangsu was better than that of Northern Jiangsu Province. From each component point of view, the vigor, resilience, and population health of each city in Jiangsu Province showed a trend of continuous improvement, while the organization and service function first increased and then decreased. The common limiting factors of UEH in Jiangsu Province were Engel’s coefficient of urban households, number of beds of hospitals, health centers per 10,000 people, and total investment in the treatment of environmental pollution as percent GDP. These results help decision makers to make suitable decisions to maintain the UEH of each city in Jiangsu Province. Full article

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

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Open AccessArticle

Taking a Stand: The Effects of Standing Desks on Task Performance and Engagement

by Laura E. Finch, A. Janet Tomiyama and Andrew Ward

Int. J. Environ. Res. Public Health 2017, 14(8), 939; https://doi.org/10.3390/ijerph14080939 - 21 Aug 2017

Cited by 27 | Viewed by 9529

Abstract

Time spent sitting is associated with negative health outcomes, motivating some individuals to adopt standing desk workstations. This study represents the first investigation of the effects of standing desk use on reading comprehension and creativity. In a counterbalanced, within-subjects design, 96 participants completed [...] Read more.

Time spent sitting is associated with negative health outcomes, motivating some individuals to adopt standing desk workstations. This study represents the first investigation of the effects of standing desk use on reading comprehension and creativity. In a counterbalanced, within-subjects design, 96 participants completed reading comprehension and creativity tasks while both sitting and standing. Participants self-reported their mood during the tasks and also responded to measures of expended effort and task difficulty. In addition, participants indicated whether they expected that they would perform better on work-relevant tasks while sitting or standing. Despite participants’ beliefs that they would perform worse on most tasks while standing, body position did not affect reading comprehension or creativity performance, nor did it affect perceptions of effort or difficulty. Mood was also unaffected by position, with a few exceptions: Participants exhibited greater task engagement (i.e., interest, enthusiasm, and alertness) and less comfort while standing rather than sitting. In sum, performance and psychological experience as related to task completion were nearly entirely uninfluenced by acute (~30-min) standing desk use. Full article

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

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Open AccessArticle

An Experiment Assessing Punitive versus Wellness Framing of a Tobacco-Free Campus Policy on Students’ Perceived Level of University Support

by Joseph G. L. Lee, Christopher J. Purcell and Beth H. Chaney

Int. J. Environ. Res. Public Health 2017, 14(8), 938; https://doi.org/10.3390/ijerph14080938 - 20 Aug 2017

Cited by 4 | Viewed by 4528

Abstract

The objective of this study was to examine how different ways of describing a hypothetical tobacco-free campus policy would impact college students’ perceived level of support from the college. In the spring of 2016, we randomized 1885 undergraduate students in a required course [...] Read more.

The objective of this study was to examine how different ways of describing a hypothetical tobacco-free campus policy would impact college students’ perceived level of support from the college. In the spring of 2016, we randomized 1885 undergraduate students in a required course to three message conditions in an online survey: control (no message), wellness (emphasizing promoting health and quitting support), and punitive (emphasizing consequences for violating the policy). The dependent variable was perceived organizational support. We selected items previously shown to be relevant for college students (alpha = 0.92 in our data). Given significant non-normality, we used non-parametric Kruskal-Wallis tests with pairwise comparisons to examine differences in perceived organizational support across the three conditions. We examined results by smoking status and if the participant correctly reported the message they received. We found no significant difference in perceived organizational support among students exposed to different tobacco-free campus policy announcements (p = 0.75). We also found no significant difference among smokers (p = 0.66). However, among smokers who correctly reported the message they received, we found significantly lower perceived university support (p = 0.01). Messages about tobacco-free campus policies should focus on the role of policy in supporting a healthy environment instead of punitive enforcement. Campus administrators should use caution when using message frames focusing on consequences of violating newly adopted policies. Full article

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

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Open AccessArticle

A Geographical Analysis of Emergency Medical Service Calls and Extreme Heat in King County, WA, USA (2007–2012)

by Aubrey C. DeVine, Phuong T. Vu, Michael G. Yost, Edmund Y. W. Seto and Tania M. Busch Isaksen

Int. J. Environ. Res. Public Health 2017, 14(8), 937; https://doi.org/10.3390/ijerph14080937 - 20 Aug 2017

Cited by 9 | Viewed by 5546

Abstract

This research analyzed the relationship between extreme heat and Emergency Medical Service (EMS) calls in King County, WA, USA between 2007 and 2012, including the effect of community-level characteristics. Extreme heat thresholds for the Basic Life Support (BLS) data and the Advanced Life [...] Read more.

This research analyzed the relationship between extreme heat and Emergency Medical Service (EMS) calls in King County, WA, USA between 2007 and 2012, including the effect of community-level characteristics. Extreme heat thresholds for the Basic Life Support (BLS) data and the Advanced Life Support (ALS) data were found using a piecewise generalized linear model with Akaike Information Criterion (AIC). The association between heat exposure and EMS call rates was investigated using a generalized estimating equations with Poisson mean model, while adjusting for community-level indicators of poverty, impervious surface, and elderly population (65+). In addition, we examined the effect modifications of these community-level factors. Extreme-heat thresholds of 31.1 °C and 33.5 °C humidex were determined for the BLS and ALS data, respectively. After adjusting for other variables in the model, increased BLS call volume was significantly associated with occurring on a heat day (relative rate (RR) = 1.080, p < 0.001), as well as in locations with higher percent poverty (RR = 1.066, p < 0.001). No significant effect modification was identified for the BLS data on a heat day. Controlling for other variables, higher ALS call volume was found to be significantly associated with a heat day (RR = 1.067, p < 0.001), as well as in locations with higher percent impervious surface (RR = 1.015, p = 0.039), higher percent of the population 65 years or older (RR = 1.057, p = 0.005), and higher percent poverty (RR = 1.041, p = 0.016). Furthermore, percent poverty and impervious surface were found to significantly modify the relative rate of ALS call volumes between a heat day and non-heat day. We conclude that EMS call volume increases significantly on a heat day compared to non-heat day for both call types. While this study shows that there is some effect modification between the community-level variables and call volume on a heat day, further research is necessary. Our findings also suggest that with adequate power, spatially refined analyses may not be necessary to accurately estimate the extreme-heat effect on health. Full article

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

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Open AccessArticle

I Walk My Dog Because It Makes Me Happy: A Qualitative Study to Understand Why Dogs Motivate Walking and Improved Health

by Carri Westgarth, Robert M. Christley, Garry Marvin and Elizabeth Perkins

Int. J. Environ. Res. Public Health 2017, 14(8), 936; https://doi.org/10.3390/ijerph14080936 - 19 Aug 2017

Cited by 70 | Viewed by 37309

Abstract

Dog walking is a popular everyday physical activity. Dog owners are generally more active than non-owners, but some rarely walk with their dog. The strength of the dog–owner relationship is known to be correlated with dog walking, and this qualitative study investigates why. [...] Read more.

Dog walking is a popular everyday physical activity. Dog owners are generally more active than non-owners, but some rarely walk with their dog. The strength of the dog–owner relationship is known to be correlated with dog walking, and this qualitative study investigates why. Twenty-six interviews were combined with autoethnography of dog walking experiences. Dog walking was constructed as “for the dog”, however, owners represented their dog’s needs in a way which aligned with their own. Central to the construction of need was perceptions of dog personality and behaviour. Owners reported deriving positive outcomes from dog walking, most notably, feelings of “happiness”, but these were “contingent” on the perception that their dogs were enjoying the experience. Owner physical activity and social interaction were secondary bonuses but rarely motivating. Perceptions and beliefs of owners about dog walking were continually negotiated, depending on how the needs of the owner and dog were constructed at that time. Complex social interactions with the “significant other” of a pet can strongly motivate human health behaviour. Potential interventions to promote dog walking need to account for this complexity and the effect of the dog-owner relationship on owner mental wellbeing. Full article

(This article belongs to the Special Issue Social and Environmental Influences on Physical Activity Behaviours)

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Open AccessArticle

Changes in Urinary Phthalate Metabolite Levels Before and After the Phthalate Contamination Event and Identification of Exposure Sources in a Cohort of Taiwanese Children

by Chian-Feng Huang and I-Jen Wang

Int. J. Environ. Res. Public Health 2017, 14(8), 935; https://doi.org/10.3390/ijerph14080935 - 19 Aug 2017

Cited by 8 | Viewed by 4194

Abstract

In 2011, the Taiwan Food and Drug Administration inadvertently discovered that, for decades, manufacturers had replaced expensive natural emulsifiers in food products with diethylhexyl phthalate (DEHP). We wanted to compare urinary phthalate metabolite levels of children before and after the DEHP food contamination [...] Read more.

In 2011, the Taiwan Food and Drug Administration inadvertently discovered that, for decades, manufacturers had replaced expensive natural emulsifiers in food products with diethylhexyl phthalate (DEHP). We wanted to compare urinary phthalate metabolite levels of children before and after the DEHP food contamination event and identify source(s) of phthalate exposure in addition to the illegal food additives. In the present study, morning urine samples were collected from a cohort of 453 children in 2010 in Taipei. After the DEHP food contamination event, there were 200 cohort children left at follow-up in 2013. The geometric means (GMs) of urinary mono(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP) levels before and after the event were 9.39 and 13.34 µg/g of creatinine, respectively, with no significant difference (p = 0.093). After the DEHP food contamination event, we found that urinary phthalate metabolite levels were significantly higher in people who frequently consumed microwave-heated food and used fragrance-containing products (p < 0.05). In addition, children who did not frequently wash hands before eating had significantly higher urinary phthalate metabolite levels than those who did (p < 0.05). These results demonstrate that urinary phthalate metabolite levels did not decrease after the DEHP food contamination event, thus, other sources must contribute to phthalate exposure in daily life. Public awareness of approaches to reducing phthalate exposure is necessary. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Identifying Key Performance Indicators for Holistic Hospital Management with a Modified DEMATEL Approach

by Sheng-Li Si, Xiao-Yue You, Hu-Chen Liu and Jia Huang

Int. J. Environ. Res. Public Health 2017, 14(8), 934; https://doi.org/10.3390/ijerph14080934 - 19 Aug 2017

Cited by 55 | Viewed by 9725

Abstract

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the [...] Read more.

Performance analysis is an important way for hospitals to achieve higher efficiency and effectiveness in providing services to their customers. The performance of the healthcare system can be measured by many indicators, but it is difficult to improve them simultaneously due to the limited resources. A feasible way is to identify the central and influential indicators to improve healthcare performance in a stepwise manner. In this paper, we propose a hybrid multiple criteria decision making (MCDM) approach to identify key performance indicators (KPIs) for holistic hospital management. First, through integrating evidential reasoning approach and interval 2-tuple linguistic variables, various assessments of performance indicators provided by healthcare experts are modeled. Then, the decision making trial and evaluation laboratory (DEMATEL) technique is adopted to build an interactive network and visualize the causal relationships between the performance indicators. Finally, an empirical case study is provided to demonstrate the proposed approach for improving the efficiency of healthcare management. The results show that “accidents/adverse events”, “nosocomial infection”, ‘‘incidents/errors”, “number of operations/procedures” are significant influential indicators. Also, the indicators of “length of stay”, “bed occupancy” and “financial measures” play important roles in performance evaluation of the healthcare organization. The proposed decision making approach could be considered as a reference for healthcare administrators to enhance the performance of their healthcare institutions. Full article

(This article belongs to the Section Health Economics)

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Open AccessArticle

Odorous Compounds from Poultry Manure Induce DNA Damage, Nuclear Changes, and Decrease Cell Membrane Integrity in Chicken Liver Hepatocellular Carcinoma Cells

by Adriana Nowak, Tadeusz Bakuła, Katarzyna Matusiak, Remigiusz Gałęcki, Sebastian Borowski and Beata Gutarowska

Int. J. Environ. Res. Public Health 2017, 14(8), 933; https://doi.org/10.3390/ijerph14080933 - 18 Aug 2017

Cited by 12 | Viewed by 4994

Abstract

Animal breeding and management of organic wastes pose a serious problem to the health of livestock and workers, as well as the nearby residents. The aim of the present study was to determine the mechanisms of toxicity of selected common odorous compounds from [...] Read more.

Animal breeding and management of organic wastes pose a serious problem to the health of livestock and workers, as well as the nearby residents. The aim of the present study was to determine the mechanisms of toxicity of selected common odorous compounds from poultry manure, including ammonia, dimethylamine (DMA), trimethylamine (TMA), butyric acid, phenol, and indole. We measured their genotoxic and cytotoxic activity in the model chicken cell line (LMH), in vitro, by comet assay and lactate dehydrogenase assay, respectively. We also made microscopic observations of any morphological changes in these cells by DAPI staining. Four compounds, namely ammonia, DMA, TMA, and butyric acid increased DNA damage in a dose-dependent manner (p < 0.05), reaching genotoxicity as high as 73.2 ± 1.9%. Phenol and indole induced extensive DNA damage independent of the concentration used. Ammonia, DMA, and TMA caused a dose-dependent release of lactate dehydrogenase (p < 0.05). The IC₅₀ values were 0.02%, 0.05%, and 0.1% for DMA, ammonia and TMA, respectively. These compounds also induced nuclear morphological changes, such as chromatin condensation, shrinkage, nuclear fragmentation (apoptotic bodies), and chromatin lysis. Our study exhibited the damaging effects of odorous compounds in chick LMH cell line. Full article

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

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Open AccessArticle

Urinary Levels of 4-Nonylphenol and 4-t-Octylphenol in a Representative Sample of the Korean Adult Population

by Hyejin Park and Kisok Kim

Int. J. Environ. Res. Public Health 2017, 14(8), 932; https://doi.org/10.3390/ijerph14080932 - 18 Aug 2017

Cited by 28 | Viewed by 3689

Abstract

4-Nonylphenol (4-NP) and 4-t-octylphenol (4-t-OP) are xenoestrogen compounds to which humans are exposed via contaminated food, water, and air. This study assessed the body burden of 4-NP and 4-t-OP in Koreans aged 18–69 years using data from the Korean National Human Biomonitoring Survey [...] Read more.

4-Nonylphenol (4-NP) and 4-t-octylphenol (4-t-OP) are xenoestrogen compounds to which humans are exposed via contaminated food, water, and air. This study assessed the body burden of 4-NP and 4-t-OP in Koreans aged 18–69 years using data from the Korean National Human Biomonitoring Survey conducted in 2009. Based on data from 1865 representative Koreans, 83.2% and 91.8% had urinary 4-NP and 4-t-OP concentrations >0.05 ng/mL (limit of detection). Of the Korean adult population, the geometric mean urinary concentrations of 4-NP and 4-t-OP were 3.70 ng/mL (95% confidence interval (CI) = 3.20–4.27) and 0.60 ng/mL (95% CI = 0.55–0.66), respectively. Urine 4-NP concentrations were significantly associated with place of residence and smoking status, whereas urine 4-t-OP concentrations were not correlated with any of the demographic factors. These findings suggest that most Koreans have detectable levels of 4-NP and 4-t-OP in their urine and that the body burden of 4-NP, but not 4-t-OP, varies according to some demographic factors. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Population-Based Study on the Effect of a Forest Environment on Salivary Cortisol Concentration

by Hiromitsu Kobayashi, Chorong Song, Harumi Ikei, Bum-Jin Park, Juyoung Lee, Takahide Kagawa and Yoshifumi Miyazaki

Int. J. Environ. Res. Public Health 2017, 14(8), 931; https://doi.org/10.3390/ijerph14080931 - 18 Aug 2017

Cited by 33 | Viewed by 6381

Abstract

The purpose of this study was to evaluate the effect of a forest environment on salivary cortisol concentration, particularly on the characteristics of its distribution. The participants were 348 young male subjects. The experimental sites were 34 forests and 34 urban areas across [...] Read more.

The purpose of this study was to evaluate the effect of a forest environment on salivary cortisol concentration, particularly on the characteristics of its distribution. The participants were 348 young male subjects. The experimental sites were 34 forests and 34 urban areas across Japan. The subjects viewed the landscape (forest or urban environment) for a period of 15 min while sitting in a chair. Saliva was sampled from the participants at the end of this 15-min period and then analyzed for cortisol concentration. Differences in the skewness and kurtosis of the distributions between the two environments were tested by performing a permutation test. The cortisol concentrations exhibited larger skewness (0.76) and kurtosis (3.23) in a forest environment than in an urban environment (skewness = 0.49; kurtosis = 2.47), and these differences were statistically significant. The cortisol distribution exhibited a more peaked and longer right-tailed curve in a forest environment than in an urban environment. Full article

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

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Open AccessArticle

Cycle Tracks and Parking Environments in China: Learning from College Students at Peking University

by Changzheng Yuan, Yangbo Sun, Jun Lv and Anne C. Lusk

Int. J. Environ. Res. Public Health 2017, 14(8), 930; https://doi.org/10.3390/ijerph14080930 - 18 Aug 2017

Cited by 13 | Viewed by 6057

Abstract

China has a historic system of wide cycle tracks, many of which are now encroached by cars, buses and bus stops. Even with these conditions, college students still bicycle. On campuses, students park their bikes on facilities ranging from kick-stand-plazas to caged sheds [...] Read more.

China has a historic system of wide cycle tracks, many of which are now encroached by cars, buses and bus stops. Even with these conditions, college students still bicycle. On campuses, students park their bikes on facilities ranging from kick-stand-plazas to caged sheds with racks, pumps and an attendant. In other countries, including Canada, some of the newer cycle tracks need to be wider to accommodate an increasing number of bicyclists. Other countries will also need to improve their bike parking, which includes garage-basement cages and two-tiered racks. China could provide lessons about cycle tracks and bike parking. This study applied the Maslow Transportation Level of Service (LOS) theory, i.e., for cycle tracks and bike parking, only after the basic needs of safety and security are met for both vehicle occupants and bicyclists can the higher needs of convenience and comfort be met. With random clustering, a self-administered questionnaire was collected from 410 students in six dormitory buildings at Peking University in Beijing and an environmental scan of bicycle parking conducted in school/office and living areas. Cycle tracks (1 = very safe/5 = very unsafe) shared with moving cars were most unsafe (mean = 4.6), followed by sharing with parked cars (4.1) or bus stop users (4.1) (p < 0.001). Close to half thought campus bike parking lacked order. The most suggested parking facilities were sheds, security (guard or camera), bicycle racks and bicycle parking services (pumps, etc.). If parking were improved, three quarters indicated they would bicycle more. While caged sheds were preferred, in living areas with 1597 parked bikes, caged sheds were only 74.4% occupied. For the future of China’s wide cycle tracks, perhaps a fence-separated bus lane beside a cycle track might be considered or, with China’s recent increase in bike riding, shared bikes and E-bikes, perhaps cars/buses could be banned from the wide cycle tracks. In other countries, a widened cycle track entrance should deter cars. Everywhere, bike parking sheds could be built and redesigned with painted lines to offer more space and order, similar to car parking. Full article

(This article belongs to the Special Issue Sustainable Transportation and Health)

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Open AccessArticle

Beverage Intake among Children: Associations with Parent and Home-Related Factors

by Arwa Zahid, Cynthia Davey and Marla Reicks

Int. J. Environ. Res. Public Health 2017, 14(8), 929; https://doi.org/10.3390/ijerph14080929 - 18 Aug 2017

Cited by 38 | Viewed by 5001

Abstract

Beverage intake can influence child diet quality in a positive or negative manner depending on the beverage type and amounts consumed. Parenting practices such as role modeling and control of home beverage availability have been associated with child beverage intake, whereas examination of [...] Read more.

Beverage intake can influence child diet quality in a positive or negative manner depending on the beverage type and amounts consumed. Parenting practices such as role modeling and control of home beverage availability have been associated with child beverage intake, whereas examination of the influence of parental beverage nutrition knowledge has been more limited. The purpose of this study was to examine the relationships between sugar-sweetened and dairy beverage intake among children (9–12 years) and home and parental factors. A questionnaire was administered among a convenience sample of parents (n = 194) to assess beverage nutrition knowledge, beverage intake and home availability of beverages. Children completed a questionnaire to estimate usual beverage intake. Daily sugar-sweetened beverage intake by children ranged from 0.4 to 48 oz. Logistic regression analysis was used to examine relationships. Parents were mostly female, white, well educated, and employed. Home availability of sugar-sweetened and dairy beverages was positively associated with child sugar-sweetened (OR = 1.48, p = 0.03) and dairy beverage intake (OR = 1.34, p = 0.03), respectively. Parent dairy beverage intake was associated with child dairy beverage intake (OR = 1.06, p = 0.01). Parent knowledge about sugar in beverages was related to child dairy beverage intake (OR = 1.46, p = 0.02), whereas calcium/dairy knowledge and general beverage nutrition knowledge were not related to child beverage intake. Parenting practices and knowledge may play a role in determining child beverage intake. Full article

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

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Open AccessArticle

Personal Hygiene Practices among Urban Homeless Persons in Boston, MA

by Jessica H. Leibler, Daniel D. Nguyen, Casey León, Jessie M. Gaeta and Debora Perez

Int. J. Environ. Res. Public Health 2017, 14(8), 928; https://doi.org/10.3390/ijerph14080928 - 18 Aug 2017

Cited by 26 | Viewed by 14177

Abstract

Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors [...] Read more.

Persons experiencing homelessness in the United States experience significant barriers to self-care and personal hygiene, including limited access to clean showers, laundry and hand washing facilities. While the obstacles to personal hygiene associated with homelessness may increase risk of infectious disease, hygiene-related behaviors among people experiencing homelessness has received limited attention. We conducted a cross-sectional study of individuals experiencing homelessness in Boston, MA (n = 194) to identify hygiene-related self-care practices and risk factors for reduced hygiene in this population. Most participants (72%) reported taking a daily shower. More than 60% reported hand washing with soap five or more times each day, and use of hand sanitizer was widespread (89% reported using sanitizer in the last week). A majority (86%) used a laundromat or laundry machine to wash clothing, while 14% reported washing clothing in the sink. Heavy drinking, injection drug use, and sleeping outdoors were identified as significant risk factors for reduced hygiene practices. People experiencing homelessness who also engage in these activities may be among the most difficult to reach for intervention, yet targeted efforts may decrease illness risk associated with reduced hygiene. Housed friends and family play a critical role in assisting homeless individuals maintain hygiene by providing showers and laundry facilities. Full article

(This article belongs to the Special Issue Health and Health Care for Homeless People in Various Contexts)

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Open AccessArticle

Drinking Water Uranium and Potential Health Effects in the German Federal State of Bavaria

by Andre Banning and Mira Benfer

Int. J. Environ. Res. Public Health 2017, 14(8), 927; https://doi.org/10.3390/ijerph14080927 - 18 Aug 2017

Cited by 39 | Viewed by 6494

Abstract

Mainly due to its nephrotoxic and osteotoxic potential, uranium (U) increasingly finds itself in the spotlight of environmental and health-related research. Germany decided on a binding U guideline value in drinking water of 10 µg/L, valid since 2011. It is yet widely unknown [...] Read more.

Mainly due to its nephrotoxic and osteotoxic potential, uranium (U) increasingly finds itself in the spotlight of environmental and health-related research. Germany decided on a binding U guideline value in drinking water of 10 µg/L, valid since 2011. It is yet widely unknown if and how public health was affected by elevated U concentrations before that. In this ecological study we summarized available drinking water U data for the German federal state of Bavaria (703 analyses in total for 553 different municipalities) at county level (for 76 out of 96 Bavarian counties, representing about 83% of Bavaria’s and about 13% of Germany’s total population) in terms of mean and maximum U concentration. Bavaria is known to regionally exhibit mainly geogenically elevated groundwater U with a maximum value of 40 µg/L in the database used here. Public health data were obtained from federal statistical authorities at county resolution. These included incidence rates of diagnosed diseases suspected to be potentially associated with chronic U uptake, e.g., diseases of the skeleton, the liver or the thyroid as well as tumor and genito-urinary diseases. The datasets were analyzed for interrelations and mutual spatial occurrence using statistical approaches and GIS as well as odds ratios and relative risks calculations. Weak but significant positive associations between maximum U concentrations and aggregated ICD-10 diagnose groups for growths/tumors as well as liver diseases were observed, elevated incidence rates of thyroid diseases seem to occur where mean drinking water U concentrations exceed 2 µg/L. Here, we discuss obtained results and their implications for potential impacts of hydrochemistry on public health in southeast Germany. Full article

(This article belongs to the Special Issue Proceedings from the 3rd International Symposium on Environment and Health)

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Open AccessArticle

Estimation of the Vertical Distribution of Radiocesium in Soil on the Basis of the Characteristics of Gamma-Ray Spectra Obtained via Aerial Radiation Monitoring Using an Unmanned Helicopter

by Kotaro Ochi, Miyuki Sasaki, Mutsushi Ishida, Shoichiro Hamamoto, Taku Nishimura and Yukihisa Sanada

Int. J. Environ. Res. Public Health 2017, 14(8), 926; https://doi.org/10.3390/ijerph14080926 - 17 Aug 2017

Cited by 4 | Viewed by 3902

Abstract

After the Fukushima Daiichi Nuclear Power Plant accident, the vertical distribution of radiocesium in soil has been investigated to better understand the behavior of radiocesium in the environment. The typical method used for measuring the vertical distribution of radiocesium is troublesome because it [...] Read more.

After the Fukushima Daiichi Nuclear Power Plant accident, the vertical distribution of radiocesium in soil has been investigated to better understand the behavior of radiocesium in the environment. The typical method used for measuring the vertical distribution of radiocesium is troublesome because it requires collection and measurement of the activity of soil samples. In this study, we established a method of estimating the vertical distribution of radiocesium by focusing on the characteristics of gamma-ray spectra obtained via aerial radiation monitoring using an unmanned helicopter. The estimates are based on actual measurement data collected at an extended farm. In this method, the change in the ratio of direct gamma rays to scattered gamma rays at various depths in the soil was utilized to quantify the vertical distribution of radiocesium. The results show a positive correlation between the abovementioned and the actual vertical distributions of radiocesium measured in the soil samples. A vertical distribution map was created on the basis of this ratio using a simple equation derived from the abovementioned correlation. This technique can provide a novel approach for effective selection of high-priority areas that require decontamination. Full article

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

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Open AccessArticle

Forecasting the Incidence of Mumps in Zibo City Based on a SARIMA Model

by Qinqin Xu, Runzi Li, Yafei Liu, Cheng Luo, Aiqiang Xu, Fuzhong Xue, Qing Xu and Xiujun Li

Int. J. Environ. Res. Public Health 2017, 14(8), 925; https://doi.org/10.3390/ijerph14080925 - 17 Aug 2017

Cited by 28 | Viewed by 5229

Abstract

This study aimed to predict the incidence of mumps using a seasonal autoregressive integrated moving average (SARIMA) model, and provide theoretical evidence for early warning prevention and control in Zibo City, Shandong Province, China. Monthly mumps data from Zibo City gathered between 2005 [...] Read more.

This study aimed to predict the incidence of mumps using a seasonal autoregressive integrated moving average (SARIMA) model, and provide theoretical evidence for early warning prevention and control in Zibo City, Shandong Province, China. Monthly mumps data from Zibo City gathered between 2005 and 2013 were used as a training set to construct a SARIMA model, and the monthly mumps in 2014 were defined as a test set for the model. From 2005 to 2014, a total of 8722 cases of mumps were reported in Zibo City; the male-to-female ratio of cases was 1.85:1, the age group of 1–20 years old accounted for 94.05% of all reported cases, and students made up the largest proportion (65.89%). The main serious endemic areas of mumps were located in Huantai County, Linzi District, and Boshan District of Zibo City. There were two epidemic peaks from April to July and from October to January in next year. The fitted model SARIMA (0, 1, 1) (0, 1, 1)₁₂ was established (AIC = 157.528), which has high validity and reasonability. The SARIMA model fitted dynamic changes of mumps in Zibo City well. It can be used for short-term forecasting and early warning of mumps. Full article

(This article belongs to the Section Global Health)

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Open AccessArticle

Quality of Vegetables Based on Total Phenolic Concentration Is Lower in More Rural Consumer Food Environments in a Rural American State

by Selena Ahmed and Carmen Byker Shanks

Int. J. Environ. Res. Public Health 2017, 14(8), 924; https://doi.org/10.3390/ijerph14080924 - 17 Aug 2017

Cited by 10 | Viewed by 5493

Abstract

While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality [...] Read more.

While daily consumption of fruits and vegetables (FVs) is widely recognized to be associated with supporting nutrition and health, disparities exist in consumer food environments regarding access to high-quality produce based on location. The purpose of this study was to evaluate FV quality using total phenolic (TP) scores (a phytochemical measure for health-promoting attributes, flavor, appearance, and shelf-life) in consumer food environments along a rural to urban continuum in the rural state of Montana, United States. Significant differences were found in the means of the FV TP scores (p < 0.0001) and vegetable TP scores (p < 0.0001) on the basis of rurality, while no significant difference was found for fruit TP scores by rurality (p < 0.2158). Specifically, FV TP scores and vegetable TP scores were highest for the least rural stores and lowest for the most rural stores. Results indicate an access gap to high-quality vegetables in more rural and more health-disparate consumer food environments of Montana compared to urban food environments. Findings highlight that food and nutrition interventions should aim to increase vegetable quality in rural consumer food environments in the state of Montana towards enhancing dietary quality and food choices. Future studies are called for that examine TP scores of a wide range of FVs in diverse food environments globally. Studies are further needed that examine linkages between FV quality, food choices, diets, and health outcomes towards enhancing food environments for public health. Full article

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Open AccessProtocol

A Youth-Led, Social Marketing Intervention Run by Adolescents to Encourage Healthy Lifestyles among Younger School Peers (EYTO-Kids Project): A Protocol for Pilot Cluster Randomized Controlled Trial (Spain)

by Lucia Tarro, Magaly Aceves-Martins, Ignasi Papell-Garcia, Lluís Arola, Montse Giralt, Elisabet Llauradó and Rosa Solà

Int. J. Environ. Res. Public Health 2017, 14(8), 923; https://doi.org/10.3390/ijerph14080923 - 17 Aug 2017

Cited by 7 | Viewed by 4377

Abstract

Introduction: The EYTO-kids (European Youth Tackling Obesity in Adolescents and Children) study aims to increase fruit and/or vegetable consumption and physical activity, decrease sedentary lifestyles, and reduce the intake of sugary drinks and fast food using an innovative methodology based on social marketing [...] Read more.

Introduction: The EYTO-kids (European Youth Tackling Obesity in Adolescents and Children) study aims to increase fruit and/or vegetable consumption and physical activity, decrease sedentary lifestyles, and reduce the intake of sugary drinks and fast food using an innovative methodology based on social marketing and youth involvement. Methods: This study is a pilot school-based cluster randomized controlled 10-month intervention spanning two academic years (2015–2016 and 2016–2017), with eight primary schools and three high schools randomized into and designated the control group and eight primary schools and four high schools designated the intervention group in Reus, Spain. At least 301 younger school peers per group should be included. At the intervention high schools, the adolescent creators (ACs) receive an initial 16-h training session. In total, 26–32 high school ACs (12–14 years) from the four high schools will design and implement four health-promotion activities (1 h/each) for their younger (8–10 years), primary school peers. The control group will not receive any intervention. The outcomes (fruit, vegetable, fast food and sugary drink consumption; physical activity; and sedentary behaviors) of the control and intervention groups will be measured pre- and post-intervention. Conclusion: This study describes a protocol for pilot, peer-led, social marketing and youth-involved intervention, where adolescents design and implement activities for their younger peers to promote healthy lifestyles. Full article

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Open AccessReview

An Overview of Factors Associated with Adherence to Lifestyle Modification Programs for Weight Management in Adults

by Alice W. Y. Leung, Ruth S. M. Chan, Mandy M. M. Sea and Jean Woo

Int. J. Environ. Res. Public Health 2017, 14(8), 922; https://doi.org/10.3390/ijerph14080922 - 16 Aug 2017

Cited by 110 | Viewed by 9413

Abstract

This review aims to provide an overview of the factors associated with adherence reported in existing literature on lifestyle modification programs for weight management among the adult population. An electronic search was performed using PubMed, Medline, PsycINFO and PsycARTICLE to identify studies that [...] Read more.

This review aims to provide an overview of the factors associated with adherence reported in existing literature on lifestyle modification programs for weight management among the adult population. An electronic search was performed using PubMed, Medline, PsycINFO and PsycARTICLE to identify studies that examined the factors of adherence to lifestyle modification programs with explicit definition of adherence indicators. We identified 19 studies published between 2004 and 2016. The most commonly used indicator of adherence was attrition, followed by attendance, self-monitoring and dietary adherence. A broad array of factors has been studied but only few studies exploring each factor. Limited evidence suggested older age, higher education, healthier eating and physical activity behaviours, higher stage of change at baseline and higher initial weight loss may predict better adherence. On the other hand, having depression, stress, strong body shape concern, more previous weight loss attempts and being unemployed may predict poor adherence. Inconsistent findings were obtained for self-efficacy, motivation and male gender. This review highlights the need for more rigorous studies to enhance our knowledge on factors related to adherence. Identification of the factors of adherence could provide important implication for program improvement, ultimately improving the effectiveness and the cost-effectiveness of lifestyle modification program. Full article

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

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Open AccessArticle

Association between Promoter Methylation of Gene ERCC3 and Benzene Hematotoxicity

by Min Zheng, Feiliang Lin, Fenxia Hou, Guilan Li, Caiying Zhu, Peiyu Xu, Caihong Xing and Qianfei Wang

Int. J. Environ. Res. Public Health 2017, 14(8), 921; https://doi.org/10.3390/ijerph14080921 - 16 Aug 2017

Cited by 9 | Viewed by 3862

Abstract

Benzene is a primary industrial chemical and a ubiquitous environmental pollutant. ERCC3 is a key player in nucleotide excision repair. Recent studies suggested that site-specific methylation is a possible mechanism of the transcriptional dysregulation by blocking transcription factors binding. We previously found that [...] Read more.

Benzene is a primary industrial chemical and a ubiquitous environmental pollutant. ERCC3 is a key player in nucleotide excision repair. Recent studies suggested that site-specific methylation is a possible mechanism of the transcriptional dysregulation by blocking transcription factors binding. We previously found that the average promoter methylation level of ERCC3 was increased in benzene-exposed workers. In order to test whether specific CpG sites of ERCC3 play an important role in benzene-induced epigenetic changes and whether the specific methylation patterns are associated with benzene hematotoxicity, we analyzed the promoter methylation levels of individual CpG sites, transcription factor binding motif and the correlation between aberrant CpG methylation and hematotoxicity in 76 benzene-exposed workers and 24 unexposed controls in China. Out of all the CpGs analyzed, two CpG units located 43 bp upstream and 99 bp downstream of the transcription start site of ERCC3 (CpG 2–4 and CpG 17–18, respectively), showed the most pronounced increase in methylation levels in benzene-exposed workers, compared with unexposed controls (Mean ± SD: 5.86 ± 2.77% vs. 4.92 ± 1.53%, p = 0.032; 8.45 ± 4.09% vs. 6.79 ± 2.50%, p = 0.024, respectively). Using the JASPAR CORE Database, we found that CpG 2–4 and CpG 17–18 were bound by three putative transcription factors (TFAP2A, E2F4 and MZF1). Furthermore, the methylation levels for CpG 2–4 were correlated negatively with the percentage of neutrophils (β = −0.676, p = 0.005) in benzene-exposed workers. This study demonstrates that CpG-specific DNA methylation in the ERCC3 promoter region may be involved in benzene-induced epigenetic modification and it may contribute to benzene-induced hematotoxicity. Full article

(This article belongs to the Section Environmental Health)

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Open AccessArticle

Impact of Orientation on the Vitamin D Weighted Exposure of a Human in an Urban Environment

by Michael Schrempf, Nadine Thuns, Kezia Lange and Gunther Seckmeyer

Int. J. Environ. Res. Public Health 2017, 14(8), 920; https://doi.org/10.3390/ijerph14080920 - 16 Aug 2017

Cited by 15 | Viewed by 4317

Abstract

The vitamin D₃-weighted UV exposure of a human with vertical posture was calculated for urban locations to investigate the impact of orientation and obstructions on the exposure. Human exposure was calculated by using the 3D geometry of a human and integrating [...] Read more.

The vitamin D₃-weighted UV exposure of a human with vertical posture was calculated for urban locations to investigate the impact of orientation and obstructions on the exposure. Human exposure was calculated by using the 3D geometry of a human and integrating the radiance, i.e., the radiant energy from the direct solar beam and the diffuse sky radiation from different incident and azimuth angles. Obstructions of the sky are derived from hemispherical images, which are recorded by a digital camera with a fisheye lens. Due to the low reflectivity of most surfaces in the UV range, the radiance from obstructed sky regions was neglected. For spring equinox (21 March), the exposure of a human model with winter clothing in an environment where obstructions cover 40% of the sky varies by up to 25%, depending on the orientation of the human model to the sun. The calculation of the accumulated vitamin D₃-weighted exposure of a human with winter clothing walking during lunch break shows that human exposure is reduced by the obstruction of buildings and vegetation by 40%. Full article

(This article belongs to the Section Environmental Health)

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Open AccessComment

Comment on Piscitelli et al. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health. Int. J. Environ. Res. Public Health 2017, 14, 495

by Benedetto Terracini, Daniela Alessi, Elena Isaevska, Vanda Macerata, Corrado Magnani, Milena Manasievska, Milena Maule, Franco Merletti, Maria Luisa Mosso, Tiziana Rosso and Carlotta Sacerdote

Int. J. Environ. Res. Public Health 2017, 14(8), 919; https://doi.org/10.3390/ijerph14080919 - 16 Aug 2017

Cited by 2 | Viewed by 2971

Abstract

In the “Epikit study” [1], P. Piscitelli with 27 co-authors from 20 scientific institutions estimated the absolute number of hospital admissions for newly diagnosed cancer in people aged 0–19 in Italian provinces and regions in 2007–2011.[...] Full article

(This article belongs to the Section Environmental Health)

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