International Journal of Environmental Research and Public Health

7 pages, 278 KiB

Open AccessArticle

Occupational Exposures in an Equestrian Centre to Respirable Dust and Respirable Crystalline Silica

by Kathleen Bulfin, Hilary Cowie, Karen S. Galea, Alison Connolly and Marie Ann Coggins

Int. J. Environ. Res. Public Health 2019, 16(17), 3226; https://doi.org/10.3390/ijerph16173226 - 03 Sep 2019

Cited by 6 | Viewed by 4585

Sand-based products are regularly used as footing material on indoor equestrian arenas, creating a potential occupational exposure risk for respirable crystalline silica (RCS) for equestrian workers training and exercising horses in these environments. The objective of this study was to evaluate an equestrian [...] Read more.

Sand-based products are regularly used as footing material on indoor equestrian arenas, creating a potential occupational exposure risk for respirable crystalline silica (RCS) for equestrian workers training and exercising horses in these environments. The objective of this study was to evaluate an equestrian worker’s personal RCS and respirable dust (RD) exposure. Sixteen personal full-shift RD measurements were collected from an equestrian worker and analysed for RD, quartz and cristobalite. Geometric mean exposures of 0.12 mg m⁻³ and 0.02 mg m⁻³ were calculated for RD and RCS concentrations, respectively. RCS exposures of between 0.01 to 0.09 mg m⁻³ were measured on days when the indoor arena surface was not watered, compared to lower exposures (<LOD-0.03 mg m⁻³) on days when the indoor arena was watered (p < 0.01); however, manual watering is time intensive and less likely to be implemented in practice. This small-scale study provides new data on RCS and RD exposures among equestrian workers. RCS exposures are within the range considered to be associated with increased risk for lung cancer. The use of dust control solutions such as water suppression should be promoted for equestrian work in horse riding arenas. Equestrian workers need to receive occupational health training on the health risks associated with RCS exposure. Full article

(This article belongs to the Special Issue Occupational and Environmental Cancer)

11 pages, 876 KiB

Open AccessArticle

Relationship between Self-Identity Confusion and Internet Addiction among College Students: The Mediating Effects of Psychological Inflexibility and Experiential Avoidance

by Kuan-Ying Hsieh, Ray C. Hsiao, Yi-Hsin Yang, Kun-Hua Lee and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2019, 16(17), 3225; https://doi.org/10.3390/ijerph16173225 - 03 Sep 2019

Cited by 34 | Viewed by 7769

Abstract

Internet addiction (IA) has become a major public health problem among college students. The aim of this study was to examine the relationship between self-identity confusion and IA and the mediating effects of psychological inflexibility and experiential avoidance (PI/EA) indicators in college students. [...] Read more.

Internet addiction (IA) has become a major public health problem among college students. The aim of this study was to examine the relationship between self-identity confusion and IA and the mediating effects of psychological inflexibility and experiential avoidance (PI/EA) indicators in college students. A total of 500 college students (262 women and 238 men) were recruited. Their levels of self-identity were evaluated using the Self-Concept and Identity Measure. Their levels of PI/EA were examined using the Acceptance and Action Questionnaire-II. The severity of IA was assessed using the Chen Internet Addiction Scale. The relationships among self- identity, PI/EA, and IA were examined using structural equation modeling. The severity of self-identity confusion was positively associated with both the severity of PI/EA and the severity of IA. In addition, the severity of PI/EA indicators was positively associated with the severity of IA. These results demonstrated that the severity of self-identity confusion was related to the severity of IA, either directly or indirectly. The indirect relationship was mediated by the severity of PI/EA. Self-identity confusion and PI/EA should be taken into consideration by the community of professionals working on IA. Early detection and intervention of self-identity confusion and PI/EA should be the objectives for programs aiming to lower the risk of IA. Full article

(This article belongs to the Special Issue Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research)

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18 pages, 341 KiB

Open AccessArticle

Association between Sick Building Syndrome and Indoor Environmental Quality in Slovenian Hospitals: A Cross-Sectional Study

by Sedina Kalender Smajlović, Andreja Kukec and Mateja Dovjak

Int. J. Environ. Res. Public Health 2019, 16(17), 3224; https://doi.org/10.3390/ijerph16173224 - 03 Sep 2019

Cited by 19 | Viewed by 3954

Abstract

Increased exposure times to various health risk factors and the vulnerability of building users might result in significantly higher prevalence rates of sick building syndrome (SBS) in a hospital setting compared to other indoor environments. The purpose of our study was to assess [...] Read more.

Increased exposure times to various health risk factors and the vulnerability of building users might result in significantly higher prevalence rates of sick building syndrome (SBS) in a hospital setting compared to other indoor environments. The purpose of our study was to assess the association between SBS symptoms and measured environmental parameters at a Slovenian general hospital. A combination of a self-assessment study and field measurements was conducted in order to estimate the health risk factors for SBS symptoms among the users of a Slovenian general hospital. The Chi-square test was used to analyse the association between observed health and environmental parameters. The response rate was 67.5%. A total of 12.0% of healthcare workers at hospital wards reported at least six SBS symptoms, 19.0% reported 2–3 SBS symptoms. At the observed hospital wards, the most deviations were recorded for the level of lighting (83.3%), noise level (73.6%), and room temperature (55.3%). A statistically significant association was found between indoor environmental quality and skin-related SBS symptoms (χ² = 0.009; p = 0.006). This information will be of great value in defining an integral strategy of environmental health activities aimed at healthier indoor environmental quality in hospitals. Full article

(This article belongs to the Section Environmental Health)

10 pages, 1323 KiB

Open AccessArticle

Enhancement of COD Removal from Oilfield Produced Wastewater by Combination of Advanced Oxidation, Adsorption and Ultrafiltration

by Xiaodong Dai, Jian Fang, Lei Li, Yan Dong and Jianhua Zhang

Int. J. Environ. Res. Public Health 2019, 16(17), 3223; https://doi.org/10.3390/ijerph16173223 - 03 Sep 2019

Cited by 15 | Viewed by 3111

Abstract

The wastewater produced from the oilfield is chemically corrosive due to high salinity in combination with high temperatures. It is also rich in contaminants, such as oil, polyacrylamide, emulsions, suspended solid, etc. The density difference between the oil and water in the wastewater [...] Read more.

The wastewater produced from the oilfield is chemically corrosive due to high salinity in combination with high temperatures. It is also rich in contaminants, such as oil, polyacrylamide, emulsions, suspended solid, etc. The density difference between the oil and water in the wastewater is low, which makes separation via gravity difficult. In this study, a combined pilot treatment is studied, which includes Fenton oxidation, settlement, activated carbon adsorption, and ultrafiltration (UF). The operational conditions of Fenton oxidation are optimized based on alleviating the fouling of the UF membrane. When the Fenton oxidation was operated at the molar ratio of H₂O₂ to FeSO₄ 3:1 and pH 2.2–2.5, the UF membrane could operate continuously for 20 h without cleaning. The membrane was fouled by the organics (oil/grease) and polymer, which can be effectively removed by composite cleaning reagent consisting of 0.1% NaOH and 0.1% sodium dodecylbenzenesulfonate (SDBS). With the UF treatment, the chemical oxygen demand (COD) of the effluent was less than 50 mg/L, which could meet the upgraded standard. Full article

(This article belongs to the Special Issue Membrane Technologies for Water and Wastewater Treatment)

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10 pages, 1506 KiB

Open AccessArticle

The Antialgal Mechanism of Luteolin-7-O-Glucuronide on Phaeocystis globosa by Metabolomics Analysis

by Jingyi Zhu, Yeyin Yang, Shunshan Duan and Dong Sun

Int. J. Environ. Res. Public Health 2019, 16(17), 3222; https://doi.org/10.3390/ijerph16173222 - 03 Sep 2019

Cited by 7 | Viewed by 2775

Abstract

Antialgal compounds from plants have been identified as promising candidates for controlling harmful algal blooms (HABs). In our previous study, luteolin-7-O-glucuronide was used as a promising algistatic agent to control Phaeocystis globosa (P. globose) blooms; however, its antialgal mechanism on P. [...] Read more.

Antialgal compounds from plants have been identified as promising candidates for controlling harmful algal blooms (HABs). In our previous study, luteolin-7-O-glucuronide was used as a promising algistatic agent to control Phaeocystis globosa (P. globose) blooms; however, its antialgal mechanism on P. globosa have not yet been elaborated in detail. In this study, a liquid chromatography linked to tandem mass spectrometry (LC-MS/MS)-based untargeted metabolomic approach was used to investigate changes in intracellular and extracellular metabolites of P. globosa after exposure to luteolin-7-O-glucuronide. Significant differences in intracellular metabolites profiles were observed between treated and untreated groups; nevertheless, metabolic statuses for extracellular metabolites were similar among these two groups. For intracellular metabolites, 20 identified metabolites showed significant difference. The contents of luteolin, gallic acid, betaine and three fatty acids were increased, while the contents of α-Ketoglutarate and acetyl-CoA involved in tricarboxylic acid cycle, glutamate, and 11 organic acids were decreased. Changes in those metabolites may be induced by the antialgal compound in response to stress. The results revealed that luteolin played a vital role in the antialgal mechanism of luteolin-7-O-glucuronide on P. globosa, because luteolin increased the most in the treatment groups and had strong antialgal activity on P. globosa. α-Ketoglutarate and acetyl-CoA were the most inhibited metabolites, indicating that the antialgal compound inhibited the growth through disturbed the tricarboxylic acid (TCA) cycle of algal cells. To summarize, our data provides insights into the antialgal mechanism of luteolin-7-O-glucuronide on P. globosa, which can be used to further control P. globosa blooms. Full article

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14 pages, 633 KiB

Open AccessReview

The Public Distribution System and Food Security in India

by Neetu Abey George and Fiona H. McKay

Int. J. Environ. Res. Public Health 2019, 16(17), 3221; https://doi.org/10.3390/ijerph16173221 - 03 Sep 2019

Cited by 48 | Viewed by 13829

Abstract

The Public Distribution System (PDS) of India plays a crucial role in reducing food insecurity by acting as a safety net by distributing essentials at a subsidised rate. While the PDS forms a cornerstone of government food and nutrition policy, India continues to [...] Read more.

The Public Distribution System (PDS) of India plays a crucial role in reducing food insecurity by acting as a safety net by distributing essentials at a subsidised rate. While the PDS forms a cornerstone of government food and nutrition policy, India continues to be home to a large population of hungry and malnourished people. This review seeks to explore the functioning and efficiency of the PDS in achieving food and nutritional security in India. A comprehensive and systematic search using the key terms “food insecurity” OR “food security” AND “Public Distribution System” OR “PDS” OR “TPDS” AND “India” identified 23 articles which met the inclusion criteria. This review draws attention to the lack of published literature in areas of PDS and food security in India. The findings of the review emphasise the role of PDS in tackling hunger and malnutrition while highlighting its limited role in improving food security and childhood mortality due to operational inefficiencies. The PDS has the potential to act as a solution to food insecurity in India if the operational inefficiencies and environmental footprints are addressed by adequate policy reforms. Full article

(This article belongs to the Section Global Health)

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15 pages, 2792 KiB

Open AccessArticle

Construction of Ecological Security Patterns in Nature Reserves Based on Ecosystem Services and Circuit Theory: A Case Study in Wenchuan, China

by Jianying Xu, Feifei Fan, Yanxu Liu, Jianquan Dong and Jixing Chen

Int. J. Environ. Res. Public Health 2019, 16(17), 3220; https://doi.org/10.3390/ijerph16173220 - 03 Sep 2019

Cited by 46 | Viewed by 3618

Abstract

Facing the demands of biodiversity conservation and ecosystem service improvement, the spatial pattern optimization of nature reserves has always been a research topic of interest. However, there remains a lack of methodological guidance in the planning of nature reserves and the surrounding areas. [...] Read more.

Facing the demands of biodiversity conservation and ecosystem service improvement, the spatial pattern optimization of nature reserves has always been a research topic of interest. However, there remains a lack of methodological guidance in the planning of nature reserves and the surrounding areas. To promote the landscape sustainability of nature reserves, we constructed ecological security patterns (ESPs) with two scenarios as a case study in Wenchuan, China. In detail, the ecological sources were identified by ecosystem service evaluation, and the resistance surface was characterized by the habitat quality. The ecological corridors were determined based on circuit theory and the minimum cumulative resistance model. The ecological sources were mainly aggregated in the protected areas, with an area of more than 1000 ha; the high-resistance values were mainly in the area with dense roads or high elevation. There were 21 corridors in the scenario of only optimizing the nature reserve, while 31 corridors were identified when considering non-nature reserves, and the landscape connectivity was enhanced accordingly. The result supported constructing the ESPs between nature and non-nature reserves in Wenchuan to further protect pandas, and a methodological contribution was made to understand the differences of ESPs between them, thus supporting a methodological formulation of sustainable landscape patterns. Full article

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Graphical abstract

18 pages, 4795 KiB

Open AccessArticle

Synergy of Photocatalysis and Adsorption for Simultaneous Removal of Hexavalent Chromium and Methylene Blue by g-C₃N₄/BiFeO₃/Carbon Nanotubes Ternary Composites

by Huiwen Huo, Xinjiang Hu, Hui Wang, Jiang Li, Guangyu Xie, Xiaofei Tan, Qi Jin, Daixi Zhou, Chuang Li, Guoqiang Qiu and Yunguo Liu

Int. J. Environ. Res. Public Health 2019, 16(17), 3219; https://doi.org/10.3390/ijerph16173219 - 03 Sep 2019

Cited by 22 | Viewed by 3414

Abstract

A novel graphite-phase carbon nitride (g-C₃N₄)/bismuth ferrite (BiFeO₃)/carbon nanotubes (CNTs) ternary magnetic composite (CNBT) was prepared by a hydrothermal synthesis. Using this material, Cr(VI) and methylene blue (MB) were removed from wastewater through synergistic adsorption and photocatalysis. [...] Read more.

A novel graphite-phase carbon nitride (g-C₃N₄)/bismuth ferrite (BiFeO₃)/carbon nanotubes (CNTs) ternary magnetic composite (CNBT) was prepared by a hydrothermal synthesis. Using this material, Cr(VI) and methylene blue (MB) were removed from wastewater through synergistic adsorption and photocatalysis. The effects of pH, time, and pollutant concentration on the photocatalytic performance of CNBT, as well as possible interactions between Cr(VI) and MB species were analyzed. The obtained results showed that CNTs could effectively reduce the recombination rate of electron-hole pairs during the photocatalytic reaction of the g-C₃N₄/BiFeO₃ composite, thereby improving its photocatalytic performance, while the presence of MB increased the reduction rate of Cr(VI). After 5 h of the simultaneous adsorption and photocatalysis by CNBT, the removal rates of Cr(VI) and MB were 93% and 98%, respectively. This study provides a new theoretical basis and technical guidance for the combined application of photocatalysis and adsorption in the treatment of wastewaters containing mixed pollutants. Full article

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

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16 pages, 2738 KiB

Open AccessArticle

Biouptake Responses of Trace Metals to Long-Term Irrigation with Diverse Wastewater in the Wheat Rhizosphere Microenvironment

by Renfei Li, Yuan Zhang, Hong Yu, Qiuling Dang, Hanxia Yu, Beidou Xi and Wenbing Tan

Int. J. Environ. Res. Public Health 2019, 16(17), 3218; https://doi.org/10.3390/ijerph16173218 - 03 Sep 2019

Cited by 1 | Viewed by 2307

Abstract

Wastewater irrigation is widely practiced and may cause serious environmental problems. However, current knowledge on the effects of long-term irrigation with wastewater from different sources on the biouptake of trace metals (TMs) in the rhizosphere zone by plants in farmlands is limited. Here, [...] Read more.

Wastewater irrigation is widely practiced and may cause serious environmental problems. However, current knowledge on the effects of long-term irrigation with wastewater from different sources on the biouptake of trace metals (TMs) in the rhizosphere zone by plants in farmlands is limited. Here, we analyzed wheat rhizosphere soil and wheat roots collected from a typical wastewater irrigation area in North China to evaluate the influence of wastewater irrigation from different sources on the bioavailability of trace metals in soils. Results showed that irrigation with tanning and domestic wastewater helped enhance the bioavailability of trace metals in rhizosphere soil by increasing the active organic carbon content, soil redox potential, and catalase activity, thus enhancing the proportion of the potentially bioavailable part of trace metal speciation. Conversely, irrigation with pharmaceutical wastewater can reduce the bioavailability of trace metals in rhizosphere soil by increasing total soil antibiotics and thus decreasing the proportions of bioavailable and potentially bioavailable parts of trace metal speciation. These findings can provide insights into the migration and transformation of trace metal speciation in soil rhizosphere microenvironments under the context of wastewater irrigation. Full article

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12 pages, 1216 KiB

Open AccessArticle

Correlates of School Children’s Handwashing: A Study in Tibetan Primary Schools

by Chang Sun, Qingzhi Wang, Sasmita Poudel Adhikari, Ruixue Ye, Sha Meng, Yuju Wu, Yuping Mao, Hein Raat and Huan Zhou

Int. J. Environ. Res. Public Health 2019, 16(17), 3217; https://doi.org/10.3390/ijerph16173217 - 03 Sep 2019

Cited by 7 | Viewed by 4577

Abstract

Hand hygiene, including handwashing by children, has been reported to contribute to the prevention of various infectious conditions. This study aims to explore the correlates of handwashing behavior among 1690 fourth to sixth grade primary school students in 19 Tibetan primary schools (Golog, [...] Read more.

Hand hygiene, including handwashing by children, has been reported to contribute to the prevention of various infectious conditions. This study aims to explore the correlates of handwashing behavior among 1690 fourth to sixth grade primary school students in 19 Tibetan primary schools (Golog, Qinghai, China). The theory of reasoned action (TRA) was applied. Data was collected by questionnaire. Structural equation modeling (SEM) analysis showed that students’ attitude (β = 0.22, 95% CI 0.13–0.31) and subjective norms in terms of compliance to teachers’, parents’ and peers’ suggestions to wash hands (β = 0.09, 95% CI 0.01–0.18) were directly associated with students’ handwashing behavior. Students’ knowledge (β = 0.04, 95% CI 0.03–0.07) had an indirect association with handwashing behavior, mediated by students’ attitudes and subjective norms. Subjective norms (β = 0.12, 95% CI 0.07–0.17) were also indirectly correlated with handwashing through students’ attitudes. Therefore, our study supported the theory of reasoned action through our findings that students’ attitude and knowledge, and also attitudes from teachers, parents and peers were correlated with student handwashing behavior. Students reported higher level of compliance to teachers than to their parents and classmates. Based on this information, we recommend teacher-involved participatory hygiene education to promote students’ handwashing behaviors in areas at high risk for infectious diseases that can be prevented by handwashing. Full article

(This article belongs to the Special Issue Advanced Inequalities in Child and Adolescent Health and Well-being)

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12 pages, 330 KiB

Open AccessArticle

The Reliability and Validity of the Telephone-Based and Online Polish eHealth Literacy Scale Based on Two Nationally Representative Samples

by Mariusz Duplaga, Karolina Sobecka and Sylwia Wójcik

Int. J. Environ. Res. Public Health 2019, 16(17), 3216; https://doi.org/10.3390/ijerph16173216 - 03 Sep 2019

Cited by 29 | Viewed by 3855

Abstract

Adequate ehealth literacy is one of the key instruments safeguarding people against unreliable health-related information obtained from the Internet. This paper presents an assessment of the reliability and the validity of a Polish version of the ehealth literacy scale (Pl-eHEALS). The assessment was [...] Read more.

Adequate ehealth literacy is one of the key instruments safeguarding people against unreliable health-related information obtained from the Internet. This paper presents an assessment of the reliability and the validity of a Polish version of the ehealth literacy scale (Pl-eHEALS). The assessment was carried out on the basis of two nationally representative samples of the Polish population. In the first survey of adults at least 50 years old, the technique of computer-assisted telephone interviewing (CATI) was applied. In the second survey of young adult women (18–35 years old), the technique of computer-assisted web interviewing (CAWI) was used. The reliability and the validity of the Pl-eHEALS was analyzed. There were no floor or ceiling effects revealed in either sample. The Cronbach’s alpha coefficients were 0.90 and 0.88, and Guttman split-half coefficients were 0.89 and 0.81, respectively. Exploratory factors analysis revealed single factor models in both cases. The sum of squared loadings in the first survey was 6.090 and accounted for 58.72% of the variance. In the second survey, the sum was 5.927 and was responsible for 55.06% of the variance. Hypothesis testing showed that, for older adults, higher ehealth literacy was prevalent in the respondents who used the Internet more frequently. Among young adult women, higher readiness to use the Internet as a primary source of health-related information and to undertake specific internet health-related activities was associated with higher ehealth literacy. The analysis reported in this paper confirmed the reliability and the validity of the instrument. It should be stressed that, prior to this study, there was no validated Polish version of the eHEALS that could be used with Polish-speaking respondents. Full article

(This article belongs to the Section Digital Health)

13 pages, 288 KiB

Open AccessArticle

Knowledge, Attitude and Practice of Pilgrims Regarding Heat-Related Illnesses during the 2017 Hajj Mass Gathering

by Saber Yezli, Abdulaziz Mushi, Yara Yassin, Fuad Maashi and Anas Khan

Int. J. Environ. Res. Public Health 2019, 16(17), 3215; https://doi.org/10.3390/ijerph16173215 - 03 Sep 2019

Cited by 15 | Viewed by 3387

Abstract

The Hajj mass gathering attended by over two million Muslim pilgrims from around the world is a risk for heat-related illnesses (HRIs). We investigated the knowledge, attitude and practice (KAP) of pilgrims attending the 2017 Hajj regarding HRIs and their prevention. Adult pilgrims [...] Read more.

The Hajj mass gathering attended by over two million Muslim pilgrims from around the world is a risk for heat-related illnesses (HRIs). We investigated the knowledge, attitude and practice (KAP) of pilgrims attending the 2017 Hajj regarding HRIs and their prevention. Adult pilgrims (1801) from six countries in Africa, Asia and the Middle East were interviewed using a structured questionnaire. Pilgrims had a mean age of 47.2 years (SD = 12.6) and a male:female ratio of 2.2:1. Over 83% declared having at least a secondary education. Pilgrims generally had good knowledge and above average attitude and practice according to our scoring criteria. Most pilgrims were aware of HRIs and preventive measures. However, poor hydration and reluctance to use certain preventive measures or to change Hajj activities’ schedule based on environmental temperature were noted. Age, nationality and level of education were significantly associated with a good knowledge of HRIs. Only nationality was significantly associated with good attitude, and good practice was significantly associated with gender, age and nationality. There were significant positive correlations between the KAP scores. These results can serve as baseline data to design effective general or targeted interventions to improve pilgrims’ knowledge and behavior and to reduce their risk of HRIs during Hajj. Full article

(This article belongs to the Section Environmental Health)

14 pages, 573 KiB

Open AccessArticle

Investigating the Prevalence and Predictors of Injury Occurrence in Competitive Hip Hop Dancers: Prospective Analysis

by Eva Ursej, Damir Sekulic, Dasa Prus, Goran Gabrilo and Petra Zaletel

Int. J. Environ. Res. Public Health 2019, 16(17), 3214; https://doi.org/10.3390/ijerph16173214 - 03 Sep 2019

Cited by 17 | Viewed by 4204

Abstract

Hip hop is a popular form of competitive and recreational sport worldwide, but studies rarely investigate injury prevalence and factors associated with injury occurrence in this sport. This study aimed to prospectively examine injury occurrence in hip hop dancers in a three-month period [...] Read more.

Hip hop is a popular form of competitive and recreational sport worldwide, but studies rarely investigate injury prevalence and factors associated with injury occurrence in this sport. This study aimed to prospectively examine injury occurrence in hip hop dancers in a three-month period and to evaluate potential predictors of injury occurrence in hip hop dancers. The participants were 129 competitive hip hop dancers (114 females, 17.95 ± 4.15 years of age). Study predictors were obtained at study baseline and included sociodemographic factors, sport-related factors, previous injury status, anthropometric and body build indices (body height, mass, body mass index, and body composition variables), and dynamic balance performance (obtained by the Star Excursion Balance Test—SEBT). The outcome was injury occurrence, which was prospectively observed once a week by the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC). During the course of the study, 101 injuries occurred, equating to an annual injury incidence of 312%. On average, each dancer suffered 0.78 injuries (95% Confidence Interval (95% CI): 0.61–0.97) across a study period of three months (0.76 (95% CI: 0.60–0.95) and 0.93 (95% CI: 0.75–1.13), in females and males, respectively; Mann Whitney Z-value: 0.68, p = 0.52). Seventeen percent of dancers suffered multiple injuries, and 49% of all injuries were time-loss injuries. The knee was the most frequently injured body location (42% of all reported injuries), followed by the back region (32%) and the ankle (15%). Previous injury was a strong predictor of injury occurrence (Odds Ratio: 3.76, 95% CI: 1.87–4.59). Lower injury risk was evidenced among those participants who achieved better scores on several SEBT variables, irrespective of gender and previous injury status; with no significant influence of anthropometric and body build variables on injury occurrence. This study highlighted a high injury rate in hip hop dancers. Dancers and coaches should be informed about the certain protective effects of dynamic balance on the prevention of musculoskeletal injury in hip hop in order to assure safe and effective practices. The usage of SEBT as a convenient and cheap testing procedure is encouraged in other dance disciplines. Full article

(This article belongs to the Special Issue Effect of Sport Activity on Health Promotion 2019)

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14 pages, 322 KiB

Open AccessArticle

Secondary Traumatization, Psychological Stress, and Resilience in Psychosocial Emergency Care Personnel

by Anja Greinacher, Alexander Nikendei, Renate Kottke, Jürgen Wiesbeck, Wolfgang Herzog and Christoph Nikendei

Int. J. Environ. Res. Public Health 2019, 16(17), 3213; https://doi.org/10.3390/ijerph16173213 - 03 Sep 2019

Cited by 25 | Viewed by 4310

Abstract

Volunteers active in psychosocial emergency care offer psychological first aid to survivors of accidents and trauma, their relatives, eye witnesses, bystanders, and other first responders. So far, there are no studies that investigate the secondary and primary traumatization of this group of first [...] Read more.

Volunteers active in psychosocial emergency care offer psychological first aid to survivors of accidents and trauma, their relatives, eye witnesses, bystanders, and other first responders. So far, there are no studies that investigate the secondary and primary traumatization of this group of first responders. We included N = 75 volunteers, who filled out questionnaires to assess their secondary (QST/FST) and primary traumatization (PDS), and levels of comorbid psychological stress (PHQ-9, GAD-7, SF-12). We investigated factors of resilience by measuring attachment behavior (ECR-RD, RQ-2), level of personality functioning (OPD-SFK), sense of coherence (SOC-29), social support (F-SozU), and mindfulness (MAAS). The volunteers’ levels of secondary and primary traumatization were below cut-off scores. Their levels of comorbid psychological stress were comparable to representative norm samples. Additionally, the volunteers presented high levels of resilience. Gender (β = 0.26; p < 0.05), case discussions (β = −0.37; p < 0.05), and social support (β = 0.45; p < 0.01) were revealed to be predictors of secondary traumatization, while mindfulness turned out to be a predictor of primary traumatization (β = −0.34; p = 0.008). However, we cannot rule out that the low prevalence of traumatization and comorbid psychological stress in our study sample might not be explained by a positive response bias. Full article

(This article belongs to the Section Health Care Sciences & Services)

14 pages, 871 KiB

Open AccessArticle

Can Leadership Enhance Patient Satisfaction? Assessing the Role of Administrative and Medical Quality

by Muhammad Asif, Arif Jameel, Noman Sahito, Jinsoo Hwang, Abid Hussain and Faiza Manzoor

Int. J. Environ. Res. Public Health 2019, 16(17), 3212; https://doi.org/10.3390/ijerph16173212 - 03 Sep 2019

Cited by 42 | Viewed by 10802

Abstract

This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and [...] Read more.

This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and medical quality on the relationship between participative leadership and patient satisfaction. The data was obtained from 123 public sector hospitals in Pakistan. We employed confirmatory factor analysis (CFA) and structural equation modeling (SEM) techniques to test the structural model. From the study results, we found significant and positive relationships between participative, administrative quality, medical quality, and patient satisfaction. In addition, our research found administrative quality and medical quality as potential mediators on PL-PS relation. Adopting participative leadership as an exogenous factor, and both administrative and medical quality as potential mediators of patient satisfaction, provided new insights into MBNQA criteria. Full article

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

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18 pages, 1562 KiB

Open AccessArticle

Handmade Comal Tortillas in Michoacán: Traditional Practices along the Rural-Urban Gradient

by Esperanza Arnés and Marta Astier

Int. J. Environ. Res. Public Health 2019, 16(17), 3211; https://doi.org/10.3390/ijerph16173211 - 03 Sep 2019

Cited by 11 | Viewed by 4868

Abstract

Certain components of global food security continue to be threatened. Globalization has impacted food patterns, leading to greater homogenization of diets and the standardization of processes of food transformation, both in the countryside and in the cities. In Mexico, this has led to [...] Read more.

Certain components of global food security continue to be threatened. Globalization has impacted food patterns, leading to greater homogenization of diets and the standardization of processes of food transformation, both in the countryside and in the cities. In Mexico, this has led to a drop in the use of native corn landraces and in the value associated with traditional practices around their growing and the processing and consumption of tortillas. The aim of this work was to analyze the main characteristics of the handmade comal tortilla system along the rural-urban gradient taking into account: (1) The type of seed and production, (2) manufacturing processes, (3) marketing channels and purpose of sales, and (4) perceptions regarding the quality of the product. Research was conducted on 41 handmade tortilla workshops located in rural areas in the Lake Pátzcuaro Basin and in urban and peri-urban areas of a medium-sized city in Michoacán (Mexico). Results showed that the origin of the grain follows a gradient-like pattern: In rural areas, tortillas are made with local and native corn predominate, while in urban contexts most tortillas come from hybrid corn produced in Sinaloa or Jalisco. There is a generalized preference for white tortillas, but blue tortillas are used for personal consumption in rural areas and as a gourmet product in the city. 100% of the rural workshops make their own nixtamal, while almost 50% of the peri-urban and urban businesses buy pre-made nixtamal dough. Surprisingly, 50% of the rural handmade tortilla workshops admit that they add nixtamalized corn flour and/or wheat flour to their tortilla mix. We conclude that not all handmade comal tortillas are produced equally and, although in rural areas traditions are better preserved, these also have contradictions. We also conclude that it is important to promote the revaluation of agrobiodiversity, traditional gastronomy, and food security without sacrificing quality, nutrition, and flavor. Full article

(This article belongs to the Special Issue Towards More Sustainable Food Systems)

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12 pages, 335 KiB

Open AccessArticle

Assessing the Mental Health, Physical Activity Levels, and Resilience of Today’s Junior College Students in Self-Financing Institutions

by Susan Ka Yee Chow and Edward Kwok Yiu Choi

Int. J. Environ. Res. Public Health 2019, 16(17), 3210; https://doi.org/10.3390/ijerph16173210 - 03 Sep 2019

Cited by 30 | Viewed by 7284

Abstract

In recent decades, the number of adolescents and young adults with poor mental health has been increasing, particularly among students in tertiary institutions. This study investigates the physical activities, resilience, and mental health status of junior college students in Hong Kong. The questionnaire [...] Read more.

In recent decades, the number of adolescents and young adults with poor mental health has been increasing, particularly among students in tertiary institutions. This study investigates the physical activities, resilience, and mental health status of junior college students in Hong Kong. The questionnaire consisted of demographic characteristics, the Positive Mental Health Scale, the Brief Resilience Scale, and the Godin-Shephard Leisure-Time Physical Activity Questionnaire. Four hundred and sixteen students participated in the study. The results showed a moderate positive correlation (r = 0.485) between resilience and mental health, and a low positive correlation (r = 0.258) between resilience and physical activity. The one-way analysis of variance (ANOVA) with a post hoc test showed that arts students engaged in more physical activity than students from other disciplines. A multiple regression analysis was used to examine the predictors of a positive mental health status. The significant predictors are: resilience (β = 0.704; 95% CI = 0.575–0.833; P < 0.001), physical activity score (β = 0.032; 95% CI = 0.016–0.048; P < 0.001), the male gender (β = 1.035, 95% CI = 0.171–1.900; P < 0.05), and students’ enrollment in a health science discipline (β = 1.052, 95% CI = 0.175–1.930; P < 0.05). Preventive measures, such as strengthening resilience, a broad curriculum and taking note of the demographic and cognitive characteristics of students are essential for improving the mental health of freshmen in colleges. Full article

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

9 pages, 877 KiB

Open AccessArticle

Presbyopia and Other Eye Conditions in Teachers in Ghana

by Charles Koduah, Catey Bunce and Clare Gilbert

Int. J. Environ. Res. Public Health 2019, 16(17), 3209; https://doi.org/10.3390/ijerph16173209 - 03 Sep 2019

Cited by 3 | Viewed by 3232

Abstract

The aim of this paper is to assess the eye health needs of school teachers in the Asutifi districts of Ghana. Presenting distance visual acuity was measured in each eye. Those with visual acuity of <6/12 in one or both eyes had subjective [...] Read more.

The aim of this paper is to assess the eye health needs of school teachers in the Asutifi districts of Ghana. Presenting distance visual acuity was measured in each eye. Those with visual acuity of <6/12 in one or both eyes had subjective refraction. All underwent basic eye examination and near functional vision was assessed for teachers aged ≥35 years using the Near Activity Visual Questionnaire (NVAQ). Teachers with uncorrected presbyopia were given a near correction and NVAQ was assessed again at two weeks. Three hundred teachers were examined with mean (SD) age of 36.5 (9.7) years, 54.3% were male and 6.3% (95% CI: 3.8 to 9.8%) had a presenting acuity of <6/12 in one or both eyes. The estimated prevalence of moderate visual impairment was 0.7% (95% CI: 0.08 to 2.4%). Lens opacities (50%) and refractive error (18%) were the main causes of visual loss. Seventy-five out of 136 (55.1%, 95% CI: 46.6 to 63.4%) of teachers aged ≥35 years were presbyopic, 45.3% (95% CI: 36.9 to 53.7%) of whom had presbyopic correction. Lack of awareness was the major barrier to presbyopic correction. Median Rasch score for teachers given presbyopic correction (n = 39) decreased by 60.6% from 46.0 (IQR: 10.7 to 72.8) to 18.1 (IQR: 0 to 58.9) and overall satisfaction with near vision improved at follow up. Prevalence of presbyopia was high, and spectacles improved satisfaction with near vision. Full article

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10 pages, 497 KiB

Open AccessArticle

The Relationship between Sleep Duration and Perceived Stress: Findings from the 2017 Community Health Survey in Korea

by Hwi Jun Kim, So Yeon Oh, Jae Hong Joo, Dong-Woo Choi and Eun-Cheol Park

Int. J. Environ. Res. Public Health 2019, 16(17), 3208; https://doi.org/10.3390/ijerph16173208 - 03 Sep 2019

Cited by 18 | Viewed by 5136

Abstract

Sleep is exceedingly important for our physical, physiological, psychological, and social health. Currently, few Koreans get the recommended daily amount of sleep. Stress can also have a major impact on our physiological, neurological, and mental health. In this study, we explored the correlation [...] Read more.

Sleep is exceedingly important for our physical, physiological, psychological, and social health. Currently, few Koreans get the recommended daily amount of sleep. Stress can also have a major impact on our physiological, neurological, and mental health. In this study, we explored the correlation between sleep duration and perceived stress. The study used data from the Community Health Survey (CHS), 2017, which included 133,444 responses from Koreans. Sleeping time and stress were measured by self-diagnosis. The relationship between sleeping time and stress was analyzed using the chi-square test and multivariable regression. Both men and women felt the most stress when they slept for an average of 6 h a day. The results of the subgroup analysis showed that even when they sleep for the same time, younger people felt more stressed than older people. In the group that slept for an average of 6 h a day, women were the most stressed. We observed a correlation between sleeping time and stress in Korean adults. We found that about 16.7% of Koreans were sleeping for less than 5 h. This is less than the 7–9 h of sleep recommended by the National Sleep Foundation (NSF). In addition, stress was found to increase when sleep was insufficient. In particular, it was also observed that young people who slept for less than 8 h felt stressed more easily. Full article

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11 pages, 708 KiB

Open AccessArticle

Polymorphisms in PCSK9, LDLR, BCMO1, SLC12A3, and KCNJ1 Are Associated with Serum Lipid Profile in Chinese Han Population

by Zheng Li, Tianyu Zhao, Xiaohua Tan, Song Lei, Liu Huang and Lei Yang

Int. J. Environ. Res. Public Health 2019, 16(17), 3207; https://doi.org/10.3390/ijerph16173207 - 02 Sep 2019

Cited by 7 | Viewed by 2685

Abstract

Unfavorable serum lipid levels are the most important risk factors for coronary artery disease (CAD), cerebral infarction, and other cardiovascular and cerebrovascular diseases. This study included 2323 Han Chinese in southern China. We collected medical reports, lifestyle details, and blood samples of individuals [...] Read more.

Unfavorable serum lipid levels are the most important risk factors for coronary artery disease (CAD), cerebral infarction, and other cardiovascular and cerebrovascular diseases. This study included 2323 Han Chinese in southern China. We collected medical reports, lifestyle details, and blood samples of individuals and used the polymerase chain reaction-ligase detection reaction method to genotype single-nucleotide polymorphisms (SNPs). Two SNPs showed a strong evidence of association with total cholesterol (TC): rs1003723 and rs6413504 in the low-density lipoproteins receptor (LDLR). Two SNPs in LDLR showed a strong evidence of association with low-density lipoprotein cholesterol (LDL-C), rs1003723 and rs6413504. Two SNPs showed a strong evidence of association with triglycerides (TG), namely, rs662145 in pro-protein convertase subtilisin-kexin type 9 (PCSK9) and rs11643718 in the solute carrier family 12 member 3 (SLC12A3). For the TC, LDL-C, and TG levels, these SNPs generated strong combined effects on these lipid levels. For each additional dangerous gene, TC increased by 0.085 mmol/L (p = 7.00 × 10⁻⁶), and LDL-C increased by 0.075 mmol/L (p = 9.00 × 10⁻⁶). The TG increased by 0.096 mmol/L (p = 2.90 × 10⁻⁵). Compared with those bearing no risk alleles, the risk of hypertriglyceridemia, hypercholesterolemia, and dyslipidemia increased in those with two or more risk alleles and one risk gene. Polymorphisms of PCSK9, LDLR, and SLC12A3 were associated with the plasma lipid levels in people in southern China. These results provide a theoretical basis for gene screening and the prevention of dyslipidemia. Full article

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15 pages, 898 KiB

Open AccessArticle

Exploring the Linkage between the Neighborhood Environment and Mental Health in Guangzhou, China

by Yingzhi Qiu, Yuqi Liu, Yi Liu and Zhigang Li

Int. J. Environ. Res. Public Health 2019, 16(17), 3206; https://doi.org/10.3390/ijerph16173206 - 02 Sep 2019

Cited by 34 | Viewed by 4614

Abstract

The relationship between the neighborhood environment and mental health has been investigated mostly in developed countries. Yet few studies have systematically examined the impact of the neighborhood-level built-environment and social environment on mental health within different localities in the Chinese context. Based on [...] Read more.

The relationship between the neighborhood environment and mental health has been investigated mostly in developed countries. Yet few studies have systematically examined the impact of the neighborhood-level built-environment and social environment on mental health within different localities in the Chinese context. Based on a household survey and geographical data in Guangzhou, China, this study aimed to explore the linkage between the neighborhood environment and mental health, with a particular focus on aspects of the built-environment that are related to new urbanism or compact cities and contextual social capital, using three geographic delineations. Our findings indicated that built-environment indicators based on a road network buffer had a higher explanatory power towards residents’ mental health than did those based on a circular buffer. The analytical models demonstrated that neighborhood floor-area ratio, building density, and per capita green area were positively correlated with mental health. Neighborhood safety and contextual neighborhood interactions and reciprocity had positive associations with mental health. These findings provide policy makers and urban planners with valuable information on the role of the compact city strategy and the neighborhood social environment to improve the mental health of residents. Full article

(This article belongs to the Section Mental Health)

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14 pages, 2166 KiB

Open AccessArticle

Impact of a Formative Program on Transgender Healthcare for Nursing Students and Health Professionals. Quasi-Experimental Intervention Study

by Jesús Manuel García-Acosta, Maria Elisa Castro-Peraza, Ángeles Arias Rodriguez, María Luisa Perez-Cánovas, Maria Inmaculada Sosa-Alvarez, Rosa Llabrés-Solé, Ana María Perdomo-Hernández and Nieves Doria Lorenzo-Rocha

Int. J. Environ. Res. Public Health 2019, 16(17), 3205; https://doi.org/10.3390/ijerph16173205 - 02 Sep 2019

Cited by 10 | Viewed by 3943

Abstract

Background: The field of specific healthcare for transgender people has not been included in the official curriculum of professionals. This causes a lack of knowledge that can be presumed to become a barrier to healthcare. Currently, different methodologies are emerging to achieve meaningful [...] Read more.

Background: The field of specific healthcare for transgender people has not been included in the official curriculum of professionals. This causes a lack of knowledge that can be presumed to become a barrier to healthcare. Currently, different methodologies are emerging to achieve meaningful learning for students and professionals. The objective of this study was to evaluate the increase in the level of knowledge of final-year nursing students, applying methodological strategies such as problem-based learning (PBL) and film-forum. Methods: 59 nursing students were randomly assigned to two intervention groups (G1 = 31 and G2 = 28), and another 57 were assigned to the control group (without specific classes or workshops on the subject of the study). The intervention consisted of a specific training course on transgender issues (TGSC&W, TransGender Specific Course and Workshop), where the type of meaningful learning strategy used depended on the group (G1 = film-forum and G2 = PBL). The study was carried out at the Faculty of Nursing Nuestra Señora de Candelaria of the Canary Islands Health Service. The randomization was done by blindly choosing a computer-generated code. Results: The main outcome was based on 116 participants, comparing their level of knowledge before and after the workshop. The comparison by pairs shows that there were statistically significant differences (p = 0.000) between those undergoing the methodological interventions and the control group. Statistical significance between film-forum and PBL was not obtained (p = 1.000): Both methodologies increased the level of knowledge, but there was no significant difference between them. The means for satisfaction with the learning methodology used did not show statistically significant differences. Conclusion: The workshop carried out was highly effective and significant in terms of increasing knowledge. No significant differences were observed in the level of knowledge, or in the degree of satisfaction, between the two methodologies used (PBL and film-forum). Full article

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22 pages, 12272 KiB

Open AccessArticle

Measuring Spatial Patterns of Health Care Facilities and Their Relationships with Hypertension Inpatients in a Network-Constrained Urban System

by Zhensheng Wang and Ke Nie

Int. J. Environ. Res. Public Health 2019, 16(17), 3204; https://doi.org/10.3390/ijerph16173204 - 02 Sep 2019

Cited by 3 | Viewed by 2494

Abstract

There is evidence of a strong correlation between inequality in health care access and disparities in chronic health conditions. Equal access to health care is an important indicator for overall population health, and the urban road network has a significant influence on the [...] Read more.

There is evidence of a strong correlation between inequality in health care access and disparities in chronic health conditions. Equal access to health care is an important indicator for overall population health, and the urban road network has a significant influence on the spatial distribution of urban service facilities. In this study, the network kernel density estimation was applied to detect the hot spots of health care service along the road network of Shenzhen, and we further explored the influences of population and road density on the aggregate intensity distributions at the community level, using spatial stratified heterogeneity analyses. Then, we measured the spatial clustering patterns of health care facilities in each of the ten districts of Shenzhen using the network K-function, and the interrelationships between health care facilities and hypertension patients. The results can be used to examine the reasonability of the existing health care system, which would be valuable for developing more effective prevention, control, and treatment of chronic health conditions. Further research should consider the influence of nonspatial factors on health care service access. Full article

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18 pages, 320 KiB

Open AccessArticle

Prevalence and Predictors of Violence Victimization and Violent Behavior among Youths: A Population-Based Study in Serbia

by Biljana Obradovic-Tomasevic, Milena Santric-Milicevic, Vladimir Vasic, Dejana Vukovic, Sandra Sipetic-Grujicic, Vesna Bjegovic-Mikanovic, Zorica Terzic-Supic, Ratko Tomasevic, Jovana Todorovic and Uros Babic

Int. J. Environ. Res. Public Health 2019, 16(17), 3203; https://doi.org/10.3390/ijerph16173203 - 02 Sep 2019

Cited by 11 | Viewed by 2547

Abstract

The study identifies the prevalence of violence victimization and the perpetration among youths, and explores the determinants and predictors using a socio-ecological model. The data of 36 variables from a representative sample of 1722 persons, ages 15–24 years, from the National Health Survey [...] Read more.

The study identifies the prevalence of violence victimization and the perpetration among youths, and explores the determinants and predictors using a socio-ecological model. The data of 36 variables from a representative sample of 1722 persons, ages 15–24 years, from the National Health Survey of Serbia in 2013, were analyzed by a multivariate logistic regression modeling. The study shows that 13.4% of youths experienced multi-victimization, while 10.4% were perpetrators of violence. Up to one-third of the victims were violence perpetrators. A small percentage of victims seek family and community support. Predictors of violence among youths were: male sex, households with fewer members, urban settlements, violence perpetration, self-assessed health as poor, lack of close friends and perception that it was difficult to obtain the assistance needed. Predictors of youth violence highlighted the need to improve health education, social support and community regulations, as well as strengthen the promotion of gender equality and a healthy environment. Full article

19 pages, 597 KiB

Open AccessArticle

A Systematic Review and Meta-Analysis of Nature-Based Mindfulness: Effects of Moving Mindfulness Training into an Outdoor Natural Setting

by Dorthe Djernis, Inger Lerstrup, Dorthe Poulsen, Ulrika Stigsdotter, Jesper Dahlgaard and Mia O’Toole

Int. J. Environ. Res. Public Health 2019, 16(17), 3202; https://doi.org/10.3390/ijerph16173202 - 02 Sep 2019

Cited by 59 | Viewed by 13957

Abstract

Research has proven that both mindfulness training and exposure to nature have positive health effects. The purpose of this study was to systematically review quantitative studies of mindfulness interventions conducted in nature (nature-based mindfulness), and to analyze the effects through meta-analyses. Electronic searches [...] Read more.

Research has proven that both mindfulness training and exposure to nature have positive health effects. The purpose of this study was to systematically review quantitative studies of mindfulness interventions conducted in nature (nature-based mindfulness), and to analyze the effects through meta-analyses. Electronic searches revealed a total of 25 studies to be included, examining 2990 participants. Three analyses were conducted: Nature-based mindfulness interventions evaluated as open trials (k = 13), nature-based mindfulness compared with groups in non-active control conditions (k = 5), and nature-based mindfulness compared with similar interventions but without contact with nature (k = 7). The overall combined psychological, physiological, and interpersonal effects from pre- to post-intervention were statistically significant and of medium size (g = 0.54, p < 0.001). Moderation analyses showed that natural environments characterized as forests/wild nature obtained larger numerical effects than environments characterized as gardens/parks, as did informal mindfulness compared with formal mindfulness. The small number of studies included, as well as the heterogeneity and generally low quality of the studies, must be taken into consideration when the results are interpreted. PROSPERO registration number: CRD42017065639. Full article

(This article belongs to the Special Issue Nature-Based Therapies and Human Health)

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18 pages, 3159 KiB

Open AccessArticle

The Validity of Google Trends Search Volumes for Behavioral Forecasting of National Suicide Rates in Ireland

by Joana M. Barros, Ruth Melia, Kady Francis, John Bogue, Mary O’Sullivan, Karen Young, Rebecca A. Bernert, Dietrich Rebholz-Schuhmann and Jim Duggan

Int. J. Environ. Res. Public Health 2019, 16(17), 3201; https://doi.org/10.3390/ijerph16173201 - 02 Sep 2019

Cited by 42 | Viewed by 9143

Abstract

Annual suicide figures are critical in identifying trends and guiding research, yet challenges arising from significant lags in reporting can delay and complicate real-time interventions. In this paper, we utilized Google Trends search volumes for behavioral forecasting of national suicide rates in Ireland [...] Read more.

Annual suicide figures are critical in identifying trends and guiding research, yet challenges arising from significant lags in reporting can delay and complicate real-time interventions. In this paper, we utilized Google Trends search volumes for behavioral forecasting of national suicide rates in Ireland between 2004 and 2015. Official suicide rates are recorded by the Central Statistics Office in Ireland. While similar investigations using Google trends data have been carried out in other jurisdictions (e.g., United Kingdom, United Stated of America), such research had not yet been completed in Ireland. We compiled a collection of suicide- and depression-related search terms suggested by Google Trends and manually sourced from the literature. Monthly search rate terms at different lags were compared with suicide occurrences to determine the degree of correlation. Following two approaches based on vector autoregression and neural network autoregression, we achieved mean absolute error values between 4.14 and 9.61 when incorporating search query data, with the highest performance for the neural network approach. The application of this process to United Kingdom suicide and search query data showed similar results, supporting the benefit of Google Trends, neural network approach, and the applied search terms to forecast suicide risk increase. Overall, the combination of societal data and online behavior provide a good indication of societal risks; building on past research, our improvements led to robust models integrating search query and unemployment data for suicide risk forecasting in Ireland. Full article

(This article belongs to the Special Issue Technological Innovation in Clinical Healthcare and Health Management)

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12 pages, 653 KiB

Open AccessArticle

Smoke-Free Policies and Smoking Cessation in the United States, 2003–2015

by Andrea R. Titus, Lucie Kalousova, Rafael Meza, David T. Levy, James F. Thrasher, Michael R. Elliott, Paula M. Lantz and Nancy L. Fleischer

Int. J. Environ. Res. Public Health 2019, 16(17), 3200; https://doi.org/10.3390/ijerph16173200 - 02 Sep 2019

Cited by 15 | Viewed by 4525

Abstract

(1) Background: Smoking restrictions have been shown to be associated with reduced smoking, but there are a number of gaps in the literature surrounding the relationship between smoke-free policies and cessation, including the extent to which this association may be modified by sociodemographic [...] Read more.

(1) Background: Smoking restrictions have been shown to be associated with reduced smoking, but there are a number of gaps in the literature surrounding the relationship between smoke-free policies and cessation, including the extent to which this association may be modified by sociodemographic characteristics. (2) Methods: We analyzed data from the Tobacco Use Supplement to the Current Population Survey, 2003–2015, to explore whether multiple measures of smoking restrictions were associated with cessation across population subgroups. We examined area-based measures of exposure to smoke-free laws, as well as self-reported exposure to workplace smoke-free policies. We used age-stratified, fixed effects logistic regression models to assess the impact of each smoke-free measure on 90-day cessation. Effect modification by gender, education, family income, and race/ethnicity was examined using interaction terms. (3) Results: Coverage by workplace smoke-free laws and self-reported workplace smoke-free policies was associated with higher odds of cessation among respondents ages 40–54. Family income modified the association between smoke-free workplace laws and cessation for women ages 25–39 (the change in the probability of cessation associated with coverage was most pronounced among lower-income women). (4) Conclusions: Heterogeneous associations between policies and cessation suggest that smoke-free policies may have important implications for health equity. Full article

(This article belongs to the Special Issue Tobacco Control: Policy Perspectives)

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14 pages, 3402 KiB

Open AccessArticle

Co-Exposure to SiO₂ Nanoparticles and Arsenic Induced Augmentation of Oxidative Stress and Mitochondria-Dependent Apoptosis in Human Cells

by Maqusood Ahamed, Mohd Javed Akhtar and Hisham A. Alhadlaq

Int. J. Environ. Res. Public Health 2019, 16(17), 3199; https://doi.org/10.3390/ijerph16173199 - 01 Sep 2019

Cited by 39 | Viewed by 3469

Abstract

Widespread application of silica nanoparticles (nSiO₂) and ubiquitous metalloid arsenic (As) may increase their chances of co-exposure to human beings in daily life. Nonetheless, studies on combined effects of nSiO₂ and As in human cells are lacking. We investigated the [...] Read more.

Widespread application of silica nanoparticles (nSiO₂) and ubiquitous metalloid arsenic (As) may increase their chances of co-exposure to human beings in daily life. Nonetheless, studies on combined effects of nSiO₂ and As in human cells are lacking. We investigated the co-exposure effects of nSiO₂ and As in human liver (HepG2) and human fibroblast (HT1080) cells. Results showed that nSiO₂ did not cause cytotoxicity. However, exposure of As caused oxidative stress and apoptosis in both types of cells. Interesting results were that co-exposure of a non-cytotoxic concentration of nSiO₂ significantly augmented the As induced toxicity in both cells. Intracellular level of As was higher in the co-exposure group (nSiO₂ + As) than the As group alone, suggesting that nSiO₂ facilitates the cellular uptake of As. Co-exposure of nSiO₂ and As potentiated oxidative stress indicated by pro-oxidants generation (reactive oxygen species, hydrogen peroxide and lipid peroxidation) and antioxidants depletion (glutathione level, and glutathione reductase, superoxide dismutase and catalase activities). In addition, co-exposure of nSiO₂ and As also potentiated mitochondria-mediated apoptosis suggested by increased expression of p53, bax, caspase-3 and caspase-9 genes (pro-apoptotic) and decreased expression of bcl-2 gene (anti-apoptotic) along with depleted mitochondrial membrane potential. To the best of our knowledge, this is the first study showing that co-exposure of nSiO₂ and As induced augmentation of oxidative stress and mitochondria-mediated apoptosis in HepG2 and HT1080 cells. Hence, careful attention is required for human health assessment following combined exposure to nSiO₂ and As. Full article

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

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15 pages, 1021 KiB

Open AccessArticle

Snowball Effect of User Participation in Online Environmental Communities: Elaboration Likelihood under Social Influence

by Yali Zhang, Haixin Zhang, Zhaojun Yang, Jun Sun and Chrissie Diane Tan

Int. J. Environ. Res. Public Health 2019, 16(17), 3198; https://doi.org/10.3390/ijerph16173198 - 01 Sep 2019

Cited by 3 | Viewed by 3749

Abstract

Ecological preservation and sustainable development depend on active public involvement. The emergence of online environmental communities greatly facilitates people’s participation in green endeavors. The population penetration of such platforms accelerates as existing users persuade people around them and media coverage further attracts public [...] Read more.

Ecological preservation and sustainable development depend on active public involvement. The emergence of online environmental communities greatly facilitates people’s participation in green endeavors. The population penetration of such platforms accelerates as existing users persuade people around them and media coverage further attracts public attention. This snowball effect plays an important role in the user base expansion, but the specific mechanism of social influence involved is yet to be examined. Based on the social influence theory, cognitive response theory, and elaboration likelihood model, this study establishes a research model depicting the relationship between persuasion in terms of social influence and outcomes in terms of behavioral intention and actual participation through the mediation of cognitive responses in terms of perceived value and perceived risk. Empirical results from survey observations show that social influence has both moderated (by education) and mediated (through perceived risk) effects on behavioral intention, which leads to actual participation. Meanwhile, social influence shapes the perceived value, which has a direct and strong impact on actual participation. These central and peripheral routes through which social influence affects individual participation yield useful theoretical and practical implications on human behavior with online environmental communities. Full article

(This article belongs to the Section Environmental Health)

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13 pages, 340 KiB

Open AccessArticle

Conventional Cigarette and E-Cigarette Smoking among School Personnel in Shanghai, China: Prevalence and Determinants

by Jingfen Zhu, Fanghui Shi, Gang Xu, Na Li, Jiahui Li, Yaping He and Jinming Yu

Int. J. Environ. Res. Public Health 2019, 16(17), 3197; https://doi.org/10.3390/ijerph16173197 - 01 Sep 2019

Cited by 12 | Viewed by 3294

Abstract

Smoking cigarettes and e-cigarettes is widely popular among Chinese students. Considering that school personnel are considered role models in the student community, we investigated the prevalence and determinants of such behavior among high school personnel in China so as to provide references for [...] Read more.

Smoking cigarettes and e-cigarettes is widely popular among Chinese students. Considering that school personnel are considered role models in the student community, we investigated the prevalence and determinants of such behavior among high school personnel in China so as to provide references for future related intervention measures. We used a stratified cluster sampling design on a total number of 3311 school employees recruited from 33 representative schools. Complex sampling analysis and logistic regressions were used for univariate and multivariate analyses. Among 3194 participants that met the study criteria, 7.4% were cigarette users, and 3.6% e-cigarette consumers. For conventional cigarette smokers, certain characteristics, such as being older and male, attaining less education, and having been exposed to secondhand smoke, were associated with heavier smoking. Nevertheless, e-cigarette users were predominantly male and of younger age. Those who understood the hazards of conventional cigarette smoking had less inclination to smoke but were at a higher risk of e-cigarette use. Our analysis suggests that it is necessary to target different populations for monitoring and controlling conventional cigarette smoking and e-cigarette use respectively among school personnel. In addition, China is in need of more relevant and strict anti-smoking regulations. Full article

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

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Int. J. Environ. Res. Public Health, Volume 16, Issue 17 (September-1 2019) – 221 articles

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