ALBERT

Description: Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters’ willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters’ payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters’ general practitioners using contractual service supply cost. Methods: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60–85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox’s proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. Results: More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox’s proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. Conclusions: The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However, people are willing to pay less than half of the current personal financing of cooperative medical insurance of urban and rural residents. Education level, family per capita income, and self-reported health status are the main factors affecting the cost sharing intention for general practitioners using contract service supply. According to the existing situation of different empty nesters, it is important to perfect the design of general practitioners using a contractual service policy system, according to differentiated personal financing levels.

Description: Model selection is an integral, yet contentious, component of epidemiologic research. Unfortunately, there remains no consensus on how to identify a single, best model among multiple candidate models. Researchers may be prone to selecting the model that best supports their a priori, preferred result; a phenomenon referred to as “wish bias”. Directed acyclic graphs (DAGs), based on background causal and substantive knowledge, are a useful tool for specifying a subset of adjustment variables to obtain a causal effect estimate. In many cases, however, a DAG will support multiple, sufficient or minimally-sufficient adjustment sets. Even though all of these may theoretically produce unbiased effect estimates they may, in practice, yield somewhat distinct values, and the need to select between these models once again makes the research enterprise vulnerable to wish bias. In this work, we suggest combining adjustment sets with model averaging techniques to obtain causal estimates based on multiple, theoretically-unbiased models. We use three techniques for averaging the results among multiple candidate models: information criteria weighting, inverse variance weighting, and bootstrapping. We illustrate these approaches with an example from the Pregnancy, Infection, and Nutrition (PIN) study. We show that each averaging technique returns similar, model averaged causal estimates. An a priori strategy of model averaging provides a means of integrating uncertainty in selection among candidate, causal models, while also avoiding the temptation to report the most attractive estimate from a suite of equally valid alternatives.

Description: The widespread, intentional and increasingly frequent chemical emplacement in the troposphere has gone unidentified and unremarked in the scientific literature for years. The author presents evidence that toxic coal combustion fly ash is the most likely aerosolized particulate sprayed by tanker-jets for geoengineering, weather-modification and climate-modification purposes and describes some of the multifold consequences on public health. Two methods are employed: (1) Comparison of 8 elements analyzed in rainwater, leached from aerosolized particulates, with corresponding elements leached into water from coal fly ash in published laboratory experiments, and (2) Comparison of 14 elements analyzed in dust collected outdoors on a high-efficiency particulate air (HEPA) filter with corresponding elements analyzed in un-leached coal fly ash material. The results show: (1) the assemblage of elements in rainwater and in the corresponding experimental leachate are essentially identical. At a 99% confidence interval, they have identical means (T-test) and identical variances (F-test); and (2) the assemblage of elements in the HEPA dust and in the corresponding average un-leached coal fly ash are likewise essentially identical. The consequences on public health are profound, including exposure to a variety of toxic heavy metals, radioactive elements, and neurologically-implicated chemically mobile aluminum released by body moisture in situ after inhalation or through transdermal induction.

Description: The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region’s coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region’s unique vulnerabilities, and outlines recommendations for improving the region’s ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

Description: Background and Purpose: The aim of the present study was to assess a relationship between readiness to quit and post-stroke smoking behavior. Methods: Eighty-six active smokers with first-ever ischemic stroke were recruited in a tertiary-care stroke unit. The question “Are you ready to quit smoking within the next month?” with yes/no responses and the 10-cm readiness visual analog scale (VAS) was administered during the anti-smoking intervention. Smoking status was verified at the 3- and 12-month follow-up. Results: The readiness VAS score at hospitalization was significantly lower in patients classified as smokers as compared to patients classified as non-smokers. The readiness score 〈5 cm was a significant predictor of smoking at the 3-month (OR, 7.3) and 12-month follow-up (OR, 4.9). Conclusions: The present results suggest that the readiness VAS can be used as a simple and inexpensive instrument for early identification of patients who continue to smoke after stroke.

Description: Patients with a polyherbal prescription are more likely to receive duplicate medications and thus suffer from adverse drug reactions. We conducted a population-based retrospective study to examine the items of Chinese herbal medicine (CHM) per prescription in the ambulatory care of traditional Chinese medicine (TCM) in Taiwan. We retrieved complete TCM ambulatory visit datasets for 2010 from the National Health Insurance database in Taiwan. A total of 59,790 patients who received 313,482 CHM prescriptions were analyzed. Drug prescriptions containing more than five drugs were classified as polyherbal prescriptions; 41.6% of patients were given a polyherbal prescription. There were on average 5.2 ± 2.5 CHMs: 2.3 ± 1.1 compound herbal formula items, and 3.0 ± 2.5 single Chinese herb items in a single prescription. Approximately 4.6% of patients were prescribed 10 CHMs or more. Men had a lower odds ratio (OR) among polyherbal prescriptions (OR = 0.96, 95% confidence interval [CI] 0.92–0.99), and middle-aged patients (35–49 years) had the highest frequency of polyherbal prescription (OR = 1.19, 95% CI = 1.13–1.26). Patients with neoplasm, skin and subcutaneous tissue disease, or genitourinary system disease were more likely to have a polyherbal prescription; OR = 2.20 (1.81–2.67), 1.65 (1.50–1.80), and 1.52 (1.40–1.64), respectively. Polyherbal prescription is widespread in TCM in Taiwan. Potential herb interactions and iatrogenic risks associated with polyherbal prescriptions should be monitored.

Description: Objective: To assess the burden of regional environmental factors influencing the incidence of Melanoma in the Italian population and overcome the problem of partial population coverage by local cancer registries and thematic archives. Methods: We analyzed the Italian national hospitalization records from 2001 to 2008 provided by the Ministry of Health, excluding hospital re-admissions of the same patients, in order to assess the occurrence of Melanoma over a 8-year period. Data were presented by age groups (absolute number of cases from 20 to ≥80 years old) and per Region (rates per 100,000 inhabitants) for each year. Results: The overall number of new hospitalizations due to malignant Melanoma increased by 16.8% from 2001 (n = 4846) to 2008 (n = 5823), with the rate per 100,000 inhabitants passing from 10.5 to almost 12.0 at a national level. The majority of new diagnoses of malignant Melanoma was observed in two age groups: 61–70 years old (from 979 in 2001 up to 2109 in 2008, corresponding to 15.1 and 18.1 new cases per 100,000 inhabitants, respectively) and 71–80 years old (from 954 in 2001 up to 1141 in 2008, corresponding to 19.5 and 21.8 new cases per 100,000 inhabitants, respectively). The number of hospitalizations due to Melanoma increased in all age groups with the only exception of the youngest patients aged 20–30 years old. The highest increases over the 8-year period were observed in people aged ≥81 years old (+34%), 61–70 years old (+20%) and surprisingly in the age group 31–40 years old (+17%). Southern Regions showed lower hospitalization rates compared to Northern Italy and Region Lazio. The highest increases between 2001 and 2008 were observed in Trentino/Alto Adige, Friuli Venezia Giulia, Valla d’Aosta and Veneto Region. Conclusions: Hospitalizations due to malignant Melanoma in Italy seem to be influenced by environmental or population-related factors showing a decreasing incidence rate from the Northern to Southern Regions.

Description: Background: Second hand smoke (ETS)-associated particulate matter (PM) contributes considerably to indoor air contamination and constitutes a health risk for passive smokers. Easy to measure, PM is a useful parameter to estimate the dosage of ETS that passive smokers are exposed to. Apart from its suitability as a surrogate parameter for ETS-exposure, PM itself affects human morbidity and mortality in a dose-dependent manner. We think that ETS-associated PM should be considered an independent hazard factor, separately from the many other known harmful compounds of ETS. We believe that brand-specific and tobacco-product-specific differences in the release of PM matter and that these differences are of public interest. Methods: To generate ETS of cigarettes and cigarillos as standardized and reproducible as possible, an automatic second hand smoke emitter (AETSE) was developed and placed in a glass chamber. L&M cigarettes (“without additives”, “red label”, “blue label”), L&M filtered cigarillos (“red”) and 3R4F standard research cigarettes (as reference) were smoked automatically according to a self-developed, standardized protocol until the tobacco product was smoked down to 8 mm distance from the tipping paper of the filter. Results: Mean concentration (Cmean) and area under the curve (AUC) in a plot of PM2.5 against time were measured, and compared. CmeanPM2.5 were found to be 518 μg/m3 for 3R4F cigarettes, 576 μg/m3 for L&M “without additives” (“red”), 448 μg/m3 for L&M “blue label”, 547 μg/m3 for L&M “red label”, and 755 μg/m3 for L&M filtered cigarillos (“red”). AUCPM2.5-values were 208,214 μg/m3·s for 3R4F reference cigarettes, 204,629 μg/m3·s for L&M “without additives” (“red”), 152,718 μg/m3·s for L&M “blue label”, 238,098 μg/m3·s for L&M “red label” and 796,909 μg/m3·s for L&M filtered cigarillos (“red”). Conclusion: Considering the large and significant differences in particulate matter emissions between cigarettes and cigarillos, we think that a favorable taxation of cigarillos is not justifiable.

Description: We wish to make the following changes to the published article [1], agreed upon by all authors. Claudia R. Binder has withdrawn her co-authorship. The corrected author list should therefore read: Camilo Lesmes-Fabian.[...]

Description: The cadmium (Cd) contaminated rice fields in Mae Sot District, Tak Province, Thailand has been one of the major environmental problems in Thailand for the last 10 years. We used disability adjusted life years (DALYs) to estimate the burden of disease attributable to Cd in terms of additional DALYs of Mae Sot residents. Cd exposure data included Cd and β2–microglobulin (β2-MG) in urine (as an internal exposure dose) and estimated cadmium daily intake (as an external exposure dose). Compared to the general Thai population, Mae Sot residents gained 10%–86% DALYs from nephrosis/nephritis, heart diseases, osteoporosis and cancer depending on their Cd exposure type and exposure level. The results for urinary Cd and dietary Cd intake varied according to the studies used for risk estimation. The ceiling effect was observed in results using dietary Cd intake because of the high Cd content in rice grown in the Mae Sot area. The results from β2-MG were more robust with additional DALYs ranging from 36%–86% for heart failure, cerebral infraction, and nephrosis/nephritis. Additional DALYs is a useful approach for assessing the magnitude of environmental Cd exposure. The Mae Sot population lost more healthy life compared to populations living in a non- or less Cd polluted area. This method should be applicable to various types of environmental contamination problems if exposure assessment information is available.

Description: Titanium dioxide nanoparticles (TiO2NPs) suspensions (concentration 1.0 g/L) in synthetic sweat solution were applied on Franz cells for 24 h using intact and needle-abraded human skin. Titanium content into skin and receiving phases was determined. Cytotoxicity (MTT, AlamarBlue® and propidium iodide, PI, uptake assays) was evaluated on HaCat keratinocytes after 24 h, 48 h, and seven days of exposure. After 24 h of exposure, no titanium was detectable in receiving solutions for both intact and damaged skin. Titanium was found in the epidermal layer after 24 h of exposure (0.47 ± 0.33 μg/cm2) while in the dermal layer, the concentration was below the limit of detection. Damaged skin, in its whole, has shown a similar concentration (0.53 ± 0.26 μg/cm2). Cytotoxicity studies on HaCaT cells demonstrated that TiO2NPs induced cytotoxic effects only at very high concentrations, reducing cell viability after seven days of exposure with EC50s of 8.8 × 10−4 M (MTT assay), 3.8 × 10−5 M (AlamarBlue® assay), and 7.6 × 10−4 M (PI uptake, index of a necrotic cell death). Our study demonstrated that TiO2NPs cannot permeate intact and damaged skin and can be found only in the stratum corneum and epidermis. Moreover, the low cytotoxic effect observed on human HaCaT keratinocytes suggests that these nano-compounds have a potential toxic effect at the skin level only after long-term exposure.

Description: The disposal of industrial paper mill sludge waste is a big issue and has a great importance all over the world. A study was conducted to determine the chemical properties of recycled paper mill sludge (RPMS) and assess its possibilities for land application. RPMS samples were collected from six different paper mills in Malaysia and analyzed for physical and chemical properties, heavy metals, polycyclic aromatic hydrocarbons, 13C-NMR spectra and for the presence of dioxins/furans. The RPMS was dewatered, sticky with a strong odour, an average moisture of 65.08%, pH 7.09, cation exchange capacity (CEC) 14.43 cmol (+) kg–1, N 1.45, P 0.18, K 0.12, Ca 0.82, Mg 0.73, Na 0.76 and Al, 1.38%. The polycyclic aromatic hydrocarbons (PAHs) and heavy metals levels were below the standard Class 2 limits. The dioxin and furan were in below the standard concentration of Class 1. The most prominent peak in the 13C-NMR spectra of RPMS was centered at 31 ppm, proving the presence of methylene (-CH2) groups in long aliphatic chains, with lipids and proteins. The signal at 89 ppm and highly shielded shoulder at 83 ppm were due to presence of cellulose carbon C-4, and the peak at 63 and 65 ppm was due to the cellulose carbon spectrum. The RPMS therefore contains significant amount of nutrients with safe levels of heavy metals and PAHs for environment and can be used as a fertilizer and soil amendment for land application.

Description: Doctor-shopping has caused an increase in medical expense, potential to receive duplicate medications, and suffer adverse drug reactions. We carried out a population-based retrospective study aimed at examining the user patterns of traditional Chinese medicine (TCM) ambulatory care in Taiwan. We retrieved complete TCM ambulatory visit datasets for the year 2007 from the National Health Insurance database in Taiwan. We defined the patients whose distribution of TCM physician numbers scored more than 97.5 percent (more than, or equal to, five TCM physicians) within one year as TCM doctor-shoppers. In total, 6,596,814 subjects (28.9%) paid TCM visits during that year. All 177,728 subjects (2.69%) who visited more than five (including) TCM physicians were classified as TCM shoppers. The most prevalent diagnostic grouping was upper respiratory infections (44.7%) and sprains and strains (44.0%). Men had a lower odds ratio (OR) among TCM shoppers than women (OR = 0.94, 95% confidence interval (CI) = 0.93–0.96). Younger people were less likely to be TCM shoppers than other people were. The ORs of TCM shoppers were higher among veterans and low-income patients (OR = 1.29 (1.23–1.35), and 1.33 (1.27–1.41)). In conclusion, health education on the potential of drug interactions and iatrogenic health risks incurred from doctor-shopping should be addressed to those high-risk patients.

Description: Day-to-day variability and stability of children’s physical activity levels across days of the week are not well understood. Our aims were to examine the day-to-day variability of moderate-to-vigorous physical activity (MVPA), to determine factors influencing the day-to-day variability of MVPA and to estimate stability of MVPA in children. The sample comprises 686 Portuguese children (10 years of age). MVPA was assessed with an accelerometer, and BMI was computed from measured height and weight. Daily changes in MVPA and their correlates (gender, BMI, and maturity) were modeled with a multilevel approach, and tracking was calculated using Foulkes & Davies γ. A total of 51.3% of boys and 26.2% of girls achieved 60 min/day of MVPA on average. Daily MVPA was lower during the weekend (23.6% of boys and 13.6% of girls comply with the recommended 60 min/day of MVPA) compared to weekdays (60.8% and 35.4%, boys and girls, respectively). Normal weight children were more active than obese children and no effect was found for biological maturation. Tracking is low in both boys (γ = 0.59 ± 0.01) and girls (γ = 0.56 ± 0.01). Children’s MVPA levels during a week are highly unstable. In summary, boys are more active than girls, maturation does not affect their MVPA, and obese children are less likely to meet 60 min/day of MVPA. These results highlight the importance of providing opportunities for increasing children’s daily MVPA on all days of week, especially on the weekend.

Description: The microbiological sanitary quality and safety of leafy greens and strawberries were assessed in the primary production in Belgium, Brazil, Egypt, Norway and Spain by enumeration of Escherichia coli and detection of Salmonella, Shiga toxin-producing E. coli (STEC) and Campylobacter. Water samples were more prone to containing pathogens (54 positives out of 950 analyses) than soil (16/1186) and produce on the field (18/977 for leafy greens and 5/402 for strawberries). The prevalence of pathogens also varied markedly according to the sampling region. Flooding of fields increased the risk considerably, with odds ratio (OR) 10.9 for Salmonella and 7.0 for STEC. A significant association between elevated numbers of generic E. coli and detection of pathogens (OR of 2.3 for STEC and 2.7 for Salmonella) was established. Generic E. coli was found to be a suitable index organism for Salmonella and STEC, but to a lesser extent for Campylobacter. Guidelines on frequency of sampling and threshold values for E. coli in irrigation water may differ from region to region.

Description: The objective of this research is to provide a standardized platform to monitor and predict indicators of people with traumatic brain injury using the International Classification of Functioning, Disability and Health, and analyze its potential benefits for people with disabilities, health centers and administrations. We developed a platform that allows automatic standardization and automatic graphical representations of indicators of the status of individuals and populations. We used data from 730 people with acquired brain injury performing periodic comprehensive evaluations in the years 2006–2013. Health professionals noted that the use of color-coded graphical representation is useful for quickly diagnose failures, limitations or restrictions in rehabilitation. The prognosis system achieves 41% of accuracy and sensitivity in the prediction of emotional functions, and 48% of accuracy and sensitivity in the prediction of executive functions. This monitoring and prognosis system has the potential to: (1) save costs and time, (2) provide more information to make decisions, (3) promote interoperability, (4) facilitate joint decision-making, and (5) improve policies of socioeconomic evaluation of the burden of disease. Professionals found the monitoring system useful because it generates a more comprehensive understanding of health oriented to the profile of the patients, instead of their diseases and injuries.

Description: Objectives: In 2005, China acceded to the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), the foundation for the global fight against tobacco. Certain cities in China have established local regulations to control tobacco use ahead of national policy; however, without the enforcement of statutory law, some of these regulations are merely lip service. The aim of the study was to assess the effects of city policy on smoking prevalence and on second-hand smoke (SHS) exposure status among non-smokers in Changchun City. Methods: A cross-sectional survey covering a multiple-stage, representative sample of the urban population aged ≥15 years was conducted between 1 Dec 2013 and 31 Jan 2014. The WHO and the US Centers for Disease Control and Prevention developed the questionnaires used, which included demographic characteristics, smoking behaviors and SHS exposure status. Results: Overall cigarette smoking prevalence was 23.5%; daily cigarette smoking prevalence was 21.2%. Smoking prevalence and cigarettes consumed per day was higher among men (p 〈 0.05) and those aged 45–64 years (p 〈 0.05). Among current smokers, 8.1% planned to quit within 12 months; 53.4% had no intention of quitting. Overall SHS exposure prevalence was 41.9% (workplace) and 34.1% (at home) over the previous 30 days. The weighted workplace SHS exposure prevalence increased with age. Conclusions: The high proportion of smokers with no intention of quitting and the high level of SHS exposure may constitute one of the most significant barriers to successful smoking cessation in the city. A continued drive to promote full implementation of the WHO FCTC is still needed.

Description: Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture—in the form of a primer—of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being.

Description: There is growing evidence of climate change affecting infectious disease risk in Western Europe. The call for effective adaptation to this challenge becomes increasingly stronger. This paper presents the results of a survey exploring Dutch expert perspectives on adaptation responses to climate change impacts on infectious disease risk in Western Europe. Additionally, the survey explores the expert sample’s prioritization of mitigation and adaptation, and expert views on the willingness and capacity of relevant actors to respond to climate change. An integrated view on the causation of infectious disease risk is employed, including multiple (climatic and non-climatic) factors. The results show that the experts consider some adaptation responses as relatively more cost-effective, like fostering interagency and community partnerships, or beneficial to health, such as outbreak investigation and response. Expert opinions converge and diverge for different adaptation responses. Regarding the prioritization of mitigation and adaptation responses expert perspectives converge towards a 50/50 budgetary allocation. The experts consider the national government/health authority as the most capable actor to respond to climate change-induced infectious disease risk. Divergence and consensus among expert opinions can influence adaptation policy processes. Further research is necessary to uncover prevailing expert perspectives and their roots, and compare these.

Description: Cigarette butts (tobacco product waste (TPW)) are the single most collected item in environmental trash cleanups worldwide. This brief descriptive study used an online survey tool (Survey Monkey) to assess knowledge, attitudes, and beliefs among individuals representing the Framework Convention Alliance (FCA) about this issue. The FCA has about 350 members, including mainly non-governmental tobacco control advocacy groups that support implementation of the World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC). Although the response rate (28%) was low, respondents represented countries from all six WHO regions. The majority (62%) have heard the term TPW, and nearly all (99%) considered TPW as an environmental harm. Most (77%) indicated that the tobacco industry should be responsible for TPW mitigation, and 72% felt that smokers should also be held responsible. This baseline information may inform future international discussions by the FCTC Conference of the Parties (COP) regarding environmental policies that may be addressed within FCTC obligations. Additional research is planned regarding the entire lifecycle of tobacco’s impact on the environment.

Description: The aim of this study was to assess the correlation between blood lead levels and both serum uric acid and hyperuricemia in adult residents living within an area of China with lead pollution.  We conducted a cross-sectional analysis of 2120 subjects (1180 of whom were male) between the ages of 20 and 75 years who had undergone health examinations at the Centers for Disease Control and Prevention (CDC) in a lead-polluted area of China between January 2013 and August 2014. Blood lead was positively correlated with serum uric acid in both males (r = 0.095, p = 0.001) and females (r = 0.134, p 〈 0.001). Multivariate linear regression analysis demonstrated that for males, blood lead (p = 0.006), age (p = 0.001), current smoking (p = 0.012), education (p = 0.001), triglycerides (TG) (p 〈 0.001), and serum creatinine (p 〈 0.001) were independently associated with serum uric acid. For females, blood lead (p 〈 0.001), body mass index (BMI) (p = 0.009), and TG (p 〈 0.001) were independently associated with serum uric acid. After multiple adjustments, blood lead was significantly associated with a higher prevalence of hyperuricemia when female subjects were categorized into quartiles (for the highest quartile vs. the lowest quartile, odds ratio (OR) = 2.190; 95% confidence interval (CI): 1.106–4.338; p = 0.025); however, no such association was observed for male subjects. Continuous lead exposure has an independent impact on serum uric acid for both males and females, although this impact is more pronounced for females than for males. Lead exposure is significantly associated with hyperuricemia for females but not for males.

Description: This study investigated the capability of a biosurfactant produced by a novel strain of Bacillus salmalaya to enhance the biodegradation rates and bioavailability of organic contaminants. The biosurfactant produced by cultured strain 139SI showed high physicochemical properties and surface activity in the selected medium. The biosurfactant exhibited a high emulsification index and a positive result in the drop collapse test, with the results demonstrating the wetting activity of the biosurfactant and its potential to produce surface-active molecules. Strain 139SI can significantly reduce the surface tension (ST) from 70.5 to 27 mN/m, with a critical micelle concentration of 0.4%. Moreover, lubricating oil at 2% (v/v) was degraded on Day 20 (71.5). Furthermore, the biosurfactant demonstrated high stability at different ranges of salinity, pH, and temperature. Overall, the results indicated the potential use of B. salmalaya 139SI in environmental remediation processes.

Description: Objective: To evaluate the outcome of 80 pregnant women with systemic lupus erythematosus (SLE) and explore the risk factors for lupus flare, obstetric complications and fetal loss. Methods: 83 pregnancies in 80 women were divided into three groups. Group A: patients in remission for > 6 months before pregnancy, proteinuria 〈 0.5 g per day, without renal failure and discontinuation of cytotoxic drugs for > one year; Group B: patients with SLE disease activity in the six months before pregnancy; Group C: patients with new onset SLE during pregnancy. Results: In group A, 76.47% pregnancies achieved full-term deliveries and 80.39% achieved live born infants. In group B and C, the outcome was poor. Among 62 patients (64 pregnancies) diagnosed as SLE before pregnancy, SLE flares occurred in 27 (42.19%) pregnancies. SLE disease activity in the six months before pregnancy was significantly associated with lupus flare (OR 5.00, 95% CI 1.14–21.87, p = 0.03) and fetal loss. New onset lupus during pregnancy was independently associated with obstetric complications (OR 7.22, 95% CI 2.14–24.38, p = 0.001). Conclusions: The current study confirmed the previous report that SLE should be considered a high risk of pregnancy. If pregnancy is planned after remission for > 6 months, the favorable outcome can be achieved.

Description: Purpose: To determine the epidemiological characteristics of work-related eye injury in representative southwest region of China. Methods: Patients with eye injuries treated at the Ninth People’s Hospital of Chongqing from 1 January 2014 to 31 December 2014 were included in the current study. All patients completed a comprehensive examination and interview. Demographic characteristics and injury details were recorded. The International Classification of Diseases (ICD-10) and Birmingham Eye Trauma Terminology (BETT) were used. Results: The average age of eye injury patients was 37.52 years and the majority were male. Among the 1055 total patients, approximately 42.9% of the injuries were work-related. The highest proportion of occupational eye trauma was observed in the group between 36 and 45 years of age. Occupational ocular trauma occurred more frequently in summer, with most from 16:00 to 18:00. Metal was the most common injury cause. Foreign body on external eye was the most common diagnosis. Workers in the manufacturing industry without pre-work safety training or eye protection were far more likely to suffer from occupational ocular trauma than those with training and protection. Conclusions: This study provides insight into the epidemiological characteristics of occupational ocular trauma in southwest region of China. The current findings might be considered as a baseline for future research on regional work-related eye injuries. Our findings will provide valuable information for further development of preventive strategies.

Description: Published evidence on the impact of the integration of International Board Certified Lactation Consultants (IBCLCs) for breastfeeding promotion is growing, but still relatively limited. Our study aims at evaluating the effects of adding an IBCLC for breastfeeding support in a mother and child hospital environment. We conducted a prospective study in the maternity ward of our maternal and child health Institute, recruiting 402 mothers of healthy term newborns soon after birth. The 18-month intervention of the IBCLC (Phase II) was preceded (Phase I) by data collection on breastfeeding rates and factors related to breastfeeding, both at hospital discharge and two weeks later. Data collection was replicated just before the end of the intervention (Phase III). In Phase III, a significantly higher percentage of mothers: (a) received help to breastfeed, and also received correct information on breastfeeding and community support, (b) started breastfeeding within two hours from delivery, (c) reported a good experience with the hospital staff. Moreover, the frequency of sore and/or cracked nipples was significantly lower in Phase III. However, no difference was found in exclusive breastfeeding rates at hospital discharge or at two weeks after birth.

Description: Currently, use and disposal of plastic by consumers through waste management activities in Ghana not only creates environmental problems, but also reinforces the notion of a wasteful society. The magnitude of this problem has led to increasing pressure from the public for efficient and practical measures to solve the waste problem. This paper analyses the impact of plastic use and disposal in Ghana. It emphasizes the need for commitment to proper management of the impacts of plastic waste and effective environmental management in the country. Sustainable Solid Waste Management (SSWM) is a critical problem for developing countries with regards to climate change and greenhouse gas emission, and also the general wellbeing of the populace. Key themes of this paper are producer responsibility and management of products at end of life. The paper proposes two theatrical recovery models that can be used to address the issue of sachet waste in Ghana.

Description: A person’s image, which is determined through physical appearance, considerably affects self-esteem developed from early childhood. Scoliosis causes multiple trunk deformations that can affect a person’s perception of the body. The aim of the study was to analyze the impact of scoliosis dimension and the degree of trunk deformation on the level of self-esteem and sexual functioning in women with idiopathic scoliosis. Thirty-six women diagnosed with idiopathic scoliosis were recruited to a prospective, double-blind, randomized controlled trial. The subjects were divided into two groups depending on the value of the Cobb angle. The level of self-esteem was determined by means of the Rosenberg Self-Esteem Scale (SES), whereas the sexual functioning was assessed via the Female Sexual Function Index (FSFI). The trunk deformations were specified with the Posterior Trunk Symmetry Index (POTSI). A statistically significant correlation was proved between the amount of points received in the Rosenberg scale evaluation and the POTSI index in Group A (R = −0.56, p = 0.04). Subjects with smaller deformations within the coronal plane had a higher level of self-confidence. The trunk asymmetries in the coronal plane may have a negative effect on women with scoliosis and their self-appraisal.

Description: To investigate the association of the hygiene index values of live fresh aquatic products and food-borne diarrhea in the population of the Ningbo area in China. Volatile basic nitrogen (VBN), histamine (HIS), indole, tetrodotoxin (TTX), and paralytic, neurotoxic, amnesic and diarrhetic shellfish poisons (PSP, NSP, ASP, and DSP, respectively) in the samples of live fresh aquatic products and food-borne diarrhea cases in six studied districts were analyzed. Results indicate that the incidence rate of food-borne diarrhea is related to the hygiene index values. Aside from VBN, the main risk factors related to food-borne diarrhea in edible aquatic products include DSP (in marine fish, shrimp, and other shellfishes), NSP, and ASP (in marine shrimp and crab). Hygiene index values among different species were significantly different. No significant difference in the monitoring index values was found among the six different studied districts. The reported cases of food-borne diarrhea were positively associated with VBN and DSP in aquatic products in Haishu, Jiangbei, Zhenhai, and Beilun, as well as VBN and NSP in aquatic products in Jiangdong and Yinzhou. In conclusion, VBN, DSP, NSP, and ASP are important risk factors for the occurring of food-borne diarrhea in the population of the Ningbo area in China.

Description: Background: The relationship between policy networks and policy development among local health departments (LHDs) is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. Methods: This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer) in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. Results: All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD). Connectedness was highest among local health officials (density = .55), and slightly lower for chief science officers (d = .33) and chiefs of policy (d = .29). After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic) and tenure were the most significant predictors of formation of network ties. Conclusion: Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

Description: Computer work is characterized by sedentary static workload with low-intensity energy metabolism. The aim of our study was to evaluate the dynamics of skin surface temperature in the hand during prolonged computer mouse work under different ergonomic setups. Digital infrared imaging of the right forearm and wrist was performed during three hours of continuous computer work (measured at the start and every 15 minutes thereafter) in a laboratory with controlled ambient conditions. Four people participated in the study. Three different ergonomic computer mouse setups were tested on three different days (horizontal computer mouse without mouse pad; horizontal computer mouse with mouse pad and padded wrist support; vertical computer mouse without mouse pad). The study revealed a significantly strong negative correlation between the temperature of the dorsal surface of the wrist and time spent working with a computer mouse. Hand skin temperature decreased markedly after one hour of continuous computer mouse work. Vertical computer mouse work preserved more stable and higher temperatures of the wrist (>30 °C), while continuous use of a horizontal mouse for more than two hours caused an extremely low temperature (〈28 °C) in distal parts of the hand. The preliminary observational findings indicate the significant effect of the duration and ergonomics of computer mouse work on the development of hand hypothermia.

Description: LDH-C4 is a lactate dehydrogenase that catalyzes the conversion of pyruvate to lactate. In mammals, ldh-c was originally thought to be expressed only in testis and spermatozoa. Plateau pika (Ochotona curzoniae), which belongs to the genus Ochotona of the Ochotonidea family, is a hypoxia tolerant mammal living 3000–5000 m above sea level on the Qinghai-Tibet Plateau, an environment which is strongly hypoxic. Ldh-c is expressed not only in testis and sperm but also in somatic tissues of plateau pika. In this study, the effects of N-propyl oxamate and N-isopropyl oxamate on LDH isozyme kinetics were compared to screens for a selective inhibitor of LDH-C4. To reveal the role and physiological mechanism of LDH-C4 in skeletal muscle of plateau pika, we investigated the effect of N-isopropyl oxamate on the pika exercise tolerance as well as the physiological mechanism. Our results show that Ki of N-propyl oxamate and N-isopropyl oxamate for LDH-A4, LDH-B4, and LDH-C4 were 0.094 mmol/L and 0.462 mmol/L, 0.119 mmol/L and 0.248 mmol/L, and 0.015 mmol/L and 0.013 mmol/L, respectively. N-isopropyl oxamate is a powerful selective inhibitor of plateau pika LDH-C4. In our exercise tolerance experiment, groups treated with inhibitors had significantly lower swimming times than the uninhibited control group. The inhibition rates of LDH, LD, and ATP were 37.12%, 66.27%, and 32.42%, respectively. Our results suggested that ldh-c is expressed in the skeletal muscle of plateau pika, and at least 32.42% of ATP in the skeletal muscle is catalyzed by LDH-C4 by anaerobic glycolysis. This suggests that pika has reduced dependence on oxygen and enhanced adaptation to hypoxic environment due to increased anaerobic glycolysis by LDH-C4 in skeletal muscle. LDH-C4 in plateau pika plays the crucial role in anaerobic glycolysis and generates ATP rapidly since this is the role of LDH-A4 in most species on plain land, which provide evidence that the native humans and animals in Qinghai-Tibet plateau can adapt to the hypoxia environment.

Description: Leukemias and hematopoietic disorders induced by benzene may arise from the toxicity of benzene to hematopoietic stem or progenitor cells (HS/PCs). Since there is a latency period between initial benzene exposure and the development of leukemia, subsequent impact of benzene on HS/PCs are crucial for a deeper understanding of the carcinogenicity and hematotoxicity in post-exposure stage. This study aims to explore the effects of benzene on HS/PCs and gene-expression in Wnt, Notch and Hh signaling pathways in post-exposure stage. The C3H/He mice were injected subcutaneously with benzene (0, 150, 300 mg/kg/day) for three months and were monitored for another 10 months post-exposure. The body weights were monitored, the relative organ weights, blood parameters and bone marrow smears were examined. Frequency of lineage- sca-1+ c-kit+ (LSK) cells, capability of colony forming and expression of genes in Wnt, Notch and Hedghog (Hh) signaling pathways were also analyzed. The colony formation of the progenitor cells for BFU-E, CFU-GEMM and CFU-GM was significantly decreased with increasing benzene exposure relative to controls, while no significant difference was observed in colonies for CFU-G and CFU-M. The mRNA level of cyclin D1 was increased and Notch 1 and p53 were decreased in LSK cells in mice exposed to benzene but with no statistical significance. These results suggest that subsequent toxic effects of benzene on LSK cells and gene expression in Wnt, Notch and Hh signaling pathways persist in post-exposure stage and may play roles in benzene-induced hematotoxicity.

Description: Background: An earthquake struck Ludian in Yunnan Province (China) on 3 August 2014, resulting in 3143 injuries, 617 deaths, and 112 missing persons. Our study aimed at estimating the health status and associated determinants among adolescent survivors after the Ludian earthquake. Methods: A cross-sectional survey of 845 was conducted at the Ludian No. 1 Middle School. Descriptive statistics, t-tests, ANOVA and stepwise linear regression analysis were used for data analysis. Results: The mean scores on the physical component summary (PCS) and mental component summary (MCS) were 46.23 (SD = 7.10) and 36.34 (SD = 7.09), respectively. Lower PCS scores in the aftermath of an earthquake were associated with being trapped or in danger, being female, being an ethnic minority, injury to self and house damage, while lower MSC scores were associated with fear during the earthquake, Han ethnicity, death in the family, not being involved in the rescue and low household income. Conclusions: In our study, significant associations between demographic, socio-economic, and trauma-related experiences variables and overall physical and mental health of adolescent survivors were presented. The results of this study help expand our knowledge of health status among adolescent survivors after the Ludian earthquake.

Description: A diverse, cross-sectorial group of partners, stakeholders and researchers, collaborated to develop an evidence-informed Position Statement on active outdoor play for children aged 3–12 years. The Position Statement was created in response to practitioner, academic, legal, insurance and public debate, dialogue and disagreement on the relative benefits and harms of active (including risky) outdoor play. The Position Statement development process was informed by two systematic reviews, a critical appraisal of the current literature and existing position statements, engagement of research experts (N = 9) and cross-sectorial individuals/organizations (N = 17), and an extensive stakeholder consultation process (N = 1908). More than 95% of the stakeholders consulted strongly agreed or somewhat agreed with the Position Statement; 14/17 participating individuals/organizations endorsed it; and over 1000 additional individuals and organizations requested their name be listed as a supporter. The final Position Statement on Active Outdoor Play states: “Access to active play in nature and outdoors—with its risks— is essential for healthy child development. We recommend increasing children’s opportunities for self-directed play outdoors in all settings—at home, at school, in child care, the community and nature.” The full Position Statement provides context for the statement, evidence supporting it, and a series of recommendations to increase active outdoor play opportunities to promote healthy child development.

Description: Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression. The review indicated the need for additional “good quality” studies; however, we note that even in the face of the generally exclusionary systematic review process, our findings support the promotion of risky outdoor play for healthy child development. These positive results with the marked reduction in risky outdoor play opportunities in recent generations indicate the need to encourage action to support children’s risky outdoor play opportunities. Policy and practice precedents and recommendations for action are discussed.

Description: Background: Smoking cessation research output should move beyond descriptive research of the health problem to testing interventions that can provide causal data and effective evidence-based solutions. This review examined the number and type of published smoking cessation studies conducted in low-socioeconomic status (low-SES) and disadvantaged population groups. Methods: A systematic database search was conducted for two time periods: 2000–2004 (TP1) and 2008–2012 (TP2). Publications that examined smoking cessation in a low-SES or disadvantaged population were coded by: population of interest; study type (reviews, non-data based publications, data-based publications (descriptive, measurement and intervention research)); and country. Intervention studies were coded in accordance with the Cochrane Effective Practice and Organisation of Care data collection checklist and use of biochemical verification of self-reported abstinence was assessed. Results: 278 citations were included. Research output (i.e., all study types) had increased from TP1 27% to TP2 73% (χ² = 73.13, p 〈 0.001), however, the proportion of data-based research had not significantly increased from TP1 and TP2: descriptive (TP1 = 23% vs. TP2 = 33%) or intervention (TP1 = 77% vs. TP2 = 67%). The proportion of intervention studies adopting biochemical verification of self-reported abstinence had significantly decreased from TP1 to TP2 with an increased reliance on self-reported abstinence (TP1 = 12% vs. TP2 = 36%). Conclusions: The current research output is not ideal or optimal to decrease smoking rates. Research institutions, scholars and funding organisations should take heed to review findings when developing future research and policy.

Description: The fine particulate matter (PM2.5) problem has attracted much scientific and public attention, due to its effects on visibility, human health, and global climate. There are three factors that have important effect on PM2.5 mass concentration: domestic pollutant emission sources, external sources outside of the country, and the meteorological conditions. Nagasaki is a coastal prefecture located at the westernmost part of Japan, which is an ideal location to study pollutants from long range transport and correlation between PM2.5 and meteorological conditions. In this paper, PM2.5 concentration data and meteorological data were obtained during 1 January 2013~31 December 2013. The spatial distribution depicts that the western part of the study area has the most serious PM2.5 pollution. The correlation analysis results between PM2.5 concentration and meteorological data showed that temperature had a negative, and precipitation had a positive, correlation with PM2.5. There was a threshold in the correlations between humidity and wind speed and PM2.5. The correlation was positive or negative depending on the meteorological variable values, if these were lower or higher than the threshold. From the relationship with wind direction, it can be depicted that the west wind might bring the most pollutants to Nagasaki.

Description: Based on our field investigations of landslide hazards in the Wenchuan earthquake, some findings can be reported: (1) the multi-aspect terrain facing empty isolated mountains and thin ridges reacted intensely to the earthquake and was seriously damaged; (2) the slope angles of most landslides was larger than 45°. Considering the above disaster phenomena, the reasons are analyzed based on shaking table tests of one-sided, two-sided and four-sided slopes. The analysis results show that: (1) the amplifications of the peak accelerations of four-sided slopes is stronger than that of the two-sided slopes, while that of the one-sided slope is the weakest, which can indirectly explain the phenomena that the damage is most serious; (2) the amplifications of the peak accelerations gradually increase as the slope angles increase, and there are two inflection points which are the point where the slope angle is 45° and where the slope angle is 50°, respectively, which can explain the seismic phenomenon whereby landslide hazards mainly occur on the slopes whose slope angle is bigger than 45°. The amplification along the slope strike direction is basically consistent, and the step is smooth.

Description: Water transparency is a useful indicator of water quality or productivity and is widely used to detect long-term changes in the water quality and eutrophication of lake ecosystems. Based on short-term spatial observations in the spring, summer, and winter and on long-term site-specific observation from 1988 to 2013, the spatial, seasonal, long-term variations, and the factors affecting transparency are presented for Xin’anjiang Reservoir (China). Spatially, transparency was high in the open water but low in the bays and the inflowing river mouths, reflecting the effect of river runoff. The seasonal effects were distinct, with lower values in the summer than in the winter, most likely due to river runoff and phytoplankton biomass increases. The transparency decreased significantly with a linear slope of 0.079 m/year, indicating a 2.05 m decrease and a marked decrease in water quality. A marked increase occurred in chlorophyll a (Chla) concentration, and a significant correlation was found between the transparency and Chla concentration, indicating that phytoplankton biomass can partially explain the long-term trend of transparency in Xin’anjiang Reservoir. The river input and phytoplankton biomass increase were associated with soil erosion and nutrient loss in the catchment. Our study will support future management of water quality in Xin’anjiang Reservoir.

Description: Understanding the factors that affect residents’ waste separation behaviors helps in constructing effective environmental campaigns for a community. Using the theory of planned behavior (TPB), this study examines factors associated with waste separation behaviors by analyzing responses to questionnaires distributed in Guangzhou, China. Data drawn from 208 of 1000-field questionnaires were used to assess socio-demographic factors and the TPB constructs (i.e., attitudes, subjective norms, perceived behavioral control, intentions, and situational factors). The questionnaire data revealed that attitudes, subjective norms, perceived behavioral control, intentions, and situational factors significantly predicted household waste behaviors in Guangzhou, China. Through a structural equation modeling analysis, we concluded that campaigns targeting moral obligations may be particularly effective for increasing the participation rate in waste separation behaviors.

Description: Dengue is a serious infectious disease and a growing public health problem in many tropical and sub-tropical countries. To control this neglected tropical disease (NTD), vaccines are likely to be the most cost-effective solution. This study analyzed dengue vaccines from both a historical and longitudinal perspective by using patent data, evaluating the geographic and time coverage of innovations, the primary patent holders, the network of cooperation and partnership for vaccine research and development (R & D), the flow of knowledge and the technological domain involved. This study can be seen as an example of the use of patent information to inform policy discussions, strategic research planning, and technology transfer. The results show that 93% of patents were granted since 2000, the majority belonging to the United States and Europe, although the share of patents from developing countries has increased. Unlike another NTDs, there is great participation of private companies in R & D of dengue vaccines and partnerships and collaboration between public and private companies. Finally, in this study, the main holders showed high knowledge absorption and generated capabilities. Therefore, this issue suggests that to overcome the difficulty of translational R & D it is necessary to stimulate the generation of knowledge and relevant scientific research, to enable the productive sector to have the capacity to absorb knowledge, to turn it into innovation, and to articulate partnerships and collaboration.

Description: We examined the associations of mothers’ perception of neighborhood quality and maternal resilience with risk of preterm birth and whether maternal resilience moderated the effect of neighborhood quality perception. We analyzed data from 10,758 women with singleton births who participated in 2010–2012 Los Angeles Mommy and Baby surveys. Multilevel logistic regression models assessed the effects of mothers’ perception of neighborhood quality and maternal resilience on preterm birth (yes/no), controlling for potential confounders and economic hardship index, a city-level measure of neighborhood quality. Interaction terms were assessed for moderation. Mothers’ perception of neighborhood quality and maternal resilience were each uniquely associated with preterm birth, independent of potential confounders (p-values 〈 0.05). The risk of preterm birth among mothers who perceived their neighborhood as of poor quality was about 30% greater compared to mothers who perceived their neighborhood as of good quality; the risk was 12% greater among mothers with low resilience compared to those with high resilience. Effects of neighborhood quality were not modified by maternal resilience. The findings suggest that mothers’ perception of neighborhood quality and resilience are associated with the risk of preterm birth. Further research should explore whether initiatives aimed at improving neighborhood quality and women’s self-esteem may improve birth outcomes.

Description: The epidemic nature of obesity in industrialized countries is a serious health and social concern. The number of obese people has significantly increased in the past 20 years. In Poland excess weight and obesity are a serious epidemiological concern. In terms of the number of overweight people, Poland is a leader in Europe. Therefore, indicating many serious health concerns that are the natural consequences of this phenomenon has become important from the point of view of public health. This work identifies numerous diseases which are a direct consequence of obesity due to bad eating habits and lack of physical exercise among Poles. It discusses the negative effect of television and food commercials contributing to an increase in obesity, not only among adults but also among children. This is an overview forming grounds for further studies into ways of preventing the development of diseases due to obesity, both in Poland and in the world.

Description: In September 2005 Thailand became the first Asian country to implement a complete ban on the display of cigarettes and other tobacco products at point-of-sale (POS). This paper examined the impact of the POS tobacco display ban in Thailand, with Malaysia (which did not impose bans) serving as a comparison. The data came from the International Tobacco Control Southeast Asia Survey (2005–2011), a prospective cohort survey designed to evaluate the psychosocial and behavioral impacts of tobacco control policies. Main measures included smokers’ reported awareness of tobacco displays and advertising at POS. At the first post-ban survey wave over 90% of smokers in Thailand were aware of the display ban policy and supported it, and about three quarters thought the ban was effective. Noticing tobacco displays in stores was lowest (16.9%) at the first post-ban survey wave, but increased at later survey waves; however, the levels were consistently lower than those in Malaysia. Similarly, exposure to POS tobacco advertising was lower in Thailand. The display ban has reduced exposure to tobacco marketing at POS. The trend toward increased noticing is likely at least in part due to some increase in violations of the display bans and/or strategies to circumvent them.

Description: The rapid growth of the economy in China has caused dramatic growth in the industrial and agricultural development in the Yellow River (YR) watershed. The hydrology of the YR has changed dramatically due to the climate changes and water management practices, which have resulted in a great variation in the fluxes of riverine nutrients carried by the YR. To study these changes dissolved nutrients in the YR were measured monthly at Lijin station in the downstream region of the YR from 2002 to 2004. This study provides detailed information on the nutrient status for the relevant studies in the lower YR and the Bohai Sea. The YR was enriched in nitrate (average 314 μmol·L−1) with a lower concentration of dissolved silicate (average 131 μmol·L−1) and relatively low dissolved phosphate (average 0.35 μmol·L−1). Nutrient concentrations exhibited substantial seasonal and yearly variations. The annual fluxes of dissolved inorganic nitrogen, phosphate, and silicate in 2004 were 5.3, 2.5, and 4.2 times those in 2002, respectively, primarily due to the increase in river discharge. The relative contributions of nutrient inputs to nitrogen in the YR were: wastewater > fertilizer > atmospheric deposition > soil; while to phosphorus were: wastewater > fertilizer > soil > atmospheric deposition. The ratios of N, P and Si suggest that the YR at Lijin is strongly P-limited with respect to potential phytoplankton growth.

Description: The initiation of breastfeeding within one hour of birth has numerous nutritional and immunological benefits and has been found to reduce neonatal mortality. This community-based prospective cohort study aimed to report the rate of, and factors associated with, early initiation of breastfeeding in Western Nepal. The rate of early initiation of breastfeeding was reported, and associations between early initiation and independent variables were tested by Chi-square test, followed by multiple logistic regression. Of the 735 mother-infant pairs, a total of 310 (42.2%) reported early initiation. Mothers who were assisted by traditional attendants during childbirth, delivered by caesarean section, from ethnically disadvantaged families and had delivered low birth weight infants, were less likely to initiate breastfeeding early whereas the mothers who were from the poorest families and did not introduce prelacteal feeds to their infants were more likely to initiate breastfeeding within the first hour. Skills-training to support breastfeeding as part of the training of skilled birth attendants and other health workers is likely to promote recommended infant feeding practices.

Description: Dissolved oxygen (DO) is not only a fundamental parameter of coastal water quality, but also an indication of organics decomposed in water and their degree of eutrophication. There has been a concern about the deterioration of dissolved oxygen conditions in the Minjiang River Estuary, the longest river in Fujian Province, Southeast China. In this study, the syntheses effects on DO was analyzed by using a four year time series of DO concentration and ancillary parameters (river discharge, water level, and temperature) from the Fuzhou Research Academy of Environmental Sciences, at three automated stations along the Minjiang River Estuary. Hypoxia occurred exclusively in the fluvial sections of the estuary during the high temperature and low river discharge period and was remarkably more serious in the river reach near the large urban area of Fuzhou. Enhancement of respiration by temperature and discharge of domestic sewage and industrial wastewater, versus regeneration of waters and dilution of pollutant concentration with increased river discharge, which regarded as the dominant antagonist processes that controlled the appearance of seasonal hypoxia. During the high temperature and the drought period, minimal mainstream flow above 700 m3s−1, reduction of pollutants and forbidding sediment dredging in the South Channel should be guaranteed for strong supports on water quality management and drinking water source protection.

Description: Objectives: We evaluated the effects of the Italian 2005 smoking ban in public places on the prevalence of smoking, quitting and cigarette consumption of young workers. Data and Methods: The dataset was obtained from non-computerized registers of medical examinations for a population of workers with apprenticeship contracts residing in the province of Viterbo, Italy, in the period 1996–2007. To estimate the effects of the ban, a segmented regression approach was used, exploiting the discontinuity introduced by the application of the law on apprentices’ smoking behavior. Results: It is estimated that the Italian smoking ban generally had no effect on smoking prevalence, quitting ratio, or cigarette consumption of apprentices. However, when the estimates were applied to subpopulations, significant effects were found: −1% in smoking prevalence, +2% in quitting, and −3% in smoking intensity of apprentices with at least a diploma.

Description: The risk assessment matrix is a widely accepted, semi-quantitative tool for assessing risks, and setting priorities in risk management. Although the method can be useful to promote discussion to distinguish high risks from low risks, a published critique described a problem when the frequency and severity of risks are negatively correlated. A theoretical analysis showed that risk predictions could be misleading. We evaluated a practical public health example because it provided experiential risk data that allowed us to assess the practical implications of the published concern that risk matrices would make predictions that are worse than random. We explored this predicted problem by constructing a risk assessment matrix using a public health risk scenario—Tainted blood transfusion infection risk—That provides negative correlation between harm frequency and severity. We estimated the risk from the experiential data and compared these estimates with those provided by the risk assessment matrix. Although we validated the theoretical concern, for these authentic experiential data, the practical scope of the problem was limited. The risk matrix has been widely used in risk assessment. This method should not be abandoned wholesale, but users must address the source of the problem, apply the risk matrix with a full understanding of this problem and use matrix predictions to inform, but not drive decision-making.

Description: Urban landscape plants are an important component of the urban ecosystem, playing a significant role in the adsorption of airborne particulates and air purification. In this study, six common landscape plants in Beijing were chosen as research subjects, and the adsorption capacities for each different plant leaf and the effects of the leaf structures for the adsorption capacities for particulates were determined. Preliminary results show that needle-leaved tree species adsorbed more airborne particulates than broad-leaved tree species for the same leaf area. Pinus tabuliformis exhibits the highest adsorption capacity, at 3.89 ± 0.026 μg·cm−2, almost two times as much as that of Populus tomentosa (2.00 ± 0.118 μg·cm−2). The adsorption capacities for PM10 of the same tree species leaves, in different polluted regions had significant differences, and the adsorption capacities for PM10 of the tree species leaf beside the Fifth Ring Road were higher than those of the tree species leaves in the Botanical Garden, although the adsorption capacities for PM2.5 of the same tree species in different polluted regions had no significant differences. By determining the soluble ion concentrations of the airborne particulates in two regions, it is suggested that the soluble ion concentrations of PM10 in the atmosphere in the Botanical Garden and beside the Fifth Ring Road have significant differences, while those of PM2.5 in the atmosphere had no significant differences. In different polluted regions there are significant adaptive changes to the leaf structures, and when compared with slightly polluted region, in the seriously polluted region the epidermis cells of the plant leaves shrinked, the surface textures of the leaves became rougher, and the stomas’ frequency and the pubescence length increased. Even though the plant leaves exposed to the seriously polluted region changed significantly, these plants can still grow normally and healthily.

Description: The review explores the feasibility of simultaneous removal of pathogens and chemical pollutants by solar-enhanced advanced oxidation processes (AOPs). The AOPs are based on in-situ generation of reactive oxygen species (ROS), most notably hydroxyl radicals •OH, that are capable of destroying both pollutant molecules and pathogen cells. The review presents evidence of simultaneous removal of pathogens and chemical pollutants by photocatalytic processes, namely TiO2 photocatalysis and photo-Fenton. Complex water matrices with high loads of pathogens and chemical pollutants negatively affect the efficiency of disinfection and pollutant removal. This is due to competition between chemical substances and pathogens for generated ROS. Other possible negative effects include light screening, competitive photon absorption, adsorption on the catalyst surface (thereby inhibiting its photocatalytic activity), etc. Besides, some matrix components may serve as nutrients for pathogens, thus hindering the disinfection process. Each type of water/wastewater would require a tailor-made approach and the variables that were shown to influence the processes—catalyst/oxidant concentrations, incident radiation flux, and pH—need to be adjusted in order to achieve the required degree of pollutant and pathogen removal. Overall, the solar-enhanced AOPs hold promise as an environmentally-friendly way to substitute or supplement conventional water/wastewater treatment, particularly in areas without access to centralized drinking water or sewage/wastewater treatment facilities.

Description: The mechanisms of toxicity of Ag nanoparticles (NPs) are unclear, in particular in the terrestrial environment. In this study the effects of AgNP (AgNM300K) were assessed in terms of oxidative stress in the soil worm Enchytraeus crypticus, using a range of biochemical markers [catalase (CAT), glutathione peroxidase (GPx), glutathione S-transferase (GST), glutathione reductase (GR), total glutathione (TG), metallothionein (MT), lipid peroxidation (LPO)]. E. crypticus were exposed during 3 and 7 days (d) to the reproduction EC20, EC50 and EC80 levels of both AgNP and AgNO3. AgNO3 induced oxidative stress earlier (3 d) than AgNP (7 d), both leading to LPO despite the activation of the anti-redox system. MT increased only for AgNP. The Correspondence Analysis showed a clear separation between AgNO3 and AgNP, with e.g. CAT being the main descriptor for AgNP for  7 d. LPO, GST and GPx were for both 3 and 7 d associated with AgNO3, whereas MT and TG were associated with AgNP. These results may reflect a delay in the effects of AgNP compared to AgNO3 due to the slower release of Ag+ ions from the AgNP, although this does not fully explain the observed differences, i.e., we can conclude that there is a nanoparticle effect.

Description: Cognitive and mobility functions are involved in health-related quality of life (HRQoL). The present cross-sectional study aimed at investigating what facets of efficient cognition and functional mobility interactively contribute to mental and physical HRQoL. Fifty-six healthy older individuals (aged 65–75 years) were evaluated for mental and physical HRQoL, core cognitive executive functions (inhibition, working memory, and cognitive flexibility), and functional mobility (walking) under single and dual task conditions. Multiple regression analyses were run to verify which core executive functions predicted mental and physical HRQoL and whether the ability to perform complex (dual) walking tasks moderated such association. Inhibitory efficiency and the ability to perform physical-mental dual tasks interactively predicted mental HRQoL, whereas cognitive flexibility and the ability to perform physical dual tasks interactively predicted physical HRQoL. Different core executive functions seem relevant for mental and physical HRQoL. Executive function efficiency seems to translate into HRQoL perception when coupled with tangible experience of the ability to walk under dual task conditions that mirror everyday life demands. Implications of these results for supporting the perception of mental and physical quality of life at advanced age are discussed, suggesting the usefulness of multicomponent interventions and environments conducive to walking that jointly aid successful cognitive aging and functional mobility.

Description: The small peptides representation of the original proteins are a valuable source of information that can be used as biomarkers involved in toxicity mechanism for chemical exposure. The aim of this study is to investigate serum peptide biomarkers of benzene exposure. C57BL/6 mice were enrolled into control group and benzene groups of 150 and 300 mg/kg/d Serum peptides were identified by mass spectrometry using an assisted laser desorption ionization/time of flight mass spectrometry (MS). Differential peptide spectra were obtained by tandem mass spectrometry and analyzed by searching the International Protein Index using the Sequest program. Forty-one peptide peaks were found in the range of 1000–10,000 Da molecular weight. Among them, seven peaks showed significantly different expression between exposure groups and control group. Two peptide peaks (1231.2 and 1241.8), which showed a two-fold increase in expression, were sequenced and confirmed as glucose 6-phosphate dehydrogenase (G6PD) and heat shock protein 90 Beta (HSP90 Beta), respectively. Furthermore, the expression of the two proteins in liver cells showed the same trend as in serum. In conclusion, G6PD and HSP90 beta might be the candidate serum biomarkers of benzene exposure. It also provided possible clues for the molecular mechanism of benzene-induced oxidative stress.

Description: This study focused on the effect of powder activated carbon (PAC) adsorption on microfiltration (MF) membrane performance. The results showed that PAC pretreatment offered high organic matter removal rates for both dissolved organic carbon (DOC) and ultraviolet absorbance at 254 nm (UV254) during 10–200 mg/L PAC dosage. The removal efficiencies of organic matter by MF membrane filtration decreased with the increase of organic matter removal rate by PAC adsorption. PAC mainly removed organic matter of about 3 kDa molecular weight (MW). MF membrane maintained more than 5 kDa MW organic matter on the membrane after PAC adsorption. The results of membrane filtration indicated that PAC pretreatment slightly promoted membrane flux, regardless of PAC dosage. It seems that the organic matter fouling membrane was concentrated in more than 3 kDa MW. PAC removed markedly less than 3 kDa MW organic matter and had less effect on more than 3 kDa organic matter. Thus, PAC cannot reduce membrane fouling.

Description: The Delphi technique is a means of facilitating discussion among experts in order to develop consensus, and can be used for policy formulation. This article describes a modified Delphi approach in which 27 multi-disciplinary academics and 22 stakeholders from Ghana and North America were polled about ways to address negative effects of small-scale gold mining (ASGM) in Ghana. In early 2014, the academics, working in disciplinary groups, synthesized 17 response options based on data aggregated during an Integrated Assessment of ASGM in Ghana. The researchers participated in two rounds of Delphi polling in March and April 2014, during which 17 options were condensed into 12. Response options were rated via a 4-point Likert scale in terms of benefit (economic, environmental, and benefit to people) and feasibility (economic, social/cultural, political, and implementation). The six highest-scoring options populated a third Delphi poll, which 22 stakeholders from diverse sectors completed in April 2015. The academics and stakeholders also prioritized the response options using ranking exercises. The technique successfully gauged expert opinion on ASGM, and helped identify potential responses, policies and solutions for the sector. This is timely given that improvement to the ASGM sector is an important component within the UN Minamata Convention.

Description: Community participation is an important goal for people who have experienced homelessness. The aim of this study was to use the International Classification of Functioning, Disability and Health (ICF) as a framework to examine factors associated with community participation among people who are homeless or recently housed through housing programs. Participants (n = 120) recruited from six housing placement and search programs completed measures of community participation (including productivity, social and leisure, and community-services-use domains), psychiatric and physical symptoms, functional limitations, and a demographic form. Multiple regression analyses were used to identify predictors of overall community participation and subdomain scores. Results suggested that cognitive and mobility limitations, relationship status, and housing status significantly predicted both overall participation and participation in productivity and social and leisure subdomains. Participants who were housed through housing programs, who had cognitive and mobility limitations, and who were single showed less community participation. The findings suggest that activity limitations and environmental and personal factors may need to be addressed in efforts to enhance community participation in this population.

Description: Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management in Chinese adults. The results showed that confrontation, resignation, overall health beliefs, perceived susceptibility, perceived barriers, and self-efficacy were factors associated with overall diabetes self-management performance and six aspects of diabetes self-management behaviors. There is some limited evidence to suggest that provider-patient communication, married individuals, higher educational level, and higher household income level may also be linked to better diabetes self-management practice. Having healthcare insurance and utilizing chronic illness resources generally appeared to have a favorable effect on diabetes self-management performance. In addition, there were a number of factors for which the evidence is too limited to be able to ascertain its strength of association with diabetes self-management practice. The findings of this review suggest that diabetes self-management behaviors are affected by a wide range of personal and environmental factors, which allow health care providers to develop theory-based strategies to improve diabetes-self-management behaviors in this population.

Description: Mercury (Hg) is a global pollutant with adverse health effects on humans and wildlife. It is of special concern in the Arctic due to accumulation in the food web and exposure of the Arctic population through a rich marine diet. Climate change may alter the exposure of the Arctic population to Hg. We have investigated the effect of climate change on the atmospheric Hg transport to and deposition within the Arctic by making a sensitivity study of how the atmospheric chemistry-transport model Danish Eulerian Hemispheric Model (DEHM) reacts to climate change forcing. The total deposition of Hg to the Arctic is 18% lower in the 2090s compared to the 1990s under the applied Special Report on Emissions Scenarios (SRES-A1B) climate scenario. Asia is the major anthropogenic source area (25% of the deposition to the Arctic) followed by Europe (6%) and North America (5%), with the rest arising from the background concentration, and this is independent of the climate. DEHM predicts between a 6% increase (Status Quo scenario) and a 37% decrease (zero anthropogenic emissions scenario) in Hg deposition to the Arctic depending on the applied emission scenario, while the combined effect of future climate and emission changes results in up to 47% lower Hg deposition.

Description: Many older adults face challenges that prevent them from accomplishing common daily activities such as moving around, home maintenance, and leisure activities. There is still a need to examine and understand how environmental factors impact daily participation across gender. This study sought to make a qualitative comparison of gender differences regarding environmental barriers to participation in daily occupations from the perspectives of older adults who live alone in Puerto Rico. Twenty-six Hispanic older adults, 70 years or older participated in this study. We used a descriptive qualitative research design in which researchers administered an in-depth interview to each participant. The results elucidated that women were more likely than men to experience restricted participation due to lack of accessibility of the built environment and transportation systems. The findings could help with the development of tailored, occupation-based, preventive interventions that address gender specific environmental barriers and promote greater participation among both women and men. Further research is required to explore whether these environmental barriers to occupational participation remain consistent across living situations, socioeconomic status and ethnicity.

Description: The effects of the sorption of environmental applications by various source materials of natural organic matter, i.e., bone powder, was examined. Sorption capacities and subsequent rare earth element retention characteristics of all metals tested were markedly increased by ionic task-specific. In this study, the abilities of three models’ isotherms widely were used for the equilibrium sorption data: Langmuir, Freundlich and Redlich-Peterson. For all studied metal ions the maximum adsorption capacity is close to those experimentally determined. The characteristic parameters for each isotherm and related coefficients of determination have been determined. The experimental data achieved excellent fits within the following isotherms in the order: Langmuir > Redlich-Peterson > Freundlich, based on their coefficient of determination values. The bone powder has developed higher adsorption performance in the removal process of Nd(III), Eu(III), La(III) from aqueous solutions than in the case of the removal process of Cs(I), Sr(II) and Tl(I) from aqueous solutions. The described relationships provide direct experimental evidence that the sorption-desorption properties of bone powder are closely related to their degree of the type of the metal. The results suggest a potential for obtaining efficient and cost-effective engineered natural organic sorbents for environmental applications.

Description: Background: This study aims to examine the characteristics of people who talk about suicide on Chinese microblogs (referred to as Weibo suicide communication (WSC)), and the psychological antecedents of such behaviors. Methods: An online survey was conducted on Weibo users. Differences in psychological and social demographic characteristics between those who exhibited WSC and those who did not were examined. Three theoretical models were proposed to explain the psychological mechanisms of WSC and their fitness was examined by Structural Equation Modeling (SEM). Results: 12.03% of our respondents exhibited WSC in the past 12 months. The WSC group was significantly younger and less educated, preferred using blogs and online forums for expressing themselves, and reported significantly greater suicide ideation, negative affectivity, and vulnerable personality compared to non-WSC users. SEM examinations found that Weibo users with higher negative affectivity or/and suicidal ideation, who were also using blogs and forums more, exhibited a significantly higher possibility of WSC. Conclusion: Weibo users who are at greater suicide risk are more likely to talk about suicide on Weibo. WSC is a sign of negative affectivity or suicide ideation, and should be responded to with emotional support and suicide prevention services.

Description: Fire blight (FB), caused by Erwinia amylovora, is one of the most important pome fruit pathogens worldwide. To control this devastating disease, various chemical and biological treatments are commonly applied in Switzerland, but they fail to keep the infection at an acceptable level in years of heavy disease pressure. The Swiss authorities therefore currently allow the controlled use of the antibiotic streptomycin against FB in years that are predicted to have heavy infection periods, but only one treatment per season is permitted. Another strategy for controlling Erwinia is to breed resistant/tolerant apple cultivars. One way of accelerating the breeding process is to obtain resistant cultivars by inserting one or several major resistance genes, using genetic engineering. To date, no study summarizing the impact of different FB control measures on the environment and on human health has been performed. This study consequently aims to compare different disease-control measures (biological control, chemical control, control by antibiotics and by resistant/tolerant apple cultivars obtained through conventional or molecular breeding) applied against E. amylovora, considering different protection goals (protection of human health, environment, agricultural diversity and economic interest), with special emphasis on biosafety aspects. Information on each FB control measure in relation to the specified protection goal was assessed by literature searches and by interviews with experts. Based on our results it can be concluded that the FB control measures currently applied in Switzerland are safe for consumers, workers and the environment. However, there are several gaps in our knowledge of the human health and environmental impacts analyzed: data are missing (1) on long term studies on the efficacy of most of the analyzed FB control measures; (2) on the safety of operators handling streptomycin; (3) on residue analyses of Equisetum plant extract, the copper and aluminum compounds used in apple production; and (4) on the effect of biological and chemical control measures on non-target fauna and flora. These gaps urgently need to be addressed in the near future.

Description: Immersive virtual environment (IVE) technology offers a wide range of potential benefits to research focused on understanding how individuals perceive and respond to built and natural environments. In an effort to broaden awareness and use of IVE technology in perception, preference and behavior research, this review paper describes how IVE technology can be used to complement more traditional methods commonly applied in public health research. The paper also describes a relatively simple workflow for creating and displaying 360° virtual environments of built and natural settings and presents two freely-available and customizable applications that scientists from a variety of disciplines, including public health, can use to advance their research into human preferences, perceptions and behaviors related to built and natural settings.

Description: Heavy metals and a metalloid in agricultural soils in 19 communities in Tarkwa were analyzed to assess the potential ecological risk. A total of 147 soil samples were collected in June, 2012 and analyzed for As, Cd, Co, Cr, Cu, Hg, Ni, Pb and Zn. Mean concentrations (mg/kg dw) of heavy metals in the communities decreased in order of Zn (39) ˃ Cr (21) ˃ Pb (7.2) ˃ Cu (6.2) ˃ As (4.4) ˃ Ni (3.7) ˃ Co (1.8) ˃ Hg (0.32) ˃ Cd (0.050). Correlations among heavy metals and soil properties indicated that soil organic matter could have substantial influence on the total contents of these metals in soil. From the results, integrated pollution (Cdeg) in some communities such as, Wangarakrom (11), Badukrom (13) and T–Tamso (17) indicated high pollution with toxic metals, especially from As and Hg. Potential ecological risk (RI) indices indicated low (Mile 7) to high risks (Wangarakrom; Badukrom) of metals. Based on pollution coefficient (Cif), Cdeg, monomial ecological risk (Eir) and RI, the investigated soils fall within low to high contamination and risk of heavy metals to the ecological system especially plants, soil invertebrates and/or mammalian wildlife. This represented moderate potential ecological risk in the study area, and mining activities have played a significant role.

Description: In this study, a multiple linear regression model to evaluate the risk of morbidity and mortality of ischemic cardiovascular disease is demonstrated. In this model, predictor variables are selected from physiological chemicals in a blood test of the subjects. Meanwhile, the calculated risk score is selected as a response variable. Four major latent variables including hepatic, nephric, metabolic, and BMI (Body Mass Index) are revealed by performing statistical and principal component analysis for the collected survey data. The analyzed result also shows that the cardiac disorder is correlated with symptoms of abnormal BMI, hepatic disorder, nephric disorder, and metabolic disorder. Thus, the risk of morbidity and mortality of ischemic cardiovascular disease can be assessed from the proposed multiple regression model.

Description: The purpose of the study was to evaluate the relationship between serum adiponectin and leptin concentrations and body composition, hematological indices and lipid profile parameters in adults. The study involved 95 volunteers (BMI from 23.3 to 53 kg/m2). Anthropometric parameters were measured: body weight and height, waist and hip circumference, waist-to-hip ratio, body fat mass (BMF), subcutaneous and visceral fat mass (SFM, VFM), lean body mass (LBM), skeletal muscle mass (SMM). In serum we determined adiponectin and leptin concentrations, extracellular hemoglobin, total bilirubin, as well as lipid metabolism (TCh, HDL-Ch, LDL-Ch, TG). Mean adipokine levels were significantly higher in women (p ≤ 0.01), adiponectin significantly negatively correlated with body height and weight, systolic blood pressure and absolute LBM and SMM values. The same relation was observed for erythroid system indicators and lipid indicators. A positive correlation was exceptionally found between adiponectin and HDL-Ch. LEP negatively correlated with some percentage rates (%LBM, %SMM). Only in women, we observed a positive correlation between LEP and body weight, BMI and WHR. Studies on ADPN and the ADPN/LEP ratio as a valuable complementary diagnostic element in the prediction and prevention of cardiovascular diseases need to be continued.

Description: We have read with great interest the Comments related to the article entitled “Prevalence of marijuana use among university 20 students in Bolivia, Colombia, Ecuador and Peru” and appreciate the readers’ feedback [1]. [...]

Description: We have read and analyzed the article entitled “Prevalence of marijuana use among university students in Bolivia, Colombia, Ecuador and Peru”. We propose some objective points which could enhance the internal validity of the study (i.e., we suggest to report participation proportions).

Description: We applied a river habitat quality (RHQ) assessment method to the Hai River Basin (HRB); an important economic centre in China; to obtain baseline information for water quality improvement; river rehabilitation; and watershed management. The results of the assessment showed that the river habitat in the HRB is seriously degraded. Specifically; 42.41% of the sites; accounting for a river length of 3.31 × 104 km; were designated poor and bad. Habitat in the plain areas is seriously deteriorated; and nearly 50% of the sites; accounting for a river length of 1.65 × 104 km; had either poor or bad habitats. River habitat degradation was attributable to the limited width of the riparian zone (≤5 m); lower coverage of riparian vegetation (≤40%); artificial land use patterns (public and industrial land); frequent occurrence of farming on the river banks and high volumes of solid waste (nearly 10 m3); single flow channels; and rare aquatic plants (≤1 category). At the regional scale; intensive artificial land use types caused by urbanization had a significant impact on the RHQ in the HRB. RHQ was significantly and negatively correlated with farmland (r = 1.000; p 〈 0.01) and urban land (r = 0.998; p 〈 0.05); and was significantly and positively correlated with grassland and woodland (r = 1.000; p 〈 0.01). Intensive artificial land use; created through urbanization processes; has led to a loss of the riparian zone and its native vegetation; and has disrupted the lateral connectivity of the rivers. The degradation of the already essentially black rivers is exacerbated by poor longitudinal connectivity (index of connectivity is 2.08–16.56); caused by reservoirs and sluices. For river habitat rehabilitation to be successful; land use patterns need to be changed and reservoirs and sluices will have to be regulated.

Description: In studies of disease with potential environmental risk factors, residential location is often used as a surrogate for unknown environmental exposures or as a basis for assigning environmental exposures. These studies most typically use the residential location at the time of diagnosis due to ease of collection. However, previous residential locations may be more useful for risk analysis because of population mobility and disease latency. When residential histories have not been collected in a study, it may be possible to generate them through public-record databases. In this study, we evaluated the ability of a public-records database from LexisNexis to provide residential histories for subjects in a geographically diverse cohort study. We calculated 11 performance metrics comparing study-collected addresses and two address retrieval services from LexisNexis. We found 77% and 90% match rates for city and state and 72% and 87% detailed address match rates with the basic and enhanced services, respectively. The enhanced LexisNexis service covered 86% of the time at residential addresses recorded in the study. The mean match rate for detailed address matches varied spatially over states. The results suggest that public record databases can be useful for reconstructing residential histories for subjects in epidemiologic studies.

Description: There are limitations in our capacity to interpret point estimates and trends of infectious diseases occurring among diverse migrant populations living in the European Union/European Economic Area (EU/EEA). The aim of this study was to design a data collection framework that could capture information on factors associated with increased risk to infectious diseases in migrant populations in the EU/EEA. The authors defined factors associated with increased risk according to a multi-dimensional framework and performed a systematic literature review in order to identify whether those factors well reflected the reported risk factors for infectious disease in these populations. Following this, the feasibility of applying this framework to relevant available EU/EEA data sources was assessed. The proposed multidimensional framework is well suited to capture the complexity and concurrence of these risk factors and in principle applicable in the EU/EEA. The authors conclude that adopting a multi-dimensional framework to monitor infectious diseases could favor the disaggregated collection and analysis of migrant health data.

Description: Artisanal and small-scale gold mining (ASGM) is growing in many regions of the world including Ghana. The problems in these communities are complex and multi-faceted. To help increase understanding of such problems, and to enable consensus-building and effective translation of scientific findings to stakeholders, help inform policies, and ultimately improve decision making, we utilized an Integrated Assessment approach to study artisanal and small-scale gold mining activities in Ghana. Though Integrated Assessments have been used in the fields of environmental science and sustainable development, their use in addressing specific matter in public health, and in particular, environmental and occupational health is quite limited despite their many benefits. The aim of the current paper was to describe specific activities undertaken and how they were organized, and the outputs and outcomes of our activity. In brief, three disciplinary workgroups (Natural Sciences, Human Health, Social Sciences and Economics) were formed, with 26 researchers from a range of Ghanaian institutions plus international experts. The workgroups conducted activities in order to address the following question: What are the causes, consequences and correctives of small-scale gold mining in Ghana? More specifically: What alternatives are available in resource-limited settings in Ghana that allow for gold-mining to occur in a manner that maintains ecological health and human health without hindering near- and long-term economic prosperity? Several response options were identified and evaluated, and are currently being disseminated to various stakeholders within Ghana and internationally.

Description: Hardell and Carlberg claim in a recent article that both the Cause of Death Register and the National Inpatient Care Register indicate that there was a severe and increasing underreporting of malignant brain tumors to the Swedish Cancer Register during recent years [1]. [...]

Description: We thank Ahlbom et al., the authors of [1] for their interest in our paper [2]. Since this is an important issue, the letter deserves a comprehensive and thorough response. [...]

Description: Objectives: We propose a novel approach to examine vulnerability in the relationship between heat and years of life lost and apply to neighborhood social disparities in Montreal and Paris. Methods: We used historical data from the summers of 1990 through 2007 for Montreal and from 2004 through 2009 for Paris to estimate daily years of life lost social disparities (DYLLD), summarizing social inequalities across groups. We used Generalized Linear Models to separately estimate relative risks (RR) for DYLLD in association with daily mean temperatures in both cities. We used 30 climate scenarios of daily mean temperature to estimate future temperature distributions (2021–2050). We performed random effect meta-analyses to assess the impact of climate change by climate scenario for each city and compared the impact of climate change for the two cities using a meta-regression analysis. Results: We show that an increase in ambient temperature leads to an increase in social disparities in daily years of life lost. The impact of climate change on DYLLD attributable to temperature was of 2.06 (95% CI: 1.90, 2.25) in Montreal and 1.77 (95% CI: 1.61, 1.94) in Paris. The city explained a difference of 0.31 (95% CI: 0.14, 0.49) on the impact of climate change. Conclusion: We propose a new analytical approach for estimating vulnerability in the relationship between heat and health. Our results suggest that in Paris and Montreal, health disparities related to heat impacts exist today and will increase in the future.

Description: The current study examined potential psycho-physiological benefits from exercising in simulated natural environments among a sample of post-menopausal women using a laboratory based protocol. Participants cycled on a stationary exercise bike for 15 min while facing either a blank wall (Control) or while watching one of three videos: Urban (Grey), Countryside (Green), Coast (Blue). Blood pressure, heart rate and affective responses were measured pre-post. Heart rate, affect, perceived exertion and time perception were also measured at 5, 10 and 15 min during exercise. Experience evaluation was measured at the end. Replicating most earlier findings, affective, but not physiological, outcomes were more positive for exercise in the simulated Green and, for the first time, Blue environment, compared to Control. Moreover, only the simulated Blue environment was associated with shorter perceived exercise duration than Control and participants were most willing to repeat exercise in the Blue setting. The current research extended earlier work by exploring the effects of “blue exercise” and by using a demographic with relatively low average levels of physical activity. That this sample of postmenopausal women were most willing to repeat a bout of exercise in a simulated Blue environment may be important for physical activity promotion in this cohort.

Description: Background: The occurrence of faecal pathogens in drinking water resources constitutes a threat to the supply of safe drinking water, even in industrialized nations. To efficiently assess and monitor the risk posed by these pathogens, sampling deserves careful design, based on preliminary knowledge on their distribution dynamics in water. For the protozoan pathogens Cryptosporidium and Giardia, only little is known about their spatial distribution within drinking water supplies, especially at fine scale. Methods: Two-dimensional distribution maps were generated by sampling cross-sections at meter resolution in two different zones of a drinking water reservoir. Samples were analysed for protozoan pathogens as well as for E. coli, turbidity and physico-chemical parameters. Results: Parasites displayed heterogeneous distribution patterns, as reflected by significant (oo)cyst density gradients along reservoir depth. Spatial correlations between parasites and E. coli were observed near the reservoir inlet but were absent in the downstream lacustrine zone. Measurements of surface and subsurface flow velocities suggest a role of local hydrodynamics on these spatial patterns. Conclusion: This fine-scale spatial study emphasizes the importance of sampling design (site, depth and position on the reservoir) for the acquisition of representative parasite data and for optimization of microbial risk assessment and monitoring. Such spatial information should prove useful to the modelling of pathogen transport dynamics in drinking water supplies.

Description: The purpose of this study was to develop an interview guide for use by primary healthcare professionals to support them in identifying the rehabilitation needs of forced resettled women from the Middle East living with chronic pain. Previous findings together with the existing literature were used as the basis for developing the interview guide in three steps: item generation, cognitive interviews, and a pilot study. The study resulted in a 16-item interview guide focusing on patients’ concerns and expectations, with consideration of pre-migration, migration, and post-migration factors that might affect their health. With the help of the guide, patients were also invited to identify difficulties in their daily activities and to take part in setting goals and planning their rehabilitation. The current interview guide provides professional guidance to caretakers, taking a person-centered participative point of departure when meeting and planning care, for and together, with representatives from dispersed ethnic populations in Sweden. It can be used together with the patient by all staff members working in primary healthcare, with the aim of contributing to continuity of care and multi-professional collaboration.

Description: Background: This study is one part of a five-year tobacco-control project in China, which aimed to gain insight into the smoking behavior, knowledge, and attitudes among medical teachers in China. Methods: In May 2010, a cross-sectional survey was conducted among medical teachers of Xiangya Medical School, Central South University, China. Results: A total number of 682 medical teachers completed the surveys. Latent class analysis indicated the sample of smoking patterns was best represented by three latent subgroups of smoking consumption severity levels. Most respondents were informed of smoking related knowledge, but lack of knowledge on smoking cessation. Most of them held a supportive attitude towards their responsibilities among tobacco control, as well as the social significance of smoking. However, both smoking related knowledge and attitude were not correlated with severity of smoking consumption among medical teachers. Conclusion: The smoking prevalence among medical teachers in China remains high. Programs on smoking cessation training are required. Future study should also develop targeted interventions for subgroups of smokers based on smoking consumption. Persistent and effective anti-tobacco efforts are needed to achieve the goals of creating smoke-free campuses and hospitals.

Description: To ensure the well-being of a rapidly growing elderly population, it is fundamental to find strategies to foster healthy brain aging. With this intention, we designed a program of scientific-based lectures aimed at dissemination by established neuroscientists about brain function, brain plasticity and how lifestyle influences the brain. We also carried out a pilot study on the impact of the lectures on attendees. The objective was to provide information to elderly people in order to encourage them to identify unhealthy and healthy daily habits, and more importantly, to promote behavioral changes towards healthy brain aging. Here we report on our experience. In order to determine the impact of the lectures in the daily routine of the attendees, we asked them to fill out questionnaires. Preliminary results indicate that neuroscientific information-based strategies can be a useful method to have a positive impact on the lives of elderly, increase their awareness on how to improve brain function and promote positive lifestyle modifications. Furthermore, based on self-reported data, we also found that through this strategy it is possible to promote behavioral changes related to nutrition, sleep, and realization of physical and cognitively stimulating activities. Finally, based on the results obtained, the importance of promoting self-efficacy and the empowerment of the older populations is highlighted.

Description: Background: Establishing early healthy eating and physical activity behaviours is critical in supporting children’s long-term health and well-being. The objective of the current paper was to examine the association between health behaviours and academic performance in elementary school students in a school board in Nova Scotia, Canada. Methods: Our population-based study included students in grades 4–6 across 18 schools in a rural school board. Diet and physical activity were assessed through validated instruments. Academic performance measures were obtained from the school board for Mathematics and English Language Arts (ELA). Associations between health behaviours and academic performance were assessed using multilevel logistic regression. Results: Students with unhealthy lifestyle behaviours were more likely to have poor academic performance for both ELA and Mathematics compared to students with healthy lifestyle behaviours; associations were statistically significant for diet quality, physical activity, sugar-sweetened beverage consumption for ELA; and breakfast skipping, not being physically active at morning recess, and not being physically active after school for Mathematics. The effects of diet and physical activity were independent of each other and there was no interaction between the two exposures. Conclusions: Our findings suggest that support for healthy behaviours may help to improve academic outcomes of students.

Description: Objective: To explore the impact of workplace violence on job performance and quality of life of community healthcare workers in China, especially the relationship of these three variables. Methods: From December 2013 to April 2014, a total of 1404 healthcare workers were recruited by using the random cluster sampling method from Community Health Centers in Guangzhou and Shenzhen. The workplace violence scale, the job performance scale and the quality of life scale (SF-36) were self-administered. The structural equation model constructed by Amos 17.0 was employed to assess the relationship among these variables. Results: Our study found that 51.64% of the respondents had an experience of workplace violence. It was found that both job performance and quality of life had a negative correlation with workplace violence. A positive association was identified between job performance and quality of life. The path analysis showed the total effect (β = −0.243) of workplace violence on job performance consisted of a direct effect (β = −0.113) and an indirect effect (β = −0.130), which was mediated by quality of life. Conclusions: Workplace violence among community healthcare workers is prevalent in China. The workplace violence had negative effects on the job performance and quality of life of CHCs’ workers. The study suggests that improvement in the quality of life may lead to an effective reduction of the damages in job performance caused by workplace violence.

Description: Mental health (MH) has a relevant burden on the health of populations. Common MH disorders (anxiety and non-psychotic depression) are well associated to socioeconomic individual and neighborhood characteristics, but little is known about the influence of urban structure. We analyzed among a Turin (Northwest Italy) urban population the association at area level of different urban structure characteristics (density, accessibility by public transport, accessibility to services, green and public spaces) and consumption of antidepressants. Estimates were adjusted by individual socio-demographic variables (education, housing tenure, employment) and contextual social environment (SE) variables (social and physical disorder, crime rates). Data was extracted from the Turin Longitudinal Study (TLS)—a census-based cohort study following up prospectively the mortality and morbidity of the population. As expected, individual characteristics show the strongest association with antidepressant drug consumption, while among built environment (BE) indicators accessibility by public transport and urban density only are associated to MH, being slightly protective factors. Results from this study, in agreement with previous literature, suggest that BE has a stronger effect on MH for people who spend more time in the neighborhood. Therefore, this research suggests that good accessibility to public transport, as well as a dense urban structure (versus sprawl), could contribute to reduced risk of depression, especially for women and elderly, by increasing opportunities to move around and have an active social life.

Description: Social activities are an important aspect of health and quality of life of the aging population. They are key elements in the prevention of loneliness. In order to create living environments that stimulate older adults to engage in social activities, more insight is needed in the social activity patterns of the aging population. This study therefore analyzes the heterogeneity in older adults’ preferences for different social activity location types and the relationship between these preferences and personal and mobility characteristics. This is done using a latent class multinomial logit model based on two-day diary data collected in 2014 in Noord-Limburg in the Netherlands among 213 respondents aged 65 or over. The results show that three latent classes can be identified among the respondents who recorded social activities in the diary: a group that mainly socializes at home, a group that mainly socializes at a community center and a group that is more likely to socialize at public ‘third’ places. The respondents who did not record any interactions during the two days, are considered as a separate segment. Relationships between segment membership and personal and mobility characteristics were tested using cross-tabulations with chi-square tests and analyses of variance. The results suggest that both personal and mobility characteristics play an important role in social activity patterns of older adults.

Description: The association between maternal smoking during pregnancy and autism spectrum disorder (ASD) risk in offspring has been investigated in several studies, but the evidence is not conclusive. We, therefore, conducted this meta-analysis to explore whether an association exists between maternal smoking during pregnancy and ASD risk in offspring. We searched PubMed, Embase, Web of Science, and the Cochrane Library for studies of maternal smoking during pregnancy and ASD risk in offspring up to 10 June 2015. The random-effects model was used to combine results from individual studies. 15 observational studies (6 cohort studies and 9 case-control studies), with 17,890 ASD cases and 1,810,258 participants were included for analysis. The pooled odds ratio (OR) was 1.02 (95% confidence interval (CI): 0.93–1.13) comparing mothers who smoked during pregnancy with those who did not. Subgroup and sensitivity analysis suggested the overall result of this analysis was robust. Results from this meta-analysis indicate that maternal smoking during pregnancy is not associated with ASD risk in offspring. Further well-designed cohort studies are needed to confirm the present findings.

Description: Reservoirs are artificial environments built by humans, and the impacts of these environments are not completely known. Retention time and high nutrient availability in the water increases the eutrophic level. Eutrophication is directly correlated to primary productivity by phytoplankton. These organisms have an important role in the environment. However, high concentrations of determined species can lead to public health problems. Species of cyanobacteria produce toxins that in determined concentrations can cause serious diseases in the liver and nervous system, which could lead to death. Phytoplankton has photoactive pigments that can be used to identify these toxins. Thus, remote sensing data is a viable alternative for mapping these pigments, and consequently, the trophic. Chlorophyll-a (Chl-a) is present in all phytoplankton species. Therefore, the aim of this work was to evaluate the performance of images of the sensor Operational Land Imager (OLI) onboard the Landsat-8 satellite in determining Chl-a concentrations and estimating the trophic level in a tropical reservoir. Empirical models were fitted using data from two field surveys conducted in May and October 2014 (Austral Autumn and Austral Spring, respectively). Models were applied in a temporal series of OLI images from May 2013 to October 2014. The estimated Chl-a concentration was used to classify the trophic level from a trophic state index that adopted the concentration of this pigment-like parameter. The models of Chl-a concentration showed reasonable results, but their performance was likely impaired by the atmospheric correction. Consequently, the trophic level classification also did not obtain better results.

Description: This paper applies probabilistic risk assessment in quantifying risks from cumulative and aggregate risk pathways for selected goitrogens in water and food. Results show that the percentages of individuals with a Hazard Index (HI) value above 1 ranges between 30% and 50% both with and without serum half-life correction when a traditional regulatory assessment approach based on establishment of a No Observed Effects Level (NOEL) is used. When an exposure-response curve is instead used and a threshold of 50% inhibition is assumed, 1.1% or less of the population exceeds an HI value of 1 with no serum half-life correction, rising to as high as 11% when serum half-life correction is applied. If 0% to 5% threshold for iodide uptake inhibition is assumed for production of adverse effects, the percentage of the population with an HI above 1 is 46.2% or less with no serum half-life correction, and 47.2% or less when serum half-life correction is applied. The probabilistic analysis shows that while there are exposed groups for whom perchlorate exposures are the primary cause of individuals having HI values above 1, these constitute significantly less than 1% of the population. Instead, the potential risk from exposure to goitrogens is dominated by nitrates without serum half-life correction and thiocyanates with serum half-life correction, suggesting public health protection is better accomplished by a focus on these and other goitrogens expect in highly limited cases where waterborne perchlorate is at unusually high concentrations.

Description: Active commuting (walking or cycling) to school has been positively associated with improved fitness among adolescents. However, current evidence lacks information on whether this association persists in children. The aim of this study was to examine the association of active commuting to school with different fitness parameters in Spanish school-aged children. A total of 494 children (229 girls) from five primary schools in Granada and Jaén (Spain), aged between eight and 11 years, participated in this cross-sectional study. Participants completed the Assessing Levels of Physical Activity (ALPHA) fitness test battery and answered a self-reported questionnaire regarding the weekly travel mode to school. Active commuting to school was significantly associated with higher levels of speed-agility in boys (p = 0.048) and muscle strength of the lower body muscular fitness in girls (p = 0.016). However, there were no significant associations between active commuting to school and cardiorespiratory fitness and upper body muscular fitness. Our findings suggest that active commuting to school was associated with higher levels of both speed-agility and lower body muscular fitness in boys and girls, respectively. Future studies should confirm whether increasing active commuting to school increases speed-agility and muscle strength of the lower body.

Description: Ambient air pollution causes a considerable disease burden, particularly in South Asia. The objective of the study is to test the feasibility of applying the environmental burden of disease method at state level in India and to quantify a first set of disease burden estimates due to ambient air pollution in Kerala. Particulate Matter (PM) was used as an indicator for ambient air pollution. The disease burden was quantified in Years of Life Lost (YLL) for the population (30 + years) living in urban areas of Kerala. Scenario analyses were performed to account for uncertainties in the input parameters. 6108 (confidence interval (95% CI): 4150–7791) of 81,636 total natural deaths can be attributed to PM, resulting in 96,359 (95% CI: 65,479–122,917) YLLs due to premature mortality (base case scenario, average for 2008–2011). Depending on the underlying assumptions the results vary between 69,582 and 377,195 YLLs. Around half of the total burden is related to cardiovascular deaths. Scenario analyses show that a decrease of 10% in PM concentrations would save 15,904 (95% CI: 11,090–19,806) life years. The results can be used to raise awareness about air quality standards at a local level and to support decision-making processes aiming at cleaner and healthier environments.

Description: Epidemiological data often include excess zeros. This is particularly the case for data on rare conditions, diseases that are not common in specific areas or specific time periods, and conditions and diseases that are hard to detect or on the rise. In this paper, we provide a review of methods for modeling data with excess zeros with focus on count data, namely hurdle and zero-inflated models, and discuss extensions of these models to data with spatial and spatio-temporal dependence structures. We consider a Bayesian hierarchical framework to implement spatial and spatio-temporal models for data with excess zeros. We further review current implementation methods and computational tools. Finally, we provide a case study on five-year counts of confirmed cases of Lyme disease in Illinois at the county level.

Description: Cadmium (Cd) is a heavy metal and environmental toxin. Exposure to Cd has been associated with a variety of human cancers. In this study, we performed in vitro assays to examine the effects of cadmium chloride (CdCl2) on A549 cells, a human lung adenocarcinoma cell line. Cd does not affect proliferation, migration, or apoptosis of A549 cells at concentrations of 0.1–10 μM. At 0.5 and 1 μM, Cd increases the expression of vascular endothelial growth factor (VEGF) (p 〈 0.05, p 〈 0.01, respectively), but not basic fibroblast growth factor (b-FGF) in A549 cells. The conditioned media were collected from the A549 cells treated with 1 μM Cd and were co-cultured with human umbilical vein endothelial cells (HUVECs). Upon treatment with the conditioned media, the proliferation and migration of HUVECs significantly increased (p 〈 0.01, p 〈 0.05, respectively), while apoptosis remained unchanged. In addition, 1 μM Cd increases the level of hypoxia inducible factor 1-α (HIF1-α), which is a positive regulator of VEGF expression. Although low-dose Cd does not directly affect the growth of lung adenocarcinoma cells, it might facilitate the development of tumors through its pro-angiogenic effects.

Description: Background: Air pollution is a problem, especially in developing countries. We examined the association between personal exposure to particulate matter with an aerodynamic diameter less than 2.5 µm (PM2.5) on respiratory health in a group of adults with chronic obstructive pulmonary disease (COPD). Methods: All participants resided in Mexico City and during follow-up, personal exposure to PM2.5, respiratory symptoms, medications, and daily activity were registered daily. Peak expiratory flow (PEF) was measured twice daily, from February through December, 2000, in 29 adults with moderate, severe, and very severe COPD. PEF changes were estimated for each 10 µg/m3 increment of PM2.5, adjustment for severity of COPD, minimum temperature, and day of the sampling. Results: For a 10-µg/m3 increase in the daily average of a two-day personal exposure to PM2.5, there was a significant 33% increase in cough (95% CI, range, 5‒69%), and 23% in phlegm (95% CI, range, 2‒54%), a reduction of the PEF average in the morning of −1.4 L/min. (95% CI , range, −2.8 to −0.04), and at night of −3.0 L/min (95% CI, range, −5.7 to −0.3), respectively. Conclusions: Exposure to PM2.5 was associated with reductions in PEF and increased respiratory symptoms in adults with COPD. The PEF reduction was observed both at morning and at night.

Description: The aim of the study was to assess the effect of a polyunsaturated omega-3 fatty acids (PUFA) supplementation on the parameters of body composition, muscle strength and physical performance in elderly people with decreased muscle mass (DMM). Fifty three elderly people with an ALM index (the ratio of appendicular lean mass to squared height) either below (−2SD: low muscle mass-LMM) or between (−1SD and −2SD: the risk of LMM-rLMM) the ALM index for the young Polish reference population were randomly assigned to PUFA-treated groups (LMM-PUFA, rLMM-PUFA) or control groups (LMM-control, rLMM-control). PUFA-treated groups received capsules containing 1.3 g of PUFA and 10 mg of vitamin E, while the control groups received 11 mg of vitamin E daily for 12 weeks. Body composition (BIA analysis), muscle strength (hand grip measured with dynamometer) and physical performance (Timed Up and Go test-TUG) were assessed before and after supplementation. No statistically significant differences were observed either in muscle mass or in the hand grip and TUG in any group. The post-pre difference (mean ± SD) in ALM index was as follows (kg/m2): LMM-PUFA: 0.00 ± 0.30, rLMM-PUFA: 0.00 ± 0.22, LMM-control: 0.03 ± 0.36, rLMM-control: –0.03 ± 0.20. In our study, a 12 week supplementation of PUFA did not affect the evaluated parameters in elderly individuals with DMM.

Description: Most smokers start young. Initiation of cigarette smoking at an earlier age leads to more life-years for tobacco use, makes quitting harder, and increases the risk of serious health consequences. Despite these challenges, research focusing on smoking behavior among adolescent boys in Taiwan is rare. Although the Taiwanese government enacted the Tobacco Hazards Prevention Act in 2009, aimed at prevention and reducing the rate of smoking, the percentage of high school students who smoke has continued to increase. In 2006, 7.5% of adolescent boys engaged in smoking. By 2012 the rate had increased to 24.6%. This paper explores the experiences that contribute to adolescent Taiwanese boys making the decision to smoke. A phenomenological approach to inquiry was used as the philosophical foundations for this study with twelve adolescent boys who engaged in smoking behaviors. Data was gathered through two face-to-face semi-structured interviews and a focus group. Data analysis was performed using Colaizzi’s analysis method. Findings indicated that decisions to begin smoking were motivated by curiosity and as a means of establishing friendships while decisions to continue smoking were linked to the addictive nature of smoking and as a means of coping with stress and passing the time. The findings can be used to inform the prevention of tobacco use and to reduce the high smoking rates among adolescent boys.

Description: Slight changes in the abundance of certain lipid species in the brain may drastically alter normal neurodevelopment via membrane stability, cell signalling, and cell survival. Previous findings have demonstrated that postnatal exposure to di (2-ethylhexyl) phthalate (DEHP) disrupts normal axonal and neural development in the hippocampus. The goal of the current study was to determine whether postnatal exposure to DEHP alters the lipid profile in the hippocampus during postnatal development. Systemic treatment with 10 mg/kg DEHP during postnatal development led to elevated levels of phosphatidylcholine and sphingomyelin in the hippocampus of female rats. There was no effect of DEHP exposure on the overall abundance of phosphatidylcholine or sphingomyelin in male rats or of lysophosphatidylcholine in male or female rats. Individual analyses of each identified lipid species revealed 10 phosphatidylcholine and six sphingomyelin lipids in DEHP-treated females and a single lysophosphatidylcholine in DEHP-treated males with a two-fold or higher increase in relative abundance. Our results are congruent with previous work that found that postnatal exposure to DEHP had a near-selective detrimental effect on hippocampal development in males but not females. Together, results suggest a neuroprotective effect of these elevated lipid species in females.

Description: Petroleum coke, or petcoke, is a granular coal-like industrial by-product that is separated during the refinement of heavy crude oil. Recently, the processing of material from Canadian oil sands in U.S. refineries has led to the appearance of large petcoke piles adjacent to urban communities in Detroit and Chicago. The purpose of this literature review is to assess what is known about the effects of petcoke exposure on human health. Toxicological studies in animals indicate that dermal or inhalation petcoke exposure does not lead to a significant risk for cancer development or reproductive and developmental effects. However, pulmonary inflammation was observed in long-term inhalation exposure studies. Epidemiological studies in coke oven workers have shown increased risk for cancer and chronic obstructive pulmonary diseases, but these studies are confounded by multiple industrial exposures, most notably to polycyclic aromatic hydrocarbons that are generated during petcoke production. The main threat to urban populations in the vicinity of petcoke piles is most likely fugitive dust emissions in the form of fine particulate matter. More research is required to determine whether petcoke fine particulate matter causes or exacerbates disease, either alone or in conjunction with other environmental contaminants.

Description: Large amounts of organic pollutants emitted from industries have accumulated and caused serious human health risks, especially in urban areas with rapid industrialization. This paper focused on the carcinogen benzo[a]pyrene (BaP) from industrial effluent and gaseous emissions, and established a multi-pathway exposure model based on a Level IV multimedia fugacity model to analyze the human health risks in a city that has undergone rapid industrialization. In this study, GIS tools combined with land-use data was introduced to analyze smaller spatial scales so as to enhance the spatial resolution of the results. An uncertainty analysis using a Monte Carlo simulation was also conducted to illustrate the rationale of the probabilistic assessment mode rather than deterministic assessment. Finally, the results of the case study in Nanjing, China indicated the annual average human cancer risk induced by local industrial emissions during 2002–2008 (lowest at 1.99´10–6 in 2008 and highest at 3.34´10–6 in 2004), which was lower than the USEPA prescriptive level (1´10–6–1´10–4) but cannot be neglected in the long term. The study results could not only instruct the BaP health risk management but also help future health risk prediction and control.

Description: Background: Researchers in tobacco control are concerned about the increasing prevalence of waterpipe smoking in the United States, which may pose similar risks as cigarette smoking. This review explores the prevalence of waterpipe smoking in the United States as well as the shortcomings of current U.S. policy for waterpipe control and regulation. Methods: Researchers conducted a literature review for waterpipe articles dated between 2004 and 2015 using five online databases: MEDLINE, CINHAHL, ScienceDirect, PMC, and Cochrane Library. Results: To date, few studies have explored the marketing and regulation of waterpipe smoking in the U.S., which has increased in the last ten years, especially among women, adolescents, and young adults. Data indicate that the majority of waterpipe smokers are unaware of the potential risks of use. In addition, current tobacco control policies do not address waterpipe smoking, enabling tobacco companies to readily market and sell waterpipe products to young adults, who are at risk for becoming lifelong smokers. Conclusion: Policy makers in the area of public health need to update existing tobacco regulations to include waterpipe smoking. Similarly, public health researchers should develop public health campaigns and interventions to address the increasing rates of waterpipe smoking in the United States.

Description: Staphylococcus aureus is one the top five pathogens causing domestically acquired foodborne illness in the U.S. Only a few studies are available related to the prevalence of S. aureus and MRSA in the U.S. retail poultry industry. The objectives of this study were to determine the prevalence of S. aureus (MSSA and MRSA) in retail chicken and turkey meats sold in Tulsa, Oklahoma and to characterize the recovered strains for their antimicrobial resistance and possession of toxin genes. A total of 167 (114 chicken and 53 turkey) retail poultry samples were used in this study. The chicken samples included 61 organic samples while the rest of the poultry samples were conventional. The overall prevalence of S. aureus was 57/106 (53.8%) in the conventional poultry samples and 25/61 (41%) in the organic ones. Prevalence in the turkey samples (64.2%) was higher than in the chicken ones (42.1%). Prevalence of S. aureus did not vary much between conventional (43.4%) and organic chicken samples (41%). Two chicken samples 2/114 (1.8%) were positive for MRSA. PFGE identified the two MRSA isolates as belonging to PFGE type USA300 (from conventional chicken) and USA 500 (from organic chicken) which are community acquired CA-MRSA suggesting a human based source of contamination. MLST and spa typing also supported this conclusion. A total of 168 Staphylococcus aureus isolates (101 chicken isolates and 67 turkey isolates) were screened for their antimicrobial susceptibility against 16 antimicrobials and their possession of 18 different toxin genes. Multidrug resistance was higher in the turkey isolates compared to the chicken ones and the percentage of resistance to most of the antimicrobials tested was also higher among the turkey isolates. The hemolysin hla and hld genes, enterotoxins seg and sei, and leucocidins lukE-lukD were more prevalent in the chicken isolates. The PVL gene lukS-lukF was detected only in chicken isolates including the MRSA ones. In conclusion, S. aureus is highly prevalent in poultry retail meats sold in Oklahoma with a very low presence of human-originated MRSA. Multidrug resistance is not only prevalent in the MRSA isolates, but also in many MSSA poultry strains, particularly turkey.