Int. J. Environ. Res. Public Health, Volume 16, Issue 15 (August-1 2019) – 177 articles

Climate change has often caused failure in water treatment operations. In this study, we report a real case study at a major surface water treatment plant in Alabama, USA. Following a severe winter storm, the effluent water turbidity surged to >15.00 Nephelometric Turbidity Units (NTU), far exceeding the 0.30 NTU standard. As a result, the plant operation had to be shut down for three days, causing millions of dollars of losses and affecting tens of thousands of people. Systematic jar tests were carried out with sediment samples from 22 upstream locations. The coagulation and settleability of sediment particles were tested under simulated storm weather conditions, i.e., low temperature (7 °C) and in the presence of various types and concentrations of natural organic matter (NOM) that was extracted from the local sediments. Experimental results proved that elevated NOM (6.14 mg·L⁻¹ as Total Organic Carbon, TOC) in raw water was the root cause for the failure of the plant while the low temperature played a minor but significant role. Pre-oxidation with permanganate and/or elevated coagulant dosage were found effective to remove TOC in raw water and to prevent similar treatment failure. Moreover, we recommend that chemical dosages should be adjusted based on the TOC level in raw water, and a reference dosage of 0.29 kg-NaMnO₄/kg-TOC and 19 kg- polyaluminum chloride (PACl) /kg-TOC would be appropriate to cope with future storm water impacts. To facilitate timely adjustment of the chemical dosages, the real time key water quality parameters should be monitored, such as turbidity, TOC, Ultraviolet (UV) absorbance, pH, and color. The findings can guide other treatment operators to deal with shock changes in the raw water quality resulting from severe weather or other operating conditions. Full article

The present research aimed to analyze the modification in performance, body composition, and autonomic modulation of reverse and traditional linear training periodization in amateur triathletes. We analyzed running and swimming performance, strength manifestation, body composition, and autonomic modulation before and after a traditional linear training periodization (four weeks of volume-based training plus four weeks of intensity-based training plus two-week tapering), a reverse linear training periodization (four weeks of intensity-based training plus four weeks of volume-based training plus two-week tapering), and a free training control physical active group (10-week free training) in 32 amateur athletes. Independently of the periodization model, the combination of two four-week mesocycles followed by a two-week taper is an efficiency strategy to avoid overreaching, obtaining an increase in parasympathetic modulation. Moreover, both types of training periodization proposed in this study do not modified body composition of amateur triathletes. Also, compared with traditional periodization, reverse periodization efficiently improves horizontal jump performance. Finally, reverse and traditional periodization were an effective strategy to improve running biomechanical, performance, and physiological variables, as well as efficient periodization strategies to improve swimming technical ability, aerobic, and anaerobic swimming performance. Full article

Introduction: Suicide is one of the most frequent causes of death. According to the World Health Organization (WHO), each year, over eight hundred thousand people worldwide die as a result of suicide. The most common risk factors for suicide are depressive disorders and alcohol dependence. Alcohol can directly influence a decision about suicide, or be a factor facilitating this decision. The aim of the study was to analyse the seasonality of suicides among persons under the influence of alcohol. Material and Methods: Data for analysis were obtained from the Department of Forensic Medicine (DFM) of the Medical University of Warsaw. A retrospective analysis was performed on 317 victims of suicides by hanging, those which were entered into the registry of deaths kept by the DFM in the years 2009–2013. The analysis took into account the age and sex of victims, initial cause of death, date of post-mortem examination, autopsy result and alcohol concentration in the blood or muscles of the victims. Statistical analysis was performed using IBM SPSS Statistics version 20. Results: In the analysis, a spring peak of suicides was found for men, and an autumn peak was revealed for women. In addition, a significant correlation was observed between the age of victims and the concentration of alcohol; the older the victims, the higher the alcohol concentration. However, this correlation was reported only in the spring months. Conclusions: The results of the analysis seem to be consistent with seasonal patterns observed in other studies, and they indicate the occurrence of suicide seasonality. In order to improve the strategies of suicide prevention, it is necessary to identify factors which are related to the seasonal variation of suicidal behaviours, as well as to gain knowledge about the mechanisms behind this phenomenon. Full article

The intense management practices in greenhouse production may lead to heavy metal (HM) accumulations in soils. To determine the accumulation characteristics of HM and to evaluate possible HM sources in greenhouse soils, thirty typical greenhouse soil samples were collected in Shouguang District, Shandong Province, China. The results indicate that the Cd, Cu, and Zn concentrations are, respectively, 164.8%, 78.6%, and 123.9% higher than their background values. In the study area, Cd exhibits certain characteristics, such as wide variations in the proportion of its exchangeable form and the highest mobility factor and geo-accumulation index, which are indicative of its high bioavailability and environmental risk. In addition, there is a significant positive correlation between pairs of Cd, P, soil organic carbon, and cultivation age. Combined with principal component analysis, the results indicate the clear effects that agricultural activities have on Cd, Cu, and Zn accumulation. However, Cr, Ni, and Pb have a significant correlation with soil Fe and Al (hydr)-oxides, which indicates that these metals mainly originate from parent materials. This research indicated that long-term intensive fertilization (especially the application of chemical fertilizers and livestock manure) leads to Cd, Cu, and Zn accumulation in greenhouse soils in Shouguang. And the time required to reach the maximum permeable limit in agricultural soils for Cd, Cu, and Zn is 23, 51, and 42 years, respectively, based on their current increasing rates. Full article

Implementing smoking bans is a worldwide common practice for tobacco control. However, if the policy prohibits smoking partially rather than comprehensively, it may increase nonsmokers’ exposure to secondhand smoke (SHS) in nonprohibited places. This paper investigates how a partial smoking ban affected nonsmokers’ SHS exposure (measured by frequency of having exposure to SHS in days per month) in households, workplaces, and restaurants by examining the case of a partial smoking ban introduced in a large Japanese prefecture in 2013. Using data from the National Health and Nutrition Survey (NHNS) in 2010, 2013, and 2016 (n = 30,244) and the Comprehensive Survey of Living Conditions (CSLC) from 2001 to 2016 (n = 2,366,896), this paper employs a difference-in-differences (DID) approach. We found that the partial smoking ban significantly increased their SHS exposure in households and workplaces by 2.64 days and 4.70 days per month, respectively, while it did not change nonsmokers’ SHS exposure in restaurants. The results imply that the smoking ban displaced smokers from public places to private places. We also found that neither smokers’ smoking status nor smoking intensity changed significantly after implementing the partial smoking ban. Comprehensive smoking bans are needed to better protect nonsmokers from SHS exposure. Full article

The present study aimed to develop and validate an Interdisciplinary Worker’s Health Approach Instrument (IWHAI). The development stage comprised a group of 10 professionals, including physicians, nurses, nutritionists, dentists and physical educators, as well as a judges’ committee, composed by 19 recognized experts in the area of worker’s health (WH). For the validation of the IWHAI, the Spearman’s correlation coefficient (r_s) was calculated, the factor analysis to the instrument was applied, and the Cronbach’s alpha (α) and the Intraclass correlation coefficient (ICC) were calculated. The IWHAI was structured in five dimensions, integrating 43 health indicators, on a scale of 0–4, totalling 215 sub-indices with closed response coding. The instrument was validated with a Kappa coefficient (KAPPA) (k), with excellent agreement for all attributes, i.e., k = 0.88 for applicability, k = 0.80 for clarity and k = 0.82 for relevance. p > 0.05 results reveal moderate to strong positive correlations between some variables, i.e., pests, vectors and air quality/drinking water quality (r_s = 0.69). A total of 14 components of the factor analysis, explaining 62.6% of the data variance, were extracted. α value is considered moderate to high, α = 0.61, the ICC value also being considered moderate to high, with ICC = 0.61. The IWHAI is considered validated, constituting a technological innovation for an interdisciplinary approach in the field of WH, enabling the prevention and integral promotion of health. Full article

In order to evaluate the stability of deep surrounding rock, all of the affecting factors should be theoretically identified. However, some factors have slight impacts on the stability of deep surrounding rock compared with others. To conduct an effective risk assessment, key factors should be first extracted. The analytic hierarchy process (AHP) and grey relation analysis (GRA) methods are integrated to determine the key factors. First, the AHP method is applied to sort the factors by calculating the weights of them. Seven out of fifteen factors are extracted as the key factors, which account for 80% of the weights. Further, the GCA method is used to validate the effects of these key factors by analyzing the correlation between the performance of each factor and that of the reference. Considering the influence of these key factors and experts’ judgements, the multilevel fuzzy comprehensive evaluation method is adopted to obtain the risk level of the deep surrounding rock stability. Finally, the risk assessment of the deep surrounding rock in the E-Zhuang coal mine of Chinese Xinwen Mining Area illustrates the operability of the proposed method. Full article

Driven by the pull of gravity, mass-wasting comprises all of the sedimentary processes related to remobilization of sediments deposited on slopes, including creep, sliding, slumping, flow, and fall. It is vital to conduct mass-wasting susceptibility mapping, with the aim of providing decision makers with management advice. The current study presents two individual data mining methods—the frequency ratio (FR) and information value model (IVM) methods—to map mass-wasting susceptibility in four catchments in Miyun County, Beijing, China. To achieve this goal, nine influence factors and a mass-wasting inventory map were used and produced, respectively. In this study, 71 mass-wasting locations were investigated in the field. Of these hazard locations, 70% of them were randomly selected to build the model, and the remaining 30% of the hazard locations were used for validation. Finally, a receiver operating characteristic (ROC) curve was used to assess the mass-wasting susceptibility maps produced by the above-mentioned models. Results show that the FR had a higher concordance and spatial differentiation, with respective values of 0.902 (area under the success rate) and 0.883 (area under the prediction rate), while the IVM had lower values of 0.865 (area under the success rate) and 0.855 (area under the prediction rate). Both proposed methodologies are useful for general planning and evaluation purposes, and they are shown to be reasonable models. Slopes of 6–21° were the most common thresholds that controlled occurrence of mass-wasting. Farmland terraces were mainly composed of gravel, mud, and clay, which are more prone to mass-wasting. Mass-wasting susceptibility mapping is feasible and potentially highly valuable. It could provide useful information in support of environmental health policies. Full article

Around half of methadone maintenance treatment (MMT) participants choose the tapering phase, however, the guidelines on tapering differ between countries and only include the tapering rate. Physicians need more evidence to guide clinical practice. We aimed to explore a specific tapering strategy to improve heroin abstinence among MMT participants. We conducted a retrospective study from 2006 to 2017 at nine MMT clinics in Guangdong, China, involving 853 participants with 961 treatment episodes. We performed two-level hierarchical logistic regression models to identify tapering phase characteristics associated with heroin abstinence. Among all treatment episodes, 419 (43.6%) were heroin abstinent. Participants who started tapering after 52 weeks, had a taper start dose of less than 60 mg and a taper ratio of less than 5%/week, while a dose reduction in 75%–89% of the tapering weeks provided the highest odds of heroin abstinence. This study highlights the need for a more gradual taper than current guidelines recommend and strongly suggests the inclusion of other tapering phase characteristics. Those who start the tapering phase later, have a lower dose of methadone, with a more gradual rate of taper, and a dose reduction in 75%–89% of the tapering phase increased the odds of heroin abstinence. Full article

For decades, researchers have debated whether climate change has an adverse impact on diseases, especially infectious diseases. They have identified a strong relationship between climate variables and vector’s growth, mortality rate, reproduction, and spatiotemporal distribution. Epidemiological data further indicates the emergence and re-emergence of infectious diseases post every single extreme weather event. Based on studies conducted mostly between 1990-2018, three aspects that resemble the impact of climate change impact on diseases are: (a) emergence and re-emergence of vector-borne diseases, (b) impact of extreme weather events, and (c) social upliftment with education and adaptation. This review mainly examines and discusses the impact of climate change based on scientific evidences in published literature. Humans are highly vulnerable to diseases and other post-catastrophic effects of extreme events, as evidenced in literature. It is high time that human beings understand the adverse impacts of climate change and take proper and sustainable control measures. There is also the important requirement for allocation of effective technologies, maintenance of healthy lifestyles, and public education. Full article

Background: Providing public access to exercise and play is vital for health promotion across populations. We evaluated the use of and satisfaction at Trojan Park, a multigenerational playground with multiple activity areas and fitness zones in the city of Wellston in St. Louis County, MO. Methods: We used video footage and the System for Observing Play and Recreation in Communities (SOPARC), which is a valid and reliable system for collecting data on physical activity in parks. We then performed intercept interviews to gather user information and measure overall satisfaction with the park. Results: The park received a variety of attendees across age groups, with children and middle-aged adults representing 41.1% and 50.3% of total park users, respectively. During the time observed, 47% of attendees were engaged in moderate to vigorous physical activity (MVPA), 22% were engaged in light physical activity (walking), and 30% were sedentary. We also observed participants spending the most time on the basketball court (38%), playground (28%), and picnic (17%) areas. Park users traveled a wide range of distances to access the park and the overwhelming majority reported a high level of satisfaction. Conclusions: Our findings demonstrate that multigenerational playgrounds with access to various activities and fitness zones may provide social and physical health benefits. Full article

This study investigated the effect of a school-based violence prevention programme implemented in Grade 1 classrooms in Jamaican primary schools. Fourteen primary schools were randomly assigned to receive training in classroom behaviour management (n = 7 schools, 27 teachers/classrooms) or to a control group (n = 7 schools, 28 teachers/classrooms). Four children from each class were randomly selected to participate in the evaluation (n = 220 children). Teachers were trained through a combination of workshop and in-class support sessions, and received a mean of 11.5 h of training (range = 3–20) over 8 months. The primary outcomes were observations of (1) teachers’ use of violence against children and (2) class-wide child aggression. Teachers in intervention schools used significantly less violence against children (effect size (ES) = −0.73); benefits to class-wide child aggression were not significant (ES = −0.20). Intervention teachers also provided a more emotionally supportive classroom environment (ES = 1.22). No benefits were found to class-wide prosocial behaviour, teacher wellbeing, or child mental health. The intervention benefited children’s early learning skills, especially oral language and self-regulation skills (ES = 0.25), although no benefits were found to achievement in maths calculation, reading and spelling. A relatively brief teacher-training programme reduced violence against children by teachers and increased the quality of the classroom environment. Full article

Rapid urbanization and industrialization in developing countries have caused an increase in air pollutant concentrations, and this has attracted public concern due to the resulting harmful effects to health. Here we present, through the spatial-temporal characteristics of six criteria air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃) in Sichuan, a human health risk assessment framework conducted to evaluate the health risk of different age groups caused by ambient air pollutants. Public health resilience was evaluated with respect to the risk resulting from ambient air pollutants, and a spatial inequality analysis between the risk caused by ambient air pollutants and hospital density in Sichuan was performed based on the Lorenz curve and Gini coefficient. The results indicated that high concentrations of PM_2.5 (47.7 μg m⁻³) and PM₁₀ (75.9 μg m⁻³) were observed in the Sichuan Basin; these two air pollutants posed a high risk to infants. The high risk caused by PM_2.5 was mainly distributed in Sichuan Basin (1.14) and that caused by PM₁₀ was principally distributed in Zigong (1.01). Additionally, the infants in Aba and Ganzi had high health resilience to the risk caused by PM_2.5 (3.89 and 4.79, respectively) and PM₁₀ (3.28 and 2.77, respectively), which was explained by the low risk in these two regions. These regions and Sichuan had severe spatial inequality between the infant hazard quotient caused by PM_2.5 (G = 0.518, G = 0.493, and G = 0.456, respectively) and hospital density. This spatial inequality was also caused by PM₁₀ (G = 0.525, G = 0.526, and G = 0.466, respectively), which is mainly attributed to the imbalance between hospital distribution and risk caused by PM_2.5 (PM₁₀) in these two areas. Such research could provide a basis for the formulation of medical construction and future air pollution control measures in Sichuan. Full article

The assessment of work-related functioning is a key process in vocational rehabilitation to identify specific domains of disability that can be considered within return to work strategies. The Work Rehabilitation Questionnaire (WORQ) was developed to evaluate work-related functioning based on the International Classification of Functioning, Disability, and Health (ICF) framework and is available in different languages. The aim of this study was to assess the French version of the WORQ using item response theory to further validate the scale. Rasch analysis of WORQ and the WORQ-BRIEF (a brief version of the WORQ) was performed using a calibration sample of 221 persons with musculoskeletal injuries. A four-testlet solution indicated the unidimensionality of WORQ, with no differential item functioning for age, education, physical job demands, and injury severity. Reliability was 0.969 and 0.918 for WORQ and WORQ-BRIEF, respectively. The minimal detectable change was calculated to be 4.2% of its operational range for WORQ and 8.5% for WORQ-BRIEF. Consequently, the French version of WORQ can be considered a good measure of work-related functioning in musculoskeletal conditions. WORQ can be used in rehabilitation practice to comprehensively identify the disability and guide clinical decision making and intervention planning. Further studies are needed to evaluate the psychometric properties of WORQ in other health conditions. Full article

An important goal of building “age-friendly communities” is to help the elderly to access more opportunities for social participation and better health. However, little is known about the complex relationships between neighborhood environment, social participation, and elderly health. This study examined the mediating role of social participation in the area of neighborhood environment affecting elderly health and explored the discrepancy among different age groups in 43 neighborhoods of Shanghai. Both neighborhood environment and social participation had significant positive effects on elderly health in all the samples. Meanwhile, social participation served as a mediator of the relationship between interpersonal environment and elderly health. Furthermore, remarkably, health promotion effects transferred from the physical environment to interpersonal environment and social participation with age; the influence of physical environment on elderly health decreased with the increase of age, while the influence of interpersonal environment and social participation on the health of the elderly increased with the increase of age. This study found that physical environment, interpersonal environment, and social participation had different effects on elderly health of different ages. Different policies should be applied toward improving the interpersonal environment, optimizing of physical environment, and guiding the community activities. Full article

In this paper, an improved fuzzy matter-element (IFME) method was proposed, which integrates the classical matter-element (ME) method, set pair analysis (SPA), and variable coefficient method (VCM). The method was applied to evaluate water quality of five monitor stations along Caoqiao River in Yixing city, Jiangsu Province, China. The levels of river water quality were determined according to fuzzy closeness degree. Compared with the traditional evaluation methods, the IFME method has several characteristics as follows: (i) weights were determined by the VCM method, which can reduce workload and overcome the adverse effects of abnormal values, (ii) membership degrees were defined by SPA, which can utilize monitored data more scientifically and comprehensively, and (iii) IFME is more suitable for seriously polluted rivers. Overall, these findings reinforce the notion that an integrated approach is essential for attaining scientific and objective assessment of river water quality. Full article

Background: Non-syndromic cleft lip/palate (NSCL/P) has an etiology, including both genetic and environmental factors. Herein, we evaluated the association of rs13041247 and rs11696257 v-maf musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB) polymorphisms with the risk of NSCL/P in a meta-analysis. Methods: The PubMed/Medline, Scopus, Cochrane Library, Web of Science, and HuGE Navigator databases were systematically searched to retrieve relevant articles published up to January 2019. The Newcastle–Ottawa scale was applied for quality evaluation of retrieved articles. The 95% confidence interval (CI) and crude odds ratio (OR) were calculated for each study using the Review Manager 5.3 software to show the association between MAFB polymorphisms and risk of NSCL/P. The comprehensive meta-analysis 2.0 software was used to calculate the publication bias. In addition, sensitivity analysis was carried out to show the stability of results. Results: Of 102 articles retrieved from the databases, 10 articles were analyzed in this meta-analysis. Ten articles, including eleven studies reporting rs13041247 MAFB polymorphism, included 3082 NSCL/P patients and 4104 controls. Three studies that reported rs11696257 MAFB polymorphism involved 845 NSCL/P patients and 927 controls. The rs11696257 MAFB polymorphism was not associated with the risk of NSCL/P, but the CC and TC genotypes of rs13041247 polymorphism were associated with the risk of NSCL/P. Nevertheless, the C allele and CC and TC genotypes were associated with a significant decline in the risk of NSCL/P in population-based studies. Conclusions: The results of this meta-analysis demonstrated that the risk of NSCL/P was related to rs13041247 polymorphism, not rs11696257 MAFB polymorphism. Well-designed studies are required to assess the interaction of MAFB and other genes with environmental factors in different ethnic groups. Full article

Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent forms of chronic liver disorders among adults, children, and adolescents, and a growing epidemic, worldwide. Notwithstanding the known susceptibility factors for NAFLD, i.e., obesity and metabolic syndrome, the exact cause(s) of this disease and the underlying mechanisms of its initiation and progression are not fully elucidated. NAFLD is a multi-faceted disease with metabolic, genetic, epigenetic, and environmental determinants. Accumulating evidence shows that exposure to environmental toxicants contributes to the development of NAFLD by promoting mitochondrial dysfunction and generating reactive oxygen species in the liver. Imbalances in the redox state of the cells are known to cause alterations in the patterns of 5-hydroxymethylcytosine (5hmC), the oxidative product of 5-methylcytosine (5mC), thereby influencing gene regulation. The 5hmC-mediated deregulation of genes involved in hepatic metabolism is an emerging area of research in NAFLD. This review summarizes our current knowledge on the interactive role of xenobiotic exposure and DNA hydroxymethylation in the pathogenesis of fatty liver disease. Increasing the mechanistic knowledge of NAFLD initiation and progression is crucial for the development of new and effective strategies for prevention and treatment of this disease. Full article

In order to accurately estimate the effects of tidal scenarios on the CH₄ emission from tidal wetlands, we examined the CH₄ effluxes, dissolved CH₄ concentrations, and environmental factors (including in situ pH, Eh and electrical conductivity, porewater SO₄²⁻, NO₃⁻, and NH₄⁺) during inundation and air-exposure periods in high- and low-tide seasons in the Min River Estuary in southeast China. By applying static and floating chambers, our results showed that the CH₄ effluxes during the inundation periods were relatively constant and generally lower than those during the air-exposed periods in both seasons. When compared, the CH₄ effluxes during the air-exposed periods were significantly higher in the high-tide season than those in the low-tide season. In contrast, CH₄ effluxes during the inundation periods were significantly lower in the high-tide season than those in the low-tide season. During the inundation periods, dissolved CH₄ concentrations were inversely proportional to in situ Eh. Under air-exposed conditions, CH₄ effluxes were proportional to in situ pH in both seasons, while the dissolved CH₄ concentrations were negatively correlated with the porewater SO₄²⁻ concentrations in both seasons. Our results highlighted that CH₄ effluxes were more dynamic between inundation and air-exposure periods compared to low- and high-tide seasons. Full article

Since the theory of planned behavior (TPB) was proposed by Ajzen in 1985, it has attracted extensive interest and been widely applied worldwide. Although an increasing number of studies have employed the TPB in the domain of environmental science, there have been no attempts to retrospectively analyze existing articles. The current study aimed to holistically understand the application status of the TPB in environmental science from a knowledge domain visualization perspective. A total of 531 journal articles were obtained through the Scopus database to perform a bibliometric analysis and content analysis. The results showed that waste management, green consumption, climate and environment, saving and conservation, and sustainable transportation are the primary research topics; the United States (U.S.), Mainland China, the United Kingdom (UK), and Malaysia are the most productive countries/regions. Moreover, the cross-disciplinary situations, main source journals, and key articles were revealed. Furthermore, the extended factors, integrated theories, major methods, specific groups, and control variables of environmental science research using the TPB were elaborated and integrated into a comprehensive application framework. Constructive criticisms were ultimately discussed. The findings contribute in several ways to help relevant researchers learn about the application of TPB to environmental science and provide new insights and holistic references for further research on environment-related behavior. Full article

Background: Professional pharmacists should be directly involved in patient healthcare as members of therapeutic teams are not the only dispensers of medication. Public perceptions of the professional role of pharmacists is expressed through patients’ attitudes, trust, and expectations as health and illness consultants, or qualified retailers of medicines. This perception is influenced by numerous determinants, both health-related and social. Objective: This research intends to describe the range of social roles pharmacists play from the perspective of potential pharmacy customers/patients. Methods: The data presented in the article comes from cross-sectional survey-based research, undertaken in 2018, on a representative sample of 600 Polish adults. Results: Over-the-counter medication is purchased by almost all Polish adults, but they do not tend to ask for advice at pharmacies. Most respondents consider a pharmacist to be “a person qualified to sell medicines”, with some of the participants regarding pharmacists as “ordinary retailers”. A small number of respondents are interested in benefiting from pharmaceutical care, but the pharmacy is still perceived to be a point of purchase for medication. Conclusions: Respondents do not treat pharmacists as health advisors and reduce its role to that of dispensing medication. Sociodemographic variables have no significant effect on social perception of pharmacists. Full article

Maternal exposure to polychlorinated biphenyls (PCBs) results in abnormal fetal development, possibly because of epigenetic alterations. However, the association between PCB levels in cord serum with fetal DNA methylation status in cord tissue is unclear. This study aims to identify alterations in DNA methylation in cord tissue potentially associated with PCB levels in cord serum from a birth cohort in Chiba, Japan (male neonates = 32, female neonates = 43). Methylation array analysis identified five sites for female neonates (cg09878117, cg06154002, cg06289566, cg12838902, cg01083397) and one site for male neonates (cg13368805) that demonstrated a change in the methylation degree. This result was validated by pyrosequencing analysis, showing that cg06154002 (tudor domain containing 9: TDRD9) in cord tissue from female neonates is significantly correlated with total PCB levels in cord serum. These results indicate that exposure to PCBs may alter TDRD9 methylation levels, although this hypothesis requires further validation using data obtained from female neonates. However, since the present cohort is small, further studies with larger cohorts are required to obtain more data on the effects of PCB exposure and to identify corresponding biomarkers. Full article

High consumption of sugar-sweetened beverages (SSBs) among adolescents has turned into a global concern due to its negative impact on health. This cross-sectional study determined the amount of SSB consumption among adolescents and its associated factors. A total of 421 adolescents aged 13.3 ± 1.3 years (41.8% males, 58.2% females) completed a self-administered questionnaire on sociodemographic characteristics, physical activity, screen-viewing behavior, sleep quality, frequency of eating at fast food restaurants, home food availability, peer social pressure, parenting practice, and SSB consumption. Weight and height were measured. Results showed that the mean daily consumption of SSBs among adolescents was 1038.15 ± 725.55 mL. The most commonly consumed SSB was malted drink, while the least commonly consumed SSB was instant coffee. The multiple linear regression results revealed that younger age (β = −0.204, p < 0.001), higher physical activity (β = 0.125, p = 0.022), higher screen time (β = 0.147, p = 0.007), poorer sleep quality (β = 0.228, p < 0.001), and unhealthy home food availability (β = 0.118, p = 0.032) were associated with a higher SSB intake. Therefore, promoting a healthy lifestyle may help to reduce the excessive consumption of SSBs among adolescents. Full article

The Chinese Hui ethnic minority group is an Islamic minority. The Hui people comprise the third largest minority population in China and are widely distributed throughout the country. Previous research shows that the Hui had a higher prevalence of cardiovascular risk factors (CVRFs) than most other ethnic groups. Therefore, the availability of health information relating to these factors is especially important for the Hui minority’s preventive healthcare. They do, however, experience difficulties in obtaining health-related information. The current research aims to identify the needs of the Hui people on where and how they obtain cardiovascular disease (CVD) related information from the media and other sources. Six focus groups were conducted in Shenyang City. The results revealed that the participants relied on different sources to get advice about CVDs, of which the internet and television were the most prominent ones. The participants expressed a desire for credible and professional information from different sources and asked for mediated health communication programs specifically targeted at the Hui. In addition, the participants felt ignored by the Chinese mainstream media at large, which created barriers for them to get health information. Full article

Background: Oil spill chemicals (OSCs) result not only from the crude oil components but also from dispersants used in the clean-up activities, where some may result in adverse health effects under certain exposure and dosage conditions. One of the main populations of concern for exposure to OSCs are children, who are frequent beach users. Activities such as ingestion of and digging in sand can increase dermal and ingestion exposure. Longer times spent at the beach can also increase exposures for all routes. Objectives: The Beach Exposure and Child Health Study (BEaCHeS) was initiated to evaluate the risk of exposure to children from oil contaminants. Reported here are results for surveys collected, as a part of the project, to address exposure-related behavior patterns and risk perception for parents or guardians who visit the beach. Methods: Over 400 parental surveys were collected at four beaches, two in Miami and two in Texas, to evaluate children’s exposure related activities. Surveys consisted of three general sections: demographics, exposure, and risk perception. Surveys were analyzed in REDcap and Stata to evaluate demographic and regional differences on activities related to beach behavior and potential exposures to oil contaminants (e.g., how much time spent on beach, cleaning habits following beach activities). The statistical analysis included the mean and standard errors, along with regressions to evaluate associations between parameters. Results: Overall, the data showed high variability in how children play on the beach, influenced more by age and less by gender. Variations were also seen in certain variables by beach region (e.g., hygiene practices). By race, variations were seen in income, distance of travel to beach, and preferred method of communication for beach warning. Other important findings are reflected in the article. Discussion: The data presented here may prove useful for those evaluating children exposures to a variety of contaminants, chemical, or bacterial in origin. In addition, coastal managers may find the risk perception and general behaviors useful for planning and maintenance of beach areas. Full article

Background This study investigated the relationships between children’s friendship ties and their physical activity (PA) both before and after their transition to a new school year. Methods In 2011–2012, children in grades 5–8 attending a Canadian urban middle-school completed web-based health and friendship surveys two times before (“pre-transition”) and three times after (“post-transition”) they moved up in school grade. Cross-sectional associations between an average daily frequency of ≥60 min/day of moderate-to-vigorous intensity PA (MVPA) and characteristics of children’s friendships were estimated for pre-transition (n = 191) and post-transition (n = 255) data. Sociodemographic-adjusted linear regression (β) estimated associations between a child’s MVPA and friendship characteristics. Results We found positive associations between a child’s MVPA and the average MVPA of their friends at post-transition only (β = 0.61, 95% CI 0.10 to 1.13) and the number of sent friendships at pre-transition (β = 0.03, 95% CI 0.01 to 0.05) and post-transition (β = 0.02, 95% CI 0.01 to 0.04). A statistically significant interaction between popularity and friends’ average PA at pre-transition was also found. Conclusions The PA of friends and the number of school friends that a child identified are positively associated with MVPA. The estimated associations between MVPA and aspects of children’s friendships are similar for boys and girls. Full article

Background: Dementia is one of the public health priorities in China. This study aimed to examine the hospitalization costs of patients with dementia and analyzed the factors associated with their inpatient costs. Methods: This was a prevalence-based, observational study using claims data derived from two urban insurance schemes during the period from 2008 through 2013 in Guangzhou. The extended estimating equations model was performed to identify the main drivers of total inpatient costs. Results: We identified 5747 dementia patients with an average age of 77.4. The average length of stay (LOS) was 24.2 days. The average hospitalization costs per inpatient was Chinese Yuan (CNY) 9169.0 (CNY 9169.0 = US$1479.8 in 2013). The mean inpatient costs for dementia patients with the Urban Employee-based Basic Medical Insurance (UEBMI) scheme (CNY 9425.0 = US$1521.1) were higher than those for patients with the Urban Resident-based Basic Medical Insurance scheme (CNY 7420.5 = US$1197.6) (p < 0.001). Having UEBMI coverage, dementia subtypes, having hypertension, being admitted in larger hospitals, and longer LOS were significantly associated with hospitalization costs of dementia. Conclusions: The costs of hospitalization for dementia were high and differed by types of insurance schemes. Dementia was associated with substantial hospitalization costs, mainly driven by insurance type and long LOS. These findings provided economic evidence for evaluating the burden of dementia in China. Full article

Background. Exposure to fictional suicide scenes raises concerns about the risk of suicide contagion. However, researchers and clinicians still lack empirical evidence to estimate this risk. Here, we propose a theory-grounded tool that measures properties related to aberrant identification and suicidal contagion of potentially harmful suicide scenes. Methods. The items of the Movies and Video: Identification and Emotions in reaction to Suicide (MoVIES) operationalize the World Health Organization’s recommendations for media coverage of suicide, and were adapted and completed with identification theory principles and cinematographic evidence. Inter-rater reliability (Cohen’s kappa) and internal consistency (Cronbach’s alpha) were estimated and optimized for two series of 19 and 30 randomly selected movies depicting a suicide scene. The validity of the scale in predicting identification with the suicidal character was tested in nine unknowledgeable participants who watched seven suicide movie scenes each. Results. The MoVIES indicated satisfying psychometric properties with kappas measured at 0.7 or more for every item and a global internal consistency of [α = 0.05]. The MoVIES score significantly predicted participants’ strength of identification independently from their baseline empathy ((β = 0.20), p < 0.05). Conclusions. The MoVIES is available to scholars as a valid, reliable, and useful tool to estimate the amount of at-risk components of fictional suicidal behavior depicted in films, series, or television shows. Full article

Disaster preparedness initiatives are increasingly focused on building community resilience. Preparedness research has correspondingly shifted its attention to community-level attributes that can support a community’s capacity to respond to and recover from disasters. While research at the community level is integral to building resilience, it may not address the specific barriers and motivators to getting individuals prepared. In particular, people with disabilities are vulnerable to disasters, yet research suggests that they are less likely to engage in preparedness behaviors. Limited research has examined what factors influence their ability to prepare, with no studies examining both the individual and community characteristics that impact these behaviors. Multilevel modeling thus offers a novel contribution that can assess both levels of influence. Using Los Angeles County community survey data from the Public Health Response to Emergent Threats Survey and the Healthy Places Index, we examined how social cognitive and community factors influence the relationship between disability and preparedness. Results from hierarchical linear regression models found that participants with poor health and who possessed activity limitations engaged in fewer preparedness behaviors. Self-efficacy significantly mediated the relationship between self-rated health and disaster preparedness. Living in a community with greater advantages, particularly with more advantaged social and housing attributes, reduced the negative association between poor self-rated health and preparedness. This study highlights the importance of both individual and community factors in influencing people with disabilities to prepare. Policy and programming should therefore be two-fold, both targeting self-efficacy as a proximal influence on preparedness behaviors and also addressing upstream factors related to community advantage that can create opportunities to support behavioral change while bolstering overall community resilience. Full article