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Enviromental essay

International Journal of Environmental Research and Public Health (ISSN 1660-4601; CODEN: IJERGQ; ISSN 1661-7827 for printed edition) is an interdisciplinary, open access journal published monthly online by MDPI.
  • Open Access - free for readers, with publishing fees paid by authors or their institutions.
  • High visibility: indexed by the Science Citation Index Expanded (Web of Science), MEDLINE (PubMed) and other databases. Full-text available in PubMed Central .
  • Rapid publication: manuscripts are peer-reviewed and a first decision provided to authors approximately 26 days after submission; acceptance to publication is undertaken in 7 days (median values for papers published in this journal in 2015).

Impact Factor: 2.035 (2015) ; 5-Year Impact Factor: 2.471 (2015)

Int. J. Environ. Res. Public Health2017. 14 (1), 11; doi:10.3390/ijerph14010011 (registering DOI) - 24 December 2016

In this study, we developed curcumin-encapsulated hyaluronic acid–polylactide nanoparticles (CEHPNPs) to be used for liver fibrosis amelioration. CD44, the hyaluronic acid (HA) receptor, is upregulated on the surface of cancer cells and on activated hepatic stellate cells (aHSCs) rather than normal cells. CEHPNPs

In this study, we developed curcumin-encapsulated hyaluronic acid–polylactide nanoparticles (CEHPNPs) to be used for liver fibrosis amelioration. CD44, the hyaluronic acid (HA) receptor, is upregulated on the surface of cancer cells and on activated hepatic stellate cells (aHSCs) rather than normal cells. CEHPNPs could bind to CD44 and be internalized effectively through endocytosis to release curcumin, a poor water-soluble liver protective agent. Thus, CEHPNPs were potentially not only improving drug efficiency, but also targeting aHSCs. HA and polylactide (PLA) were crosslinked by adipic acid dihydrazide (ADH). The synthesis of HA–PLA was monitored by Fourier-transform infrared (FTIR) and Nuclear Magnetic Resonance (NMR). The average particle size was approximately 60–70 nm as determined by dynamic light scattering (DLS) and scanning electron microscope (SEM). Zeta potential was around −30 mV, which suggested a good stability of the particles. This drug delivery system induced significant aHSC cell death without affecting quiescent HSCs, hepatic epithelial, and parenchymal cells. This system reduced drug dosage without sacrificing therapeutic efficacy. The cytotoxicity IC50 (inhibitory concentration at 50%) value of CEHPNPs was approximately 1/30 to that of the free drug treated group in vitro. Additionally, the therapeutic effects of CEHPNPs were as effective as the group treated with the same curcumin dose intensity in vivo. CEHPNPs significantly reduced serum aspartate transaminase/alanine transaminase (ALT/AST) significantly, and attenuated tissue collagen production and cell proliferation as revealed by liver biopsy. Conclusively, the advantages of superior biosafety and satisfactory therapeutic effect mean that CEHPNPs hold great potential for treating hepatic fibrosis. Full article

Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing

Int. J. Environ. Res. Public Health2017. 14 (1), 12; doi:10.3390/ijerph14010012 (registering DOI) - 24 December 2016

Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of

Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of the guidelines is required. Worldwide, Legionella has been detected from many potable water sources, suggesting it is ubiquitous in this environment. Previous studies have identified the limitations of the current standard method for Legionella detection and the high possibility of it returning both false negative and false positive results. There is also huge variability in Legionella test results for the same water sample when conducted at different laboratories. However, many guidelines still recommend the testing of water systems. This commentary argues for the removal of routine Legionella monitoring from all water distribution guidelines. This procedure is financially consuming and false negatives may result in managers being over-confident with a system or a control mechanism. Instead, the presence of the pathogen should be assumed and focus spent on managing appropriate control measures and protecting high-risk population groups. Full article

Int. J. Environ. Res. Public Health2017. 14 (1), 13; doi:10.3390/ijerph14010013 (registering DOI) - 24 December 2016

Currently, under- and over-nutrition problems co-exist in China. However, systematic studies on the diet quality of Chinese residents have been scant. This study described the trend in diet quality of Chinese residents over a recent eight-year period and investigated the relevant influential factors.

Currently, under- and over-nutrition problems co-exist in China. However, systematic studies on the diet quality of Chinese residents have been scant. This study described the trend in diet quality of Chinese residents over a recent eight-year period and investigated the relevant influential factors. The data of Chinese adults aged 20–59 years was extracted from 2004, 2006, 2009, and 2011 China Health and Nutrition Survey. The China diet quality index (DQI) was employed to assess the diet quality of Chinese adults. The dietary consumption data of each individual was collected using a 24-h dietary recall and weighed food records implemented for three consecutive days. A mixed ordinary least squares regression model was applied to analyze the factors influencing the DQI scores of Chinese residents. Results showed that the diet quality of Chinese residents increased from 2004 to 2006, followed by a decrease in 2009 and 2011. The income, urbanicity index, and southern dummy were positively associated with DQI scores, whereas the size of household and labor intensity were negative predictors of DQI scores. The DQI scores also varied over BMI values. With an increase of the average income level in the future, the diet quality of Chinese residents is estimated to further improve. Moreover, urbanization could also contribute to reaching a more balanced diet. Full article

The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT)

The personal health record (PHR) is a system that enables borderless medical care services by combining technological innovation and human consideration. This study explored factors affecting the adoption of PHR from technical, medical, and social perspectives according to the Protection Motivation Theory (PMT) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A survey using a structured questionnaire was subsequently conducted, which produced the following results: (1) The PMT and UTAUT were effective at predicting PHR usage behaviors; (2) Perceived ease-of-use was the most decisive factor influencing the use of PHR, followed by self-efficacy and perceived usefulness; and (3) Behavioral intention for PHR was significantly and positively correlated with usage behavior. From the obtained results, this study recommends that health authorities and medical institutions promote self-efficacy in the use of PHR to improve the levels of behavioral intention and usage behavior among the people. Additionally, medical care institutions are recommended to promote health management and preventive healthcare concepts to help improve public acceptance of the PHR system as a means to self-manage their health. Finally, community centers, medical institutions, and health authorities are urged to work together to enhance public medical knowledge and pool resources for the PHR system, both of which are essential for improving the popularity of the PHR, public quality of life, and the effectiveness of health management. Full article

In China, a flashing green (FG) indication of 3 s followed by a yellow (Y) indication of 3 s is commonly applied to end the green phase at signalized intersections. Stop-line crossing behavior of drivers during such a phase transition period significantly influences

In China, a flashing green (FG) indication of 3 s followed by a yellow (Y) indication of 3 s is commonly applied to end the green phase at signalized intersections. Stop-line crossing behavior of drivers during such a phase transition period significantly influences safety performance of signalized intersections. The objective of this study is thus to empirically analyze and model drivers’ stop-line crossing time and speed in response to the specific phase transition period of FG and Y. High-resolution trajectories for 1465 vehicles were collected at three rural high-speed intersections with a speed limit of 80 km/h and two urban intersections with a speed limit of 50 km/h in Shanghai. With the vehicle trajectory data, statistical analyses were performed to look into the general characteristics of stop-line crossing time and speed at the two types of intersections. A multinomial logit model and a multiple linear regression model were then developed to predict the stop-line crossing patterns and speeds respectively. It was found that the percentage of stop-line crossings during the Y interval is remarkably higher and the stop-line crossing time is approximately 0.7 s longer at the urban intersections, as compared with the rural intersections. In addition, approaching speed and distance to the stop-line at the onset of FG as well as area type significantly affect the percentages of stop-line crossings during the FG and Y intervals. Vehicle type and stop-line crossing pattern were found to significantly influence the stop-line crossing speed, in addition to the above factors. The red-light-running seems to occur more frequently at the large intersections with a long cycle length. Full article

Int. J. Environ. Res. Public Health2017. 14 (1), 10; doi:10.3390/ijerph14010010 - 23 December 2016

Adults with mental health conditions (MHC) are especially likely to smoke and experience tobacco-related health disparities. Individuals with MHC may also use electronic nicotine delivery devices (ENDS) at disproportionately high rates. However, there is a relative dearth of knowledge regarding ENDS use among

Adults with mental health conditions (MHC) are especially likely to smoke and experience tobacco-related health disparities. Individuals with MHC may also use electronic nicotine delivery devices (ENDS) at disproportionately high rates. However, there is a relative dearth of knowledge regarding ENDS use among individuals with MHC. In a large representative sample of U.S. adults (n = 6051), associations between self-reported MHC diagnoses and ENDS use and susceptibility were examined, stratified by smoking status. Participants with MHC were approximately 1.5 times more likely to have used ENDS in their lifetime and almost twice as likely to currently use ENDS as those without MHC. MHC status was most strongly linked to higher ENDS use among former smokers, and former smokers with MHC were more likely to report using ENDS during past smoking quit attempts than those without MHC. Among participants who had not tried ENDS, former smokers with MHC were especially susceptible to future ENDS use. The potential advantage of ENDS for cessation purposes should be balanced with the risk of attracting former smokers with MHC to ENDS. Full article

Visualizing the Heterogeneity of Effects in the Analysis of Associations of Multiple Myeloma with Glyphosate Use. Comments on Sorahan, T. Multiple Myeloma and Glyphosate Use: A Re-Analysis of US Agricultural Health Study (AHS) Data. Int. J. Environ. Res. Public Health 2015, 12. 1548–1559

We address a methodological issue of the evaluation of the difference in effects in epidemiological studies that may arise, for example, from stratum-specific analyses or differences in analytical decisions during data analysis. We propose a new simulation-based method to quantify the plausible extent

We address a methodological issue of the evaluation of the difference in effects in epidemiological studies that may arise, for example, from stratum-specific analyses or differences in analytical decisions during data analysis. We propose a new simulation-based method to quantify the plausible extent of such heterogeneity, rather than testing a hypothesis about its existence. We examine the contribution of the method to the debate surrounding risk of multiple myeloma and glyphosate use and propose that its application contributes to a more balanced weighting of evidence. Full article

This study aims to understand the nature and significance of online lay discussions about e-cigarettes and mental illness. We systematically searched the website Redditusing keywords related to e-cigarettes and mental illness. We coded relevant posts into themes under the framework of motivations

This study aims to understand the nature and significance of online lay discussions about e-cigarettes and mental illness. We systematically searched the website Redditusing keywords related to e-cigarettes and mental illness. We coded relevant posts into themes under the framework of motivations for and limitations of vaping for people with mental illness. The thematic analysis included 3263 comments from 133 discussion threads. Six themes were classified as motivations to vape for people with mental illness: Self-medication; Quitting smoking; Freedom and control; Hobby; Social connectedness; and Motivation from caregivers and online communities. The limitations of vaping included: Unsatisfactory substitute for cigarettes and psychiatric medicines; Drug interactions; Nicotine addiction; Risks of e-liquid; Practical difficulties and Cost. People with mental illness; and their carers; use online discussion boards like Reddit to discuss the benefits and limitations of e-cigarettes for people with mental illness. Both positive and negative views exist. Media platforms like Reddit may shape the opinions of stakeholders and generate lay expertise about contentious health topics such as e-cigarettes. These findings have implications for policy and practice concerning assisting smokers with mental illness to reduce their health risk through switching to e-cigarettes. Full article

The purpose of this study was to assess the major risk factors for hypertension in oil workers, and investigate the effect of occupational stress on the incidence of hypertension after controlling for other risk factors. A prospective cohort approach was used following enrollment

The purpose of this study was to assess the major risk factors for hypertension in oil workers, and investigate the effect of occupational stress on the incidence of hypertension after controlling for other risk factors. A prospective cohort approach was used following enrollment of 1354 oil workers. The occupational stress experienced by oil workers was higher than for the general population in China. By the end of the cohort study, 231 new cases of hypertension among the oil workers had been diagnosed. The cumulative incidence of hypertension was 17.06%. There were 44, 112, and 75 workers who developed hypertension in the low, intermediate, and high occupational stress groups, which represented a 12.0%, 15.6%, and 20.3% cumulative incidence, respectively (chi-square value = 9.812, p < 0.01). Multivariate Cox proportional hazard model analysis showed that type of work, cigarette smoking, excess body weight, and obesity were risk factors for hypertension (p < 0.05). After risk factors such as type of work, cigarette smoking, alcohol consumption, and body mass index (BMI) were controlled, the hypertension risk (hazard ratio, HR) in the high occupational stress group was 1.549 (1.072–2.236) compared to the low exposure group, and 2.337 (1.191–4.585) in female subjects. Our study indicated that an increase in occupational stress was associated with an increased risk of hypertension after other factors were adjusted. Full article

Assessing ecosystem health is helpful to determine reasonable eco-environmental restoration and resource management strategies. Based on a pressure-state-response (PSR) framework, a set of comprehensive indicators including natural, social and economic aspects was proposed and applied for assessing the ecosystem health of Yuanzhou County,

Assessing ecosystem health is helpful to determine reasonable eco-environmental restoration and resource management strategies. Based on a pressure-state-response (PSR) framework, a set of comprehensive indicators including natural, social and economic aspects was proposed and applied for assessing the ecosystem health of Yuanzhou County, Loess Plateau, Ningxia Province, China. The basic data used to calculate the values of the assessment indicators include Landsat TM image and socio-economic data, and remote sensing (RS) and the geographic information system (GIS) were used to process image data. The results showed that the ecosystem health conditions of most townships in Yuanzhou County were at the moderately healthy level, three townships were at the healthy level, and only two townships were at the unhelathy level; the areas (percentage) at the unhealthy, moderately healthy and healthy levels were 443.91 km 2 (12.66%), 2438.75 km 2 (69.54%) and 624.50 km 2 (17.81%), respectively. The results could provide useful information for local residents and the government to take measures to improve the health conditions of their township ecosystem. Full article

Ambient particulate matter (PM) can trigger adverse reactions in the respiratory system, but less is known about the effect of indoor PM. In this longitudinal study, we investigated the relationships between indoor PM and clinical parameters in patients with moderate to very severe

Ambient particulate matter (PM) can trigger adverse reactions in the respiratory system, but less is known about the effect of indoor PM. In this longitudinal study, we investigated the relationships between indoor PM and clinical parameters in patients with moderate to very severe chronic obstructive pulmonary disease (COPD). Indoor air quality (PM2.5 and PM10 levels) was monitored in the patients’ bedroom, kitchen, living room, and front door at baseline and every two months for one year. At each home visit, the patients were asked to complete spirometry and questionnaire testing. Exacerbations were assessed by chart review and questionnaires during home visits. Generalized estimating equation (GEE) analysis (n = 83) showed that the level of wheezing was significantly higher in patients whose living room and kitchen had abnormal (higher than ambient air quality standards in Taiwan) PM2.5 and PM10 levels. Patients who lived in houses with abnormal outdoor PM2.5 levels had higher COPD Assessment Test scores (physical domain), and those who lived in houses with abnormal PM10 levels in the living room and kitchen had higher London Chest Activity of Daily Living scores. Increased PM levels were associated with worse respiratory symptoms and increased risk of exacerbation in patients with moderate to very severe COPD. Full article

Research indicates that higher levels of traffic-related pollution exposure increase the risk of diabetes, but the association between road proximity and diabetes risk remains unclear. To assess and quantify the association between residential proximity to major roadways and type 2 diabetes, a systematic

Research indicates that higher levels of traffic-related pollution exposure increase the risk of diabetes, but the association between road proximity and diabetes risk remains unclear. To assess and quantify the association between residential proximity to major roadways and type 2 diabetes, a systematic review and meta-analysis was performed. Embase, Medline, and Web of Science were searched for eligible studies. Using a random-effects meta-analysis, the summary relative risks (RRs) were calculated. Bayesian meta-analysis was also performed. Eight studies (6 cohort and 2 cross-sectional) with 158,576 participants were finally included. The summary unadjusted RR for type 2 diabetes associated with residential proximity to major roadways was 1.24 (95% confidence interval [CI]: 1.07–1.44, p = 0.001, I 2 = 48.1%). The summary adjusted RR of type 2 diabetes associated with residential proximity to major roadways was 1.12 (95% CI: 1.03–1.22, p = 0.01, I 2 = 17.9%). After excluding two cross-sectional studies, the summary results suggested that residential proximity to major roadways could increase type 2 diabetes risk (Adjusted RR = 1.13; 95% CI: 1.02–1.27, p = 0.025, I 2 = 36.6%). Bayesian meta-analysis showed that the unadjusted RR and adjusted RR of type 2 diabetes associated with residential proximity to major roadways were 1.22 (95% credibility interval: 1.06–1.55) and 1.13 (95% credibility interval: 1.01–1.31), respectively. The meta-analysis suggested that residential proximity to major roadways could significantly increase risk of type 2 diabetes, and it is an independent risk factor of type 2 diabetes. More well-designed studies are needed to further strengthen the evidence. Full article

Int. J. Environ. Res. Public Health2016. 13 (12), 1265; doi:10.3390/ijerph13121265 - 21 December 2016

Intersections are one of the major locations where safety is a big concern to drivers. Inappropriate driver behaviors in response to frequent changes when approaching intersections often lead to intersection-related crashes or collisions. Thus to better understand driver behaviors at intersections, especially in

Intersections are one of the major locations where safety is a big concern to drivers. Inappropriate driver behaviors in response to frequent changes when approaching intersections often lead to intersection-related crashes or collisions. Thus to better understand driver behaviors at intersections, especially in the dilemma zone, a Hidden Markov Model (HMM) is utilized in this study. With the discrete data processing, the observed dynamic data of vehicles are used for the inference of the Hidden Markov Model. The Baum-Welch (B-W) estimation algorithm is applied to calculate the vehicle state transition probability matrix and the observation probability matrix. When combined with the Forward algorithm, the most likely state of the driver can be obtained. Thus the model can be used to measure the stability and risk of driver behavior. It is found that drivers’ behaviors in the dilemma zone are of lower stability and higher risk compared with those in other regions around intersections. In addition to the B-W estimation algorithm, the Viterbi Algorithm is utilized to predict the potential dangers of vehicles. The results can be applied to driving assistance systems to warn drivers to avoid possible accidents. Full article

Int. J. Environ. Res. Public Health2016. 13 (12), 1266; doi:10.3390/ijerph13121266 - 21 December 2016

Background: The current study examined relationships between the neighborhood social environment (parental perceived collective efficacy (PCE)), constrained behaviors (e.g. avoidance or defensive behaviors) and adolescent offspring neighborhood physical activity in low- versus high-incivility neighborhoods. Methods: Adolescents (n = 71; 11–18 years (14.2,

Background: The current study examined relationships between the neighborhood social environment (parental perceived collective efficacy (PCE)), constrained behaviors (e.g. avoidance or defensive behaviors) and adolescent offspring neighborhood physical activity in low- versus high-incivility neighborhoods. Methods: Adolescents (n = 71; 11–18 years (14.2, SD ± 1.6); male = 37 (52%); non-white = 24 (33.8%); low-income = 20 (29%); overweight/obese = 40 (56%)) and their parents/guardians enrolled in the Molecular and Social Determinants of Obesity in Developing Youth study were included in the current study. Questionnaires measured parents’/guardians’ PCE, constrained outdoor play practices and offspring neighborhood physical activity. Systematic social observation performed at the parcel-level using Google Street View assessed neighborhood incivilities. t -tests and chi-square tests determined differences by incivilities. Multilevel regression models examined relationships between PCE and: (1) constrained behaviors; and (2) neighborhood physical activity. The Hayes (2013) macro determined the mediating role of constrained behaviors. Results: Parents who had higher PCE reported lower levels of avoidance (p = 0.04) and defensive (p = 0.05) behaviors. However, demographic variables (i.e. gender, race and annual household income) limited these results. The direct relationship between PCE and parent-reported neighborhood physical activity was statistically significant in high-incivility neighborhoods only. Neither avoidance nor defensive behavior mediated the relationship between PCE and neighborhood physical activity. Conclusions: PCE influences parenting behaviors related to youth physical activity. Community-based programs that seek to facilitate social cohesion and control may be needed to increase adolescents’ physical activity. Full article

Int. J. Environ. Res. Public Health2016. 13 (12), 1268; doi:10.3390/ijerph13121268 - 21 December 2016

Regular maintenance of non-communicable chronic diseases can constrain disease progression in diabetic and hypertensive patients. To identify the individual and social factors that are associated with positive health-seeking behaviors and regular maintenance of chronic diseases, we have conducted a follow up study in

Regular maintenance of non-communicable chronic diseases can constrain disease progression in diabetic and hypertensive patients. To identify the individual and social factors that are associated with positive health-seeking behaviors and regular maintenance of chronic diseases, we have conducted a follow up study in 2015 on diabetic and hypertensive patients in Hubei Province. We used binary logistic regression models to determine specific factors associated with diabetic and hypertensive patients that sought healthcare services for their conditions in accordance with current Chinese Centers for Disease Prevention and Control (CDC) guidelines. Our findings show that 42.16% of 510 people living with chronic conditions (PLCDs) sought health services in line with existing guidelines. Findings also show a higher probability (8.418 times) for PLCDs seeking healthcare services at higher-tiered hospitals (secondary and tertiary hospitals) than for PLCDs seeking care at primary hospitals (odds ratio (OR) = 8.418, 95% confidence interval (CI) = 4.82, 14.27, p < 0.001). These analyses underscore the importance of having patient advocates who can provide support, where necessary, and encourage positive health-seeking behavior. The study also shows a negative impact on regular maintenance for PLCDs in households with high financial constraints. In contrast, the study shows positive impacts for increased household income, age, and residency in rural locations. In sum, this study underscores the importance of primary hospitals as key points of care and critical players in care coordination for PLCDs. The study provides more evidence for Chinese policymakers seeking to contain costs and improve population health. The findings also underscore the need for community-based interventions, specifically interventions that link local primary hospitals, friends/family members, and PLCDs. Full article

Int. J. Environ. Res. Public Health2016. 13 (12), 1267; doi:10.3390/ijerph13121267 - 21 December 2016

Mosquito-borne diseases are responsible for more than a million human deaths every year. Modern mosquito control strategies such as sterile insect technique (SIT), release of insects carrying a dominant lethal (RIDL), population replacement strategies (PR), and Wolbachia -based strategies require the rearing of

Mosquito-borne diseases are responsible for more than a million human deaths every year. Modern mosquito control strategies such as sterile insect technique (SIT), release of insects carrying a dominant lethal (RIDL), population replacement strategies (PR), and Wolbachia -based strategies require the rearing of large numbers of mosquitoes in culture for continuous release over an extended period of time. Anautogenous mosquitoes require essential nutrients for egg production, which they obtain through the acquisition and digestion of a protein-rich blood meal. Therefore, mosquito mass production in laboratories and other facilities relies on vertebrate blood from live animal hosts. However, vertebrate blood is expensive to acquire and hard to store for longer times especially under field conditions. This review discusses older and recent studies that were aimed at the development of artificial diets for mosquitoes in order to replace vertebrate blood. Full article

Int. J. Environ. Res. Public Health2016. 13 (12), 1260; doi:10.3390/ijerph13121260 - 21 December 2016

Urban waterlogging seriously threatens the safety of urban residents and properties. Wargame simulation research on resident emergency evacuation from waterlogged areas can determine the effectiveness of emergency response plans for high risk events at low cost. Based on wargame theory and emergency evacuation

Urban waterlogging seriously threatens the safety of urban residents and properties. Wargame simulation research on resident emergency evacuation from waterlogged areas can determine the effectiveness of emergency response plans for high risk events at low cost. Based on wargame theory and emergency evacuation plans, we used a wargame exercise method, incorporating qualitative and quantitative aspects, to build an urban waterlogging disaster emergency shelter using a wargame exercise and evaluation model. The simulation was empirically tested in Daoli District of Harbin. The results showed that the wargame simulation scored 96.40 points, evaluated as good. From the simulation results, wargame simulation of urban waterlogging emergency procedures for disaster response can improve the flexibility and capacity for command, management and decision-making in emergency management departments. Full article

Int. J. Environ. Res. Public Health2016. 13 (12), 1264; doi:10.3390/ijerph13121264 - 21 December 2016

Predictors of high-risk patterns of substance use are often analysed in relation to demographic and school-related factors. The interaction between these factors and the additional impact of family wealth are still new areas of research. The aim of this study was to find

Predictors of high-risk patterns of substance use are often analysed in relation to demographic and school-related factors. The interaction between these factors and the additional impact of family wealth are still new areas of research. The aim of this study was to find determinants of the most common patterns of psychoactive substance use in mid-adolescence, compared to non-users. A sample of 1202 Polish students (46.1% boys, mean age of 15.6 years) was surveyed in 2013/2014. Four patterns of psychoactive substance use were defined using cluster analysis: non-users—71.9%, mainly tobacco and alcohol users—13.7%, high alcohol and cannabis users—7.2%, poly-users—7.2%. The final model contained the main effects of gender and age, and one three-way (perceived academic achievement × gender × family affluence) interaction. Girls with poor perception of school performance (as compared to girls with better achievements) were at significantly higher risk of being poly-users, in both less and more affluent families (adjusted odds ratio (OR) = 5.55 and OR = 3.60, respectively). The impact of family affluence was revealed only in interaction with other factors. Patterns of substance use in mid-adolescence are strongly related to perceived academic achievements, and these interact with selected socio-demographic factors. Full article

Int. J. Environ. Res. Public Health2016. 13 (12), 1263; doi:10.3390/ijerph13121263 - 21 December 2016

While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette

While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette marketing among smokers in the United States. Our aim was to examine these disparities in a Midwestern metropolitan area in the United States. We conducted a telephone survey to collect data on 999 smokers. Cigarette marketing was measured by asking respondents three questions about noticing advertisements, promotions, and displays of cigarettes within their respective neighborhoods. The questions were combined to create a summated scale. We estimated ordered logistic regression models to examine the association of sociodemographic variables with exposure to POS cigarette marketing. Adjusted results showed that having a lower income (p < 0.003) and belonging to a race/ethnicity other than “non-Hispanic White” (p = 0.011) were associated with higher levels of exposure to POS cigarette marketing. The results highlight social disparities in exposure to POS cigarette marketing in the United States, which can potentially be eliminated by banning all forms of cigarette marketing. Full article

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