One health disparities and COVID-19

 The global impact of the COVID-19 pandemic has disproportionately affected some communities and populations more than others. We propose that an interdisciplinary framework of ‘One Health Disparities’ advances understanding of the social and systemic issues that drive COVID-19 in vulnerable populations. One Health Disparities integrates the social environment with One Health perspectives on the interconnectedness of human, animal, and environmental health. To apply this framework, we consider One Health Disparities that emerge in three key components of disease transmission: exposure, susceptibility, and disease expression. Exposure disparities arise through variation in contact with COVID-19’s causative agent, SARS-CoV-2. Disparities in susceptibility and disease expression also exist; these are driven by biological and social factors, such as diabetes and obesity, and through variation in access to healthcare. We close by considering how One Health Disparities informs understanding of spillback into new animal reservoirs, and what this might mean for further human health disparities.Lay summaryOne Health focuses on interconnections between human, animal, and environmental health. We propose that social environments are also important to One Health and help illuminate disparities in the coronavirus pandemic, including its origins, transmission and susceptibility among humans, and spillback to other species. We call this framework One Health Disparities.     

Web Data Mining: Validity of Data from Google Earth for Food Retail Evaluation

To overcome the challenge of obtaining accurate data on community food retail, we developed an innovative tool to automatically capture food retail data from Google Earth (GE). The proposed method is relevant to non-commercial use or scholarly purposes. We aimed to test the validity of web sources data for the assessment of community food retail environment by comparison to ground-truth observations (gold standard). A secondary aim was to test whether validity differs by type of food outlet and socioeconomic status (SES). The study area included a sample of 300 census tracts stratified by SES in two of the largest cities in Brazil, Rio de Janeiro and Belo Horizonte. The GE web service was used to develop a tool for automatic acquisition of food retail data through the generation of a regular grid of points. To test its validity, this data was compared with the ground-truth data. Compared to the 856 outlets identified in 285 census tracts by the ground-truth method, the GE interface identified 731 outlets. In both cities, the GE interface scored moderate to excellent compared to the ground-truth data across all of the validity measures: sensitivity, specificity, positive predictive value, negative predictive value and accuracy (ranging from 66.3 to 100%). The validity did not differ by SES strata. Supermarkets, convenience stores and restaurants yielded better results than other store types. To our knowledge, this research is the first to investigate using GE as a tool to capture community food retail data. Our results suggest that the GE interface could be used to measure the community food environment. Validity was satisfactory for different SES areas and types of outlets.     

Spatial clusters of daily tobacco consumption before and after a smoke-free policy implementation

This study assessed the spatial dependence of daily tobacco consumption and how it is spatially impacted by individual and neighborhood socioeconomic determinants, and tobacco consumption facilities before and after a smoke-free implementation.Individual data was obtained from the Bus Santé, a cross-sectional survey in Geneva. Spatial clusters of high and low tobacco consumption were assessed using Getis-Ord Gi*.Daily tobacco consumption was not randomly clustered in Geneva and may be impacted by tobacco consumption facilities independently of socioeconomic factors and a smoking ban. Spatial analysis should be considered to highlight the impact of smoke-free policies and guide public health interventions.     

How can an agent-based model explore the impact of interventions on children's physical activity in an urban environment?

Insufficient physical activity (PA) among most children and adolescents is a global problem that is undermining the realisation of numerous developmental and health benefits. The aim of this study was to explore the potential impact of interventions on PA by using an agent-based model (ABM) simulating children's daily activities in an urban environment. Three domains for interventions were explored: outdoor play, school physical education and active travel. Simulated interventions increased children's average daily moderate-to-vigorous PA by 2–13 min and reduced the percentage of children not meeting PA guidelines, from 34% to 10%–29%, depending on the intervention. Promotion of active travel and outdoor play benefited more those in a higher socio-economic position. Agents' interactions suggested that: encouraging activity in diverse groups will reduce percentage of the least active in the population; and initiating outdoor events in neighbourhoods can generate an enhancing effect on children's engagement in PA. The ABM provided measurable outcomes for interventions that are difficult to estimate using reductionist methods. We suggest that ABMs should be used more commonly to explore the complexity of the social-environmental PA system.     

The superspreading places of COVID-19 and the associated built-environment and socio-demographic features: A study using a spatial network framework and individual-level activity data

Previous studies observed that most COVID-19 infections were transmitted by a few individuals at a few high-risk places (e.g., bars or social gathering venues). These individuals, often called superspreaders, transmit the virus to an unexpectedly large number of people. Further, a small number of superspreading places (SSPs) where this occurred account for a large number of COVID-19 transmissions. In this study, we propose a spatial network framework for identifying the SSPs that disproportionately spread COVID-19. Using individual-level activity data of the confirmed cases in Hong Kong, we first identify the high-risk places in the first four COVID-19 waves using the space-time kernel density method (STKDE). Then, we identify the SSPs among these high-risk places by constructing spatial networks that integrate the flow intensity of the confirmed cases. We also examine what built-environment and socio-demographic features would make a high-risk place to more likely become an SSP in different waves of COVID-19 by using regression models. The results indicate that some places had very high transmission risk and suffered from repeated COVID-19 outbreaks over the four waves, and some of these high-risk places were SSPs where most (about 80%) of the COVID-19 transmission occurred due to their intense spatial interactions with other places. Further, we find that high-risk places with dense urban renewal buildings and high median monthly household rent-to-income ratio have higher odds of being SSPs. The results also imply that the associations between built-environment and socio-demographic features with the high-risk places and SSPs are dynamic over time. The implications for better policymaking during the COVID-19 pandemic are discussed.     

A relational approach to evaluate food environments finds that the proximate food environment matters for those who use it

Using a relational approach, this study investigates whether shopping close to home moderates the relationship between the proximate food environment and diet. To address this question, we develop the proximate food retail quality (PFRQ) score, an inverse-distance weighted measure of all food retailers within a resident's neighborhood that incorporates audit data of each food retailer. This study relies on data collected through 24-h dietary recalls and psychosocial surveys administered to 449 adults in two socioeconomically matched neighborhoods. Food retailer audits collected data on the availability, price, and quality of healthful foods. Seventy-one percent of study participants report conducting at least 50% of their food shopping within approximately one mile of their home. Household income and education are associated with likelihood to shop close to home, while access to a personal vehicle is not. Finally, results suggest that, for residents who shop primarily close to home, a one unit increase in proximate food retail environment score is associated with a 17.2-point increase in HEI-2010 score, a measure of overall diet quality that ranges from zero to 100. This study suggests that the food environment matters for those who use it and that a low-quality proximate food environment can amplify individual disadvantage.     

Re-grounding the concept of liminality by foregrounding spatial aspects in experiences of cancer care

Liminality captures the passing stages in transitioning from one sociocultural status to another. As its spatial dimension remains under-examined, we analyse this in experiences of people affected by cancer. We review liminality in cancer-related literature and juxtapose this with empirical material. Analysing interview data (with eight patients) and participant-made photos highlights why places may be experienced differently throughout a period of illness and how places of diagnosis and care ‘stretch’ across locations. We conclude that exploring liminality's spatial dimension has implications for people ‘living beyond’ cancer, advances sociological understandings of (cancer) illness, and may inform healthcare facility design.     

The impact of school exclusion zone planning guidance on the number and type of food outlets in an English local authority: A longitudinal analysis

The use of planning policy to manage and create a healthy food environment has become a popular policy tool for local governments in England. To date there has been no evaluation of their short-term impact on the built environment. We assess if planning guidance restricting new fast food outlets within 400 m of a secondary school, influences the food environment in the local authority of Newcastle Upon Tyne, UK. We have administrative data on all food outlets in Newcastle 3 years pre-intervention 2012–2015, the intervention year 2016, and three years’ post-intervention 2016–2019. We employ a difference-in-difference approach comparing postcodes within the school fast food outlet exclusion zone to those outside the fast-food exclusion zones. In the short term (3 years), planning guidance to limit the number of new fast-food outlets in a school exclusion zone did not have a statistically significant impact on the food environment when compared with a control zone.     

重点部门常见典型操作时的高频接触表面

目的 明确不同部门的高频接触表面,为清洁消毒工作提供依据与指导。方法 采用直接观察法对西安市某三级甲等综合医院的消化内镜室、口腔科、血透室、手术室、检验科5个医院感染管理重点部门环境表面的接触频次进行调查,计算累积接触频次与频率。结果 5个重点部门高频接触表面均为5~9个。消化胃镜室高频接触表面频次（3.57~13.29次/操作）明显多于其他部门;血透室高频接触频次范围为0.56~3.44次/操作,为5个部门中最低者。接触频次最高的表面：消化内镜室为诊疗床（13.29次/操作）,口腔科为综合治疗台操作面板（3.64次/操作）,血透室为透析机触屏（3.44次/操作）,手术室为麻醉用电脑键盘及鼠标（8.25次/操作）,检验科为电脑键盘及鼠标（4.80次/操作）。治疗车为消化内镜室、手术室及血透室的高频接触表面。结论 因医疗诊疗操作的不同,各部门高频接触表面也不尽相同。电脑鼠标和键盘、治疗车、诊疗床、诊疗专用仪器以及操作台面在调查的各重点部门均为高频接触表面。     

真空紫外辐照对加成型硅橡胶光学性能的影响

考察了加成型硅橡胶在真空环境中经1000ESH紫外辐照后的性能变化。结果表明,辐照后材料均出现发黄的现象,光学透过率大幅度 下降,同时加入硅酸钾包覆后制备的热控涂层反射率下降。经原位测试与离位测试,发现加成型硅橡胶在两种不同条件下测得的结果差异较小,而在有机硅橡胶中加入ZnO后原位与离位测试结果则差异明显,表现出明显的漂白作用。