Low-income Areas Research Articles

Australian Digital Mental Health Services: Consumer Perceptions of Their Usability and Acceptability

AbstractDigital mental health interventions are effective and can greatly enhance access to mental health care. They can reach people in remote and low-income areas and reduce the stigma of seeking mental health help by offering anonymity. Despite these benefits, they have not been fully integrated into mental health service delivery. The aim of this study was to understand consumers’ experiences and perceptions of accessing care through digital mental health services. Consumers of three key Australian Digital Mental Health Services completed an online survey about their experience receiving mental health care through digital mental health services. Some consumers were also invited to elaborate on their responses by taking part in a phone interview. A total of 351 participants completed an online survey (overall response rate of 11% of all those invited to take part), and 23 participants of whom also completed a phone interview. Most consumers were female and under the age of 50 years. Overall, consumers were very positive about their experience of using digital mental health services. They appreciated the accessibility, convenience, self-paced nature, therapeutic support, and guidance. Most found the services user-friendly, easy to use and navigate and were satisfied with their experience. A small number of consumers experienced difficulties with technology and internet connections. Most consumers would recommend services to their peers and recommend that digital mental health services be better promoted to improve awareness. Digital mental health services have a vital role in mental health care provision. Further research is needed to examine how digital mental health services can cater to the specific needs of disadvantaged sub-populations and diverse cultural populations and be seamlessly implemented in mental health care systems.

From flare to care: Dermatologists' impact on pediatric atopic dermatitis hospital admissions.

Atopic dermatitis (AD) is a common chronic skin disease in the pediatric population; however, rates of admissions for flares in patients established with dermatology compared to those that are not established have not been fully assessed in prior studies. We reviewed electronic medical records of patients hospitalized (billing codes 99221-99223, 99217) with diagnoses encompassing AD, eczema, and dermatitis (ICD-10 codes L20.8-L20.9, L30.8-L30.9) between January 1, 2011, and December 31, 2021, at University Hospitals (UH) in Cleveland, Ohio. Patients were considered established with dermatology if they had been seen by a dermatology provider within 6 months prior to admission. Statistical analysis was performed using chi-square goodness of fit. A total of 95 patient encounters met criteria for inclusion. Fifteen (15.8%) patients were established with dermatology at the time of admission and 80 (84.2%) were not. The chi-square value (x2 = 44.74) was greater than the critical value of 10.828 at one degree of freedom (p < .001). There were 8 patients who had more than one admission for atopic dermatitis flares; 2 of these patients were established with dermatology prior to their first admission, and 4 were established at the time of the second admission. The majority of patients admitted with AD flare were not established with dermatology. Many of these patients lived in a low socioeconomic area and missed follow-up appointments. Increasing access to dermatologic care for patients with atopic dermatitis, especially in lower-income areas, could aid in decreasing atopic dermatitis-related hospitalizations.

Collaborative vehicle routing for equitable and effective food allocation in nonprofit settings

Purpose Inspired by a food bank distribution operation, this paper aims to study synchronized vehicle routing for equitable and effective food allocation. The primary goal is to improve operational efficiency while ensuring equitable and effective food distribution among the partner agencies. Design/methodology/approach This study introduces a multiobjective Mixed Integer Programming (MIP) model aimed at addressing the complex challenge of effectively distributing food, particularly for food banks serving vulnerable populations in low-income urban and rural areas. The optimization approach described in this paper places a significant emphasis on social and economic considerations by fairly allocating food to food bank partner agencies while minimizing routing distance and waste. To assess the performance of the approach, this paper evaluates three distinct models, focusing on key performance measures such as effectiveness, equity and efficiency. The paper conducts a comprehensive numerical analysis using randomly generated data to gain insights into the trade-offs that arise and provide valuable managerial insights for food bank managers. Findings The results of the analysis highlight the models that perform better in terms of equity and effectiveness. Additionally, the results show that restocking the vehicles through the concept of synchronization improves the overall quantity of food allocation to partner agencies, thereby increasing accessibility. Research limitations/implications This paper contributes significantly to the literature on optimization approaches in the field of humanitarian logistics. Practical implications This study provides food bank managers with three different models, each with a multifaceted nature of trade-offs, to better address the complex challenges of food insecurity. Social implications This paper contributes significantly to social responsibility by enhancing the operational efficiency of food banks, ultimately improving their ability to serve communities in need. Originality/value To the best of the authors’ knowledge, this paper is the first to propose and analyze this new variant of vehicle routing problems in nonprofit settings.

Income Diversification of Rural Households in Bangladesh (2022-23)

This study examines income diversification and inequality among rural households in Bangladesh in 2022- 23, focusing on agricultural and non-agricultural sources of income. The analysis includes three districts: Chadpur, Sirajganj and Rajshahi, with specific economic activities. Data were collected through household surveys that collect income from agriculture, livestock, fishing, services and industries, and demographic data. Rajshahi has the highest income, due to high income from cattle, while Chadpur has the lowest. The results show significant income disparities, high levels of animal activity and differences in economic activity between regions. Larger houses in Rajshahi reflect changes in family structure. The main challenges identified were land fragmentation, climate change and limited access to finance and infrastructure. Recommendations for policy interventions include targeting support to low-income areas, investing in livestock development, promoting income diversification, improving infrastructure, strengthening climate livelihoods, expanding access to finance, the adoption of technology and the implementation of family planning programs. These strategies aim to reduce income inequality, improve economic opportunities and promote sustainable development in rural Bangladesh.

How Does Agricultural Green Transformation Improve Residents’ Health? Empirical Evidence from China

Promoting green and sustainable agriculture is of great significance for ensuring food security and addressing global challenges. Meanwhile, health has increasingly become a global concern. Nutrition and health are the purpose of agricultural production. As two major global issues, how agriculture empowers human health has long been discussed. Based on the provincial panel data of China from 2003 to 2021, this paper studies the impact of agricultural green transformation (AGT) on residents’ health and explores its impact mechanism. The empirical results show that: (1) AGT in China has significantly reduced the average mortality rate and maternal mortality rate and significantly increased the average life expectancy, indicating that AGT in China has significantly improved the health level. The conclusions of robustness testing methods such as replacing AGT indicators and controlling endogeneity are still valid; and (2) The impact of AGT on residents’ health depends on the regional economic level, and there is a threshold effect. Compared with low-income areas, the positive effects of AGT in high-income areas on residents’ health are more pronounced; and (3) Agricultural carbon emissions play an intermediary effect between AGT and residents’ health, and AGT can improve residents’ health by reducing carbon emissions. The level of local education development plays a moderating role in the relationship between AGT and residents’ health. Agricultural policy implications include enhancing the ability to protect and utilize agricultural resources, promoting the green and low-carbon transformation of agriculture, and taking a more scientific and systematic approach towards the complex diversity of health risk factors.

O-091 Severe maternal and neonatal morbidity among gestational carriers: a population-based cohort study

Abstract Study question Are gestational carriers at higher risk of severe maternal (SMM) or neonatal (SNM) morbidity, compared to patients using unassisted conception or in vitro fertilization (IVF)? Summary answer A higher risk of SMM and adverse pregnancy outcomes is seen among gestational carriers, without evident neonatal morbidity. What is known already The use of gestational carriers (GC) also known as “surrogate pregnancy” is increasing. Gestational carriage may be associated with adverse outcomes linked to both IVF techniques and exposure to foreign fetal antigens. Adverse outcomes of GC pregnancies are largely unknown. Study design, size, duration Retrospective population-based cohort study of 937,938 births, derived from existing administrative health datasets. Data were linked using unique for birthing woman and child identifiers and analyzed at ICES Ontario. The study excluded participants with untreated infertility, those utilizing ovulation induction or intrauterine insemination, and those with multifetal gestation. Participants/materials, setting, methods Singleton births at &amp;gt; 20 weeks gestation in Ontario, 2012-2021. Pregnancy characteristics were obtained from the Ontario Birth Registry database. Exposure groups were i) unassisted conception (comparison group 1), ii) IVF (comparison group 2), or iii) GC. Primary outcomes included validated composite outcomes of i) SMM and ii) SNM. Secondary outcomes included hypertensive disorders of pregnancy, cesarean delivery, preterm birth, and postpartum hemorrhage. Modified Poisson regression models generated relative risks adjusted for birthing woman’s characteristics (aRR). Main results and the role of chance Of all singleton births, 937,938 (97.7%) were from unassisted conception, 20,958 (2.2%) from IVF, and 956 (0.1%) from GC. GC were more likely to be parous, reside in a lower-income area, and have higher rates of chronic hypertension. GC were more likely than unassisted conception women to be older and be non-smokers, with some opposite trends when compared to IVF recipients. Respective rates of SMM were 2.4%, 4.6% and 7.1%. The aRR were 3.07 (95% CI 2.44-3.87) comparing GC to unassisted conception, and 1.88 (95% CI 1.46-2.42) comparing GC to IVF. Respective rates of SNM were 6.0%, 9.1% and 6.5%, generating aRR of 1.21 (95% CI 0.95-1.54) for GC vs. unassisted conception, and 0.78 (95% CI 0.60-1.00) for GC vs. IVF. Respective rates of hypertensive disorders were 6.6%, 11.6% and 13.9%. The aRR were 1.89 (1.61 - 2.21) comparing GC to unassisted conception, 1.42 (1.19 - 1.69) comparing GC to IVF. Respective rates of postpartum hemorrhage were 5.7%, 10.5% and 13.9%, generating aRR of 2.87 (2.43 - 3.38) for GC vs. unassisted conception, and 1.40 (1.17 - 1.67) for GC vs. IVF. Limitations, reasons for caution The databases did not include certain baseline details, including the reasons for opting for a GC and the sources of gametes. There is a chance that the measured association may be distorted or confounded by the unmeasured variables. Wider implications of the findings GC appear to be at an elevated risk of maternal morbidity, without evident risk of neonatal morbidity. Further studies are needed to understand the mechanisms involved. Eligibility for GC should be determined using consistent selection criteria, and consideration should be given to specialized obstetrical care to promote optimal pregnancy outcomes. Trial registration number Not applicable

A proof-of-concept randomised controlled trial of an intervention designed to improve food hygiene behaviours among caregivers of young children living in low-income areas of Nairobi, Kenya

Young children are particularly vulnerable to foodborne disease due to their immature immune systems. Safe food hygiene behaviours by caregivers can potentially reduce this disease burden. Here, we evaluate the potential for a locally designed intervention to improve caregivers’ food hygiene behaviour in a peri-urban, low-income area of Nairobi, Kenya. In this cluster-randomised proof-of-concept trial, 50 community health volunteers (CHVs) were randomly assigned to intervention or control arm (1:1). 101 households under the CHV’s catchment (2-3/CHV), with at least one child aged 6–24 months, participated. Caregivers in intervention households (n = 50) received the CHV-delivered food hygiene intervention. The control arm (n-51) received no intervention. Blinding was not possible due to the nature of the intervention. Our primary outcome was the proportion of caregivers observed to practice all five pre-specified food hygiene behaviours, four weeks post intervention delivery. Secondary outcomes assessed the five observed behaviours individually plus a sixth behaviour—the proportion of caregivers who report always boiling the child’s drinking water. We found no between-arm difference in the proportion of caregivers practising all five observed behaviours. However individually, five behaviours were significantly improved. Specifically, caregivers in the intervention arm had higher odds of washing their hands before feeding the child (adjusted odds ratio (aOR) = 7.40, 95%CI 1.85, 29.62) and before preparing the child’s food (aOR = 7.05, 95%CI 1.52, 32.71), washing the child’s hands before eating (aOR = 21.57, 95%CI 1.15, 405.93) and heating the child’s food (aOR = 4.03, 95%CI 1.27, 12.85) and drinking water (aOR = 12.82, 95%CI 2.54, 64.77) to boiling. There was no effect on cleaning and storage of feeding utensils. This study offers promising preliminary evidence that a CHV-led intervention targeting caregivers of young children can improve their food hygiene behaviour. Our findings warrant further research to refine the intervention and undertake larger scale trials to explore the intervention’s potential impact more comprehensively. Trial registration: This trial was registered with Open Science Framework: osf.io/eu5kf.

Indoor temperature and CO[formula omitted] in South African primary school classrooms: Inspecting brick, container, and prefab structures

In the resource-constrained education sector in South Africa, infrastructure deemed temporary or backup elsewhere is used as permanent classrooms, mainly in areas of low income. Temperature and CO2 levels, substantial determinants of air quality, have not been studied across different classroom types, despite their direct impact on children’s cognitive performance and comfort. We measure CO2 and temperature every 11 minutes in 24 classrooms at two schools in Stellenbosch, South Africa. Container classrooms with and without insulation, mobile (prefabricated) classrooms, and brick classrooms of different configurations are included. Measurements were concurrently sampled over twelve months, across multiple seasons with relevant metadata, including ambient weather conditions. We analyse temperature and CO2 concentrations for classroom types and classroom categories and compare school days with non-school days. The results show that temporary classrooms (container and mobile) have substantially worse thermal environments, even when air conditioning is available. The CO2 concentrations in container classrooms are substantially worse, whereas mobile classrooms have better conditions comparable to brick classrooms. We conclude that container classrooms have the worst temperatures and ventilation, prefabricated classrooms have acceptable ventilation but poor thermal qualities, and brick classrooms have the best thermal environment and ventilation.

Spatiotemporal analysis of HPV vaccination and associated neighborhood-level disparities in Texas-an ecological study.

HPV is responsible for most cervical, oropharyngeal, anal, vaginal, and vulvar cancers. The HPV vaccine has decreased cervical cancer incidence, but only 49% of Texas adolescents have initiated the vaccine. Texas shows great variation in HPV vaccination rates. We used geospatial analysis to identify areas with high and low vaccination rates and explored differences in neighborhood characteristics. Using Anselin's Local Moran's I statistic, we conducted an ecological analysis of hot and cold spots of adolescent HPV vaccination coverage in Texas from 2017 to 2021. Next, we utilized a Mann-Whitney U test to compare neighborhood characteristics of vaccination coverage in hot spots versus cold spots, leveraging data from the Child Opportunity Index (COI) and American Community Survey. In Texas, there are 64 persistent vaccination coverage hotspots and 55 persistent vaccination coverage cold spots. The persistent vaccination coverage hot spots are characterized by ZIP codes with lower COI scores, higher percentages of Hispanic residents, higher poverty rates, and smaller populations per square mile compared to vaccine coverage cold spots. We found a more pronounced spatial clustering pattern for male adolescent vaccine coverage than we did for female adolescent vaccine coverage. In Texas, HPV vaccination coverage rates differ depending on the community's income level, with lower-income areas achieving higher success rates. Notably, there are also gender-based discrepancies in vaccination coverage rates, particularly among male adolescents. This knowledge can aid advocates in customizing their outreach initiatives to address these disparities.

Consequential urban development of sustainable strategies

ABSTRACT A green transition is necessary for urban development so that cities can foster a more sustainable urban future. While this need has gained increasing recognition in planning policies in recent decades, there is a risk that counterproductive interests, which are concealed by the sustainable agenda, may go unnoticed. The paper examines disparities between urban neighborhoods, which contemporary sustainable urban planning may either neglect or reinforce. It draws on an empirical study of two areas in Copenhagen and is informed by the literature on eco-gentrification and the paradox of sustainable development. The case areas exhibit divergent sustainability profiles: a low-income area with large green spaces but inadequate transport infrastructure compared to a newly built sustainable area. The paper underscores the disproportionate focus on social and green improvements in urban renewal projects that are framed as sustainable. It highlights that disparities between neighborhoods with mixed sustainability profiles become evident when focusing on the broad spectrum of sustainable urban practices in places significantly or slightly affected by them.

Caregiver, Youth, and Community Partner Perspectives on the Impact of COVID-19 on African American families

The current study identified qualitative themes describing the impact of COVID-19 on African American families living in urban, low-income areas. A total of 22 caregivers, 15 adolescents, and 37 community partners, including service providers and organizational leaders participated in qualitative interviews. Study findings identified five qualitative themes that included: (a) the worsening of existing inequities, (b) altering the framework for public education delivery, (c) changes in the dynamics of family relationships, (d) challenges in healthcare, emotional impact, and well-being, and (e) positive changes such as learning and coping. Our findings provided a context-specific examination of COVID-19′s impact, identifying some novel qualitative aspects using multiple perspectives that have implications for policy and practice.

Flavored Tobacco Sales Restrictions and Youth E-cigarette Behavior: Impact by Tobacco Retailer Density in Diverse Communities in California.

Factors that impact flavored tobacco sales restriction (flavor restrictions) effectiveness on youth e-cigarette behavior are unclear. Tobacco retailer density (retailer density) is a health equity issue with greater retailer density in high-minority, low-income areas. We examined the association between flavor restrictions and youth e-cigarette behavior by retailer density across diverse communities in the California Bay Area. We analyzed data from the California Healthy Kids Survey using a difference-in-differences (DID) strategy. We compared pre- and post-policy changes in e-cigarette access and use one-year post-implementation among high school students in the Bay Area with a flavor restriction (n = 20 832) versus without (n = 66 126). Separate analyses were conducted for students in cities with low and high retailer density, with a median cutoff of 3.3 tobacco retailers/square mile. Students with high retailer density were more likely to identify as a minority and have parents with lower education. Among students with low retailer density, flavor restrictions were associated with 24% lower odds in the pre- to post-policy increase in ease of access relative to unexposed students (DID = 0.76, 95% CI: 0.58, 0.99). Among students with high retailer density, flavor restrictions were associated with 26% higher odds in ease of access (DID: 1.26, 95% CI: 1.02, 1.56) and 57% higher odds of current use (DID = 1.57, 95% CI: 1.31, 1.87). Flavor restrictions had positive impacts on youth e-cigarette access in low, but not high retailer density cities. From a health equity perspective, our results underscore how flavor restrictions may have uneven effects among vulnerable groups. In diverse communities in the California Bay Area, our results suggest a protective association between flavored tobacco sales restrictions and youth access to e-cigarettes in low, but not high tobacco retailer density cities one-year post-implementation. These results underscore how flavor restrictions may have uneven effects, and when implemented in high retailer density areas, may disproportionately place already vulnerable groups at heightened exposure to e-cigarette use and access. In high retailer density areas, additional tobacco control efforts may need to be included with flavor restriction implementation, such as increased education, youth prevention and cessation programs, policies to reduce tobacco retailer density, or stronger tobacco retailer enforcement or compliance monitoring.

Global burden of mesothelioma attributable to occupational asbestos exposure in 204 countries and territories: 1990–2019

Malignant mesothelioma, a rare and aggressive cancer primarily caused by occupational asbestos exposure, has a poor prognosis. This study leverages the Global Burden of Disease (GBD) 2019 dataset to analyze the burden of mesothelioma linked to occupational asbestos exposure from 1990 to 2019. The analysis includes the number of mesothelioma deaths and disability-adjusted life years (DALYs) attributable to occupational asbestos exposure, focusing on trends in age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life-year rate (ASDR) by year, age, sex, country, region, and Socio-demographic Index (SDI). In 2019, 91.7% of mesothelioma deaths and 85.2% of DALYs were attributable to occupational asbestos exposure, resulting in 26,820 (95% UI 24,312–28,622) deaths and 569,429 (95% UI 509,956–617,484) DALYs. Despite a decline in ASMR and ASDR from 1990 to 2019, the absolute number of deaths and DALYs almost doubled. The United States reported the highest number of mesothelioma deaths, while China had the highest number of DALYs. Age-specific mortality rates and DALYs decreased in the 25–74 age group but increased in the 75+ age group. In conclusion, occupational asbestos exposure remains the primary cause of mesothelioma worldwide, with an increasing number of deaths and DALYs. The highest incidence rates are observed in high-income areas, and rates are rising in low-income areas. It is crucial to raise awareness about the hazards of asbestos to reduce the global burden of mesothelioma linked to occupational exposure.

Relaxed minds for healthier food choice at school: A field experiment in southern Mexico

Stress leads to unhealthy food choices since the school-age stage. Yet, there is limited evidence particularly in low- and middle-income countries regarding the impact of stress-reduction strategies on school-age children's food choices. Such aspects were crucial during the recent COVID-19 pandemic, which exacerbated psychological distress and unhealthier food choices among children. Two years after the pandemic began, we conducted a field experiment in southern Mexico to assess the impact of stress-reduction strategies on the food choices of over 1400 children aged 9–12. Half of the school-classes in the sample were randomly assigned to a stress reduction strategy namely meditation, which comprised six audios with basic relaxation techniques and intuitive messages to guide food choices. Additionally, all participants received information signalling that an amaranth snack was nutritious (i.e., the healthy snack), which was paired with a chocolate bar (i.e., the unhealthy snack) as part of a snack choice experiment. Students that practiced meditation were slightly more likely to choose the healthy snack than those in the control group, but the effect was not statistically significant. Upon collecting their snack, students had the chance to exchange their original choice for the other snack. Students that meditated were more likely to exchange their originally chosen “unhealthy snack” towards the healthy snack than students in the control group. The meditation program effectively reduced chronic stress among treated children. The effect was larger among students attending schools in lower-income areas. Our study sheds some light on the challenges to translate an improved psychological well-being into healthier food choices at school.

Socioeconomic disparity in transcatheter and surgical aortic valve replacement: a population study of National Inpatient Sample from 2015 to 2020

There is limited data on the effect of socioeconomic status (SES) on transcatheter (TAVR) and surgical aortic valve replacement (SAVR) outcomes for aortic stenosis (AS). This study conducted a population-based analysis to assess the influence of SES on valve replacement outcomes. Patients with AS undergoing TAVR or SAVR were identified in National Inpatient Sample from Q4 2015–2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients living in neighborhoods of income at the lowest and highest quartiles. Of 613,785 AS patients, 9.77% underwent TAVR and 10.13% had SAVR. These rates decline with lower neighborhood income levels, with TAVR/SAVR ratio also declining in lower-income areas. Excluding concomitant procedures, 58,064 patients received isolated TAVR (12,355 low-income and 15,212 high-income) and 43,694 underwent isolated SAVR (10,029 low-income and 10,811 high-income). Low-income patients, in both TAVR and SAVR, were younger but had more comorbid burden. For isolated TAVR, outcomes were similar across income groups. However, for isolated SAVR, low-income patients experienced higher in-hospital mortality (aOR = 1.44, p < 0.01), pulmonary (aOR = 1.13, p = 0.01), and renal complications (aOR = 1.14, p < 0.01). They also had more transfers, longer waits for operations, and extended hospital stays. Lower-income communities had reduced access to TAVR and SAVR, with TAVR accessibility being particularly limited. When given access to TAVR, patients from lower-income neighborhoods had mostly comparable outcomes. However, patients from low-income communities faced worse outcomes in SAVR, possibly due to delays in treatment. Ensuring equitable specialized healthcare resources including expanding TAVR access in economically disadvantaged communities is crucial.

Drinking water sources, quality, and associated health outcomes in Appalachian Virginia: A risk characterization study in two counties

ObjectivesIn the US, violations of drinking water regulations are highest in lower-income rural areas overall, and particularly in Central Appalachia. However, data on drinking water use, quality, and associated health outcomes in rural Appalachia are limited. We sought to assess public and private drinking water sources and associated risk factors for waterborne pathogen exposures for individuals living in rural regions of Appalachian Virginia. MethodsWe administered surveys and collected tap water, bottled water, and saliva samples in lower-income households in two adjacent rural counties in southwest Virginia (bordering Kentucky and Tennessee). Water samples were tested for pH, temperature, conductivity, total coliforms, E. coli, free chlorine, nitrate, fluoride, heavy metals, and specific pathogen targets. Saliva samples were analyzed for antibody responses to potentially waterborne infections. We also shared water analysis results with households. ResultsWe enrolled 33 households (83 individuals), 82% (n = 27) with utility-supplied water and 18% with private wells (n = 3) or springs (n = 3). 58% (n = 19) reported household incomes of <$20,000/year. Total coliforms were detected in water samples from 33% (n = 11) of homes, E. coli in 12%, all with wells or springs (n = 4), and Aeromonas, Campylobacter, and Enterobacter in 9%, all spring water (n = 3). Diarrhea was reported for 10% of individuals (n = 8), but was not associated with E. coli detection. 34% (n = 15) of saliva samples had detectable antibody responses for Cryptosporidium spp., C. jejuni, and Hepatitis E. After controlling for covariates and clustering, individuals in households with septic systems and straight pipes had significantly higher likelihoods of antibody detection (risk ratios = 3.28, 95%CI = 1.01–10.65). ConclusionsTo our knowledge, this is the first study to collect and analyze drinking water samples, saliva samples, and reported health outcome data from low-income households in Central Appalachia. Our findings indicate that utility-supplied water in this region was generally safe, and individuals in low-income households without utility-supplied water or sewerage have higher exposures to waterborne pathogens.

Factors associated with differential seropositivity to Leptospira interrogans and Leptospira kirschneri in a high transmission urban setting for leptospirosis in Brazil.

Leptospirosis is a zoonosis caused by pathogenic species of bacteria belonging to the genus Leptospira. Most studies infer the epidemiological patterns of a single serogroup or aggregate all serogroups to estimate overall seropositivity, thus not exploring the risks of exposure to distinct serogroups. The present study aims to delineate the demographic, socioeconomic and environmental factors associated with seropositivity of Leptospira serogroup Icterohaemorraghiae and serogroup Cynopteri in an urban high transmission setting for leptospirosis in Brazil. We performed a cross-sectional serological study in five informal urban communities in the city of Salvador, Brazil. During the years 2018, 2020 2021, we recruited 2.808 residents and collected blood samples for serological analysis using microagglutination assays. We used a fixed-effect multinomial logistic regression model to identify risk factors associated with seropositivity for each serogroup. Seropositivity to Cynopteri increased with each year of age (OR 1.03; 95% CI 1.01-1.06) and was higher in those living in houses with unplastered walls (exposed brick) (OR 1.68; 95% CI 1.09-2.59) and where cats were present near the household (OR 2.00; 95% CI 1.03-3.88). Seropositivity to Icterohaemorrhagiae also increased with each year of age (OR 1.02; 95% CI 1.01-1.03) and was higher in males (OR 1.51; 95% CI 1.09-2.10), in those with work-related exposures (OR 1.71; 95% CI 1.10-2.66) or who had contact with sewage (OR 1.42; 95% CI 1.00-2.03). Spatial analysis showed differences in distribution of seropositivity to serogroups Icterohaemorrhagiae and Cynopteri within the five districts where study communities were situated. Our data suggest distinct epidemiological patterns associated with the Icterohaemorrhagiae and Cynopteri serogroups in the urban environment at high risk for leptospirosis and with differences in spatial niches. We emphasize the need for studies that accurately identify the different pathogenic serogroups that circulate and infect residents of low-income areas.

Influence of Anthropogenic Pollution on Soil and Plants of Gosa Dumpsite, Abuja, Nigeria

Despite increased awareness of the causes of environmental pollution, it continues to pose a serious threat to both developed and developing countries worldwide. The Gosa dumpsite in Abuja serves as a receptacle for various waste materials from both high and low-income areas of the metropolis. Surprisingly, peri-urban farmers residing in the vicinity still cultivate edible crops on this polluted land. This study aims to assess the impact of waste dumping at Gosa dumpsite on selected soil properties and the uptake of heavy metals by plants. In order to achieve this objective, soil and plant samples were collected from established 5 x 5 m2 quadrants during the early and late dry as well as rainy seasons of 2019 and 2020. The collected samples underwent analysis using standard methods to determine their physical and chemical properties. Additionally, the study identified the dominant plant species within the dumpsite through standard methods. The findings revealed that the dumpsite soil exhibited characteristics of loamy sand, with the highest pH value of 8.85 ± 0.90 recorded during the dry season of 2020. Other significant soil results included total nitrogen at 1.09 ± 0.64 g kg-1, organic carbon at 9.88 ± 0.10 g kg-1, Cd at 11.93 ± 2.25 mg kg-1, Hg at 2.18 ± 1.08 mg kg-1, and Pb at 54.68 ± 8.68 mg kg-1, all of which were observed during the early rainy season of 2020. During the remaining seasons considered, lower values were obtained. Notably, these values exceeded the permissible levels set by the FAO for soil intended for cultivating edible crops. Furthermore, the plant species Ageratum conyzoides demonstrated the highest uptake of heavy metals, with concentrations of 4.47 ± 1.15 mg kg-1 for Cd, 1.77 ± 1.08 mg kg-1 for Hg, and 19.56 ± 4.83 mg kg-1 for Pb, all recorded during the early dry season of 2020. In conclusion, although the Gosa dumpsite in Abuja may appear fertile enough for cultivation, the study's results highlight that it cannot be deemed suitable for the production of edible crops. The presence of heavy metals and other pollutants in the soil poses a significant risk to crop health and, consequently, to human consumption.

Assessing and predicting green gentrification susceptibility using an integrated machine learning approach

ABSTRACT Greenery initiatives, such as green infrastructures (GIs), create sustainable and climate-resilient environments. However, they can also have unintended consequences, such as displacement and gentrification in low-income areas. This paper proposes an integrated machine learning (ML) approach that combines both unsupervised and supervised ML algorithms. First, 35 indicators that contribute to green gentrification were identified and categorised into 7 categories: social, economic, demographic, housing, household, amenities, and GIs. Second, data was collected for all census tracts in New York City. Third, the green gentrification susceptibility was modelled into 6 levels using k-means clustering analysis, which is an unsupervised ML model. Fourth, the Technique for Order of Preference by Similarity to the Ideal Solution (TOPSIS) was used to map the census tracts to their green gentrification susceptibility level. Finally, different supervised ML algorithms were trained and tested to predict the green gentrification susceptibility. The results showed that the artificial neural network (ANN) model is the most accurate in classifying and predicting the green gentrification susceptibility with an overall accuracy of 96%. Moreover, the outcomes showed that the Normal Difference Vegetation Index (NDVI), the proximity to GIs, the GIs frequency, and the total area of GIs were identified as the most important indicators to predict green gentrification susceptibility. Ultimately, the proposed approach allows practitioners and researchers to perform micro-level (i.e. on the census-tracts level) predictions and inferences about green gentrification susceptibility. This allows more focused and targeted mitigation actions to be designed and implemented in the most affected communities, thus promoting environmental justice.

Resilience and Vulnerability: Examining the Impact of COVID-19 Outbreaks on Indians

Even though the COVID-19 pandemic in India may have passed its height in 2023, it is still having a major effect on the country's population, economy, and healthcare system. After surviving the first wave, the public health system must now contend with the prospect of sustained pressure on its resources and workforce. Due to peak-time overcrowding, non-COVID illnesses may have gone undiagnosed or untreated. Because the pandemic hit low-income areas and informal labourers the hardest, socioeconomic gaps became wider. Many fell more into poverty as a result of lockdowns, company closures, and job losses. A possible fall in GDP and investment is one of the long-term effects that are just now becoming apparent. Anxieties about mental health also rose to the forefront. Anxiety, despair, and other mental health problems spiked during the lockdowns, social isolation, and virus dread. The road to complete recuperation will certainly be lengthy and need ongoing endeavours to fortify the healthcare system, tackle socioeconomic disparities, and offer mental health assistance to the populace; but, India has achieved progress in limiting the virus's spread. Keywords: COVID-19, India, Public Health, Long-Term Impact, Socioeconomic Disparity, Mental Health