Geographical accessibility to the supply of antiophidic sera in Brazil: Timely access possibilities

Snakebite accidents are considered category A neglected tropical diseases. Brazil stands out for snakebite accidents, mainly in the Amazon region. The best possible care after snakebite accidents is to obtain antiophidic sera on time. And the maximum ideal time to reach it is about 2 hours after an accident. Based on public health information and using a tool to analyze geographical accessibility, we evaluate the possibility of reaching Brazilian serum-providing health facilities from the relationship between population distribution and commuting time. In this exploratory descriptive study, the geographic accessibility of Brazilian population to health facilities that supply antiophidic serum is evaluated through a methodology that articulates several issues that influence the commuting time to health units (ACCESSMOD): population and facilities’ distribution, transportation network and means, relief and land use, which were obtained in Brazilian and international sources. The relative importance of the population without the possibility of reaching a facility in two hours is highlighted for Macro-Regions, States and municipalities. About nine million people live in locations more than two hours away from serum-providing facilities, with relevant variations between regions, states, and municipalities. States like Mato Grosso, Pará and Maranhão had the most important participation of population with reaching time problems to those units. The most significant gaps are found in areas with a dispersed population and sometimes characterized by a high incidence of snakebites, such as in the North of the country, especially in the Northeastern Pará state. Even using a 2010 population distribution information, because of the 2020 Census postponement, the tendencies and characteristics analyzed reveal challenging situations over the country. The growing availability of serum-providing health facilities, the enhanced possibilities of transporting accident victims, and even the availability of sera in other types of establishments are actions that would allow expanding the possibilities of access to serum supply.

Effect of commuting on the risk of COVID-19 and COVID-19-induced anxiety in Japan, December 2020

Background To prevent the spread of coronavirus disease (COVID-19), it is important to avoid 3Cs (closed spaces, crowded places, and close-contact settings). However, the risk of contact with an unspecified number of people is inevitable while commuting to and from work. In this study, we investigated the relationship between commuting, and the risk of COVID-19 and COVID-19-induced anxiety. Methods An internet-based questionnaire survey was conducted to obtain a dataset from 27,036 respondents. One-way commuting time was evaluated using a five-case method. The commuting distance was estimated using zip codes of the home and workplace. Logistic regression analysis was performed with the following outcomes: COVID-19 risk, close contact, infection anxiety, and infection anxiety due to commuting. Commuting distance and commuting time were analyzed separately in the model. We excluded participants with incalculable commuting distance, commuting distance exceeding 300 km, commuting distance of 0 km, or who telecommuted at least once a week. Results The total number of participants included in the analysis was 14,038. The adjusted odds ratios (aORs) of using public transportation for severe acute respiratory syndrome coronavirus 2 infection were 4.17 (95% confidence interval [CI]: 2.51–6.93) (commuting time) and 5.18 (95% CI: 3.06–8.78) (commuting distance). The aOR of COVID-19 diagnosis decreased significantly with increasing commuting distance. The aORs of using public transportation to infection anxiety were 1.44 (95% CI: 1.31–1.59) (commuting time) and 1.45 (95% CI: 1.32–1.60) (commuting distance). The longer the commuting time, the more the aOR increased. Conclusions COVID-19 risk, close contact, and infection anxiety were all associated with the use of public transportation during commuting. Both commuting distance and time were associated with infection anxiety due to commuting, and the strength of the association increased with increase in commuting time distance. Since transportation by commuting is associated with COVID-19 risk and anxiety, we recommend the use of telecommuting and other means of work.

Association between teleworking frequency and work functioning impairment: a nationwide cross-sectional study of Japanese full-time employees

Objective: We examined the impact of teleworking frequency, including influencing factors and work functioning impairment. Methods: This online cross-sectional study was conducted using a self-administered questionnaire among 27,036 full-time Japanese workers. We used the Work Functioning Impairment Scale to measure work functioning impairment and performed multilevel logistic regression analysis. Results: We observed higher odds for work functioning impairment among employees who teleworked 4 or more days a week compared with those almost never teleworked: odds ratio (OR) 1.18, 95% confidence interval (CI) 1.07-1.3. After adjusting for influencing factors (teleworking preference, changes in working time, and commuting time), there was no significant association between teleworking frequency and work functioning impairment (OR 0.93, 95% CI 0.82-1.05). Conclusions: Frequent telework may cause work functioning impairment; this can be explained by the impact of influencing factors.

Scenario Model to Mitigate Traffic Congestion and Improve Commuting Time Efficiency

Background: Commuting time is highly influenced by traffic congestion. System dynamics simulation can help identify the cause of traffic problems to improve travel time efficiency.Objective: This study aims to reduce traffic congestion and minimise commuting time efficiency using system dynamics simulation and scenarios. The developed scenarios implement the Bus Rapid Transit (BRT) and trams projects in the model.Methods: System dynamics simulation is used to analyse the transport system in Surabaya and the impact of BRT and trams project implementation in the model in order to improve commuting time and to reduce congestion.Results: From the simulation results, with the implementation of BRT and tram projects along with highway expansion, traffic congestion is predicted to decline by 24-44%. With the reduction of traffic congestion, travel time efficiency is predicted to improve by 11-28%. On the contrary, implementation of BRT and tram project without highway expansion is predicted to increase the traffic congestion by 5% in the initial year of implementation, then traffic congestion is predicted to decline by 2% in 2035.Conclusion: Based on the scenarios, transport project implementation such as BRT and trams should be accompanied with improvement of infrastructure. Further research is needed to develop a more comprehensive transportation system to capture a broader view of the problem. Keywords: Model, Simulation, System Dynamics, Traffic Congestion, Travel Time

Identifying the Development Potential for Urban Integration Based on Transport Accessibility—The Case for Northeast China

Urban integration, a new concept in urban and regional research, is an inevitable outcome of urban development. Based on accessibility analysis, this study uses urban and road network data to identify urban pairs in Northeast China which meet the distance threshold for urban integration and establishes an index system to evaluate the development potential. The research shows that in Northeast China, the results for urban integration are similar to those for the present urban structure in China, that is, a spatial pattern with provincial capital cities at the core and an urban belt as the axis. According to the evaluation, areas with potential for urban integration may be classified into four categories, namely, dominant areas, key areas, ordinary areas, and alternative areas. The candidate and potential areas for urban integration tend to be concentrated near a provincial capital city or a regional development zone. The results show that the development potential for urban integration varies greatly among the different urban pairs and the main constraining factors are different for each location. Among the constraining factors, the commuting time, costs, and economic conditions for the citizens are the most important.