Exploring the Effect of Family Life and Neighbourhood on the Willingness of Household Waste Sorting

For developing countries, garbage classification has become an important measure to handle the environmental pollution crisis. This empirical study examined urban and rural families’ willingness to sort and deposit garbage at fixed recycling points. We found that urban residents demonstrated a significantly higher willingness to sort and deposit garbage at designated points compared to rural residents. The average number of family meals per month, average monthly household food expenditure, household cleanliness, and household crowding (spaciousness) are significantly related to a family’s willingness to sort garbage. In terms of neighbourhood factors, families living in neighbourhoods with property management are more likely to have a higher willingness to sort garbage. The degree of air pollution in the neighbourhood also has an impact on the family’s willingness to sort garbage. This study proposes that neighbourhood factors have a non-negligible influence on a household’s willingness to sort and put garbage in designated locations. Especially in urban neighbourhoods, the willingness of residents living in commodity housing neighbourhoods to sort and place garbage at designated locations is significantly higher than that of residents living in other neighbourhoods. To improve the implementation effect of the waste sorting policy, we suggest that the configuration of neighbourhood garbage recycling services and facilities should be improved so that people can sort garbage more conveniently.

Validation of the Arabic version of the Dusseldorf Orthorexia Scale (DOS) among Lebanese adolescents

Background Orthorexia Nervosa (ON) is defined as a pathological preoccupation characterized by obsessive beliefs and compulsive behaviors regarding 'pure' eating behaviors. Many scales have been established and display good results regarding reliability and validity measures, including but not limited to ORTO-R (revised version of ORTO-15), Eating Habits Questionnaire, Teruel Orthorexia Scale (TOS) and the Düsseldorf Orthorexia Scale (DOS). Among these, the DOS seems to be a promising measure for multiple reasons. The current paper aims to validate the DOS, a measure of ON, in a non-Western population of Lebanese adolescents. Methods This was a cross-sectional designed study, conducted between May and June 2020, which enrolled 555 adolescents (15–18 years old; 75.7% females). Due the coronavirus pandemic outbreak, the data were gathered through snowball sampling using an online questionnaire. The DOS, TOS and ORTO-R scales were used in this study to screen for orthorexic tendencies and behaviors. Results We tested four competing structural models of the DOS assessing its factorial validity. The results of the current investigation revealed that the one-factorial model is the best one to represent the structure of the questionnaire. We provided evidence for validity for the DOS through demonstrating that it correlates significantly with other measures of orthorexic behaviours (Teruel Orthorexia Scale and ORTO-R). Finally, we have gathered evidence that the orthorexic behaviours as measured by DOS are not associated with age (r = −.02; p = .589), household crowding index (r = .02; p = .578), and Body Mass Index (r = .04; p = .297). Yet, females as compared to males achieved higher scores (M = 20.07, SD = 6.38 vs M = 18.29, SD = 6.37; p = .005; d = .28). Conclusion The Arabic version of the DOS seems to be a structurally valid and internally consistent questionnaire measuring orthorexic eating behavior in a sample of Lebanese adolescents. This tool may be useful for psychologists, psychiatrists, dietitians and other clinicians in the assessment and the treatment of the multidimensional nature of ON.

Preventive behaviours and family inequalities during the COVID-19 pandemic: a cross-sectional study in China

Background The coronavirus disease 2019 (COVID-19) pandemic is an international public health threat, and people's participation in disease-related preventive behaviours is the key to controlling infectious diseases. This study aimed to assess the differences in adopting preventive behaviours among populations to explore potential individual and household factors and inequalities within families. Methods This online survey was conducted in April 2020. The directional stratified convenient sampling method was used to select 4704 participants from eight provinces in eastern, central, and western China. The questionnaire included demographic information, household variables, and five target prevention behaviours. The chi-squared test, binary multilevel model, and Mantel–Haenszel hierarchical analysis were used for data analysis in the study. Results Approximately 71.2% of the participants had appropriate outdoor prevention, and 32.9% of the participants had indoor protection in place. Sharing behaviours (P < 0.001) and education level (P < 0.001) were positively associated with adopting preventive measures. The inhibiting effect of household crowding and stimulating effect of high household income on preventive behaviours were determined in this study. Household size was negatively associated with living area (β = -0.057, P < 0.05) and living style (β = -0.077, P < 0.05). Household income was positively associated with age (β = 0.023, P < 0.05), and relationship with friends (β = 0.053, P < 0.05). Vulnerable groups, such as older adults or women, are more likely to have inadequate preventive behaviours. Older adults (OR = 1.53, 95% CI 1.09–2.15), women (OR = 1.37, 95% CI 1.15–1.64), and those with more than 2 suspected symptoms (OR = 1.85, 95% CI 1.07–3.19) were more likely to be affected by the inhibiting effect of household crowding, while the stimulating effect of high household income was limited in these groups. Conclusions Inequalities in COVID-19 prevention behaviours exist between families and inadequate adoption of prevention by vulnerable groups are noteworthy. This study expands the research perspective by emphasizing the role of household factors in preventive behaviours and by focusing on family inequalities. The government should use traditional media as a platform to enhance residents’ public health knowledge. Targeted additional wage subsidies, investments in affordable housing, financial support for multigenerational households, and temporary relocation policies may deserve more attention. Communities could play a critical role in COVID-19 prevention. Graphical abstract

Social and Environmental Determinants of Community-Acquired Antimicrobial-Resistant Escherichia coli in Children Living in Semirural Communities of Quito, Ecuador

Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), a family of bacteria that includes Escherichia coli, have emerged as a global health threat. This study examined risks associated with carriage of third-generation cephalosporin-resistant (3GC-R) E. coli, including ESBL-producing, multidrug-resistant, and extensively drug-resistant (XDR) strains in children living in semirural parishes of Quito, Ecuador. We conducted a longitudinal study with two cycles of sampling (N = 374, N = 366) that included an analysis of child fecal samples and survey questions relating to water, sanitation, and hygiene, socioeconomic status, household crowding, and animal ownership. We used multivariate regression models to assess risk factors associated with a child being colonized. Across the two cycles, 18.4% (n = 516) of the 3GC-R isolates were ESBL-producing E. coli, and 40.3% (n = 516) were XDR E. coli. Children living in households that owned between 11 and 20 backyard animals had an increased odds of being colonized with XDR E. coli (odds ratio [OR] = 1.94, 95% confidence interval [CI]: 1.05–3.60) compared with those with no animals. Households that reported smelling odors from commercial poultry had increased odds of having a child positive for XDR E. coli (OR = 1.72, 95% CI: 1.11–2.66). Our results suggest that colonization of children with antimicrobial-resistant E. coli is influenced by exposure to backyard and commercial livestock and poultry. Future studies should consider community-level risk factors because child exposures to drug-resistant bacteria are likely influenced by neighborhood and regional risk factors.

From Crisis to Progress: Housing and Latino Youth since 2000

Latino youth housing conditions have transformed dramatically over the past 20 years. Rates of household crowding have plummeted, nearly all Latino children are U.S.-born citizens, and broadband Internet access is widespread. However, Latino youth remain disadvantaged and their housing conditions remain understudied as they come of age in an era of housing crises, from foreclosures, evictions, to the novel coronavirus pandemic. This article examines Latino youth housing conditions since 2000, including crowding and mixed-nativity/status households. Multivariate analyses of national data show that eviction, foreclosure, and a representative zip code sample of COVID-19 case rates are strongly linked to the housing conditions of Latino youth. The article illustrates these links by analyzing and mapping eviction rates, foreclosure rates, and zip code coronavirus cases in the census tracts of Maricopa County, Arizona. The results underscore the urgent need for policies that invest in housing Latino youth to ensure that progress of the last 20 years is lasting.

COVID-19 and the Environment, Review and Analysis

We reviewed studies linking COVID-19 cases and deaths with the environment, focusing on relationships with air pollution. We found both short- and long-term observational relationships with a range of regulated pollutants, although only two studies considered both cases (i.e., infections) and deaths within a common analytical framework. Most of these studies were limited to a few months of the pandemic period. Statistically significant relationships were found more often for PM2.5 and NO2 than for other regulated pollutants, but no rationale was suggested for such short-term relationships; latency was seldom considered for long-term relationships. It was also unclear whether confounding had been adequately controlled in either type of study. Studies of air quality improvement following lockdowns found more robust relationships with local (CO, NO2) rather than regional (PM2.5, O3) pollutants, but meteorological confounding was seldom considered. Only one of seven studies of airborne virus transmission reported actual measurements. Overall, we found the existing body of literature to be more suggestive than definitive. Due to these various deficiencies, we assembled a new state-level database of cumulative COVID-19 cases and deaths through March 2021 with a range of potential predictor variables and performed linear regression analyses on various combinations. As single predictors, we found significant (p < 0.05) relationships between cumulative cases and household crowding (+), education (−), face-mask usage (−), or voting Republican (+). For cumulative deaths, we found significant relationships with education (−), black race (+), or previous levels of PM2.5 (+). NOx (+), and elemental carbon (EC, +). We found no relationships between long-term air quality and cumulative COVID-19 cases. Our associations linking air pollution with COVID-19 mortality were not statistically different from those for all-cause mortality in previous studies. In multiple mortality regressions combining air pollution, race, and education, NOx and EC remained significant but PM2.5 did not. We concluded that the current worldwide emphasis on PM2.5 is misplaced. We predicted air pollutant effects of a few percentage points, but individual differences between races, political identification, and post-graduate education were of the order of factors of 2 to 4. In general, the factors predicting infection were personal and related to COVID-19 exposure, while those predicting subsequent mortality tended to be more situational and related to geography. Overall, we concluded that how you live is more important than where you live.

Social Distancing Associations with COVID-19 Infection and Mortality Are Modified by Crowding and Socioeconomic Status

The SARS-CoV-2 virus is a public health emergency. Social distancing is a key approach to slowing disease transmission. However, more evidence is needed on its efficacy, and little is known on the types of areas where it is more or less effective. We obtained county-level data on COVID-19 incidence and mortality during the first wave, smartphone-based average social distancing (0–5, where higher numbers indicate more social distancing), and census data on demographics and socioeconomic status. Using generalized linear mixed models with a Poisson distribution, we modeled associations between social distancing and COVID-19 incidence and mortality, and multiplicative interaction terms to assess effect modification. In multivariable models, each unit increase in social distancing was associated with a 26% decrease (p < 0.0001) in COVID-19 incidence and a 31% decrease (p < 0.0001) in COVID-19 mortality. Percent crowding, minority population, and median household income were all statistically significant effect modifiers. County-level increases in social distancing led to reductions in COVID-19 incidence and mortality but were most effective in counties with lower percentages of black residents, higher median household incomes, and with lower levels of household crowding.

Association between Household Crowding and Violent Discipline and Neglect of Children: Analysis of Multiple Indicator Cluster Surveys in 26 Low- and Middle-Income Countries

The influence of household crowding on physical and mental health has been well documented. However, research on the influence of household crowding on violent discipline and neglect of children is scarce. Therefore, we aimed to investigate whether household crowding was associated with violent discipline and neglect of children in low- and- middle-income countries (LMICs). Cross-sectional data for 280,005 and 73,030 children in 26 LMICs surveyed using the Multiple Indicator Cluster Survey were analyzed for (1) violent discipline and (2) neglect, respectively. In each country, we used logistic regression models to estimate the effects of household crowding on multiple forms of violent discipline and stimulation activities (as a proxy of the level of child neglect). Estimates were pooled using random effects meta-analyses. After adjusting for confounding variables, household crowding was associated with higher odds of any violent discipline (odds ratio (OR) = 1.09, 95% CI 1.03 to 1.15, p = 0.002) and lower odds of engaging in four or more stimulation activities (OR = 0.88, 95% CI 0.83 to 0.94, p < 0.001). The associations were stronger for urban children and children living in low- and lower-middle-income countries. The findings suggest that screenings and interventions aimed at reducing the effects of household crowding might be effective in preventing and controlling violent discipline and neglect of children in LMICs.

On the Transmission Dynamics of SARS-CoV-2 in a Temperate Climate

An epidemiological model, which describes the transmission dynamics of SARS-CoV-2 under specific consideration of the incubation period including the population with subclinical infections and being infective is presented. The COVID-19 epidemic in Greece was explored through a Monte Carlo uncertainty analysis framework, and the optimal values for the parameters that determined the transmission dynamics could be obtained before, during, and after the interventions to control the epidemic. The dynamic change of the fraction of asymptomatic individuals was shown. The analysis of the modelling results at the intra-annual climatic scale allowed for in depth investigation of the transmission dynamics of SARS-CoV-2 and the significance and relative importance of the model parameters. Moreover, the analysis at this scale incorporated the exploration of the forecast horizon and its variability. Three discrete peaks were found in the transmission rates throughout the investigated period (15 February–15 December 2020). Two of them corresponded to the timing of the spring and autumn epidemic waves while the third one occurred in mid-summer, implying that relaxation of social distancing and increased mobility may have a strong effect on rekindling the epidemic dynamics offsetting positive effects from factors such as decreased household crowding and increased environmental ultraviolet radiation. In addition, the epidemiological state was found to constitute a significant indicator of the forecast reliability horizon, spanning from as low as few days to more than four weeks. Embedding the model in an ensemble framework may extend the predictability horizon. Therefore, it may contribute to the accuracy of health risk assessment and inform public health decision making of more efficient control measures.