Systematic review of household transmission of Strep A: A potential site for prevention that has eluded attention.

BACKGROUND: Despite being the sixth most common infectious disease globally, transmission of Streptococcus pyogenes (Strep A) within the household remains an understudied driver of infection. We undertook a systematic review to better understand the transmission of Strep A between people within the home while highlighting opportunities for prevention. METHODS: A search strategy was applied to five databases between September 2022 and March 2023. Results were limited to those published between January 2000 and March 2023. Texts were reviewed by two authors and the following data extracted: article details (title, author, year), study type, transmission year, country, participant age/s, infection status, molecular testing, and transmission mode. Funding was provided by the Australian National Health and Medical Research Council (NHMRC, grant number GNT2010716). RESULTS: The final analysis comprised 28 texts. Only seven studies (25.0%) provided sufficient detail to identify the Strep A transmission mode. These were contact (4), vehicle (bedding; clothing; other fabric, and medical equipment, [2]), and contact with animals (1). All others were classified as household (specific mode unascertainable). Most articles reported outbreaks involving invasive Strep A infections. CONCLUSIONS: There is limited literature regarding household transmission of Strep A. Understanding transmission in this setting remains imperative to guide control methods.

Risk Factors for Community and Intrahousehold Transmission of SARS-CoV-2: Modeling in a Nationwide French Population-Based Cohort Study, the EpiCoV Study.

We assessed the risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from household and community exposure according to age, family ties, and socioeconomic and living conditions using serological data from a nationwide French population-based cohort study, the Epidémiologie et Conditions de Vie (EpiCoV) Study. A history of SARS-CoV-2 infection was defined by a positive anti-SARS-CoV-2 enzyme-linked immunosorbent assay immunoglobulin G result in November-December 2020. We applied stochastic chain binomial models fitted to the final distribution of household infections to data from 17,983 individuals aged ≥6 years from 8,165 households. Models estimated the competing risks of being infected from community and household exposure. The age group 18-24 years had the highest risk of extrahousehold infection (8.9%, 95% credible interval (CrI): 7.5, 10.4), whereas the oldest (≥75 years) and youngest (6-10 years) age groups had the lowest risk, at 2.6% (95% CrI: 1.8, 3.5) and 3.4% (95% CrI: 1.9, 5.2), respectively. Extrahousehold infection was also associated with socioeconomic conditions. Within households, the probability of person-to-person transmission increased with age, from 10.6% (95% CrI: 5.0, 17.9) among children aged 6-10 years to 43.1% (95% CrI: 32.6, 53.2) among adults aged 65-74 years. Transmission was higher between partners (29.9%, 95% CrI: 25.6, 34.3) and from mother to child (29.1%, 95% CrI: 21.4, 37.3) than between individuals related by other family ties. In 2020 in France, the main factors identified for extrahousehold SARS-CoV-2 infection were age and socioeconomic conditions. Intrahousehold infection mainly depended on age and family ties.

High prevalence of SARS-CoV-2 antibodies and low prevalence of SARS-CoV-2 RNA in cats recently exposed to human cases.

BACKGROUND: The primary objective of this cross-sectional study, conducted in Québec and Bristish Columbia (Canada) between February 2021 and January 2022, was to measure the prevalence of viral RNA in oronasal and rectal swabs and serum antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) amongst cats living in households with at least one confirmed human case. Secondary objectives included a description of potential risk factors for the presence of SARS-CoV-2 antibodies and an estimation of the association between the presence of viral RNA in swabs as well as SARS-CoV-2 antibodies and clinical signs. Oronasal and rectal swabs and sera were collected from 55 cats from 40 households at most 15 days after a human case confirmation, and at up to two follow-up visits. A RT-qPCR assay and an ELISA were used to detect SARS-CoV-2 RNA in swabs and serum SARS-CoV-2 IgG antibodies, respectively. Prevalence and 95% Bayesian credibility intervals (BCI) were calculated, and associations were evaluated using prevalence ratio and 95% BCI obtained from Bayesian mixed log-binomial models. RESULTS: Nine (0.16; 95% BCI = 0.08-0.28) and 38 (0.69; 95% BCI = 0.56-0.80) cats had at least one positive RT-qPCR and at least one positive serological test result, respectively. No risk factor was associated with the prevalence of SARS-CoV-2 serum antibodies. The prevalence of clinical signs suggestive of COVID-19 in cats, mainly sneezing, was 2.12 (95% BCI = 1.03-3.98) times higher amongst cats with detectable viral RNA compared to those without. CONCLUSIONS: We showed that cats develop antibodies to SARS-CoV-2 when exposed to recent human cases, but detection of viral RNA on swabs is rare, even when sampling occurs soon after confirmation of a human case. Moreover, cats with detectable levels of virus showed clinical signs more often than cats without signs, which can be useful for the management of such cases.

New Evidence From Census 2020 on the Residential Segregation of Same-Sex Households: A Research Note.

The 2020 decennial census provides new insights into the demography of same-sex households and can shed light on ongoing debates in urban and gayborhood studies. Although the U.S. Census gives a vast undercount of the LGBTQ population, it is still the largest source of nationally representative data on same-sex households and is accessible over three time points (2000, 2010, 2020). In this research note, we use 2020 census data to examine the residential patterns of same-sex households down to the neighborhood level. By employing the index of dissimilarity, we present results for the 100 largest U.S. cities and 100 largest metropolitan areas that demonstrate moderate yet persistent segregation. In a continuation of prior trends, male same-sex households remain more segregated from different-sex households than do female same-sex households. We find moderate levels of within-group segregation by gender and marital status-representing new demographic trends. Finally, metropolitan areas have a higher dissimilarity index than cities, revealing greater levels of segregation when factoring in suburban areas. We discuss these trends in light of debates regarding the spatial organization of sexuality in residential contexts and outline future avenues for research utilizing recently released 2020 census data.

Food insecurity and coping strategies associate with higher risk of anxiety and depression among South African households with children.

OBJECTIVE: To investigate food insecurity and related coping strategies, and their associations with the risk of anxiety and depression, among South African households with children. DESIGN: Nationally representative cross-sectional study. Tools for assessing food insecurity, coping strategies, risk of anxiety and depression were assessed from the Community Childhood Hunger Identification Project, Coping Strategies Index, Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. We used ordered logistic regression to test associations of food insecurity and coping strategies with the risk of anxiety and depression. Moderating effects of each coping strategy were tested in the associations of food insecurity with anxiety and depression. SETTING: South Africa, post COVID-19 restrictions, May-June 2022. PARTICIPANTS: 1,774 adults, weighted to 20,955,234 households. RESULTS: Food insecurity prevalence was 23·7 % among households with children. All coping strategies were used to some extent, but relying on less preferred and less expensive foods was the most used strategy (85·5 % of food-insecure households). Moving to a higher level of food insecurity was associated with >1·6 greater odds of being in a higher risk of anxiety and depression. Sending a household member to beg for food was the strongest associated factor (OR = 1·7, P < 0·001). All coping strategies partly moderated (lessened) the associations of food insecurity with a higher risk of anxiety and depression. CONCLUSIONS: Food insecurity among households with children was high following the COVID-19 pandemic. Collaborative efforts between government, private sector and civil society to eradicate food insecurity should prioritise poorer households with children, as these populations are the most vulnerable.

The impact of food aid interventions on food insecurity, diet quality and mental health in households with children in high-income countries: a systematic review.

OBJECTIVE: Households with children accessing food aid in high-income countries are often food insecure. We aimed to review the evidence on food aid interventions in households with children and impact on food insecurity, diet quality and mental health. DESIGN: A systematic search was conducted using Web of Science, MEDLINE, CINAHL and PsycINFO. Articles published from January 2008 to July 2022 including cross-sectional, cohort and interventional studies in high-income countries were eligible. SETTING: Food aid is defined as the use of interventions providing free food items by community and/or charitable organisations. PARTICIPANTS: Two-parent, lone parent or households with a primary caregiver with at least one child ≤ 18 years. RESULTS: From a total of 10 394 articles, nine were included. Food banks, mobile pantry combined with a free meal for children, backpack provision during school term and food parcel home delivery interventions were evaluated. Food bank models offering additional support such as community programmes, health and social services, cooking classes and free meals for children, client-choice-based models and programmes providing convenient access were associated with improved food security and diet quality (increased intake of wholegrains, fruit and vegetables). One study reported an improvement in mental health and food bank access at the end of 18 months but not at earlier timepoints and one study reported no change in parents' mental health. CONCLUSIONS: Accessing food aid was linked to improved diet quality and reduced food insecurity in some studies. Allowing clients to choose food items and providing support services were most effective.

The cost of care for children hospitalized with respiratory syncytial virus (RSV) associated lower respiratory infection in Kenya.

BACKGROUND: Respiratory syncytial virus (RSV) is one of the main causes of hospitalization for lower respiratory tract infection in children under five years of age globally. Maternal vaccines and monoclonal antibodies for RSV prevention among infants are approved for use in high income countries. However, data are limited on the economic burden of RSV disease from low- and middle-income countries (LMIC) to inform decision making on prioritization and introduction of such interventions. This study aimed to estimate household and health system costs associated with childhood RSV in Kenya. METHODS: A structured questionnaire was administered to caregivers of children aged < 5 years admitted to referral hospitals in Kilifi (coastal Kenya) and Siaya (western Kenya) with symptoms of acute lower respiratory tract infection (LRTI) during the 2019-2021 RSV seasons. These children had been enrolled in ongoing in-patient surveillance for respiratory viruses. Household expenditures on direct and indirect medical costs were collected 10 days prior to, during, and two weeks post hospitalization. Aggregated health system costs were acquired from the hospital administration and were included to calculate the cost per episode of hospitalized RSV illness. RESULTS: We enrolled a total of 241 and 184 participants from Kilifi and Siaya hospitals, respectively. Out of these, 79 (32.9%) in Kilifi and 21(11.4%) in Siaya, tested positive for RSV infection. The total (health system and household) mean costs per episode of severe RSV illness was USD 329 (95% confidence interval (95% CI): 251-408 ) in Kilifi and USD 527 (95% CI: 405- 649) in Siaya. Household costs were USD 67 (95% CI: 54-80) and USD 172 (95% CI: 131- 214) in Kilifi and Siaya, respectively. Mean direct medical costs to the household during hospitalization were USD 11 (95% CI: 10-12) and USD 67 (95% CI: 51-83) among Kilifi and Siaya participants, respectively. Observed costs were lower in Kilifi due to differences in healthcare administration. CONCLUSIONS: RSV-associated disease among young children leads to a substantial economic burden to both families and the health system in Kenya. This burden may differ between Counties in Kenya and similar multi-site studies are advised to support cost-effectiveness analyses.

Financial inclusion and improved water usage among households in Ghana.

BACKGROUND: In Ghana, about 76% of households are at risk of drinking water polluted with faecal matter, hence, poor sanitation and unsafe water are responsible for 80% of all diseases in the country. Given this, some studies have been carried out concerning the factors that determine access and use of improved water among households in Ghana. However, although financial inclusion can make it easy for households to afford and hence, use improved water, it has received very little attention. This study, thus, examines the effect of financial inclusion on the use of improved water among households in Ghana. METHODS: The Ghana Living Standards Survey round 7 (GLSS7) is used as the data source while the binary logit regression is employed as the main empirical estimation technique. RESULTS: The results show that households with financial inclusion (employing an indicator which has not been disaggregated into formal and informal financial inclusion) have a higher likelihood of using improved water sources relative to those without financial inclusion. The results are robust using formal financial inclusion as well as a combined index of financial inclusion. CONCLUSION: Enhancing financial inclusion, especially formal financial inclusion can be utilised as a major policy instrument towards increasing access and use of improved water sources among households in Ghana.

Household financial burden associated with out-of-pocket payments for healthcare in Iran: insights from a cross-sectional survey.

BACKGROUND: One of the key functions and ultimate goals of health systems is to provide financial protection for individuals when using health services. This study sought to evaluate the level of financial protection and its inequality among individuals covered by the Social Security Organization (SSO) health insurance between September and December 2023 in Iran. METHODS: We collected data on 1691 households in five provinces using multistage sampling to examine the prevalence of catastrophic healthcare expenditure (CHE) at four different thresholds (10%, 20%, 30%, and 40%) of the household's capacity to pay (CTP). Additionally, we explored the prevalence of impoverishment due to health costs and assessed socioeconomic-related inequality in OOP payments for healthcare using the concentration index and concentration curve. To measure equity in out-of-pocket (OOP) payments for healthcare, we utilized the Kakwani progressivity index (KPI). Furthermore, we employed multiple logistic regression to identify the main factors contributing to households experiencing CHE. FINDINGS: The study revealed that households in our sample allocated approximately 11% of their budgets to healthcare services. The prevalence of CHE at the thresholds of 10%, 20%, 30%, and 40% was found to be 47.1%, 30.1%, 20.1%, and 15.7%, respectively. Additionally, we observed that about 7.9% of the households experienced impoverishment due to health costs. Multiple logistic regression analysis indicated that the age of the head of the household, place of residence, socioeconomic status, utilization of dental services, utilization of medicine, and province of residence were the main factors influencing CHE. Furthermore, the study demonstrated that while wealthy households spend more money on healthcare, poorer households spend a larger proportion of their total income to healthcare costs. The KPI showed that households with lower total expenditures had higher OOP payments relative to their CTP. CONCLUSION: The study findings underscore the need for targeted interventions to improve financial protection in healthcare and mitigate inequalities among individuals covered by SSO. It is recommended that these interventions prioritize the expansion of coverage for dental services and medication expenses, particularly for lower socioeconomic status household.

Study on microbial diversity of washing machines.

Health and environmental protection are the development trend of household appliances, coupled with the impact of the COVID-19 epidemic in the past few years. Consumers have unprecedented concerns and expectations about the sterilization and disinfection functions of household appliances. As a washing and nursing equipment for household clothes, the anti-bacterial technology of washing machine has developed rapidly. The new models of washing machines in the market have basically added the function of sterilization. In order to thoroughly solve the problem of sterilization and bacteriostasis of washing machines from the source, the distribution of microbial contamination in washing machines should be fully investigated. At present, there is almost no systematic study on the microbial community structure in washing machines in China. Therefore, the purpose of this study is to analyze the bacterial community structure in Chinese household washing machines. To explore the key factors affecting the bacterial community structure of washing machines. Bacterial communities were comprehensively analyzed by high throughput sequencing. Using chao and shannon indexes as indicators, one-way ANOVA was used to explore the key factors affecting the bacterial community structure of washing machines. A total of 2,882,778 tags and 21,265 OTUs from 522 genera were sequenced from 56 washing machine samples. Genus Mycobacterium, Pseudomonas, Brevundimonas, Sphingomonas, Sphingobium, Enhydrobacter, Methylobacterium, Pseudoxanthomonas, Stenotrophomonas and Sphingopyxis were the top ten bacteria genera in abundance. The effects of sources, types, frequency of utilization, sampling locations and service life of washing machines on bacterial diversity in washing machine were systematically analyzed. The statistical analysis showed that service life was an important factor affecting bacterial diversity in washing machine. Our study lays a foundation for directional screening of characteristic microorganisms with targeted characters including malodor-producing, fouling, pathogenic and stress-resistance, the antibacterial evaluation, metabolic mechanism of key characteristic microorganisms as well as antibacterial materials development. At present, the sterilization technology of washing machines has not been fully in combination with the distribution survey of microorganisms in washing machines. According to the specific microorganism distribution condition of the washing machine, the key distribution positions and the types of specific microorganisms contained in different positions, conduct more targeted sterilization treatment. This will help to completely solve the problem of microbial growth in washing machines from the source.

Impacts of unconditional cash transfers on health care utilisation in informal sector households in Togo.

BACKGROUND: Most Togolese population earns their income from informal sector, and they are very often exposed to health outcomes. Cash transfers impact healthcare utilization by improving household's social capital, socio-economic status, lifestyle choice, and physical health. The aim of this paper was to analyse the impact of unconditional cash transfers on health care utilisation in informal sector households. METHODS: We used the propensity-score method to compare health care utilisation by households that received cash transfers from nonbeneficiary households and simulated a potential confounder to assess the robustness of the impacts of the estimated treatment (i.e., cash transfer). Data were obtained from a national survey that covered 1405 households. RESULTS: The results show that women benefited the most from cash transfers (73.1%). Our estimates indicate that health care utilisation increased by 28.3% among workers in the informal sectors who benefited from unconditional cash transfers compared to nonbeneficiaries. The greatest impact was found on agriculture households with an increase by 31.3% in the health care utilisation. In general, cash transfer beneficiaries are more likely to use public health centres; there was an increase in public health facility attendance of 21.3%. CONCLUSIONS: Cash transfers are a valuable social protection instrument that improve health care utilisation of populations in the informal sector. Policymakers could use cash transfer as the infusion of income and/or assets that may impact health outcomes. Cash transfers are an opportunity to alleviate barriers of access to health care by older people. Future research must examine impact of cash transfer on health of vulnerable groups such as older people, children, and people with disabilities.

Trends and Preferences of Rhinoplasty Among Chinese Patients: A Social Media Analysis.

BACKGROUND: This study investigated the trends, motivations and preferences of rhinoplasty in China. METHODS: Data on rhinoplasty were collected from Xiaohongshu and analyzed for trends. Text analysis and word frequency statistics were performed on the notes and comments using Python modules. RESULTS: We obtained 1065 notes with 102,153 comments, 239,383 collections and 640,579 likes. The number of rhinoplasty-related publications increased annually, correlating with per capita disposable income of households (DI) growth (r2 = 0.609, P = 0.041 < 0.05). In the Southern provinces, there was a notably higher volume of publications compared to the Northern provinces (P = 0.001). Furthermore, a significant correlation was observed between publication data, population size, and the DI (r2 = 0.786, P < 0.001). The nasal tip (3197) and nasion (1409) were the most mentioned nasal subunits. "Good-looking" (9672) and "natural" (2811) were the most used words to describe the nose shape. The "doctor" (4377), the "hospital" (2182) and "hyaluronic acid" (2106) were the most mentioned rhinoplasty procedure related vocabulary. CONCLUSIONS: Discussions about rhinoplasty in China are increasing, and more people express their desire for rhinoplasty on social networks, related to China's DI growth. The Southern provinces show a higher inclination toward these discussions, a trend that correlates with our findings of a positive association between NOPs and both DI and population size. Netizens pay more attention to the shape of nasal tip and nasion, and prefer the good-looking and natural appearance. Most people consider autologous cartilage or hyaluronic acid injection for rhinoplasty. Doctors are the primary consideration for patients. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Guiding clean energy transitions in rural households: Insights from China's pilot low-carbon policies.

The impact of Low Carbon Pilot Policies (LCPPs) on carbon reduction and energy efficiency has been extensively studied. However, the potential of these policies to promote clean energy transition (CET) in rural households remains underexplored. This article constructed a staggered-DID model using data from the China Family Panel Studies (CFPS) to investigate the impact and mechanisms of LCPPs on rural households' CET. The findings indicate that LCPPs significantly enhance the CET among rural households. Moreover, the effects of LCPPs vary across cities, while differences within communities and households are less pronounced. Mechanism analysis reveals that LCPPs facilitate rural households' CET through income effects, infrastructure improvements, and enhanced low-carbon awareness. Notably, the income and low-carbon awareness effects are heterogeneous. Additionally, LCPPs have increased rural households' expenditures on home-cooked meals. We estimate the average fixed cost of the CET for rural households to be approximately $404.495. These insights provide valuable empirical evidence that can guide other countries and regions in promoting CET in rural areas.

Incidence of diarrhea and risk factors among wastewater-irrigating urban farmers along Akaki Rivers in Addis Ababa.

The importance of diarrhea risk associated with wastewater exposure in agriculture is almost unknown. This study aimed to examine diarrheal infection and risk factors among farmers using wastewater for irrigation in Addis Ababa. A cross-sectional study was employed among 380 farmers (190 exposed and 190 unexposed farmers). Among these, a cohort of 200 adults (100 wastewater-exposed, 100 unexposed farmers) aged 25-69 years were selected and followed up biweekly for two successive vegetables growing seasons to examine the incidence of diarrhea. The incidence rate of reported diarrhea was 12 episodes per 1,000 person-weeks at risk and a maximum of 17 episodes per 1,000 person-weeks at risk. Strongly associated risk factors include washing body and clothes with wastewater [AOR: 4.2, 95%CI (1, 11.2)], using working clothes at home [AOR: 4.7, 95%CI (0.25, 87)], and wearing protective cloth [AOR: 5.6, 95 CI (0.3, 70)]. Moreover, hand washing after work, washing feet and boots, and on-site hand washing were significant determinants of farmers' diarrhea. Exposure to wastewater significantly contributes to the risk of diarrhea among adults. Significant determinants of diarrhea among farmers include washing the body and clothes with irrigation water, contamination with soil and irrigation water, and on-site hand washing. Increased risk factors include hand contamination, washing vegetables with irrigation water, eating raw vegetables, and using work clothes at home.

Awareness and use of improved livestock feed technologies among agro-pastoral households in the West African Sahel.

Seasonal scarcity of quality feed continues to be a bottleneck for agro-pastoralists and is the most important limitation to livestock production in agro-pastoral systems in the West African Sahel. In this regard, diverse promising technologies to increase the production and availability of quality feed have been introduced. Despite the introduction of various feed technologies in the region, the adoption rate by smallholder farmers is very low. The objective of this study was to identify factors affecting the likelihood of using improved livestock feed technologies among agro-pastoral households in two regions of Niger. A logit model was employed using data collected from randomly selected 218 agro-pastoral households between February and April 2023. The study revealed low awareness and use of improved livestock feed technologies among agro-pastoral households. The findings suggested the positive impact of education level, membership of farmer groups and ownership of small ruminant on enhancing the probability of using improved livestock feed technologies. Households' geographical area was one of the determinant factors in using improved livestock feed technologies. The use of improved livestock feed technologies was also influenced by family size. The study provides guidance to inform strategies by the decision-makers to enhance the utilization of improved livestock feed technologies among agro-pastoral households in the West African Sahel. Suggested strategies may in turn alleviate the current problem of low productivity of livestock, contribute to improving household food security and nutrition among agro-pastoral communities.

Improving urban waste management: A comprehensive study on household waste generation and spatial patterns in the Grand Guayaquil Metropolitan Area.

This study tackles the growing global concern about municipal waste management, particularly in cities like the Grand Guayaquil Metropolitan Area (GGA). Through realistic field studies on in situ household waste generation and geographic information system (GIS) tools, this work offers a framework to predict the quantities and types of recyclable household waste for any metropolitan area in Latin America. Over 4 weeks, students collected, sorted and weighed recyclable waste types, including plastic, paper, metal, glass and fabric, from 776 sampled household of the GGA. ArcGIS survey tool identified household locations and allowed to survey different socio-demographic features. With the help of ArcGIS interpolation method, the total household waste generation for GGA was predicted, and the classification of the different types of recyclable waste was also spatially distributed for the study area. The report identified notable trends in plastic waste, specifically polyethylene terephthalate waste's steady prevalence and 42% growth rate, emphasizing the importance of enhanced recycling techniques. Spatial density maps showed a heterogeneous waste distribution across the GGA, emphasizing locations with higher waste output. This study demonstrates that improving recyclable waste collection can be accomplished with a moderately cheap expenditure by collaborating with academia to overcome knowledge gaps. This strategy provides opportunities to mitigate the environmental impacts of poor waste management.

Individual, household and institutional level predictors of waste sorting: Evidence for Ecuador.

The rapid increase in waste generation in developing countries presents significant challenges, necessitating effective waste management strategies. This study examines the influence of individual, household and institutional factors on waste sorting behaviours in Ecuador, employing an ordered logistic regression model. Data were sourced from the 2019 National Multipurpose Household Survey (NMHS) and the Census of Economic Environmental Information in Decentralised Autonomous Governments (CEEIGAD). The NMHS uses a two-stage probabilistic sampling methodology, with census sectors as the primary sampling units and households as the secondary units. After excluding outliers and selecting individuals aged 15-65 years, the final sample consisted of 8601 households, including 26,175 individuals. The findings reveal that personal attributes such as gender, ethnicity, age, marital status and environmental concern significantly influence waste sorting behaviours. Household characteristics, including urban or rural location, are also critical. Institutional factors, such as municipal regulations, waste collection fees and waste separation at source, play essential roles in promoting waste separation. The study highlights the necessity for targeted governmental policies. Recommendations include improving environmental education, increasing sorting infrastructure in urban areas and ensuring waste collection systems maintain the separation of waste streams.

Changes in mixed ethnicity households and neighbourhood transitions in England and Wales.

Conventional explanations of neighbourhood ethnic transitions consider what drives differential growth in ethnic group populations without regard to household composition. We enrich these nonhousehold approaches by using consistent Census data on neighbourhoods and households for England and Wales for 2001, 2011 and 2021 to analyse connections between mixed-ethnicity households and neighbourhood ethnic diversity. We employ a neighbourhood typology of ethnic diversity that identifies neighbourhoods as either low- or moderate-diversity, or high-diversity, where no single ethnic group is in the majority. We focus particularly on White-majority and highly diverse neighbourhoods given the dominance of the former in residential spaces in England and Wales, and because they are the principal source of transitions to highly diverse neighbourhoods. Mixed-ethnicity households have become an increasingly important feature of the ethnic diversification of England and Wales; by 2021, almost 15% of multiperson households were mixed, a growth from 12% in 2011 and 9% in 2001. We find that higher levels of neighbourhood ethnic diversity are associated with higher shares of mixed-ethnicity households. In high-diversity neighbourhoods, for example, around 30% of multiperson households (nearly a quarter of a million households) were ethnically mixed in 2021. Levels of household mixing in moderate-diversity White neighbourhoods were considerably higher than in low-diversity White neighbourhoods. The same is found for diversifying neighbourhoods. Neighbourhoods that become more ethnically diverse were typically home to higher rates of mixed-ethnicity households. Stably moderately diverse White neighbourhoods also had a higher proportion of mixed households. Studies of neighbourhood transition that focus on individuals in neighbourhoods may be missing important processes operating in the intimate spaces of the home. Including this intermediate scale of analysis adds to our understanding of neighbourhood ethnic mixing and processes of integration.

The Association of Supplemental Nutrition Assistance Program Participation and Food Insufficiency among Households with Children in the United States during COVID-19.

BACKGROUND: As the expansion of Supplemental Nutrition Assistance Program (SNAP) benefits and pandemic emergency assistance programs ended in late 2021, little is known about subsequent trends in food insufficiency (FI) among households with children. OBJECTIVES: This research examined the association between SNAP participation and FI among households with children in the United States, particularly non-Hispanic Black (Black) and Hispanic households. METHODS: This cross-sectional analysis used Household Pulse Survey data collected from December 2021 to May 2022. Spatial analysis was conducted to visualize FI and SNAP participation rates across 50 states. With state SNAP policy rules as exogenous instruments and sociodemographic factors as control variables, 2-stage probit models were utilized to assess the SNAP and FI association among all (n = 135,074), Black (n = 13,940), and Hispanic households with children (n = 17,869). RESULTS: Approximately 13.9% [95% confidence interval (CI): 13.85%, 13.99%] of households experienced FI, and 20.4% (CI: 20.35%, 20.51%) received SNAP benefits. Among Black and Hispanic households, higher rates were observed, with 23.3% (CI: 23.12%, 23.4%) and 20.8% (CI: 20.61%, 20.95%) experiencing FI and 36.3% (CI: 36.1%, 36.5%) and 26.9% (CI: 26.61%, 27.13%) receiving SNAP benefits. These rates varied across states, ranging from 8% (Utah) to 21.1% (Mississippi) for FI and from 8.8% (Utah) to 32.7% (New Mexico) for SNAP participation. SNAP participants demonstrated a 12% lower likelihood of FI than nonparticipants (CI: -0.18, -0.05, P < 0.001). Among Black households, SNAP participants had a 29% lower likelihood of FI than nonparticipants (CI: -0.54, -0.03, P < 0.001). However, SNAP participation was not significant among Hispanic households (P = 0.99), nor did it narrow the FI gap between Hispanic and non-Hispanic households (P = 0.22). CONCLUSIONS: SNAP participation was associated with lower levels of FI among households with children, particularly for Black households. However, there was no significant association between SNAP participation and FI among Hispanic households with children.

A survey on the current status of Helicobacter pylori infection in households in Hainan Province, China.

OBJECTIVE: This study aims to assess the prevalence of Helicobacter pylori (Hp) infection at the household level in Hainan Province in China and identify the factors that contribute to its spread. The findings of this study have significant implications for public health prevention strategies in the Hainan region. METHODS: A total of 421 families, comprising 1355 individuals, were tested for Hp infection across five cities in Hainan Province between July 2021 and April 2022. The study utilized questionnaires that included questions about personal characteristics, household shared lifestyle and dietary habits, and potential pathways of Hp infection in children to identify potential factors linked to household Hp infection and transmission patterns. RESULTS: The prevalence of Hp infection on an individual basis was 46.72% (629/1355), with age ≥ 20 years, being married and having junior secondary education and above as risk factors for Hp infection. The prevalence of Hp infection in households was 80.29% (338/421), household size of 5, 6 and above were risk factors for Hp infection with Odds Ratios (ORs) of 4.09 (1.17-14.33) and 15.19 (2.01-114.73), respectively, household income ≥ 100,000 yuan and drinking boiled water from a tap source were protective factors for Hp infection with ORs of 0.52 (0.31-0.89) and 0.51 (0.28-0.95), respectively. The prevalence of Hp infection among minors in the household was 24.89% (58/233), with paternal infection and maternal infection as risk factors for child infection, with ORs of 2.93 (1.29-6.62) and 2.51 (1.07-5.89), respectively. CONCLUSION: Hp infection was prevalent among Hainan families, and interaction with infected family members may be the primary cause of transmission.