Factors intrinsic to handling and transport in pre-slaughter behavioural changes in beef cattle.

The aim of this study was to evaluate handling and transport variables as potential causes of disturbed behaviour in response to seeing a person on an overhead observation platform during pre-slaughter in batches of females and castrated males composed of pure or crossed Bos Taurus animals (Aberdeen Angus, Red Angus, Hereford and Charolais) with a maximum of 37.5% Bos indicus, and maturity at slaughter varying from zero to eight teeth, coming from pasture and confined systems. For the batches of castrated males, the independent variables included the distance covered on the trip, and the handling and facilities on the farms. For the female batches, the variables were travel time and waiting time prior to unloading. For both sexes, the presence of horns in the batches and the load density were included in the regression equations. Disturbed behaviour, the result of factors related to animal handling and transportation, is detrimental to satisfactory results in production systems. It is up to the managers in the production chain to seek alternatives in order to minimise inappropriate behaviour, which is one determinant of loss. Handling and transport are determining factors in the behaviour of beef cattle during the pre-slaughter period.

City-Level Travel Time and Individual Dietary Consumption in Latin American Cities: Results from the SALURBAL Study.

There is limited empirical evidence on how travel time affects dietary patterns, and even less in Latin American cities (LACs). Using data from 181 LACs, we investigated whether longer travel times at the city level are associated with lower consumption of vegetables and higher consumption of sugar-sweetened beverages and if this association differs by city size. Travel time was measured as the average city-level travel time during peak hours and city-level travel delay time was measured as the average increase in travel time due to congestion on the street network during peak hours. Vegetables and sugar-sweetened beverages consumption were classified according to the frequency of consumption in days/week (5-7: "frequent", 2-4: "medium", and ≤1: "rare"). We estimate multilevel ordinal logistic regression modeling for pooled samples and stratified by city size. Higher travel time (Odds Ratio (OR) = 0.65; 95% Confidence Interval (CI) 0.49-0.87) and delay time (OR = 0.57; CI 0.34-0.97) were associated with lower odds of frequent vegetable consumption. For a rare SSB consumption, we observed an inverse association with the delay time (OR = 0.65; CI 0.44-0.97). Analysis stratified by city size show that these associations were significant only in larger cities. Our results suggest that travel time and travel delay can be potential urban determinants of food consumption.

Comparing absolute and relative distance and time travel measures of geographic access to healthcare facilities in rural Haiti.

INTRODUCTION: While travel distance and time are important proxies of physical access to health facilities, obtaining valid measures with an appropriate modelling method remains challenging in many settings. We compared five measures of geographic accessibility in Haiti, producing recommendations that consider available analytic resources and geospatial goals. METHODS: Eight public hospitals within the ministry of public health and population were included. We estimated distance and time between hospitals and geographic centroids of Haiti's section communes and population-level accessibility. Geographic feature data were obtained from public administrative databases, academic research databases and government satellites. We used validated geographic information system methods to produce five geographic access measures: (1) Euclidean distance (ED), (2) network distance (ND), (3) network travel time (NTT), (4) AccessMod 5 (AM5) distance (AM5D) and (5) AM5 travel time (AM5TT). Relative ranking of section communes across the measures was assessed using Pearson correlation coefficients, while mean differences were assessed using analysis of variance (ANOVA) and pairwise t-tests. RESULTS: All five geographic access measures were highly correlated (range: 0.78-0.99). Of the distance measures, ED values were consistently the shortest, followed by AM5D values, while ND values were the longest. ND values were as high as 2.3 times ED values. NTT models generally produced longer travel time estimates compared with AM5TT models. ED consistently overestimated population coverage within a given threshold compared with ND and AM5D. For example, population-level accessibility within 15 km of the nearest studied hospital in the Center department was estimated at 68% for ED, 50% for AM5D and 34% for ND. CONCLUSION: While the access measures were highly correlated, there were significant differences in the absolute measures. Consideration of the benefits and limitations of each geospatial measure together with the intended purpose of the estimates, such as relative proximity of patients or service coverage, are key to guiding appropriate use.

Analysis of community-level factors contributing to cholera infection and water testing access in the Northern Corridor of Haiti.

Vibrio cholera, the bacteria that cause cholera, is endemic in Haiti with a presence in both cities and remote areas. Improved access to drinking water testing and treatment in remote areas may reduce the impact of the disease. This case study uses correlation and regression analysis to identify the main factors that hinder access to water testing and that lead to high cholera infection rates among communities in the Northern Corridor of Haiti. Poor road conditions, mountainous terrain, and limited transportation options lead to high travel times up to 5.7 min/km between remote communities and drinking water testing facilities. The presence of springs in a community has a significant positive correlation with cholera infection rates in the Northern Corridor. However, socioeconomic factors had no significant correlation with cholera infection rate. The results of this study will be used to plan the implementation of a new drinking water testing laboratory near the city of Cap-Haitian and other programs for vulnerable remote areas. PRACTITIONER POINTS: Topography and road conditions may be more important than distance in determining the accessibility of water testing facilities for rural communities. A lack of access to private vehicles is a substantial challenge for many rural communities in accessing water testing. The presence of springs in a community had a significant positive correlation with cholera infection rate.

Travel Time to Health Facilities as a Marker of Geographical Accessibility Across Heterogeneous Land Coverage in Peru.

To better estimate the travel time to the most proximate health care facility (HCF) and determine differences across heterogeneous land coverage types, this study explored the use of a novel cloud-based geospatial modeling approach. Geospatial data of 145,134 cities and villages and 8,067 HCF were gathered with land coverage types, roads and river networks, and digital elevation data to produce high-resolution (30 m) estimates of travel time to HCFs across Peru. This study estimated important variations in travel time to HCFs between urban and rural settings and major land coverage types in Peru. The median travel time to primary, secondary, and tertiary HCFs was 1.9-, 2.3-, and 2.2-fold higher in rural than urban settings, respectively. This study provides a new methodology to estimate the travel time to HCFs as a tool to enhance the understanding and characterization of the profiles of accessibility to HCFs in low- and middle-income countries.

Parental Perceived Travel Time to and Reported Use of Food Retailers in Association with School Children's Dietary Patterns.

Considering the association between the neighborhood food environment and individual eating behaviors, this study aimed to assess the association between parents' reported use of food facilities by their children, and parental perceived travel time to food facilities, with their children's dietary patterns. Parents reported the use of supermarkets, full-service and fast-food restaurants, and perceived travel time to these food retailers. To assess school children's food consumption, a previous day dietary recall was applied. Factor analysis was conducted to identify dietary patterns. To test the association between reported use and perceived travel time to food retailers and school children's dietary patterns, we performed multilevel linear regression analyses. Parents' reported use of supermarkets was associated with children's higher score in the "Morning/Evening Meal" pattern. The use of full-service and fast-food restaurants was associated with children's higher score in the "Fast Food" pattern. Higher parental perceived travel time to full-service and fast-food restaurants was associated with children's lower score in the "Fast Food" pattern. Although the use of full-service and fast-food restaurants was associated with a less healthy dietary pattern, the perception of living further away from these food retailers may pose a barrier for the use of these facilities.

Quantifying disparities in access to public-sector abortion based on legislative differences within the Mexico City Metropolitan Area.

OBJECTIVES: In the Mexico City Metropolitan Area, only women in the city center have local access to legal first-trimester abortion. We quantify how this legislative discrepancy affects access to legal, public-sector abortion across the metropolitan area. STUDY DESIGN: In this observational study, we used a dataset representing 67.2% of all abortions occurring between 2010 and 2012 in Mexico City's public abortion program and census population data. We calculate utilization rates for 75 municipalities in the metropolitan area for 2010-2012. We compare utilization between municipalities with and without local legal access, adjusting for differences in sociodemographic drivers of abortion demand. We explore the effects of local abortion legality, travel time and socioeconomic status (SES). RESULTS: Women who had to travel into the city center for legal abortions used services at only 18.6% (95% CI 13.3%-33.0%) of the expected rate if they had local access, adjusting for sociodemographic factors. After controlling for travel time and SES, women who lived where abortion is illegal had a 58.6% (95% CI 21.5%-78.1%) reduction in access, and each additional 15 min of travel further reduced access by 33.7% (95% CI 18.2%-46.3%). Women who travel to seek legal abortions are more likely to have completed secondary education compared to other reproductive age women in their municipality (p = <.00001). CONCLUSIONS: We find that, in the Mexico City Metropolitan Area, both living where abortion is illegal and having to travel further to access services substantially reduce access to legal, public-sector abortion. These burdens disproportionately affect women of lower SES. IMPLICATIONS: Both local legality and proximate access are key to ensuring equity in access to public-sector abortion. Legalization of abortion services across the greater Mexico City Metropolitan Area has the potential to increase equity in utilization and meet unmet demand for legal abortion.

Assessment of vulnerability and control measures to protect the Salbarua ecosystem from hypothetical spill sites.

Population pressure, urbanization, and industrial developments, among other factors, have resulted in severe degradation of environmental resources such as wetlands. Thus, a groundwater model (MODFLOW) was integrated with a particle tracking MODPATH model to simulate the hydrodynamic flow head field and to analyze the vulnerability of the Salburua ecosystem and propose control measures to protect the riparian area. The simulations show that pathways of particle tracking originating at potential contaminant sources will tend to migrate downwards towards the sensitive ecosystem, which suggests that the quality of the hydrological ecosystem is likely to deteriorate in the future. Variation in exit points of particles indicates that the time-related capture areas are affected by changes of the hydraulic gradients. Two control measures of potential sources of pollutants in the vicinity of the Salbarua ecosystem were analyzed. The study results suggest that the travel time-related capture zone with a funnel-and-gate system is much smaller than without the control alternative, which indicates that the gate configuration has an effect on capture zone size and shape and on the residence time with a better attenuation performance. It is also shown that a leakage-proof barrier is less effective for point-source containment, assuming that hydraulic control performance and cost-efficiency are the criteria for pollution control effectiveness. Instead, a program of monitoring wells would effectively characterize water quality in the aquifer and provide a decision support system. This approach may be used in helping water managers to develop more physically based and quantitative protection strategies.

Use of Adult-Trained Medical Subspecialists by Children Seeking Medical Subspecialty Care.

OBJECTIVES: To quantify the use of adult-trained medical subspecialists by children and to determine the association between geographic access to pediatric subspecialty care and the use of adult-trained subspecialists. Children with limited access to pediatric subspecialty care may seek care from adult-trained subspecialists, but data on this practice are limited. STUDY DESIGN: We identified children aged <16 years in 2007-2012 Pennsylvania Medicaid claims. We categorized outpatient visits to 9 selected medical subspecialties as either pediatric or adult-trained subspecialty visits. We used multinomial logistic regression to examine the adjusted association between travel times to pediatric referral centers and use of pediatric vs adult-trained medical subspecialists for children with and without complex chronic conditions (CCCs). RESULTS: Among 1.1 million children, 8% visited the examined medical subspecialists, with 10% of these children using adult-trained medical subspecialists. Compared with children with a ≤30-minute travel time to a pediatric referral center, children with a >90-minute travel time were more likely to use adult-trained subspecialists (without CCCs: relative risk ratio [RRR], 1.94, 95% CI, 1.79-2.11; with CCCs: RRR, 2.33; 95% CI, 2.10-2.59) and less likely to use pediatric subspecialists (without CCCs: RRR, 0.66; 95% CI, 0.63-0.68; with CCCs: RRR, 0.76, 95% CI, 0.73-0.79). CONCLUSION: Among medical subspecialty fields with pediatric and adult-trained subspecialists, adult-trained subspecialists provided 10% of care to children overall and 18% of care to children living >90 minutes from pediatric referral centers. Future studies should examine consequences of adult-trained medical subspecialist use on pediatric health outcomes and identify strategies to increase access to pediatric subspecialists.