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  • OPEN ACCESS
    Development of an age-adjusted, activity-based contact probability model for infectious diseases
    FACETS • Vol. 9 • pp. 1 - 11
    The COVID-19 pandemic highlighted the importance of gathering restrictions in slowing the spread of communicable disease. Many restrictions on activities were applied without identifying how effective the restrictions might be in curtailing disease spread. We present a model that estimates the probability of contacting an infected individual as a function of prevalence and self-reported or hypothesized activities. The model incorporates an age adjustment factor to account for differences between the age demographics of infected versus activity participants. The age adjustment factor was important to include when the difference in prevalence between age groups was sufficiently large, and prevalence and activity group sizes were moderate. We applied our contact probability model to two scenarios to demonstrate how the model may inform the development of public health measures. Our model presents a method for estimating contact probability that could be adopted by jurisdictions considering facility closures or group size limits, or for individuals evaluating their own behaviours in future outbreaks or pandemics.
  • OPEN ACCESS
    Did the COVID-19 pandemic disrupt food security in West African rural communities? Survey results from four regions of Senegal and Burkina Faso
    FACETS • Vol. 9 • pp. 1 - 16
    Transboundary rural communities in West Africa play an important role in the exchange of goods, mainly food, among countries. The COVID-19 pandemic restricted these activities due to the closure of the borders. Semi-structured interviews were conducted in two regions of Senegal and Burkina Faso to examine the impacts of these restrictions on the pillars (availability, access, utilization, and stability) of food security in rural areas on men and women. The data set included 230 interviews, and they were analyzed through thematic content analysis. The results showed a decrease in agricultural production in all the communities due to mainly lack of labor force, and limited access to inputs, resulting in increased post-harvest losses. The disruption of trade and border and market closures affected rural families engaged in transboundary trade. Farmers experienced a sharp loss of household income leading to debts and decapitalization. Availability and diversity of and access to food was also heavily affected. Food security greatly varied among the communities and between countries. Perceptions also varied between men and women in terms of production, mobility, and food consumption. The restriction measures have triggered a spiral of effects and responses seriously impacting long-term food security in already highly vulnerable countries.
  • OPEN ACCESS
    Prospective cohort study of Helicobacter pylori infection on the risk of nonalcoholic fatty liver disease
    FACETS • Vol. 9 • pp. 1 - 8
    To investigate the epidemiological connection between nonalcoholic fatty liver disease (NAFLD) and Helicobacter pylori (H. pylori). 6,478 retired and active workers, aged 22-69 years, were included in the study. Their baseline measures of height, weight, waist measurement, body mass index, blood pressure, fasting blood sugar, plasma lipid, liver function index, glycosylated hemoglobin, abdominal ultrasonography, and findings from the line “13 C urea breath test” H. pylori test were analyzed, and follow-up with consistent baseline methods and criteria was performed annually. Over a 4-year period, the prevalence of NAFLD increased by 16.9%, with 612 (18.7%) of those who tested positive for H. pylori developing NAFLD, whereas 484 (15.1%) of those who did not test positive for H. pylori were later diagnosed with new NAFLD (χ2 = 14.862, P < 0.05). One of the risk factors identified in the univariable Cox regression model for NAFLD was H. pylori (Hazard Ratio = 1.297; 95.0% confidence interval (CI) 1.150,1.485, P < 0.000); however, H. pylori continued to be an independent factor affecting the risk of NAFLD even after accounting for gender, age, and aspects of the metabolic syndrome (Hazard Ratio = 1.240; 95.0% CI 1.077,1.429, P = 0.003). The growth of NAFLD may be correlated with H. pylori infection.
  • OPEN ACCESS
    Inventory and characteristics of Canadian interhospital transfer coordination structures
    FACETS • Vol. 10 • pp. 1 - 8
    Several studies have described interhospital transfer coordination structures in the US but there is a lack of data on Canadian coordination systems. We aimed to develop an inventory of existing interhospital coordinating structures across Canada and to detail how they operate in terms of governance, re-sources, tools, and processes. A cross-sectional survey was designed and ten managers/medical officials from seven coordination structures of interhospital transfers across Canada completed the survey. Findings indicate that coordination systems had similar communication modalities and covered similar services including the provision of medical advice. However, they differed in terms of the profile of staff processing transfers and transportation coordination. Mature structures such as Ontario and Alberta, who manage high annual volumes, distinguish themselves with very clear, standardized, and efficient processes, as well as implemented quality and performance improvement methods including key performance indicators. These results suggest that Canada may benefit from having an inter-provincial community of practice for interhospital transfer coordination structures to promote best practices, identify solutions, and harmonize services and processes. Better harmonization in transfer coordination would improve equity in the access to healthcare services. Future research should focus on the elaboration of evidence-and consensus-based guidelines that apply to the Canadian context.
  • OPEN ACCESS
    Poor mental health negatively impacts farmers personally, interpersonally, cognitively, and professionally
    FACETS • Vol. 9 • pp. 1 - 16
    Farmers globally face significant occupational stressors and are reported to experience high levels of depression, anxiety, burnout, suicide ideation, and suicide. While the impacts of high stress and poor mental health have been well-studied in the general population, and to some extent, in specific occupations, the impacts on farmers are understudied. The objective here was to explore the lived experience of high stress and (or) poor mental health in Canadian farmers, including the perceived impacts. Using a phenomenological approach within a constructivist paradigm, we conducted 75 one-on-one research interviews with farmers and people who work closely with farmers, in Ontario, Canada, between July 2017 and May 2018. We analysed the data via thematic analyses and identified four major themes. Participants described myriad negative impacts of farmers’ high stress and (or) poor mental health: (1) personally, (2) interpersonally, and (3) cognitively, which ultimately negatively impacted them (4) professionally, including consequences for productivity, animals, and farm success. The data described far-reaching, interconnected impacts of high stress and poor mental health on participants, the people and animals in their lives, and most aspects of their farming operations, financial viability, and success. Farmer stress, mental health, and well-being are important considerations in promoting sustainable, successful agriculture.
  • OPEN ACCESS
    Food Systems Innovation to Nurture Equity and Resilience Globally (Food SINERGY): insights from the Food SINERGY network
    FACETS • Vol. 9 • pp. 1 - 15
    The international collaboration network Food Systems Innovation to Nurture Equity and Resilience Globally (Food SINERGY) unites food system experts concerned with the confluence of environmental, geopolitical, economic, and public health stressors that weaken food systems and increase inequalities. In March 2023, Food SINERGY participants from universities, research institutes, food policy advocacy groups, Indigenous networks, farmers’ associations, consumer organizations, social enterprises, and non-governmental organizations from around the world met in Mont Orford, Québec, for a forum to revisit food system structures across local-to-global scales and to identify key junctures for transformation. This article summarizes the network's discussions in the context of the existing literature. Key knowledge contributions include the importance of diversification throughout the food system for cultivating resilience; the value of food sovereignty in promoting equity across scales; the reconciliation between food sovereignty and equitable trade; the need for consonance between policy environments at different scales to enable positive societal actions; the pioneering role of food system innovations that challenge conventional political and economic structures, with emphasis on agroecology; and the need for critical self-reflection around knowledge production and knowledge use to better serve equitable food systems. These discussion outcomes provide insights for actors seeking to transform food systems in support of equity and resilience.
  • OPEN ACCESS
    Bat handlers, bat bites, and rabies: vaccination and serological testing of humans at risk
    FACETS • Vol. 9 • pp. 1 - 11
    Globally, bats provide critical ecosystem services. Rabies, caused by rabies virus and related lyssaviruses, is one of the most significant zoonoses associated with bats. Bat biologists study bats in the laboratory and the field. To minimize the risk of disease, all bat handlers should be vaccinated against rabies and undergo routine serological testing to measure their rabies virus neutralizing antibody levels. They should use best practices to avoid exposures, such as personal protective equipment, especially gloves appropriate to the size of the bat(s) being handled. Attention to such details will prevent unnecessary exposures and avoid some of the accompanying negative perceptions that endanger bats on a global level. The small body sizes of many bats (<50 g, many <20 g) and small teeth makes their defensive bites easy to overlook. Breaks in the skin, however small, may result in exposure to lyssaviruses in the animals’ saliva. Exposure to blood-feeding bats is less common because these species are geographically restricted to the Neotropics and are the only species whose natural feeding behavior could involve transmission of rabies virus. Understanding viral transmission, preventing exposures, and responding appropriately to bites will minimize the consequences of this deadly zoonosis.
  • OPEN ACCESS
    Exploring the use of the RISK21 approach for Indigenous community-based human health risk assessments: two case studies
    FACETS • Vol. 10 • pp. 1 - 16
    Indigenous peoples in North America are disproportionately exposed to environmental contaminants and may face elevated health risks related to unique socio-cultural ties to the land. Conventional human health risk assessment (HHRA) methods do not account for these unique contexts. Regulators (i.e., Health Canada, US EPA) have called for the development of more ethical and efficient HHRA approaches, but to our knowledge no such approaches have been designed in consideration of Indigenous community contexts. RISK21 is a new HHRA approach gaining regulatory attention. We present two case studies piloting RISK21’s use in collaboration with three unique communities (Cold Lake First Nations, Chipewyan Prairie First Nation, Apsáalooke/Crow Nation). Our objectives are first, reflect upon the benefits and challenges of using RISK21 in these contexts; second, compare RISK21-based to conventional assessments; and third, ideate adaptations and improvements to the approach. The RISK21-based analyses had similar descriptive results to the original conventional assessments, including when using less information. We found RISK21 useful for rapid chemical assessment and visually representing data from multiple sources. We recommend areas where RISK21 (and other next-generation HHRA approaches) might be improved for Indigenous community contexts, including increasing the community relevance of communication tools and incorporating holistic and non-conventional information.
  • OPEN ACCESS
    Unraveling the link between birth order and blood pressure: insights from a comprehensive systematic review and meta-analysis
    FACETS • Vol. 10 • pp. 1 - 8
    The objective of the present systematic review was to incorporate previous studies investigating the association of birth order with the risk of systolic and diastolic blood pressure (DBP). We employed random-effects and Bayesian meta-analyses, complemented by subgroup and sensitivity analyses, including funnel plots, Begg's rank correlation test, Egger's linear regression test, Galbraith plots, and leave-one-out meta-analysis. Of the 13 articles analyzed, 92% (12 articles) were published from 2010 onwards. The aggregate sample comprised 466 853 firstborns and 646 786 later-born individuals. Geographically, the studies were primarily conducted in Europe (54%), followed by Asia (23%), and America (23%). The pooled mean difference for systolic blood pressure (SBP) under a random-effects model was 0.28 mm Hg (95% CI: −7.03 to 7.59), and for DBP was 0.33 mm Hg (95% CI: −5.38 to 6.04), neither of which reached statistical significance (SBP: Z = 0.08, P = 0.939; DBP: Z = 0.11, P = 0.910). Sensitivity analyses supported these findings. Bayesian meta-analysis presented a 95% credible interval for SBP and DBP ranging from −7.25 to 7.84 and −5.60 to 6.27, respectively. The investigation found no substantial evidence of a significant difference in SBP and DBP between firstborns and later-born individuals, challenging the hypothesis that birth order significantly impacts blood pressure levels. ID registration number: 567971.