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Emerging diseases may spread rapidly through dense and large urban contact networks, especially they are transmitted by the airborne route, before new vaccines can be made available. Airborne diseases may spread rapidly as people visit different indoor environments and are in frequent contact with others. We constructed a simple indoor contact model for an ideal city with 7 million people and 3 million indoor spaces, and estimated the probability and duration of contact between any two individuals during one day. To do this, we used data from actual censuses, social behavior surveys, building surveys, and ventilation measurements in Hong Kong to define eight population groups and seven indoor location groups. Our indoor contact model was integrated with an existing epidemiological Susceptible, Exposed, Infectious, and Recovered (SEIR) model to estimate disease spread and with the Wells-Riley equation to calculate local infection risks, resulting in an integrated indoor transmission network model. This model was used to estimate the probability of an infected individual infecting others in the city and to study the disease transmission dynamics. We predicted the infection probability of each sub-population under different ventilation systems in each location type in the case of a hypothetical airborne disease outbreak, which is assumed to have the same natural history and infectiousness as smallpox. We compared the effectiveness of controlling ventilation in each location type with other intervention strategies. We conclude that increasing building ventilation rates using methods such as natural ventilation in classrooms, offices, and homes is a relatively effective strategy for airborne diseases in a large city.

ObjectivesTo examine gender differences in the reporting of, and contributors to, mental health symptoms.MethodsThis was a cross-sectional observational study of adult athletes within a national elite sporting system (n=523; women=292;56%), who completed a battery of assessments including measures of mental health and adverse life events. Group differences across a range of scores were examined, followed by gender-stratified bootstrapped linear regression and meta-regression on measures where gender differences were observed.ResultsWomen athletes reported higher rates of mental health symptoms, and lower rates of mental well-being, although there were no differences in general psychological distress or life satisfaction. Women reported experiencing several adverse life events at higher rates than men; particularly interpersonal conflict, financial hardship and discrimination. Low self-esteem was consistently associated with poorer mental health outcomes for all athletes. While a range of factors were associated with poor mental health in men or women athletes, meta-regression suggested that experiencing financial difficulty and social media abuse were more uniquely associated with mental health symptoms in men.ConclusionGender differences in mental health in elite athletes are apparent. Approaches to increasing well-being are required in elite sport.