Effective Public Health Research Articles

Evaluation of medical professionals’ knowledge about Q fever

Aims: evaluate the medical professionals’ knowledge about Q fever, seeking integrative contributions to public health that may favor the formulation of policies and the development of strategies based on a One Health approach. Methods: this is a cross-sectional and quantitative study with data collection through a structured questionnaire applied face-to-face to physicians from various clinical specialties working at the three levels of health care in Brazil. The questionnaire consisted of 25 questions, seven of which were specific to assessing knowledge about Q fever. Univariate and multivariate logistic regression analyses were conducted to assess whether the variables medical specialty, level of health care in which they work, age range and gender were associated with a correct answer to at least one specific question about Q fever. Results: among the 254 physicians included, 236 (92.9%) were unaware of Q fever. Only three (16.6%) of the 18 who correctly answered at least one specific question about the disease had a score of more than 50%. The highest rates of correct answers for at least one question (p < 0.0001) occurred among the medical specialties most related to clinical signs and symptoms or the differential diagnosis of Q fever and among males. It is highlighted that 85.8% of physicians consider Q fever a neglected and underreported disease in Brazil. Additionally, all physicians responded that they were not aware of the One Health approach. Conclusions: the almost total lack of knowledge among medical professionals regarding Q fever reinforces the need for greater disclosure for this zoonosis with a One Health approach in Medical Schools, in Residency Programs and for physicians in general. In addition, the inclusion of Q fever in the national list of notifiable diseases becomes relevant, allowing a better understanding of its epidemiological situation in Brazil. Finally, effective public health actions must be carried out to avoid underdiagnosis and the development of severe cases of the disease. Methods: this is a cross-sectional and quantitative study with data collection through a structured questionnaire applied face-to-face to physicians from various clinical specialties working at the three levels of health care in Brazil. The questionnaire consisted of 25 questions, seven of which were specific to assessing knowledge about Q fever. Univariate and multivariate logistic regression analyses were conducted to assess whether the variables medical specialty, level of health care in which they work, age range and gender were associated with a correct answer to at least one specific question about Q fever. Results: among the 254 physicians included, 236 (92.9%) were unaware of Q fever. Only three (16.6%) of the 18 who correctly answered at least one specific question about the disease had a score of more than 50%. The highest rates of correct answers for at least one question (p < 0.0001) occurred among the medical specialties most related to clinical signs and symptoms or the differential diagnosis of Q fever and among males. It is highlighted that 85.8% of physicians consider Q fever a neglected and underreported disease in Brazil. Additionally, all physicians responded that they were not aware of the One Health approach. Conclusions: the almost total lack of knowledge among medical professionals regarding Q fever reinforces the need for greater disclosure for this zoonosis with a One Health approach in Medical Schools, in Residency Programs and for physicians in general. In addition, the inclusion of Q fever in the national list of notifiable diseases becomes relevant, allowing a better understanding of its epidemiological situation in Brazil. Finally, effective public health actions must be carried out to avoid underdiagnosis and the development of severe cases of the disease.

Profiling of viral load, antibody and inflammatory response of people with monkeypox during hospitalization: a prospective longitudinal cohort study in China

The dynamics of viral shedding and the specific humoral response against monkeypox virus (MPXV) have not been well characterized in patients across their disease course during hospitalisation. The aim of this study was to determine the viral load and the levels of antibodies against MPXV using longitudinal paired-collected samples from hospitalized patients. Patients who were hospitalised with mpox were recruited at Beijing Ditan Hospital Capital Medical University in China between June 2 and September 23, 2023. Paired samples, including samples from skin lesions, the oropharynx, saliva, faeces, urine, plasma, and serum, were serially collected at days 1, 3, 7, and 14 after admission until discharge. Not all of the patients had samples obtained at all of the timepoints. All the samples were analysed via quantitative PCR. Virus isolation was performed by using clinical samples and Vero cells. The presence of IgM, IgA, IgG, and neutralising antibodies (NAbs) against MPXV was evaluated. The first collected plasma sample was taken when the patient was hospitalised, and the levels of cytokines and chemokines were measured in the sample. The demographic data, smallpox vaccination status, history of known exposure to MPVX, HIV status and other clinical data were collected using a standard case report form. A total of 510 specimens were serially collected from 39 recruited people with mpox. Among all the samples, the skin lesions had the highest viral DNA detection rates and viral loads, and the saliva samples had the second highest rates and viral loads. One day before discharge, 85% of the dry scrabs (median Ct 28.2, range 19.0-38.3) and 70% of the saliva samples (median Ct 32.4, range 24.5-38.1) were positive for viral DNA, Of which, 23.1% of dry scrabs were positive in viral culture. The rate of viral DNA detection in the oropharyngeal, saliva, and faecal samples decreased with time, while the rates in the plasma, serum, and urine samples increased quickly before 10 days post symptom onset (PSO). The median days of appearance of MPXV-IgM, MPXV-IgA, MPXV-IgG, and NAb were at 8(interquartile range [IQR] 7-9), 9 (7-10), 12 (9-15), and 12 (9-15) PSO, respectively. The IgM, IgA, IgG, and NAb titres increased with time. Between days 11 and 21 PSO, the NAb titres were lower in people living with HIV (PWH) than in people living without HIV (PWOH). Increased NAb titres were associated with decreased viral loads in the saliva (r=0.28, p=0.025), faeces (r=0.35, p=0.021), plasma (r=0.30, p=0.0044), and serum samples (r=0.37, p=0.001). Compared with PWOH, PWH had higher plasma levels of MIP-1α, MIP-1β, G-CSF, IL-4, and FGF-basic. The high positive viral culture rate of clinical samples of patients when they are discharged from the hospital indicates that effective public health management strategies are needed for people with mpox. The low NAb titres and high levels of cytokines in PWH shows that earlier treatment is needed to control inflammation in high-risk populations. National Natural Science Foundation of China, Chinese Academy of Medical Sciences, Fundamental Research Funds for the Central Universities for Peking Union Medical College, National Key R&D Program of China.

Genomic surveillance and vaccine response to the dominant SARS-CoV-2 XBB lineage in Rio Grande do Sul

The COVID-19 pandemic has been marked by novel viral variants, posing challenges to global public health. Recombination, a viral evolution mechanism, is implicated in SARS-CoV-2's ongoing evolution. The XBB recombinant lineage, known for evading antibody-mediated immunity, exhibits higher transmissibility without increased disease severity. We investigated the prevalence and genomic features of XBB in SARS-CoV-2-positive cases in Rio Grande do Sul (RS), Brazil. We sequenced 357 samples from epidemiological weeks (EW) 47/2022 to 17/2023, and included 389 publicly available sequences. Clinical and epidemiological data were obtained from DATASUS, e-SUS, and SIVEP GRIPE (data recording systems of the Brazilian Ministry of Health). Of these, 143 were classified as XBB and 586 were other Omicron lineages. In March 2023 (EW 10), XBB became dominant, accounting for 83.3% of cases. 97.7% of XBB-infected patients successfully recovered from the infection, with a low mortality rate (2.3%). Even after receiving three vaccine doses and having been previously infected, 59.5% of the patients experienced reinfection with XBB. However, for 54% of the individuals, the interval between their XBB infection and the last vaccine dose exceeded one year, potentially leading to a decline in antibody levels. In addition, we identified 90 mutations in RS circulating XBB, spread throughout the genome, notably in the Spike protein region associated with immune resistance. This study provides insights into the dynamics and impact of a recombinant variant becoming predominant for the first time in the state. Continued surveillance of SARS-CoV-2 genomic evolution is crucial for effective public health management.

The Role of Nursing in the Management of Chemotherapy Extravasation: A Systematic Review Regarding Public Health.

The scientific literature was reviewed with the aim of analysing the state of the art on the role of nursing in the management of chemotherapy extravasation, recognising the possible risk factors and identifying effective training programmes for nurses. WOS, Scopus, and PubMed databases were used to perform the searches. Papers that met the inclusion criteria and that had been published in the last 9 years were selected. The Effective Public Health Practice Project (EPHPP) instrument was applied to the selected studies. In addition, this research was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: 512480). Out of the 23 initially selected articles, a total of 9 articles were eventually included, since they met the eligibility criteria that were established after a more exhaustive analysis, which included reading their abstracts and full texts. The results show that the management of chemotherapy extravasation is closely related to factors that largely depend on the nursing staff. Among the most relevant findings are factors including the identification of the nursing role in the management of extravasation due to chemotherapy; risk factors; and effective training programmes for nursing. Nurses play a crucial role throughout the entire process of treatment, prevention, and health education in chemotherapy treatment. Training programmes for nurses are fundamental, as they increase their professional competence and improve the safety of the patient. Adequate knowledge of chemotherapy treatment and the risk factors of extravasation are basic elements for the prevention of this type of injury, as well as for the improvement of the quality of life of patients under this kind of intravenous therapy.

Understanding the Transmission Dynamics of the Chikungunya Virus in Africa.

The Chikungunya virus (CHIKV) poses a significant global public health concern, especially in Africa. Since its first isolation in Tanzania in 1953, CHIKV has caused recurrent outbreaks, challenging healthcare systems in low-resource settings. Recent outbreaks in Africa highlight the dynamic nature of CHIKV transmission and the challenges of underreporting and underdiagnosis. Here, we review the literature and analyse publicly available cases, outbreaks, and genomic data, providing insights into the epidemiology, genetic diversity, and transmission dynamics of CHIKV in Africa. Our analyses reveal the circulation of geographically distinct CHIKV genotypes, with certain regions experiencing a disproportionate burden of disease. Phylogenetic analysis of sporadic outbreaks in West Africa suggests repeated emergence of the virus through enzootic spillover, which is markedly different from inferred transmission dynamics in East Africa, where the virus is often introduced from Asian outbreaks, including the recent reintroduction of the Indian Ocean lineage from the Indian subcontinent to East Africa. Furthermore, there is limited evidence of viral movement between these two regions. Understanding the history and transmission dynamics of outbreaks is crucial for effective public health planning. Despite advances in surveillance and research, diagnostic and surveillance challenges persist. This review and secondary analysis highlight the importance of ongoing surveillance, research, and collaboration to mitigate the burden of CHIKV in Africa and improve public health outcomes.

SARS-CoV-2 S1 subunit produces a protracted priming of the neuroinflammatory, physiological, and behavioral responses to a remote immune challenge: A role for corticosteroids

Long COVID is a major public health consequence of COVID-19 and is characterized by multiple neurological and neuropsychatric symptoms. SARS-CoV-2 antigens (e.g., spike S1 subunit) are found in the circulation of Long COVID patients, have been detected in post-mortem brain of COVID patients, and exhibit neuroinflammatory properties. Considering recent observations of chronic neuroinflammation in Long COVID patients, the present study explores the idea that antigens derived from SARS-CoV-2 might produce a long-term priming or sensitization of neuroinflammatory processes, thereby potentiating the magnitude and/or duration of the neuroinflammatory response to future inflammatory insults. Rats were administered S1 or vehicle intra-cisterna magna and 7d later challenged with vehicle or LPS. The neuroinflammatory, physiological, and behavioral responses to LPS were measured at various time points post-LPS. We found that prior S1 treatment potentiated many of these responses to LPS suggesting that S1 produces a protracted priming of these processes. Further, S1 produced a protracted reduction in basal brain corticosteroids. Considering the anti-inflammatory properties of corticosteroids, these findings suggest that S1 might disinhibit innate immune processes in brain by reducing anti-inflammatory drive, thereby priming neuroinflammatory processes. Given that hypocortisolism is observed in Long COVID, we propose that similar S1-induced innate immune priming processes might play role in the pathophysiology of Long COVID.

Ginger Extract-Loaded Chitosan Nanoparticles: Investigating their Impact on Lipid Metabolism and Obesity in a Rat Model through In vitro and In vivo Analysis.

Obesity has become a pressing global health crisis, reaching alarming proportions and bearing significant consequences for public health on a global scale. In this research, chitosan nanoparticles were employed to encapsulate ginger extract, and the impact of this formulation on lipid metabolism and obesity was investigated using a rat model. In vitro experiments, encompassing assessments of cell viability, microstructure, anti-inflammatory activity, and release dynamics, were conducted to comprehensively evaluate the nanoformulation. The study extended to examining the potential anti-obesity efficacy of the developed nanoformulation in rats induced with obesity through a high-fat diet. In vitro findings affirmed the safety of the carriers and revealed their robust anti-inflammatory properties. The average particle size for ginger-loaded and ginger-free chitosan nanoparticles was measured to be 458.92 ± 139.35 nm and 466.29 ± 142.71 nm, respectively. The in vivo investigation demonstrated the dose-dependent effects of ginger extract-loaded chitosan nanoparticles, manifesting in a reduction of obesity and improvement in liver function. These promising results suggest that the developed nanoformulation could be considered a viable therapeutic option for individuals struggling with obesity.

Real-time forecast of temperature-related excess mortality at small-area level: towards an operational framework

The development of innovative tools for real-time monitoring and forecasting of environmental health impacts is central to effective public health interventions and resource allocation strategies. Though a need for such generic tools has been previously echoed by public health planners and regional authorities responsible for issuing anticipatory alerts, a comprehensive, robust and scalable real-time system for predicting temperature-related excess deaths at a local scale has not been developed yet. Filling this gap, we propose a flexible operational framework for coupling publicly available weather forecasts with temperature-mortality risk functions specific to small census-based zones, the latter derived using state-of-the-art environmental epidemiological models. Utilising high-resolution temperature data forecast by a leading European meteorological centre, we demonstrate a real-time application to forecast the excess mortality during the July 2022 heatwave over England and Wales. The output, consisting of expected temperature-related excess deaths at small geographic areas on different lead times, can be automated to generate maps at various spatio-temporal scales, thus facilitating preventive action and allocation of public health resources in advance. While the real-case example discussed here demonstrates an application for predicting (expected) heat-related excess deaths, the framework can also be adapted to other weather-related health risks and to different geographical areas, provided data on both meteorological exposure and the underlying health outcomes are available to calibrate the associated risk functions. The proposed framework addresses an urgent need for predicting the short-term environmental health burden on public health systems globally, especially in low- and middle-income regions, where rapid response to mitigate adverse exposures and impacts to extreme temperatures are often constrained by available resources.

Differences between non-obese and obese patients with hypertension according to gender

Abstract Introduction In recent years, obesity has escalated markedly, emerging as a one of major worldwide health issue. The frequency of obesity in both adults and children is rising at an alarming rate, leading to severe consequences for public health. The World Health Organization (WHO) reports that as much as 13% of the global population is grappling with obesity. Numerous research studies have established that obesity not only heightens the risk of cardiovascular diseases (CVD) including hypertension, coronary heart disease, and heart failure, but also exacerbates complications in individuals already suffering from these conditions. Purpose The aim of this study was to retrospectively analyze the differences between non-obese and obese patients admitted to the cardiology department due to hypertension according to gender. Methods We performed a retrospective analysis of 486 medical records of patients who had been admitted to the Institute of Heart Diseases of the University Clinical Hospital in Wroclaw (Poland) between January 2017 and June 2021. The study group was divided in two ways. The division of patients was into one of two groups based on the following cut-off BMI values: non-obese (BMI < 30) and obese (BMI ≥ 30). The study was conducted following the principles of the Declaration of Helsinki and approved by the independent Bioethics Committee of Wroclaw Medical University, protocol no. KB-837/2022. The significance level for all statistical tests was set to 0.05. R 4.3.0. was used for computations. Results Women accounted for 53% of the study group and were significantly older than men (64.7±12.8 vs. 60.5±11.8, p=0.466). Women with obesity had significantly higher triglycerides (TG), high-sensitivity C-reactive protein and thyroid-stimulating hormone concentrations and significantly lower high-density lipoprotein (HDL) concentrations than women who were not affected by obesity. Men with obesity had significantly higher TG levels, lower HDL levels, more more frequent to have diabetes (DM) and less frequent stroke in the past compared to men without obesity. (Table 1 and 2) Conclusions This study highlights important differences between patients with hypertension without and with obesity, with notable gender differences. Women with obesity showed differences only in laboratory test results, while men with obesity showed differences in laboratory test results and comorbidities. These findings emphasize the need for gender-specific management strategies and research in hypertension and obesity, underscoring the distinct cardiovascular risks associated with obesity in both genders.

Effect of School-Based Educational Intervention on Childhood Obesity in Croatian Urban and Rural Settings.

Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based "PETICA-Play for Health" obesity prevention program in urban and rural areas in Croatia. This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. "PETICA" multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student's t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman's correlation, and heatmaps were used. The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents' and children's physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models. The study shows that "PETICA" is an efficient school-based educational model that contributes to positive changes in children's knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention.

From Likes to Lifestyle: Predicting the Impact of Following Fitness Influencers on the Adoption of Healthy Habits in Saudi Arabia.

The increasing popularity of fitness influencers on social media has the potential to significantly impact public health by promoting healthy behaviors. Understanding how these influencers affect the adoption of healthy habits among Saudi residents can provide insights into effective public health strategies. This study aims to quantitatively assess the influence of following fitness influencers on social media on adopting healthy behaviors among Saudi residents, focusing on socio-demographic factors, characteristics of influencers, and participants' perceptions. A descriptive, cross-sectional study with an analytical component was carried out from March 25, 2023, to August 15, 2023. The study included Saudi residents aged 18 and older who actively follow fitness influencers. Data was gathered through an online questionnaire and analyzed using descriptive statistics, Pearson's chi-square test, and logistic regression analyses to identify factors associated with positive health outcomes. The study included 561 participants, revealing that marital status and residential region significantly influenced the adoption of healthy habits, with married participants and those from the Southern and Central regions more likely to report positive outcomes. Notably, engagement in physical activity more than three times a week and adherence to a healthy diet were strongly associated with positive health outcomes (p<0.05). Analysis of influencer characteristics showed that following fewer than 10 influencers and being unaware of their follower count were predictors of positive results with p<0.05. Specifically, 76.6% of participants experienced positive results after following health advice from social media, highlighting the impactful yet complex role of influencers in shaping health behaviors. Logistic regression analyses underscored the significance of socio-demographic factors, influencer characteristics, and participant perceptions in predicting the likelihood of experiencing positive health outcomes. Following fitness influencers on social media can positively impact the adoption of healthy habits, moderated by socio-demographic factors and influencer characteristics.

Improving prevention and early detection of sepsis among patient groups at risk: Introducing a model for a multimodal information campaign-The SepWiss study protocol.

Sepsis is a life-threatening organ dysfunction due to a dysregulated host response to infection. Annually, sepsis leads to approx. 90.000 deaths in Germany. Risk factors include amongst others older age (>60), innate or acquired dysfunction of the immune system, and underlying chronic diseases of the lung, heart, liver, or kidneys. The manifestation of sepsis is a medical emergency, and patient outcomes depend on timely diagnosis and immediate treatment. In addition, vaccinations e.g., against pneumococci or influenza virus, are a highly effective public health tool to prevent the most common underlying infections that may lead to sepsis. However, a lack of public awareness for the relevance of vaccination and detecting sepsis as an emergency underlines the need for public health interventions that address these issues. SepWiss aims to evaluate the effects of a multimodal information campaign designed to address this lack of awareness among the risk population in Germany. SepWiss is an intervention at state level, consisting of a multimodal information campaign targeting risk groups in the German federal states of Berlin and Brandenburg (intervention region). Based on available evidence, various information formats were developed and implemented by outdoor advertising, social media, educational formats and through stakeholders' platforms, starting in August 2021. The control region comprises of the remaining 14 German federal states. We will analyze vaccination coverage (primary outcome), and sepsis knowledge, the ability to detect sepsis as an emergency, and attitude towards vaccination (secondary outcomes) amongst the risk population in a controlled before-after comparison. The implementation is accompanied by a mixed-method process evaluation. SepWiss is the first project of its kind to evaluate a complex multi-faceted evidence-based information campaign with regards to the topics of vaccination coverage, and the importance of sepsis detection and prevention for the most vulnerable populations in Germany. Results will be valuable for informing further nationwide campaigns. German Registry for Clinical Trials: DRKS00024475. Registered February 24th, 2021.

What would John do? COVID-19 stigmatization, social distance and race

ABSTRACT Like many infectious diseases, COVID-19 is a heavily stigmatized and racialized health condition. The objective of the present study was to examine racial differences in COVID-19 stigmatization. To assess the intersection between COVID-19 stigmatization and race, we asked 568 individuals to respond to hypothetical vignettes, using a web-based survey. We presented respondents with the vignette of John, an individual infected with COVID-19 with an unspecified race, and asked them to predict how likely John might be to experience COVID-19 stigmatization. We then asked respondents to predict John’s COVID-19 stigmatization if he was Black, Chinese or Hasidic (Jewish). The study followed a 3 × 3 factorial design where there were 3 race/ethnicity groups for participants (Asian, Black, White) and 3 race/ethnicity groups for the vignette character (Chinese, Black, Hasidic). Our main findings were: (1) respondents believed that John would experience more internal shame and external problems if he was Chinese or Hasidic; (2) Black respondents believed that John would experience more external problems at work/home if John was Black; (3) Black respondents were also less likely to expect John to disclose his COVID-19 status to friends, family and neighbors; and (4) New York City residents were less likely to engage in social distancing with John. By understanding racialized perceptions about COVID-19 among diverse racial groups, we can design effective public health campaigns that do not reinforce racialized stigma.

Innovative approaches to microbial identification enhancing accuracy and speed in infectious disease diagnostics

The rapid and accurate identification of microbial pathogens is crucial for effective management of infectious diseases. Traditional methods, though reliable, are often time-consuming. Recent advancements in molecular diagnostics, mass spectrometry, and next-generation sequencing (NGS) have revolutionized the field by enhancing both the speed and accuracy of microbial identification. Polymerase chain reaction (PCR) and its derivatives, such as real-time PCR, enable rapid amplification of genetic material, significantly reducing diagnostic times. Techniques like nucleic acid sequence-based amplification (NASBA) and loop-mediated isothermal amplification (LAMP) further extend these capabilities to resource-limited settings by operating at constant temperatures. Mass spectrometry, particularly matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF), provides rapid and accurate microbial identification by analyzing protein profiles. This method has high throughput, is cost-effective, and offers the ability to detect antimicrobial resistance, significantly impacting clinical decision-making and patient management. NGS technologies offer comprehensive pathogen detection by sequencing entire microbial genomes. This approach is invaluable in diagnosing complex infections, tracking outbreaks, and identifying antibiotic resistance genes, though its high cost and complexity limit widespread use. The integration of these innovative technologies into clinical practice enhances the ability to diagnose and manage infectious diseases effectively. Molecular diagnostics, mass spectrometry, and NGS each bring unique strengths, from rapid and precise pathogen detection to comprehensive genetic analysis and resistance profiling. These advancements contribute to improved patient outcomes and more effective public health strategies. The continued development and implementation of these technologies are essential to address the evolving challenges in microbial diagnostics, paving the way for more precise and personalized approaches in infectious disease management.

Costly, confusing, polarizing, and suspect: public perceptions of plant- based eating from a thematic analysis of social media comments

IntroductionA key approach to fostering more sustainable food systems involves shifting dietary patterns towards increased plant-based eating. However, plant-based eating remains low among Canadians. The objective of this research was therefore to explore public perceptions of plant-based eating in a Canadian context.MethodsA qualitative design was used to analyze social media comments posted on Canadian news source Facebook articles between January 16th, 2019 – July 16th, 2020. Investigating perceptions of plant-based eating on social media may capture a broader sample of the population than can be captured using other qualitative methods. Template analysis, a type of codebook thematic analysis, was used to generate themes and subthemes using NVivo software.ResultsNine articles were selected for inclusion and a total of n = 4,918 comments were collected. Five themes and 19 subthemes related to plant-based eating were generated and presented with quotations. Themes included: (1) The ethics of food; (2) The affordability and accessibility of food; (3) Distrust of food system stakeholders; (4) Beliefs related to dietary behavior, health, and the environment; and (5) Sensory aspects of plant-based proteins.DiscussionFindings suggest that addressing food affordability and accessibility, increasing public food literacy, using non-judgmental approaches, and increasing food system transparency and communication may be strategies to foster plant-based eating. Results of this study provide insight for the development of more effective public health messaging about plant-based eating and help inform future research and interventions to address barriers related to plant-based eating and promote consumption.

MGLEP: Multimodal Graph Learning for Modeling Emerging Pandemics with Big Data

Accurate forecasting and analysis of emerging pandemics play a crucial role in effective public health management and decision-making. Traditional approaches primarily rely on epidemiological data, overlooking other valuable sources of information that could act as sensors or indicators of pandemic patterns. In this paper, we propose a novel framework, MGLEP, that integrates temporal graph neural networks and multi-modal data for learning and forecasting. We incorporate big data sources, including social media content, by utilizing specific pre-trained language models and discovering the underlying graph structure among users. This integration provides rich indicators of pandemic dynamics through learning with temporal graph neural networks. Extensive experiments demonstrate the effectiveness of our framework in pandemic forecasting and analysis, outperforming baseline methods across different areas, pandemic situations, and prediction horizons. The fusion of temporal graph learning and multi-modal data enables a comprehensive understanding of the pandemic landscape with less time lag, cheap cost, and more potential information indicators.

Development and validation of the Environmental Confinement Stressors Scale (ECSS-20).

The COVID-19 pandemic has generated a global crisis with severe consequences for public health. There have been negative impacts on people's quality of life and mental health due to various stressors arising in this context, such as physical, social, economic, and psychological challenges. Noteworthy among these are the indirect effects of health measures, especially social distancing and confinement, which have significantly altered people's daily lives and social activities, producing high levels of anxiety, depression, and stress. This study proposes developing and validating a cross-sectional scale called the "Environmental Stressors Scale (ECSS-20)" to address the need to measure the impact of environmental stressors during confinement. The scale, which has been validated following ethical and methodological guidelines, consists of four dimensions: economic stressors (EE), social activities (SA), habitability (H), and exposure to virtual media (EMV). A pilot study (n = 113) and a main study (n = 314) were applied. The results showed that the instrument has a reliable and valid structure, with satisfactory internal consistency and factorial validity. Likewise, gender invariance tests supported its suitability for its applicability to women and men. Overall, the ECSS-20 is a valuable instrument for assessing the impact of confinement and improving the understanding of people's subjective experiences in this situation. Future research could further develop its applicability in different contexts and populations to better understand its usefulness and psychometric properties.

Food security among black breast cancer survivors in Maryland: insights from an online pilot study.

Food security, and reliable access to nutritious food, is essential for maintaining health yet remains elusive for many, including U.S. patients with breast cancer (BC). Research specifically focusing on public health consequences of food insecurity in BC survivors is limited. We addressed this gap by exploring the relationship between food security and various sociodemographic, clinical, and cancer-related factors among Black BC survivors in Maryland. The parent study engaged Black female BC survivors in Maryland through digital campaigns and referrals, achieving 100 completed surveys. Food security was assessed through an online follow-up survey with the six-item short form from U.S. Department of Agriculture (USDA), leading to a binary classification for analysis from raw scores. Statistical analysis involved descriptive analysis and Chi-square tests to explore the relationship between food security status, various BC risk factors, and follow-up survey response status. Of the 31 participants who participated in the follow-up survey, 11 (35.5%) were categorized as having low food security. We observed significant associations between food security status and both income (< $40,000; chi-square p = 0.004) and education levels (high school/GED; chi-square p = 0.004). In comparing respondents to non-respondents, significant differences in employment (p = 0.031) and health insurance status (p = 0.006) were observed. Our descriptive findings demonstrate the importance of further studies evaluating food security screenings in Black BC survivors to enable targeted interventions aiming to improve overall health outcomes and equity in cancer survivorship care.

Effectiveness of Harm Reduction Interventions in Chemsex: A Systematic Review.

A systematic review of the scientific literature related to harm and risk reduction strategies and the effectiveness of chemsex interventions. Between January 2024 and May 2024, the articles were retrieved from the electronic databases Pubmed, Web of Science, Scopus, PsycInfo, Cochrane, Dialnet, CUIDEN, and SciELO. The review protocol was registered in the PROSPERO database (registration number CRD42024508953). The inclusion criteria were as follows: (I) original studies published in peer-reviewed journals, (II) studies exploring harm reduction interventions for chemsex, and (III) studies reflecting the efficacy of harm reduction interventions for chemsex. Two reviewers independently selected articles by title, abstract, and full paper review and extracted data. Two authors described the selected studies and assessed their methodological quality. The systematic review comprised six scientific papers that met the selection criteria and were obtained from five countries. Although a limited number of studies were included, it was observed that they presented a medium-high methodological quality. Programs evaluated interventions to reduce harm from chemsex, such as a web-based intervention that improved self-efficacy to refuse risky behaviors and accept HIV testing. The studies suggested that peer-led programs can be effective, especially with facilitators who have experienced chemsex dependence. Harm reduction strategies in chemsex are effective and should be promoted by health professionals. Interventions should be accessible, personalized, and non-judgmental to provide appropriate care and support, ensuring a comprehensive and effective public health response.

Maternal Malaria and the Risk of Subsequent Pregnancy Complications

Maternal malaria, primarily caused by Plasmodium falciparum, has well-documented immediate effects on pregnancy, including preterm birth, low birth weight, and placental dysfunction. However, its impact extends beyond the current pregnancy, potentially influencing outcomes in subsequent pregnancies. This review examines how maternal malaria affects future pregnancies, focusing on the mechanisms through which previous malaria infections contribute to subsequent complications. Key mechanisms include chronic placental damage, immune system alterations, and persistent inflammation, which can disrupt placental function and increase the risk of adverse outcomes such as preterm labor and placental abruption in future pregnancies. The review highlights evidence that women with a history of maternal malaria are at an elevated risk for complications in subsequent pregnancies, including an increased likelihood of preterm birth and low birth weight. Persistent placental damage and immune dysregulation resulting from past malaria infections contribute to these risks. Understanding these long-term effects is crucial for developing effective public health strategies and interventions aimed at mitigating the risks of adverse pregnancy outcomes in malaria-endemic regions. Keywords: Maternal malaria, Plasmodium falciparum, pregnancy complications, placental damage, immune dysregulation, chronic inflammation, preterm birth