Public Health Prevention Efforts Research Articles

Cardiovascular Disease Risk Factor Control Following Release From Carceral Facilities: A Cross-Sectional Study.

Incarceration is a social determinant of cardiovascular health but is rarely addressed in clinical settings or public health prevention efforts. People who have been incarcerated are more likely to develop cardiovascular disease (CVD) at younger ages and have worse cardiovascular outcomes compared with the general population, even after controlling for traditional risk factors. This study aims to identify incarceration-specific factors that are associated with uncontrolled CVD risk factors to identify potential targets for prevention. Using data from JUSTICE (Justice-Involved Individuals Cardiovascular Disease Epidemiology), a prospective cohort study of individuals released from incarceration with CVD risk factors, we examine the unique association between incarceration-specific factors and CVD risk factor control. Participants (N=471), with a mean age of 45.0±10.8 (SD) years, were disproportionately from racially minoritized groups (79%), and poor (91%). Over half (54%) had at least 1 uncontrolled CVD risk factor at baseline. People released from jail, compared with prison, had lower Life's Essential 8 scores for blood pressure and smoking. Release from jail, as compared with prison, was associated with an increased odds of having an uncontrolled CVD risk factor, even after adjusting for age, race and ethnicity, gender, perceived stress, and life adversity score (adjusted odds ratio 1.62 [95% CI, 1.02-2.57]). Release from jail is associated with poor CVD risk factor control and requires tailored intervention, which is informative as states design and implement the Centers of Medicare & Medicaid Services Reentry 1115 waiver, which allows Medicaid to cover services before release from correctional facilities.

Pediatric sport and nonsport concussions presenting to emergency departments: injury circumstances, characteristics, and clinical management.

The aim of this study was to compare injury circumstances, characteristics, and clinical management of emergency department (ED) presentations for sports-related concussion (SRC) and non-SRC. This multicenter prospective observational study identified patients 5-17 years old who presented to EDs within 24 hours of head injury, with one or more signs or symptoms of concussion. Participants had a Glasgow Coma Scale score of 13-15 and no abnormalities on CT (if performed). Data were stratified by age: young children (5-8 years), older children (9-12 years), and adolescents (13-17 years). Of 4709 patients meeting the concussion criteria, non-SRC accounted for 56.3% of overall concussions, including 80.9% of younger child, 51.1% of older child, and 37.0% of adolescent concussions. The most common mechanism of non-SRC was falls for all ages. The most common activity accounting for SRC was bike riding for younger children, and rugby for older children and adolescents. Concussions occurring in sports areas, home, and educational settings accounted for 26.2%, 21.8%, and 19.0% of overall concussions. Concussions occurring in a sports area increased with age, while occurrences in home and educational settings decreased with age. The presence of amnesia significantly differed for SRC and non-SRC for all age groups, while vomiting and disorientation differed for older children and adolescents. Adolescents with non-SRC were admitted to a ward and underwent CT at higher proportions than those with SRC. Non-SRC more commonly presented to EDs overall, with SRC more common with increasing age. These data provide important information to inform public health policies, guidelines, and prevention efforts.

The structure and function of FUN14 domain-containing protein 1 and its contribution to cardioprotection by mediating mitophagy.

Cardiovascular disease (CVD) is a serious public health risk, and prevention and treatment efforts are urgently needed. Effective preventive and therapeutic programs for cardiovascular disease are still lacking, as the causes of CVD are varied and may be the result of a multifactorial combination. Mitophagy is a form of cell-selective autophagy, and there is increasing evidence that mitophagy is involved in cardioprotective processes. Recently, many studies have shown that FUN14 domain-containing protein 1 (FUNDC1) levels and phosphorylation status are highly associated with many diseases, including heart disease. Here, we review the structure and functions of FUNDC1 and the path-ways of its mediated mitophagy, and show that mitophagy can be effectively activated by dephosphorylation of Ser13 and Tyr18 sites, phosphorylation of Ser17 site and ubiquitination of Lys119 site in FUNDC1. By effectively activating or inhibiting excessive mitophagy, the quality of mitochondria can be effectively controlled. The main reason is that, on the one hand, improper clearance of mitochondria and accumulation of damaged mitochondria are avoided, and on the other hand, excessive mitophagy causing apoptosis is avoided, both serving to protect the heart. In addition, we explore the possible mechanisms by which FUNDC1-mediated mitophagy is involved in exercise preconditioning (EP) for cardioprotection. Finally, we also point out unresolved issues in FUNDC1 and its mediated mitophagy and give directions where further research may be needed.

A mutation associated with resistance to synthetic pyrethroids is widespread in US populations of the tropical lineage of Rhipicephalus sanguineus s.l

The brown dog tick, Rhipicephalus sanguineus sensu lato (s.l.), is an important vector for Rickettsia rickettsii, causative agent of Rocky Mountain spotted fever. Current public health prevention and control efforts to protect people involve preventing tick infestations on domestic animals and in and around houses. Primary prevention tools rely on acaricides, often synthetic pyrethroids (SPs); resistance to this chemical class is widespread in ticks and other arthropods. Rhipicephalus sanguineus s.l. is a complex that likely contains multiple unique species and although the distribution of this complex is global, there are differences in morphology, ecology, and perhaps vector competence among these major lineages. Two major lineages within Rh. sanguineus s.l., commonly referred to as temperate and tropical, have been documented from multiple locations in North America, but are thought to occupy different ecological niches. To evaluate potential acaricide resistance and better define the distributions of the tropical and temperate lineages throughout the US and in northern Mexico, we employed a highly multiplexed amplicon sequencing approach to characterize sequence diversity at: 1) three loci within the voltage-gated sodium channel (VGSC) gene, which contains numerous genetic mutations associated with resistance to SPs; 2) a region of the gamma-aminobutyric acid-gated chloride channel gene (GABA-Cl) containing several mutations associated with dieldrin/fipronil resistance in other species; and 3) three mitochondrial genes (COI, 12S, and 16S). We utilized a geographically diverse set of Rh sanguineus s.l. collected from domestic pets in the US in 2013 and a smaller set of ticks collected from canines in Baja California, Mexico in 2021. We determined that a single nucleotide polymorphism (T2134C) in domain III segment 6 of the VGSC, which has previously been associated with SP resistance in Rh. sanguineus s.l., was widespread and abundant in tropical lineage ticks (>50 %) but absent from the temperate lineage, suggesting that resistance to SPs may be common in the tropical lineage. We found evidence of multiple copies of GABA-Cl in ticks from both lineages, with some copies containing mutations associated with fipronil resistance in other species, but the effects of these patterns on fipronil resistance in Rh. sanguineus s.l. are currently unknown. The tropical lineage was abundant and geographically widespread, accounting for 79 % of analyzed ticks and present at 13/14 collection sites. The temperate and tropical lineages co-occurred in four US states, and as far north as New York. None of the ticks we examined were positive for Rickettsia rickettsii or Rickettsia massiliae.

Comparing the interactions of risk factors by method of suicide among veterans: A moderated network analysis approach.

Despite the well-established link between firearm access and suicide, less is known about other variables that may influence the risk for death by self-inflicted gunshot versus other methods of suicide. As individual factors have demonstrated limited predictive ability, scholars have called for studies that consider the multifaceted relations between myriad variables. One alternative to the typical cause-and-effect approach for investigating various forms of psychopathology is network analysis. However, few studies have applied this method to suicidal outcomes, particularly in the context of a veteran population. Data from 19,234 male veteran suicide decedents (89.1% White; Mage = 57.16, SD = 18.64) acquired from the National Violent Death Reporting System were used to investigate characteristics of veteran suicide decedents who died by self-inflicted gunshot (gun; 66.4%) versus alternative methods (nongun, e.g., poisoning, hanging; 33.5%). Results of the overall moderated network model indicated that veterans in the gun group were more likely to have a physical health problem that contributed to the suicide than veterans in the nongun group. Additionally, results of the moderated network model revealed several pairs of associated circumstances whose relationships were significantly moderated by method of suicide, the three strongest of which included having a physical health problem that contributed to the suicide. Overall, results suggest that public health prevention and intervention efforts aimed at reducing the overall burden of physical health problems among male veterans may mitigate the risk of firearm suicides. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Screening for High-Risk Human Papillomavirus Reveals HPV52 and HPV58 among Pediatric and Adult Patient Saliva Samples.

Previous research has demonstrated that the human papillomavirus (HPV) can infect a wide range of human tissues, including those within the oral cavity. High-risk oral HPV strains have been associated with the development and progression of oral cancers, including oral squamous cell carcinomas. Although many studies have examined the prevalence of the high-risk strains HPV16 and HPV18, far fewer have assessed the prevalence of other high-risk HPV strains. An approved study protocol was used to identify HPV52 and HPV58 among clinical samples (n = 87) from a saliva biorepository. Quantitative polymerase chain reaction (qPCR) and validated primers for HPV52 and HPV58 were used to facilitate this screening. This screening demonstrated that a total of n = 4/45 or 8.9% of adult saliva samples harbored high-risk HPV52, and n = 2/45 or 4.4% tested positive for high-risk HPV58. In addition, a total of n = 6/42 or 14.3% of the pediatric saliva samples tested positive for high-risk HPV, including n = 5/42 or 11.9% with HPV52 and n = 3/42 or 7.1% for HPV58. These data demonstrate the presence of the high-risk oncogenic HPV52 and HPV58 strains among both adult and pediatric clinical patient samples. More detailed longitudinal research must be conducted to determine whether this prevalence may be increasing or decreasing over time. In addition, these data strongly support public health prevention efforts, such as knowledge and awareness of the nine-valent HPV vaccine covering additional high-risk strains, including HPV52 and HPV58.

Severe disability and self-reported depression and anxiety among persons living with Type 2 diabetes in Canada

BackgroundThis study aims to estimate the national prevalence of self-reported depression and anxiety disorders among persons living with Type 2 diabetes in Canada, as well as to investigate the potential link between disability severity and these conditions. MethodsWe conducted a cross-sectional analysis of a subsample (N=8,321) of participants living with Type 2 diabetes in the 2017-2018 Canadian Community Health Survey-Annual Component. Modified Poisson regression models were used to examine the association between disability severity and depression and anxiety disorders. Descriptive statistics, prevalence estimates, adjusted relative risk, and 95% confidence intervals are reported. All statistical analyses were conducted using STATA version 18. ResultsThe prevalence of depression and anxiety were 12.4% and 10.1% respectively. Our study found disability severity as a strong risk factor for both psychiatric disorders. We also found (1) dissatisfaction with life, (2) extremely stressful life events, (3) being female (4) single or never married, (5) poor self-rated health, (6) obesity, and (7) current smoker as significant risk factors for both psychiatric disorders. Conversely, increasing age and higher annual personal income status were significant protective factors. LimitationsThe study's limitations include the inability to establish temporal connections between risk factors and psychiatric disorders due to the cross-sectional design and the exclusion of those living in remote parts of the country and others from participation in the survey, which may underestimate the prevalence of Type 2 diabetes and severe disability. ConclusionsThis study's findings point toward a growing demand for tertiary prevention to increase the probability for those living with Type 2 diabetes in Canada of maintaining functional health, improving mental health, and having a better quality of life. Public health prevention efforts targeted at decreasing the prevalence of diabetes and its complications and disability severity are recommended.

Risk Burden of Heat-Related Morbidity Due to Urban Heat Island Effect in Tamalanrea District, Makassar

One of the problems in the urban environment is the rise in land surface temperature and heat buildup (Urban Heat Island) around built-up areas. People living in UHI areas will experience an increased risk of health burdens. Therefore, early identification for disaster mitigation is needed to achieve a sustainable city. This study aims to provide an overview of the risk of the spread of heat-related diseases based on the relative risk value in Tamalanrea District. This study considers the relationship between Land Surface Temperature (LST) values in 2019, 2020, and 2021 with the incidence of heat-related diseases obtained from the Integrated Health Center Recording and Reporting System (IHCRRS) in Tamalanrea District, Makassar City in 2019, 2020 and 2021. Data analysis used Pearson correlation test and Standardized Morbidity Ratio (SMR) epidemiological approach. The results showed a significant relationship between LST values and the incidence of hypertension, heart disease, and asthma in 2019 and the incidence of headache and hypertension in 2021. Bira and Kapasa sub-districts were at the highest risk for the spread of heat-related diseases than other sub-districts with a risk score > 4.00 (very high). These findings can be used to help guide public health interventions and preventive urban planning efforts.

Analysis of Efforts to Achieve Performance-Based Capitation Indicators Talang Banjar Public Health Center

Introduction: Performance-Based Capitation Policy is an effort to ensure FKTP performance to improve satisfaction, service quality and cost efficiency. Preliminary study, the capitation payment of the Talang Banjar Public Health Center in 2022 is only 88% with the achievement of AK 64.93 per mile, RRNS 2.12%, and RPPT 0.55%. Objective: This study aims to analyze efforts to achieve KBK indicators at Talang Banjar Public Health Center based on input and process aspects. Method: This research is qualitative research with a descriptive approach with data collection using observation, document review and in-depth interviews with 15 informants who were selected by purposive sampling. Result and Discussion: The results show that the achievement of KBK Public Health Center indicators is influenced by available inputs, namely health human resources, infrastructure, funds, and methods. The process aspect shows obstacles to achieving contact number indicators, namely difficulties in Public Health Center accessibility, promotional and preventive efforts that are not optimal, as well as reporting healthy visits, non-specialist referral indicators are influenced by the behavior of patients who want to be referred and the availability of medical devices, while controlled prolanist indicators are influenced by the difficulty of routine monitoring of officers to participants. Conclusion: A thorough evaluation is needed from BPJS Kesehatan, Dinas Kesehatan and Public Health Center leaders to identify problems that arise in achieving performance indicators as an effort to ensure the quality of service to NHI participants

COVID-19 vaccination attitudes across the European continent

This study was conducted to determine the predictors of COVID-19 vaccination attitudes across multiple waves in seven countries geographically spread across the European continent, using data from a COVID-19 survey provided by the Massachusetts Institute of Technology COVID-19. Facebook users from across the globe participated in this survey which collected information on their knowledge of COVID-19, attitudes towards risk and available information, and their willingness or lack thereof to take the vaccine. In this secondary data analysis study, neural networks were used with special attention given to the importance of the predictors of COVID-19 vaccination attitudes. Perception of social norms regarding COVID-19 vaccination was found to be the most important predictor of vaccine acceptance. Country of residence and wave of data collection were among the important predictors, with different patterns for each country emerging across different waves. Other strong predictors included attitudes towards masks and mask wearing; attitudes towards the influenza vaccine; distrust in government health authorities and scientists; and level of knowledge of existing treatments for COVID-19. The results of this study can inform effective public health prevention and intervention efforts against infectious diseases.

Investigating the association between socioeconomic and agricultural risk factors and the incidence of Salmonella Heidelberg and Salmonella Typhimurium in Ontario in 2015: A multi-level ecological approach.

The incidence of salmonellosis, and other enteric zoonotic diseases, has been associated with various food and environmental exposures and socioeconomic factors. Increasingly, there is interest in exploring differences among serotypes of Salmonella to better inform public health prevention efforts. Consequently, we investigated whether rates of Salmonella Heidelberg and Typhimurium in Ontario communities in 2015 were influenced by household characteristics, agricultural factors, and the presence of meat plants. Data for each reported case of S. Heidelberg and S. Typhimurium in Ontario in 2015 were collected. Expected cases of each serotype were calculated, stratified by age group and sex, according to the underlying population distribution from the Canadian census. Socioeconomic, agricultural census data, and data concerning provincial and federally inspected meat plants were combined with observed and expected case counts. The association between community-level agricultural, meat processing, and socioeconomic variables, serotype, and the rate of salmonellosis in each census subdivision (CSD) was explored using multilevel Poisson models, with random intercepts for CSD and census division (CD). Rates of S. Heidelberg and S. Typhimurium were associated with the proportion of married individuals in a CSD, and were higher in CSDs with the highest quantile of labour participation compared to those in the lowest quantile. There was an interaction effect between cattle, poultry and swine farm density in a CD and serotype, with rates of either serotype decreasing as cattle, poultry, or swine farm density in the encompassing CD increased. The rate of the decrease varied by serotype. Our findings concerning community-level household characteristics may be explained by the influence of family structure and occupation on food consumption patterns and environmental exposures. Rates of S. Heidelberg and S. Typhimurium may be lower in areas with increased animal farm density due to naturally acquired immunity from routine exposure to Salmonella via livestock.

Intersections of Racial/Ethnic and Religious Identities on Bodily Well-Being for Black College-Attending Emerging Adults.

Black undergraduates face threats to healthy weight and body image (i.e., bodily well-being). Having a strong racial/ethnic identity can promote health during emerging adulthood. However, less is known about the intersections of racial/ethnic and religious identities on the bodily well-being of Black college-attending emerging adults, despite evidence to indicate that aspects of religiosity are also associated with health. We use quantitative data from 767 Black college-attending emerging adults in the Multi-University Study of Identity and Culture to examine the independent contributions of racial/ethnic and religious identity for bodily health, and test a potential interaction between racial/ethnic and religious identity on bodily health outcomes. Results from a multivariate linear regression model indicate that Black college-attending emerging adults with both high religious identity and high racial/ethnic identity exploration had higher body mass index and less positive body image. Findings suggest ways to strengthen the development of culturally appropriate public health prevention and intervention efforts that target body image and weight for Black college-attending emerging adults. IMPACT STATEMENT: Black college-attending emerging adults face challenges to their health, particularly threats to healthy weight and body image during this period of psychosocial transitions. The developmental process of navigating racial/ethnic and religious identities during this time raises challenges and opportunities for health promotion for this population. Yet, research that explores the role of these identities remains scarce. We found that Black college-attending emerging adults had higher body mass index and more negative body image when they reported more racial/ethnic identity exploration coupled with higher religious identities. Results shed light on the complex ways that navigating both racial/ethnic and religious identities may put some Black college-attending emerging adults at greater health risk. Health education and promotion practice focused on improving Black emerging adult health in college contexts should ensure that behavioral interventions are appropriately nuanced and situated in these populations' developmental and cultural considerations.

Reactions to a Hypothetical Menthol Cigarette Ban among Sexual- and Gender-Minoritized Communities: A Concept Mapping Study.

Menthol cigarette use is disproportionately higher among sexual- and gender-minoritized (SGM; 36%) individuals compared to cisgender, heterosexual (29%), individuals. The FDA has announced intentions to ban menthol in cigarettes, citing these use and health disparities as partial motivation. This study identified potential outcomes of a menthol cigarette ban among SGM individuals who smoke menthol cigarettes (N = 72). Potential outcomes were identified via concept mapping using the prompt: "If menthol in cigarettes was banned, a specific action I would take related to my tobacco use is…" Participants generated 82 response statements, sorted them, and rated them on personal relevance. Eight thematic clusters were identified: (1) Thoughtful Consideration of the Ban, (2) Negative Reactions to the Ban, (3) Positive Aspects of the Ban, (4) Strategies to Reduce Cravings, (5) Intent to Quit and Cessation Strategies, (6) Support-Seeking and Engagement in Positive Behaviors, (7) Strategies to Maintain Menthol-Flavored Product Use, and (8) Substance Use Alternatives to Menthol Cigarettes. Cluster differences based on sociodemographic factors, smoking behavior, and quitting interest were identified. Results provide insight into potential responses to a menthol cigarette ban and can contribute to public health prevention and intervention efforts, messaging campaigns, and support services for SGM people who smoke menthol cigarettes, specifically.

Developing and Evaluating a Measure of the Willingness to Use Pandemic-Related mHealth Tools Using National Probability Samples in the United States: Quantitative Psychometric Analyses and Tests of Sociodemographic Group Differences.

There are no psychometrically validated measures of the willingness to engage in public health screening and prevention efforts, particularly mobile health (mHealth)-based tracking, that can be adapted to future crises post-COVID-19. The psychometric properties of a novel measure of the willingness to participate in pandemic-related screening and tracking, including the willingness to use pandemic-related mHealth tools, were tested. Data were from a cross-sectional, national probability survey deployed in 3 cross-sectional stages several weeks apart to adult residents of the United States (N=6475; stage 1 n=2190, 33.82%; stage 2 n=2238, 34.56%; and stage 3 n=2047, 31.62%) from the AmeriSpeak probability-based research panel covering approximately 97% of the US household population. Five items asked about the willingness to use mHealth tools for COVID-19-related screening and tracking and provide biological specimens for COVID-19 testing. In the first, exploratory sample, 3 of 5 items loaded onto 1 underlying factor, the willingness to use pandemic-related mHealth tools, based on exploratory factor analysis (EFA). A 2-factor solution, including the 3-item factor, fit the data (root mean square error of approximation [RMSEA]=0.038, comparative fit index [CFI]=1.000, standardized root mean square residual [SRMR]=0.005), and the factor loadings for the 3 items ranged from 0.849 to 0.893. In the second, validation sample, the reliability of the 3-item measure was high (Cronbach α=.90), and 1 underlying factor for the 3 items was confirmed using confirmatory factor analysis (CFA): RMSEA=0, CFI=1.000, SRMR=0 (a saturated model); factor loadings ranged from 1.000 to 0.962. The factor was independently associated with COVID-19-preventive behaviors (eg, "worn a face mask": r=0.313, SE=0.041, P<.001; "kept a 6-foot distance from those outside my household": r=0.282, SE=0.050, P<.001) and the willingness to provide biological specimens for COVID-19 testing (ie, swab to cheek or nose: r=0.709, SE=0.017, P<.001; small blood draw: r=0.684, SE=0.019, P<.001). In the third, multiple-group sample, the measure was invariant, or measured the same thing in the same way (ie, difference in CFI [ΔCFI]<0.010 across all grouping categories), across age groups, gender, racial/ethnic groups, education levels, US geographic region, and population density (ie, rural, suburban, urban). When repeated across different samples, factor-analytic findings were essentially the same. Additionally, there were mean differences (ΔM) in the willingness to use mHealth tools across samples, mainly based on race or ethnicity and population density. For example, in SD units, suburban (ΔM=-0.30, SE=0.13, P=.001) and urban (ΔM=-0.42, SE=0.12, P<.001) adults showed less willingness to use mHealth tools than rural adults in the third sample collected on May 30-June 8, 2020, but no differences were detected in the first sample collected on April 20-26, 2020. Findings showed that the screener is psychometrically valid. It can also be adapted to future public health crises. Racial and ethnic minority adults showed a greater willingness to use mHealth tools than White adults. Rural adults showed more mHealth willingness than suburban and urban adults. Findings have implications for public health screening and tracking and understanding digital health inequities, including lack of uptake.

Knowledge, Attitude and Conspiracy Beliefs of Healthcare Workers in Lebanon towards Monkeypox.

The emergence of a monkeypox (MPOX) outbreak in 2022 represented the most recent recognizable public health emergency at a global level. Improving knowledge and attitude towards MPOX, particularly among healthcare workers (HCWs), can be a valuable approach in public health preventive efforts aiming to halt MPOX virus spread. The aim of the current study was to evaluate the knowledge and attitude of HCWs in Lebanon towards MPOX and to assess their conspiratorial attitude towards emerging virus infections (EVIs). The current study was based on a cross-sectional online survey distributed via Google Forms during September-December 2022 implementing a convenience sampling approach. The final study sample comprised a total of 646 HCWs: physicians (n = 171, 26.5%), pharmacists (n = 283, 43.8%), and nurses (n = 168, 26.0%), among others (n = 24, 3.7%). Variable defects in MPOX knowledge were detected, with a third of the participants having MPOX knowledge above the 75th percentile (n = 218, 33.7%). Satisfactory attitude towards MPOX (>75th percentile) was observed in less than a third of the participants (n = 198, 30.7%), while a quarter of the study sample endorsed conspiracy beliefs towards EVIs at a high level (>75th percentile, n = 164, 25.4%). Slightly more than two thirds of the participants agreed that MPOX vaccination should be used in disease prevention (n = 440, 68.1%). Better levels of MPOX knowledge and attitude were significantly associated with postgraduate education and older age. Physicians had significantly higher MPOX knowledge compared to other occupational categories. Less endorsement of conspiracies towards EVIs was significantly associated with male sex, occupation as a physician, and postgraduate education. Higher MPOX knowledge was associated with better attitude towards the disease. The current study showed unsatisfactory MPOX knowledge among Lebanese HCWs. Educational efforts can be valuable to improve the attitude towards the disease. Despite the relatively low level of embracing conspiracy beliefs regarding EVIs among HCWs in this study compared to previous studies, this area should be considered based on its potential impact on health-seeking behavior.

Epidemiologic and Clinical Features of Mpox in Transgender and Gender-Diverse Adults — United States, May–November 2022

As of November 9, 2022, a total of 28,730 cases of monkeypox (mpox) had been reported in the United States,* primarily among adult cisgender men reporting recent male-to-male sexual contact (1). Transgender and gender-diverse persons, who constitute an estimated 0.5% of the U.S. adult population,† face unique health disparities and barriers to care (2-4). However, data on the epidemiologic and clinical features of Monkeypox virus infections in this population are limited (5). CDC analyzed U.S. case surveillance data on mpox cases in transgender and gender-diverse adults reported during May 17-November 4, 2022. During this period, 466 mpox cases in transgender and gender-diverse adults were reported, accounting for 1.7% of reported cases among adults. Most were in transgender women (43.1%) or gender-diverse persons (42.1%); 14.8% were in transgender men. Among 374 (80.3%) mpox cases in transgender and gender-diverse adults with information available on sexual or close intimate contact, 276 (73.8%) reported sexual or close intimate contact with a cisgender male partner during the 3 weeks preceding symptom onset. During the ongoing outbreak, transgender and gender-diverse persons have been disproportionately affected by mpox. Members of this population frequently reported recent sexual or close intimate contact with cisgender men, who might be in sexual networks experiencing the highest incidence of mpox. These findings highlight the importance of tailoring public health prevention and outreach efforts to transgender and gender-diverse communities and could guide strategies to reduce mpox transmission.

Associations Between Anabolic-Androgenic Steroid Use and Sexual Health Behaviors Among Adolescent Boys: Results From the 2019 Youth Risk Behavior Survey.

The aim of this study was to determine the association between lifetime anabolic-androgenic steroid (AAS) use and seven indicators of sexual health behaviors among a nationally representative sample of adolescent boys in the United States. Multiple modified Poisson regression analyses were conducted to determine the associations between any lifetime AAS use and seven indicators of sexual health behaviors among 2,095 sexually active adolescent boys from the 2019 National Youth Risk Behavior Survey. Sexually active boys who reported lifetime AAS use were at greater risk of having sexual intercourse before the age of 13 years (adjusted risk ratio [aRR] = 2.73, 95% confidence interval [CI] = [1.44, 5.17]), reporting ≥4 sexual partners in their lifetime (aRR = 1.96, 95% CI = [1.34, 2.89]) and in the past 3 months (aRR = 6.77, 95% CI = [3.19, 14.37]), having been tested for HIV in their lifetime (aRR = 2.49, 95% CI = [1.13, 4.73]), and having been tested for any sexually transmitted infection in the past 12 months (aRR = 3.14, 95% CI = [1.63, 6.03]). These findings align with prior research among adult men and have implications for public health and health care prevention efforts to reduce the use of AAS, as well as support the engagement in safe sexual health behaviors among adolescent boys.

Knowledge, Attitudes, and Practices of/towards Covid-19 among Cameroonians in the Bamenda Health District: A Cross-Sectional Study during the Second Wave of the Pandemic

The Coronavirus Disease 2019 (Covid-19) pandemic has and is greatly affecting the global community. This study aimed to assess knowledge, attitudes, and practices towards Covid-19 among a convenient sample of the general public in the Bamenda Health District (BHD) of Cameroon. A community-based cross-sectional study was conducted in the BHD, from 1st March to 30th April 2021. Participants were sampled from three Health Areas in Bamenda. Data collection was performed using a self-administered questionnaire. The Pearson Chi square (χ2) and regression analysis were used to determine associations between KAP and demographic characteristics. We studied 404 participants with the following demographic characteristics: 237 (58.7%) aged 25 – 49 years, 233 (57.7%) females, and 197 (48.8%) with tertiary level of education. Of the 404 participants, 182 (45.0%) were knowledgeable about Covid-19 (79 males and 103 females), 42.5% had positive attitudes towards Covid-19 (63 males and 109 females), and 122 (30.2%) were adherent to practicing public health preventive measures (48 males and 74 females). Compared to females, males were more adherent to practicing public health preventive measures (OR, 1. 3; 95% CI, 0.8 – 2.1), and had positive attitudes towards directives and guidelines (OR, 1.7; 95% CI, 1.1 – 2.8). This study shows that public health prevention efforts should be directed to closing the identified gaps in KAP among residents to halt the spread of Covid-19 in the health district as well as the Region.

An update on ACEs domain frequencies across race/ethnicity and sex in a nationally representative sample

BackgroundAdverse childhood experiences (ACEs) research has yielded important information regarding ACEs prevalence and impacts; however, few studies have included American Indian/Alaska Native (AI/AN) populations. ObjectiveWe aimed to update and expand the ACEs literature by using recent data (2009–2018; over 50% from 2015 to 2017); using a large, nationally representative sample (total N = 166,606) and AI/AN sub-sample (N = 3369); and including additional covariates (i.e., sex, age, income, education) to provide a comprehensive understanding of ACEs across diverse populations. Participants and settingData were from the CDC's BRFSS, a standardized scale used in most ACEs literature, to improve generalizability of study findings, which may contribute to investigating future ACEs trends. MethodsDescriptive statistics and negative binomial regression analyses were conducted to examine the frequency of ACEs and the eight ACEs domains across racial/ethnic and sex groups. ResultsAI/ANs had the highest ACEs compared to all racial/ethnic groups. Females had higher mean ACEs compared to males of the same racial/ethnic group; significant differences were identified between non-Hispanic White (NHW) females and NHW males, and between Hispanic females and Hispanic males. Across all 10 stratified subgroups, AI/AN females had the highest average ACEs followed by AI/AN males. Emotional abuse was the most reported ACEs domain across all individuals, and family incarceration was the lowest. AI/AN females and males had the highest ACEs frequencies in family substance use, witnessing intimate partner violence, and sexual and emotional abuse. ConclusionsFindings have important implications for public health intervention and prevention efforts that may mitigate the impact of ACEs across racial/ethnic groups, particularly for AI/AN populations.

Juridical Aspects Of Complementary Traditional Medicine In Indonesia

Alternative, complementary medicine is non-conventional medicine aimed at improving public health status, including promotive, curative, preventive, and rehabilitative efforts obtained through structured education with high quality, safety, and effectiveness based on biomedical science, which has not been accepted in conventional medicine. In several hospitals in Indonesia, this complementary medicine has begun to be applied as supportive therapy or replacement therapy for patients who refuse traditional treatment methods. This complementary therapy can also be carried out at the patient's request or with the referral of other doctors. The approach method used in this study, namely normative juridical, is a method of legal research conducted on library materials or secondary data using deductive thinking methods based on truth criteria. Coherent. There is also a complementary therapy called holistic medicine, which is because the form of therapy can affect individuals. The limitations of conventional medicine are one of the reasons why complementary and alternative therapies are an option in treating/healthy Indonesian people. The development of complementary and alternative therapies must be the responsibility of health workers, especially nurses. Legality for complementary and integrated health services must have a Traditional Health Worker Registration Certificate (STRTKT) and a Traditional Health Worker Practice License (SIPTKT).