Challenges and Opportunities in Examining and Addressing Intersectional Stigma and Health.

Background: 'Intersectional stigma' is a concept that has emerged to characterize the convergence of multiple stigmatized identities within a person or group, and to address their joint effects on health and wellbeing. While enquiry into the intersections of race, class, and gender serves as the historical and theoretical basis for intersectional stigma, there is little consensus on how best to characterize and analyze intersectional stigma, or on how to design interventions to address this complex phenomenon. The purpose of this paper is to highlight existing intersectional stigma literature, identify gaps in our methods for studying and addressing intersectional stigma, provide examples illustrating promising analytical approaches, and elucidate priorities for future health research.

Prevalence of Depression in Older Adults and the Potential Protective Role of Volunteering: Findings From the LongROAD Study.

Background: As the US population continues to age, depression and other mental health issues have become a significant challenge for healthy aging. Few studies, however, have examined the prevalence of depression in community-dwelling older adults in the United States.

Methods: Baseline data from the Longitudinal Research on Aging Drivers study were analyzed to examine the prevalence and correlates of depression in a multisite sample of community-dwelling adults aged 65-79 years who were enrolled and assessed between July 2015 and March 2017.

Perceptions of access to harm reduction services during the COVID-19 pandemic among people who inject drugs in metropolitan Chicago.

Background: The COVID-19 pandemic amplified the risk environment for people who inject drugs (PWID), making continued access to harm reduction services imperative. Research has shown that some harm reduction service providers were able to continue to provide services throughout the pandemic. Most of these studies, however, focused on staff perspectives, not those of PWID.

Advancing Delirium Treatment Trials in Older Adults: Recommendations for Future Trials From the Network for Investigation of Delirium: Unifying Scientists (NIDUS).

Objectives: To summarize the delirium treatment trial literature, identify the unique challenges in delirium treatment trials, and formulate recommendations to address each in older adults.

Design: A 39-member interprofessional and international expert working group of clinicians (physicians, nurses, and pharmacists) and nonclinicians (biostatisticians, epidemiologists, and trial methodologists) was convened. Four expert panels were assembled to explore key subtopics (pharmacological/nonpharmacologic treatment, methodological challenges, and novel research designs).

Understanding variation in management of early-onset neonatal sepsis in India: a vignette-based survey.

Background: Antibiotic use for early-onset neonatal sepsis (EONS) is common, but prolonged exposure can lead to poor outcomes. Laboratory capacity and infection prevention initiatives may impact antibiotic use for EONS in neonatal intensive care units. The objective of this study was to examine the influence of institutional capacity on antibiotic prescribing for EONS in India.

Remote Lifestyle Intervention to Reduce Postpartum Weight Retention: Protocol for a Community-Engaged Hybrid Type I Effectiveness-Implementation Randomized Controlled Trial.

Background: Maternal obesity is associated with significant racial disparities. People who identify as non-Hispanic Black and Latinx are at the highest risk related adverse short- and long-term health outcomes (eg, hypertension in pregnancy and postpartum weight retention). Remote lifestyle interventions delivered during and after pregnancy hold promise for supporting healthy weight outcomes; however, few are tested in groups of people who self-identify as non-Hispanic Black and Latinx or address the neighborhood-level and psychosocial factors driving maternal health disparities.

Longitudinal response to standard of care in pediatric metabolic dysfunction-associated steatotic liver disease: Rates of improvement and worsening, and factors associated with outcomes.

Background Aims: Longitudinal outcomes in children with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear due to the absence of a standardized monitoring approach. This study aimed to 1) define improvement and worsening in children with MASLD, 2) estimate rates of improvement or deterioration with standard of care (SOC) over one and two years, and 3) identify baseline and longitudinal factors associated with improvement or worsening.

Approach And Results: Using data from two large randomized controlled trials, we derived definitions for composite improvement and worsening of MASLD based on associations between changes in ALT, GGT, and liver histology after one and two years.

Measuring Improvement Capabilities in a Health System: Findings From a Content Validity Study.

Measurable improvements in the American Healthcare System have been elusive. To understand why, a survey measuring improvement capabilities in a health system was developed from a 2002 tool that measured an outdated quality improvement methodology. That survey was tested for content validity and achieved an overall representativeness content validity index of 87.

Advancing Delirium Treatment Trials in Older Adults: Recommendations for Future Trials From the Network for Investigation of Delirium: Unifying Scientists (NIDUS).

Objectives: To summarize the delirium treatment trial literature, identify the unique challenges in delirium treatment trials, and formulate recommendations to address each in older adults.

Design: A 39-member interprofessional and international expert working group of clinicians (physicians, nurses, and pharmacists) and nonclinicians (biostatisticians, epidemiologists, and trial methodologists) was convened. Four expert panels were assembled to explore key subtopics (pharmacological/nonpharmacologic treatment, methodological challenges, and novel research designs).

Mapping the evidence on interventions that mitigate the health, educational, social and economic impacts of child marriage and address the needs of child brides: a systematic scoping review.

More than 650 million women alive today were married as children. Relative to efforts to prevent child marriage, efforts to support child brides have received much less attention. This review set out to map and describe interventions that support child brides.

The potential impact of optimal blood pressure treatment intensity to reduce disparities in dementia between Black and White individuals.

Background: Black adults have higher dementia risk than White adults. Whether tighter population-level blood pressure (BP) control reduces this disparity is unknown.

Objective: Estimate the impact of optimal BP treatment intensity on racial disparities in dementia.

Using Large Language Models to Assist Antimicrobial Resistance Policy Development: Integrating the Environment into Health Protection Planning.

Increasing antimicrobial resistance (AMR) poses a substantial threat to global health and economies, which has led many countries and regions to develop AMR National Action Plans (NAPs). However, inadequate logistical capacity, funding, and essential information can hinder NAP policymaking, especially in low-to-middle-income countries (LMICs). Therefore, major gaps exist between aspirations and actions, such as fully operationalized environmental AMR surveillance programs in NAPs.

Heterogeneous Ribonucleoprotein K Is a Host Regulatory Factor of Chikungunya Virus Replication in Astrocytes.

Chikungunya virus (CHIKV) is an emerging, mosquito-borne arthritic alphavirus increasingly associated with severe neurological sequelae and long-term morbidity. However, there is limited understanding of the crucial host components involved in CHIKV replicase assembly complex formation, and thus virus replication and virulence-determining factors, within the central nervous system (CNS). Furthermore, the majority of CHIKV CNS studies focus on neuronal infection, even though astrocytes represent the main cerebral target.

COVID-19 Testing Behavior as a Predictor of COVID-19 Vaccination in Southeastern Louisiana: A Longitudinal Cohort Study.

Global COVID-19 vaccination effort faces the challenges of vaccine hesitancy and resistance, rooted in misinformation and institutional distrust. Addressing these barriers with customized messaging is essential, yet the relationship between vaccine hesitancy and other health-seeking behaviors, like COVID-19 testing, has been underexplored. This study assessed COVID-19 vaccine uptake in Southeastern Louisiana across 10 pharmacies and clinics in areas with historically high rates of COVID-19 infection.

Leveraging Data from a Provincial Electronic Immunization Registry to Analyze Immunization Coverage, Timeliness, and Defaulters Among 8.8 Million Children from the 2018 to 2023 Birth Cohorts in Sindh Province, Pakistan.

Background/objectives: Full immunization coverage in Pakistan remains suboptimal at 66%. An in-depth assessment is needed to understand the long-term trends in immunization and identify the extent of defaulters and associated risk factors of them being left uncovered by the immunization system.

Methods: We conducted a 5-year analysis using the Government's Provincial Electronic Immunization Registry data for the 2018-2023 birth cohorts in Sindh province.

Information Needs of State-Level Asthma Programs: Recommendations to Increase Accessibility.

Asthma is the most common pediatric chronic disease, affecting about 5 million U.S. children.

Ecological Momentary Assessment of Momentary Associations Between Availability of Physical Activity Space and Physical Activity Opportunities Among Children from Rural, Urban, and Suburban Locales.

Using Ecological Momentary Assessment (EMA), this study examined associations between momentary availability of physical activity (PA) space and accessibility of PA opportunities among 608 elementary and middle school students who were participating in an obesity prevention trial in one mid-Atlantic state in the U.S. Smartphones prompted EMA surveys at random times to assess children's perceived availability of PA space and accessibility of PA opportunities during out-of-school time, three to seven times each day over seven days.

Effective Coverage of Modern Contraceptive Use in Ethiopia: An Ecological Linking Analysis of Service Provision Assessment and National Health Equity Surveys.

The increase in contraceptive prevalence rate (crude coverage) in Ethiopia over the past two decades does not necessarily reflect service quality, and although the proportion of women with unmet needs has decreased, it remains unacceptably high. Hence, this study aimed to estimate the effective coverage (EC) of modern contraceptive methods in Ethiopia, considering the quality of care. We used nationally representative surveys, such as health facility surveys (Ethiopia Service Provision Assessment, 2021/22) and household surveys (National Health Equity Survey, 2022/2023).

Protection by natural cholera against later episodes of cholera over 10 years of follow-up in Matlab, Bangladesh: a retrospective cohort study.

Background: Patients with cholera have been shown to be protected against subsequent cholera for 3 years after their initial episode. We aimed to assess protection at 10 years of follow-up.

Methods: In this retrospective cohort study, cohorts of patients treated for cholera (index patients) and contemporaneously selected age-matched individuals without cholera (controls), randomly selected from the population of Matlab, Bangladesh, were assembled between 1990 and 2009 and followed for up to 10 years.

A multi-city COVID-19 categorical forecasting model utilizing wastewater-based epidemiology.

The COVID-19 pandemic highlighted shortcomings in forecasting models, such as unreliable inputs/outputs and poor performance at critical points. As COVID-19 remains a threat, it is imperative to improve current forecasting approaches by incorporating reliable data and alternative forecasting targets to better inform decision-makers. Wastewater-based epidemiology (WBE) has emerged as a viable method to track COVID-19 transmission, offering a more reliable metric than reported cases for forecasting critical outcomes like hospitalizations.

Perceived Barriers and Facilitators to Breastfeeding Support Practices in Hospitals and Birthing Facilities in the U.S.

Objective: The Baby-Friendly Hospital Initiative (BFHI) designation is known to increase breastfeeding rates in the U.S. However, less is known about barriers and facilitators to breastfeeding support practices in BFHI hospitals, and how they differ from non-BFHI hospitals.

Climate change, migration, and health: perspectives from Latin America and the Caribbean.

This article delves into the complex relationship between climate change, migration patterns, and health outcomes in Latin America and the Caribbean (LAC). While the severe impact of climate change on health in LAC is widely acknowledged, the article sheds light on the often-overlooked multiple effects on migration and the well-being of migrants. These impacts encompass poverty, food and water insecurity, and adverse physical and mental health outcomes.

The response of health systems to the needs of migrants and refugees in the COVID-19 pandemic: a comparative case study between Mexico, Colombia and Peru.

Background: Protecting the health of migrants and refugees during the pandemic was a significant challenge in the Latin American region. We aimed to describe and contrast the response of the health systems of Mexico, Colombia and Perú to migrants' and refugees' health needs during the COVID-19 pandemic, and to situate the response in the context of the migration and health policies of each country.

Methods: We conducted case studies of the three countries.