Chronic loneliness: neurocognitive mechanisms and interventions

Loneliness has been associated with detrimental effects on mental and physical health and is increasingly recognized as a critical public health issue which may be further exacerbated by societal challenges such as increasing urbanization, an aging society as well as the COVID-19 pandemic. We here review recent findings on the neurocognitive mechanisms and brain alterations that underpin social disconnectedness, therapeutic approaches for chronic loneliness and how these lines of research can be integrated to improve the efficacy of loneliness interventions in healthy individuals and patients with mental disorders.

Gestational Diabetes Mellitus: The Crosslink among Inflammation, Nitroxidative Stress, Intestinal Microbiota and Alternative Therapies

Gestational diabetes mellitus (GDM) is characterized by a set of metabolic complications arising from adaptive failures to the pregnancy period. Estimates point to a prevalence of 3 to 15% of pregnancies. Its etiology includes intrinsic and extrinsic aspects of the progenitress, which may contribute to the pathophysiogenesis of GDM. Recently, researchers have identified that inflammation, oxidative stress, and the gut microbiota participate in the development of the disease, with potentially harmful effects on the health of the maternal-fetal binomial, in the short and long terms. In this context, alternative therapies were investigated from two perspectives: the modulation of the intestinal microbiota, with probiotics and prebiotics, and the use of natural products with antioxidant and anti-inflammatory properties, which may mitigate the endogenous processes of the GDM, favoring the health of the mother and her offspring, and in a future perspective, alleviating this critical public health problem.

Temperature-Regulated IncX3 Plasmid Characteristics and the Role of Plasmid-Encoded H-NS in Thermoregulation

Carbapenem-resistant Enterobacteriaceae (CRE) are a critical public health problem worldwide. Globally, IncX3-type plasmids have emerged as the predominant vehicles carrying the metallo-β-lactamase gene blaNDM. Although blaNDM-bearing IncX3 plasmids have been found in various hosts from diverse environments, whether their transfer and persistence properties vary under different conditions and what factors influence any variation is unknown. By observing the effects of different temperatures on IncX3 plasmid conjugation rates, stability, and effects on host fitness in Escherichia coli, we demonstrate that temperature is an important determinant of plasmid phenotypes. The IncX3 plasmid pGZIncX3 transferred at highest frequencies, was most stable and imposed lower fitness costs at 37°C. Temperature-regulated variation in pGZIncX3 properties involved a thermoregulated plasmid-encoded H-NS-like protein, which was produced at higher levels at 30°C and 42°C and inhibited the expression of type IV secretion system genes involved in conjugation. These findings suggest that blaNDM-bearing IncX3 plasmids are adapted to carriage by enterobacteria that colonize mammalian hosts and could explain the rapid dissemination of these plasmids among human-associated species, particularly in hospital settings.

Risk Factors of Stunting in Children Aged 6–59 Months: A Case-Control Study in Horticulture Area

BACKGROUND: Stunting is a critical public health problem in Indonesia because it affects cognitive and physical development and contributes to child mortality. AIM: This study aims to identify risk factors for stunting in children aged 6–59 in the horticultural area. METHODS: A casecontrol study was conducted to compare previous exposure between stunted children and non-stunted children. Measurements and interviews were conducted with 160 participants (120 controls and 40 cases), including mothers or caregivers. SPSS was used for χ2 statistical analysis, multiple logistic regression, and odds ratios. RESULTS: The study identified four risk factors for stunting: children who were born short (adjusted odds ratio [AOR] = 17.57; 95% confident interval [CI]: 5.02–61.51), LBW (AOR = 4.35; 95% CI: 1.38–13.78), and got a low protein intake (AOR = 4.96; 95% CI: 1.22–20.26). Significantly, a relationship between stunting and access to sanitation was also found (AOR = 6.06; 95% CI: 1.25–29.35). CONCLUSIONS: The risk factors for stunting in children aged 6–59 are related to nutrition during pregnancy and the child’s quality of food. Nutrition interventions should emphasize improving the nutritional status of pregnant women and children and women empowering to affect access to resources and allocations for children’s nutrition.

Antibiotic Heteroresistance in Klebsiella pneumoniae

Klebsiella pneumoniae is one of the most common pathogens responsible for infections, including pneumonia, urinary tract infections, and bacteremias. The increasing prevalence of multidrug-resistant K. pneumoniae was recognized in 2017 by the World Health Organization as a critical public health threat. Heteroresistance, defined as the presence of a subpopulation of cells with a higher MIC than the dominant population, is a frequent phenotype in many pathogens. Numerous reports on heteroresistant K. pneumoniae isolates have been published in the last few years. Heteroresistance is difficult to detect and study due to its phenotypic and genetic instability. Recent findings provide strong evidence that heteroresistance may be associated with an increased risk of recurrent infections and antibiotic treatment failure. This review focuses on antibiotic heteroresistance mechanisms in K. pneumoniae and potential therapeutic strategies against antibiotic heteroresistant isolates.

Digital visual communication for public health: a design proposal for a vaccinated emoji (Preprint)

UNSTRUCTURED In the 21st century, the internet and particularly social media have become essential platforms for the spread of health information (and disinformation). One of the distinguishing features of communication on these platforms is the widespread use of emojis. Though seemingly trivial, emojis are now used by many if not most public health figures and organizations alongside important health updates. Much of that information has had to do with vaccination. Vaccines are a critical public health tool but one surrounded by falsehoods and phobias, especially in the time of COVID-19. Part of that has to do with their lack of positive representation on social media: the syringe emoji is a plain needle which for many people is an uncomfortable image. We thus argue that vaccination deserves an entirely new emoji, and discuss a design proposal for a vaccinated emoji that has gained traction in the global public health community.

Suicide and Suicidal Tendency in Primary Care Setting; Review Article

Suicide is critical public health problem that primary care physicians potentially can help address given that concerned patients frequently visit them in the weeks and months preceding the successful suicide. This article contemplates issues placing the patient at high risk for successful suicide and clinical valuation techniques available to the primary care physician. Patients identified as being at risk of attractive suicidal or those who have a equal of suicidal ideation or behavior judged apposite for management in the primary care setting should be monitored for risk at regular intervals. It is extremely significant to learn about and try to contextualize the patients' emotions that triggered the present crisis. Nurses can make sure that they have a thorough understanding of the present acuity, and all of the precipitating factors, and can exactly and collaboratively communicate with the caregivers and other involved medical teams.

Naloxone Buyers Club: Overlooked Critical Public Health Infrastructure for Preventing Overdose Deaths

Background Community-based naloxone distribution is an evidence-based pillar of overdose prevention. Since 2012, the naloxone Buyers Club facilitated purchase of low-cost naloxone by harm reduction and syringe service programs, the primary conduits for reaching people who use drugs. This innovative purchasing and mutual aid network has not been previously described. Methods We analyzed transactional records of naloxone orders (2017-2020, n=965), a survey of current Buyers Club members (2020, n=104), and mutual aid requests (2021, n=86). Results Between 2017 and 2020, annual orders for naloxone increased 2.6-fold. 114 unique harm reduction programs from 40 states placed orders for 3,714,110 vials of 0.4 mg/mL generic naloxone through the Buyers Club. States with most orders were: Arizona (600,000 vials), Illinois (576,800), Minnesota (347,450), California (317,200), North Carolina (315,040). Among programs that ordered naloxone in 2020, 52% (n=32) received no federal funding and ordered half as much as funded programs. During the 2021 shortage, mutual aid redistribution was common, with 80% participating as either a donor or recipient. Among 59 mutual aid requestors, 59% (n=35) were willing to accept expired naloxone; the clear preference was for generic injectable naloxone, 95% (n=56). Conclusions The naloxone Buyers Club is a critical element of overdose prevention infrastructure. Yet, barriers from corporate compliance officers and federal prescription-only status impede access. These barriers can be reduced by FDA removing the prescription requirement for naloxone and government funding for harm reduction programs.

Critical Narrative Intervention for Health Equity Research and Practice: Editorial Commentary Introducing the Health Promotion Practice Critical Narrative Intervention Special Collection

This special collection of Health Promotion Practice introduces critical narrative intervention (CNI) as a key theoretical framing for an asset-based, narrative, and participatory approach to promoting health and addressing social inequality. Innovative digital and visual methodologies highlighted in this special collection—comics and graphic novels, cellphilms and other participatory film, story booths, digital storytelling, and photovoice—are changing the way critical public health researchers and practitioners forge new knowledge, creating new possibilities for interdisciplinary and activist-based inquiry. Public health research and engagement efforts that critically contend with historically repressive structures and intervene through narrative and participatory processes to enact change with and for disenfranchised communities are long overdue. This special collection showcases six CNI projects that promote equity and justice in the context of LGBTQ, nonbinary, and other gender-diverse young people; people who inject drugs living with hepatitis C virus; young women who trade sex; undocumented and formerly undocumented immigrants; and people living with HIV/AIDS. It is our intent that this collection of exemplars can serve as a guidepost for practitioners and researchers interested in expanding the scope of critical public health praxis. Individually and collectively, the special collection illustrates how CNI can create space for the increased representation of historically silenced populations, redress stigma, and provoke important questions to guide a new era of health equity research.

Automated ELISA On-Chip for the Detection of Anti-SARS-CoV-2 Antibodies

The COVID-19 pandemic has been the most critical public health issue in modern history due to its highly infectious and deathly potential, and the limited access to massive, low-cost, and reliable testing has significantly worsened the crisis. The recovery and the vaccination of millions of people against COVID-19 have made serological tests highly relevant to identify the presence and levels of SARS-CoV-2 antibodies. Due to its advantages, microfluidic-based technologies represent an attractive alternative to the conventional testing methodologies used for these purposes. In this work, we described the development of an automated ELISA on-chip capable of detecting anti-SARS-CoV-2 antibodies in serum samples from COVID-19 patients and vaccinated individuals. The colorimetric reactions were analyzed with a microplate reader. No statistically significant differences were observed when comparing the results of our automated ELISA on-chip against the ones obtained from a traditional ELISA on a microplate. Moreover, we demonstrated that it is possible to carry out the analysis of the colorimetric reaction by performing basic image analysis of photos taken with a smartphone, which constitutes a useful alternative when lacking specialized equipment or a laboratory setting. Our automated ELISA on-chip has the potential to be used in a clinical setting and mitigates some of the burden caused by testing deficiencies.