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Abstract: The most severe consequences of climate change will accrue to the poorest people in the poorest countries, despite their own negligible contribution to greenhouse gas emissions. In recent years, global health efforts in those same countries have grown dramatically. However, the emerging scientific consensus about climate change has not yet had much influence on the routine practice and strategies of global health. We review here the anticipated types and global distribution of health impacts of climate change, discuss relevant aspects of current global interventions for health in low-income countries, and consider potential elements of a framework for appropriately and efficiently mainstreaming global climate change–mitigation and –adaptation strategies into the ongoing enterprise of global health. We propose a collaborative learning initiative involving four areas: (1) increased awareness among current global health practitioners of climate change and its potential impacts for the most disadvantaged, (2) strengthening of the evidence base, (3) incorporation now of climate change–mitigation and –adaptation concerns into design of ongoing global health programs, and (4) alignment of current global health program targets and methods with larger frameworks for climate change and sustainable development. The great vulnerability to climate change of populations reached by current global health efforts should prompt all concerned with global health to take a leading role in advocating for climate change mitigation in their own countries. [Copyright &y& Elsevier]

To examine changes in death rates by demographic group and by the leading causes of death in U.S. persons 1 to 24 years of age during the COVID-19 pandemic. A retrospective cross-sectional study using mortality data from the National Vital Statistics System from April 2017 to March 2023. Pre-pandemic death rates were compared with death rates during the pandemic overall, by race/ethnicity, age, sex, and cause group. Age-adjusted death rates in young persons 1–24 years of age increased by 14.3% during the pandemic. Injury-related causes accounted for 78.2% of the increase, driven mainly by increases in homicides and unintentional injuries related to drug overdose, firearms, and motor-vehicle traffic crashes. Non-Hispanic Black and Hispanic teens and young adults experienced the largest increases in deaths overall and across the leading causes of death. During the COVID-19 pandemic, injury-related causes accounted for the majority of the increases in deaths in children and young adults, driven mainly by firearms, drug overdoses, and motor vehicle traffic crashes. Findings highlight the importance of understanding the drivers of these marked increases in injury-related mortality and the need for injury prevention efforts among children even in the context of an infectious disease pandemic. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To identify factors associated with human immunodeficiency virus (HIV) infection among adolescent females in Zimbabwe and appropriate prevention strategies for this vulnerable population. Methods: A total of 1807 females aged 15–19 years completed a questionnaire and provided a blood sample for HIV testing as part of a nationally representative survey. Associations between HIV infection and factors operating at the individual, household, partner and community levels, as well as sexual behavior, were explored through bivariate and multivariate logistic regression analyses. Two multivariate models were fitted: the first model considered sexual risk behaviors and contextual variables, whereas the second model considered only contextual variables. Results: Of 1807 adolescent females, 192 (10.6%) were HIV positive, and 41% of HIV-positive adolescent females reported no sexual risk behaviors. In the first multivariate model, the risk associated with number of lifetime sexual partners was increased for 1 partner (odds ratio [OR] = 2.4, 95% confidence interval [CI] = 1.57–3.6), 2 partners (OR = 4.4, 95% CI = 2.22–8.55), and 3 or more partners (OR = 6.3, 95% CI = 2.56–15.7) as compared with having 0 partners. Believing that people with HIV have many sexual partners (OR = 1.71, 95% CI = 1.14–2.57) and that the man should take the initiative to have sex (OR = 1.55, 95% CI = 1.03–2.32) were also risk factors. In the second model, increased risk was associated with having ever married or lived with a man (OR = 1.99, 95% CI = 1.18–3.35) as well as the attitudes above. Decreased risk of HIV infection was associated with having a job (OR = .39, 95% CI = .18–.88), main activity in past 12 months was as a student (OR = .39, 95% CI = .19–.80), participation in school-based lectures on sexual health (OR = .49, 95% CI = .27–.87), and perceiving that AIDS is a somewhat serious problem in the community (OR = .55, 95% CI = .33–.92). Conclusions: Adolescent females in Zimbabwe who are married, not attending school and/or are unemployed, are at heightened risk for HIV infection. Interventions that improve their educational and employment opportunities, strengthen school-based prevention services, foster more equitable gender attitudes, and make marriage safer by, for example, promoting knowledge of partners’ serostatus before marriage, may reduce their risk. Future research priorities are proposed. [Copyright &y& Elsevier]

Abstract: Amyotrophic lateral sclerosis (ALS) is a severe neurodegenerative disease with a complicated pathogenesis. Compelling evidence indicates impairment of all neurovascular unit components including the blood–brain and blood–spinal cord barriers (BBB/BSCB) in both patients and animal models, leading to classification of ALS as a neurovascular disease. The present review provides an updated analysis of the normal and impaired BBB/BSCB, focusing on the ALS-altered barrier. Here we describe the roles of cellular components, tight junctions, transport systems, cell interactions, cytokines, matrix metalloproteinases, and free radicals in the BBB/BSCB disruption, along with recent evidence from experimental and clinical ALS studies. The BBB/BSCB is a promising research area in ALS and this review will reveal some aspects of microvascular pathology in ALS and hopefully provide ideas for the development of new therapeutic strategies. [Copyright &y& Elsevier]