Chloe A. Teasdale

Introduction: Suicide is a leading cause of death among young people (ages 10–24), and suicidality—which encompasses suicidal ideation, planning and attempts—is a growing public health concern. Young people living with or affected by HIV may face heightened vulnerability to suicidality; however, evidence‐based mental health interventions for this group remain scarce. This systematic review aims to characterize the prevalence of suicidality and identify its determinants among young people with HIV‐related experiences to guide future research and intervention efforts. Methods: Using the Preferred Reporting Items for Systematic reviews and Meta‐Analyses guidelines, a systematic review of four online databases from 1 January 2008 to 14 August 2023 was completed. English‐language, peer‐reviewed studies of any design that satisfied the following criteria were included: (1) data primarily collected from 2008 onwards; (2) study sample with a mean/median age between 10 and 24 years; and (3) disaggregated findings reported on suicidality for those living with and/or affected by HIV. Results: From 3737 identified articles, 54 studies met the inclusion criteria. These studies spanned 19 countries, with 17 studies explicitly focused on suicidality and only six presenting data from young people affected by HIV. Reported prevalence varied widely: 23 studies documented suicidal ideation (range: 0%–36.4%), 13 studies reported on suicide attempts (range: 0.2%−30.4%) and 2 studies provided data on suicide deaths (0.17% and 2.8%). Among 12 studies that examined associated factors, depression was the factor most consistently linked to increased suicidality risk. Discussion: This review identified a wide prevalence range of suicidal ideation and suicide attempts among young people living with or affected by HIV. Yet, few of these studies explicitly focused on suicidality or assessed factors associated with suicidality. The consistent association between depression and suicidality suggests an urgent need for tailored mental health interventions. Conclusions: To address research gaps, future studies should move beyond cross‐sectional designs, examine protective factors, recruit participants outside of healthcare settings, and specifically include young people affected by HIV. In settings with limited mental health services, establishing clear and practical guidelines for the responsible conduct of research on suicidality is essential for advancing studies in this critical area.

Background: Survivors of childhood cancer (CCS) are at risk for secondary malignant neoplasms (SMNs): serious late effects of treatment. Radiotherapy (RT) and chemotherapy (CT) are possible causes of SMNs. Aims: To measure SMN incidence and characteristics among Egyptian CCS treated with RT, and to compare SMN timing and location based on RT field and CT type. Methods and Results: We performed a retrospective cohort study of patients under 18 years who received radiotherapy for primary cancer at the Children's Cancer Hospital, Cairo, Egypt, from 2009 to 2015, with follow‐up through 2021. We calculated cumulative incidence functions for second malignant neoplasm (SMN) development overall and by primary diagnosis, using the Fine and Gray method, both for all SMNs and for in‐field SMNs. We used the Wilcoxon rank‐sum test to compare time to SMN between patients with in‐field versus out‐of‐field SMNs and those who received alkylating versus non‐alkylating chemotherapy. Of 3132 patients (60.1% male; median age 6.2 years), 23 developed an SMN (11.1‐year cumulative incidence: 1.85%, 95% CI: 0.84%–3.57%). Eight (34.8%) of the 23 SMNs arose within the prior RT field (11‐year cumulative incidence: 2.71%, 95% CI: 1.32%–4.93%). Median time to SMN was longer for in‐field than out‐of‐field cases (7.9, IQR: 6.0–9.9 vs. 4.3 years, IQR: 2.7–5.6; p = 0.002). There was no significant difference in time to SMN by CT type. Conclusion: SMN incidence in this cohort matched rates in high‐income countries. Strong long‐term follow‐up is essential for CCS in Egypt and similar settings.

Background/Objectives: Vaccination is an important strategy to protect pregnant people, fetuses, and infants from severe influenza and COVID-19. However, as of April 2025 in the United States, only 14% of pregnant women had received the 2024–2025 COVID-19 vaccine, while influenza vaccine uptake among pregnant women was 38% compared to 57% in 2020. Our study assessed the perceived safety of receiving these vaccines during pregnancy within a community-based national cohort. Methods: Participants reported safety perceptions of vaccination during pregnancy and were categorized as (1) endorsing the safety of both COVID-19 and influenza vaccines, (2) endorsing the safety of only the influenza vaccine, (3) endorsing the safety of only the COVID-19 vaccine and (4) endorsing the safety of neither vaccine during pregnancy. We examined sociodemographics, behaviors, and beliefs correlated with these four categories. Log-binomial models were used to estimate the prevalence ratios of (a) endorsing the safety of only influenza vaccine versus endorsing the safety of both COVID-19 and influenza vaccines during pregnancy, and (b) endorsing safety of neither versus both vaccines during pregnancy. Results: In total, 40% of adults (N = 1725) endorsed the safety of both vaccines during pregnancy, 18% (N = 751) endorsed the safety of only the influenza vaccine, 4% (N = 183) endorsed the safety of only the COVID-19 vaccine, and 38% (N = 1621) did not endorse the safety of either vaccine during pregnancy. Participants who were non-Hispanic Black, reported inconsistent vaccination habits, and expressed low trust in government and healthcare providers were more likely to endorse the safety of only the influenza vaccine or neither vaccine compared with endorsing both vaccines. Conclusions: These findings highlight the need to build trust in the medical system, reduce access barriers, and use equitable, community-driven messaging to strengthen confidence in the safety of receiving the COVID-19 and influenza vaccines during pregnancy.

Background: An improved understanding of the epidemiology of hospital-onset methicillin-resistant Staphylococcus aureus bloodstream infection (HO-MRSA BSI) could inform future prevention strategies for HO-MRSA BSI. Methods: We performed a retrospective cohort study of HO-MRSA BSI reported to NHSN from 2020–2023 at a system of 9 acute care hospitals located in New York City. The primary outcome was to describe the demographic and clinical characteristics of patients with HO-MRSA BSI. Secondary outcomes included comparisons of tertiary (TH) and community (CH) hospitals, standardized infection ratio (SIR) and rates per 10,000 patient-discharges, presumptive potential infectious sources, and mortality. Results: Between 2020 and 2023, 222 patients had HO-MRSA BSI. Their median age was 65 years, 139 (63%) were male, 92 (41%) had central lines, 89 (40%) were in ICUs, and 63 (28%) were on a ventilator. These characteristics were similar across the 176 (79%) patients in TH and the 46 (21%) patients in CH. SIRs were similar across each year of the study (with cumulative SIRs of 0.815 overall, 1.412 [CH] and 0.732 [TH]). Overall HO-MRSA BSI rates ranged from 2.58–3.53 per 10,000 patient-discharges. The most common sources of HO-MRSA BSI were pneumonia (41%), SSTIs (17%), CLABSIs (13%), and PIV catheter-related issues (9%). The all-cause mortality rate was 35%. Discussion: The unchanged HO-MRSA BSI SIRs in this study support the need for additional interventions that focus on prevention of the primary sources of MRSA infections. Ongoing systematic surveillance of the primary sources of HO-MRSA BSI should be implemented to inform and monitor best practices for prevention.

PURPOSE: We assessed radiotherapy (RT) utilization and completion among pediatric patients with brain tumor treated at Children's Cancer Hospital Egypt (CCHE). METHODS: A retrospective analysis was conducted among pediatric patients with brain tumor treated at CCHE between 2009 and 2020. Patients were categorized on the basis of demographics, tumor types, RT utilization status (prescribed, not prescribed, and did not complete), and geographic place of residence (urban v rural). RT utilization was stratified by tumor type and geographic region and compared using chi-square tests. RESULTS: Among 3,977 pediatric patients with brain tumor, 2,327 (58.5%) were prescribed RT. The highest RT utilization was observed among patients with diffuse intrinsic pontine glioma (DIPG; 98.2%) and germinoma (98.0%), while nonoptic low-grade glioma (LGG; 11.2%) and optic pathway glioma (OPG; 2.0%) had the lowest among patients prescribed RT, 2,264 (97.2%) completed treatment. The highest noncompletion was observed in patients with atypical teratoid rhabdoid tumor (ATRT; 6.7%) and nonoptic LGG (9.7%). Urban patients had a higher rate of RT completion (98.3%) compared with rural patients (95.9%; P < .001). CONCLUSION: RT utilization and completion varied significantly by tumor type, reflecting evidence-based treatment protocols and tumor-specific challenges. Geographic disparities in RT completion underscore systemic health care inequities in Egypt. These findings emphasize the need for targeted interventions, including decentralized radiotherapy delivery models and public health strategies, to improve access to and adherence to radiotherapy among underserved populations.

This cohort study compares rates of telehealth care among children during and after the COVID-19 pandemic in New York, New York.

Background:Asian New York City residents have the lowest cancer screening uptake across race and ethnicity. Few studies have examined screening differences across Asian ethnic subgroups in New York City.Methods:Cross-sectional survey data were analyzed using multivariable logistic and multinomial regression analyses. Differences among Chinese, Korean, and South Asian adults in breast, cervical, and colorectal cancer screening uptake; breast and colorectal cancer screening knowledge; and cancer fatalism were examined. Associations between breast and colorectal cancer screening knowledge and their uptake were also assessed along with associations between cancer fatalism and breast, cervical, and colorectal cancer screening uptake.Results:Korean women reported 0.52 times [95% confidence interval (CI), 0.31–0.89] lower odds of Pap test uptake compared with Chinese women; South Asian adults had 0.43 times (95% CI, 0.24–0.79) lower odds of colorectal cancer screening uptake compared with Chinese adults. Korean adults reported 1.80 times (95% CI, 1.26–2.58) higher odds of knowing the correct age to begin having mammograms compared with Chinese adults; South Asian adults had 0.67 times (95% CI, 0.47–0.96) lower odds of knowing the correct age to begin colorectal cancer screening compared with Chinese adults. Korean adults had 0.37 times (95% CI, 0.27–0.53) lower odds of reporting cancer fatalism compared with Chinese adults.Conclusions:Low cancer screening uptake among Asian American adults, low screening knowledge, and high cancer fatalism were found. Cancer screening uptake, knowledge, and fatalism varied by ethnic subgroup.Impact:Findings indicate the need for ethnicity-specific cultural and linguistic tailoring for future cancer screening interventions.

Cancer-related survey questions and response options