BMJ public health最新文献

{"title":"Art therapy to reduce burnout and mental distress in healthcare professionals in acute hospitals: a randomised controlled trial.","authors":"Megan Tjasink, Catherine Elizabeth Carr, Paul Bassett, Gehan Soosaipillai, Dennis Ougrin, Stefan Priebe","doi":"10.1136/bmjph-2024-002251","DOIUrl":"10.1136/bmjph-2024-002251","url":null,"abstract":"<p><strong>Introduction: </strong>Burnout and mental distress are prevalent among healthcare professionals (HCPs), particularly in acute hospital settings. This study evaluated the effectiveness of a structured group art therapy intervention in reducing burnout and associated mental distress in HCPs.</p><p><strong>Methods: </strong>We conducted a multicentre, unblinded, randomised, parallel assignment, waitlist-controlled trial in four National Health Service secondary care hospitals in London, UK, between 4 May 2023 and 5 March 2024. A total of 129 HCPs with moderate-to-severe risk of burnout or levels of perceived stress were randomly assigned to either group art therapy (6 weekly 90-min sessions) or a waitlist control.The primary outcome was change in emotional exhaustion as a core dimension of burnout, measured using the Maslach Burnout Inventory-Human Services Survey. Secondary outcomes were the other two burnout dimensions: depersonalisation and personal accomplishment, as well as perceived stress, measured on the perceived stress scale, anxiety, assessed on the generalised anxiety disorder seven-item scale, and depression, measured on the eight-item patient health questionnaire depression scale. Outcomes were assessed at baseline and 6 weeks postintervention/control period. Intervention group outcomes were also assessed at 3-month follow-up.</p><p><strong>Results: </strong>Primary outcome data were obtained from 115 (89%) of 129 participants, who represented a range of clinical specialties and professions. Emotional exhaustion scores were significantly lower in the intervention group compared with the control group at 6 weeks (adjusted mean difference: 4.8; 95% CI 2.4 to 7.3; p<0.001). Significantly more favourable scores were also found in depersonalisation, perceived stress, anxiety and depression in the intervention group. Gains were sustained at 3-month follow-up.</p><p><strong>Conclusions: </strong>Six weekly sessions of group art therapy can significantly reduce burnout risk and mental distress in HCPs from different professional backgrounds in acute hospital settings. Wider implementation of the intervention should be considered.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov ID: NCT05728086.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002251"},"PeriodicalIF":0.0,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a multicomponent HPV intervention on self-reported HPV vaccine uptake and intention among French adolescents and parents: results from the national, cluster-randomised PrevHPV trial.","authors":"Josée Dussault, Amandine Gagneux-Brunon, Anne-Sophie Le Duc-Banaszuk, Sébastien Bruel, Morgane Michel, Aurélie Gauchet, Damien Oudin Doglioni, Jonathan Sicsic, Jocelyn Raude, Anne-Sophie Barret, Nathalie Thilly, Judith E Mueller","doi":"10.1136/bmjph-2024-001007","DOIUrl":"10.1136/bmjph-2024-001007","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) infections cause several cancers, including nearly all cervical cancer cases. While there are safe and effective vaccines, the adolescent HPV vaccine coverage in France is low (<50%). Thus, we studied the effect of municipality-wide interventions to increase HPV vaccine uptake and intention among middle school students.</p><p><strong>Methods: </strong>This cluster-randomised trial used an incomplete factorial design to arrange three components (in-school education, motivation, mobilisation (EMM); in-school vaccination; and local general practitioner (GP) trainings) into six intervention conditions, which were randomly assigned to 91 participating French municipalities. We assessed HPV vaccine status using online self-reported questionnaires that students (typically aged 13-14) and parents completed at baseline and 5-month follow-up. Using adjusted linear regression, we estimated differences in (1) vaccine uptake and (2) uptake and intention to vaccinate, both by randomisation arm and by intervention component. We explored subgroup effects by at-home multilingualism, gender, age and parental education.</p><p><strong>Results: </strong>2047 of 2664 (74%) students were unvaccinated against HPV at baseline. The 5-month probability of first-dose vaccine uptake in the control group was 0·09 (95% CI 0.06 to 0.11). Vaccine campaigns alone contributed a 24-percentage-point (0.18, 0.30) increase in uptake compared with the control group. EMM was only effective in increasing vaccine uptake among monolingual francophone students, and we detected no effect from GP training. Vaccine campaigns and EMM both increased the combined outcome of vaccine intention and first-dose uptake, but EMM had the same subgroup effect. Questionnaire data from parents (N=236) were sparser but demonstrated similar overall trends.</p><p><strong>Conclusions: </strong>Our results demonstrate that in-school HPV vaccine campaigns effectively increase HPV vaccine uptake among adolescents without exacerbating extant disparities in vaccine uptake. EMM can also be a useful tool to increase HPV vaccine intention but must be improved to bridge disparities in its effectiveness. GP training results were inconclusive.</p><p><strong>Trial registration number: </strong>NCT04945655.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001007"},"PeriodicalIF":0.0,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution and extended triage of high-risk human papillomavirus genotyping based on vaginal self-sampling.","authors":"Jingran Li, Chen Yao, Chao Zhao, Mingzhu Li, Ling Li, Zhixin Lin, Zhijun Zhang, Jihong Deng, Rong Liu, Yingying Hu, Songling Zhang, Bei Lin, Ruifang An, Yun Zhao, Xinfeng Qu, Hui Du, Ruifang Wu, Lihui Wei","doi":"10.1136/bmjph-2024-001565","DOIUrl":"10.1136/bmjph-2024-001565","url":null,"abstract":"<p><strong>Background: </strong>To investigate the overall and type-specific prevalence of high-risk human papillomavirus (HR-HPV) infection in China across different age groups and regions and to evaluate the triage of HPV-positive cases.</p><p><strong>Methods: </strong>A prospective cross-sectional study recruited a total of 20 103 women aged 30-59 years from 13 provinces in China. Self-collected vaginal samples were tested for 14 HR-HPV types using next-generation sequencing or multiplex real-time PCR assays.</p><p><strong>Results: </strong>The five most common types were HPV52, 58, 16, 39 and 51. The prevalence of single-type HR-HPV was 10.70%. The overall proportion of HPV16/18 was 20.67%, with a significant difference observed among provinces (p<0.05). The age-specific prevalence curve of HR-HPV followed a U-shaped pattern from 30 to 59 years, with a lower prevalence observed in women aged 40-44 years (12.35%), which subsequently changed with age. The proportion of women aged 30-34 years with HPV16 (21.59%) was significantly higher than that in other age groups, showing two peaks in young and older women. There was a significantly higher prevalence of HPV16 single-type infection in the youngest group, whereas HPV16 multi-type infection was higher in older women. Among cervical intraepithelial neoplasia grade 2 or higher (CIN)2+ cases, HPV16 infection accounted for 43.98%, HPV18 infection for 7.84%, and other 12 infections for 48.20%. HPV16 had the highest sensitivity for detecting CIN2+, reaching 42.7% among single HPV types, followed by HPV52 and HPV58. When HPV16/18/33 were combined for detection, the sensitivity for detecting CIN2+ increased to 66.67%.</p><p><strong>Conclusions: </strong>The prevalence and genotype distribution of HR-HPV based on vaginal self-sampling varied across different regions and ages in China. HPV16 was more prevalent in both younger and older age groups. Different HPV subtypes have different detection rates for CIN2+, and combining HPV16/18/33 significantly improved the sensitivity for detecting CIN2+.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001565"},"PeriodicalIF":0.0,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise professionals in extended scope of practice roles: a qualitative exploration of a new model of rehabilitation.","authors":"Sheree McCormick, Iva Cukic, Jenny Alexanders, Gillian Yeowell, Francis Fatoye, Benjamin M Kelly, Victoria Fitzgerald, Tim Cable, Patrick Doherty, Davina Deniszczyc, Panayiotis Michael","doi":"10.1136/bmjph-2024-002322","DOIUrl":"10.1136/bmjph-2024-002322","url":null,"abstract":"<p><strong>Background: </strong>There is a need to provide greater patient choice through accessible and sustainable rehabilitation for people with long-term conditions. New models of rehabilitation employing non-clinical healthcare workers in extended service practice roles are developing. Little research has investigated the experiences of non-clinical health workers, such as exercise professionals, in extended scope of practice roles. This research explored the experiences of stakeholders and beneficiaries (exercise professionals in extended scope of practice roles, allied health professionals and people with Long COVID) participating in a new model of rehabilitation delivered online from selected Fitness and Well-being Centres of a UK charity.</p><p><strong>Methods: </strong>A qualitative design using in-depth semistructured interviews was undertaken to explore the experiences of triage physiotherapists, specialist trained exercise professionals, referred to as rehabilitation specialists and people with Long COVID participating in the new model of rehabilitation involving exercise, education and well-being support.</p><p><strong>Results: </strong>Five triage physiotherapists, two rehabilitation specialists and three people with Long COVID were recruited. Facilitators, barriers and opportunities were identified as key themes. Facilitators related to 'it isn't just exercise', 'condition specific needs are met' and 'dedicated team who make a difference'. Barriers related to 'supporting staff training needs' and 'optimising resources/mode of delivery for clinical population'. Opportunities related to the provision of a 'stepped-down approach at programme end', 'building and developing the team', and 'identifying and evaluating emerging trends through process evluations'.</p><p><strong>Conclusions: </strong>This novel model of rehabilitation provided positive experiences for people living with Long COVID. Some aspects of the role provided job satisfaction for the delivery team but mentorship, support and additional training in psychological skills and mental health are important when considering sustainability and expansion of the programme. Scaling out to other clinical populations and areas where access to conventional services is sparse could provide a viable public health strategy to improve access to services, thereby reducing mainstream healthcare costs.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002322"},"PeriodicalIF":0.0,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity progression and the heterogeneous impact of healthy ageing risk factors: a multicohort study.","authors":"Shasha Han, Wangyue Chen, Muzi Shen, Ruitai Shao, Weizhong Yang, Chen Wang","doi":"10.1136/bmjph-2024-002474","DOIUrl":"10.1136/bmjph-2024-002474","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to quantify how diseases accumulate and diminish among ageing populations, and examine how modifiable risk factors influence these progressions.</p><p><strong>Methods: </strong>In this multicohort study with four cohorts, China Health and Retirement Longitudinal Study, the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study, and the Survey of Health, Ageing and Retirement in Europe (SHARE), and 75 874 participants, we employed a multistage model that accommodated bidirectional transitions between four health stages (0, 1, 2, ≥3 conditions) from baseline to 8 years, and conducted matching analyses to examine the influence of age, sex, socioeconomic status (SES) and lifestyle factors on these transitions.</p><p><strong>Results: </strong>Disease accumulated faster than diminished (0.08-0.44 vs 0.00-0.06). Transitions accelerated towards severe multimorbidity (0→1: 0.29 (95% CI 0.28 to 0.29), 1→2: 0.27 (95% CI 0.27 to 0.28) and 2→≥3: 0.44 (95% CI 0.43 to 0.45)). Mortality risk escalated with condition count: 0.08 (95% CI 0.08 to 0.09) for 0 conditions, 0.13 (95% CI 0.12 to 0.13) for 1 condition 0.17 (95% CI 0.16 to 0.18) for 2 conditions, and 0.27 (95% CI 0.26 to 0.27) for ≥3 conditions. Cohorts exhibited broadly similar progression patterns, though ELSA demonstrated slower transitions to ≥3 conditions and SHARE showed elevated mortality from 0 and 1 conditions. Key risk factor effects emerged: disease accumulation peaked at 55-65 years; females had higher disease accumulation but lower transitions to death than males; Low-SES populations had higher probabilities of developing ≥3 conditions than the middle-SES group, while middle-SES populations had higher accumulation probabilities for 0→≥2 and 2→≥3. Lifestyle factors exerted differential impacts: smoking increased 1→3 transitions and drinking increased 0→2 transitions, while physician inactivity increased 0→3 transitions. Sensitivity analyses confirmed robustness across 11 condition-specific models.</p><p><strong>Conclusions: </strong>Multimorbidity progression accelerates nonlinearly, with risk factors exerting varying effects, depending on the magnitude of risk factors and initial health states. Precision interventions should target age, sex, SES and lifestyle-specific strategies.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002474"},"PeriodicalIF":0.0,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining mpox vaccination and behavioural changes to control possible future mpox resurgence among men who have sex with men: a mathematical modelling study.","authors":"Maria Xiridou, Daphne Amanda van Wees, Philippe Adam, Fuminari Miura, Eline Op de Coul, Maarten Reitsema, John de Wit, Birgit van Benthem, Jacco Wallinga","doi":"10.1136/bmjph-2025-002682","DOIUrl":"10.1136/bmjph-2025-002682","url":null,"abstract":"<p><strong>Introduction: </strong>The 2022 outbreak of mpox subclade IIb in the Netherlands affected primarily men who have sex with men (MSM). Despite the sharp decline in cases, concerns remain about future mpox outbreaks. This study investigated the effect of mpox introductions, accounting for vaccination, behavioural changes and introductions of subclades with different characteristics.</p><p><strong>Methods: </strong>This study developed a compartmental model for mpox among MSM. Three levels of sexual activity were distinguished: low, medium and high. The group with high activity accounted for 5% of the population with the highest numbers of sexual partners, and the group with low activity included 60% with the lowest numbers of partners. In the model, individuals were allowed to change sexual activity level. Several scenarios with mpox introductions were examined.</p><p><strong>Results: </strong>In January 2024, 54% of MSM with high sexual activity level had immunity; this declined to 39% a year later due to changes in sexual activity. The introduction of five cases in May 2025 resulted in 759 cases in the first 4 months without vaccination after 2023; however, the number of cases was 34% or 48% lower with 3000 vaccinations in August-October 2024 or February-April 2025, respectively. With earlier initiation or greater magnitude of behavioural adaptations, the number of mpox cases was 17%-51% smaller. The introduction of a subclade with 10% higher transmission probability than subclade IIb resulted in 77% more cases.</p><p><strong>Conclusions: </strong>Owing to changes in sexual activity, the fraction immune in the group with high sexual activity will decline, leading to greater possibilities for future mpox outbreaks. The number of cases can be reduced with preventive vaccination and behavioural adaptations. Recurring vaccination campaigns should prioritise individuals with high sexual activity levels, ensuring those entering high-activity groups are reached. Campaigns promoting timely behavioural changes remain crucial.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002682"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Development and validation of a biological frailty score based on CRP, haemoglobin, albumin and vitamin D within an electronic health record database in France : a cross-sectional study.","authors":"","doi":"10.1136/bmjph-2024-001941corr1","DOIUrl":"https://doi.org/10.1136/bmjph-2024-001941corr1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1136/bmjph-2024-001941.].</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001941corr1"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal health inequalities between Canadian-born and foreign-born women in Canada: a decomposition analysis.","authors":"Melia Alcantara, Sam B Harper, Gabriel D Shapiro, Tracey Bushnik, Jay S Kaufman, Zoua Vang, Angela Mashford-Pringle, Seungmi Yang","doi":"10.1136/bmjph-2024-001231","DOIUrl":"10.1136/bmjph-2024-001231","url":null,"abstract":"<p><strong>Background: </strong>Foreign-born mothers are generally believed to experience better perinatal outcomes than Canadian-born mothers, despite relatively lower socioeconomic status. However, the magnitude and direction of inequalities by nativity status vary across outcomes. Little is known about factors contributing to the health inequalities by nativity status across different perinatal outcomes. Thus, we aim to examine the direction and magnitude of inequalities by nativity status across perinatal outcomes and estimate the contributions of select individual-level characteristics to the inequalities in Canada.</p><p><strong>Methods: </strong>Using 132 639 singleton births from the 2016 Canadian Birth-Census Cohort, we estimated the risk of preterm birth (PTB), small-for-gestational-age (SGA) and large-for-gestational-age (LGA) birth, stillbirth, and infant and neonatal death by maternal nativity status. We estimated the contribution of maternal race, maternal and paternal education, paternal nativity status and employment, family income and homeownership, as well as maternal age, marital status, activity limitations and parity to inequalities specific to each outcome, using Kitagawa's decomposition method.</p><p><strong>Results: </strong>Compared with Canadian-born mothers, foreign-born mothers experienced higher rates of all outcomes examined (eg, 627 (95% CI 608, 646) PTBs per 10 000 live births among foreign-born mothers vs 580 (568, 592) among Canadian-born mothers), except for LGA births (677 (648, 706) per 10 000 for foreign-born vs 1006 (959, 1054) for Canadian-born mothers). Non-White maternal race explained the largest proportion of the observed differences for non-fatal outcomes, while the highest income quartile explained the most for the differences in fatal outcomes.</p><p><strong>Conclusion: </strong>Foreign-born women fared worse than Canadian-born women for all adverse perinatal outcomes examined apart from LGA births. Our results highlight differential contributions of determinants to perinatal health inequalities by maternal nativity status across outcomes.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001231"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective cohort study to evaluate Lassa fever incidence, symptoms and coinfection with malaria in West Africa: the Enable Lassa Research Programme ('ENABLE 1.5') - study protocol.","authors":"Henshaw Mandi, Danny Asogun, Olufemi Ayodeji, Benedict N Azuogu, Anton Camacho, William Fischer, Roice Fulton, Donald Samuel Grant, Stephan Günther, Ndapewa Ithete, Elsie Illori, Kamji Jan, Carol Kagia, Nele Martens, Sonia Menon, Aminata Ndiaye, Mark Ndifon, Robert Nsaibirni, Michael Ntiri, Paul Oloo, Sylvanus Okogbenin, Suzanne Penfold, Minnie Sankawulo-Ricks, Marion Sillah, Patrick Suykerbuyk, Nadia Tornieporth, Nathalie J Vielle, Margaret Williams, David Wohl, Fang Xie, Solomon Yimer, J Gabrielle Breugelmans","doi":"10.1136/bmjph-2024-001960","DOIUrl":"10.1136/bmjph-2024-001960","url":null,"abstract":"<p><strong>Abstract: </strong></p><p><strong>Introduction: </strong>Lassa fever (LF), a viral haemorrhagic disease, poses a significant public health challenge in West Africa. Lassa virus infection frequently causes mild malaria-like symptoms, potentially leading to misdiagnosis and an underestimated burden. Severe LF can lead to multi-organ failure, and survivors may experience sensorineural hearing loss (SNHL). Building on the contributions of the Enable Lassa Research Programme (ENABLE 1.0), which ran in West Africa from 2020 to 2024, ENABLE 1.5 aims to further address gaps in understanding LF disease burden to inform future late-stage vaccine trials. The study will assess the incidence of symptomatic reverse transcription (RT)-PCR-confirmed LF disease, including malaria coinfection.</p><p><strong>Methods and analysis: </strong>The ENABLE 1.5 prospective cohort study will be conducted across five study sites: one in Liberia, three in Nigeria and one in Sierra Leone. Stratified cluster sampling will identify eligible individuals at the household level from communities either involved in ENABLE 1.0 or identified through recent LF surveillance as hotspots. A total of 5000 participants will be recruited, 1000 per study site (minimum) and equally stratified in the following ages: 0-5, 6-10, 11-17, 18-50 and >50 years. All participants will be followed up for 12 months. Baseline data collection will gather key variables and blood specimens from all participants, with baseline SNHL prevalence assessed at three study sites. Active follow-up of all participants will involve symptom assessments every 2 weeks and blood draws every 3 months for serological testing (IgG). Suspected LF cases will undergo thorough evaluations, including malaria rapid diagnostic testing, clinical assessments and laboratory testing, including RT-PCR and malaria blood smear microscopy.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e001960"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to secondhand smoke from cigarettes and secondhand aerosol from tobacco and nicotine products in indoor and outdoor public spaces in the European Union: a cross-sectional study.","authors":"Charlotte Xin Li, Pin-Chun Wang, Ariadna Feliu, Anthony A Laverty, Cristina Martinez, Armando Peruga, Charis Girvalaki, Cornel Radu Loghin, Constantine I Vardavas, Filippos T Filippidis","doi":"10.1136/bmjph-2025-002903","DOIUrl":"10.1136/bmjph-2025-002903","url":null,"abstract":"<p><strong>Introduction: </strong>In December 2024, the Council of the European Union (EU) adopted a recommendation to expand regulations on the use of nicotine-containing products both in indoor settings and specific outdoor areas. This study aimed to examine sociodemographic factors associated with exposure to conventional tobacco smoke and aerosols across the EU and support for relevant regulations.</p><p><strong>Methods: </strong>We performed a secondary analysis of cross-sectional data from the Special Eurobarometer 99.3 (n=26 358, May-June 2023) across 27 EU Member States (MS). We estimated the weighted prevalence of secondhand exposure to tobacco smoke and aerosols and support for bans on smoking, e-cigarettes and heated tobacco products in public settings. Multilevel Poisson regression models explored associations between sociodemographic factors and these outcomes.</p><p><strong>Results: </strong>Exposure to secondhand smoke and aerosols varied across EU MS. Younger individuals, those with higher education, living with children, and current and former tobacco and nicotine users (prevalence ratio (PR) 1.16, 1.01-1.33; and PR 1.22, 1.05-1.41, respectively) were more likely to report exposure to both tobacco smoke and aerosol from emerging products. Women (PR 1.05, 1.02-1.08; and PR 1.03, 1.02-1.05, respectively), those living with children (PR 1.05, 1.02-1.07; and PR 1.04, 1.02-1.07, respectively) and those with higher education levels (PR 1.10, 1.04-1.15; and PR 1.10, 1.06-1.14) were more likely to support bans, whereas those with financial difficulties (PR 0.94, 0.89-0.99 and PR: 0.95, 0.91-0.99, respectively), as well as current and former smokers (PR 0.61, 0.55-0.67; and PR 0.78, 0.73-0.84, respectively) and emerging product users (PR 0.84, 0.76-0.92; and PR 0.69, 0.62-0.76, respectively), were less supportive.</p><p><strong>Conclusion: </strong>Our analysis found that both exposure to secondhand smoke and aerosol and support for bans in public spaces vary substantially between population subgroups and across countries. Our findings can support EU MS in implementing targeted interventions to increase population support for and implement the recent EU Council recommendations.</p>","PeriodicalId":101362,"journal":{"name":"BMJ public health","volume":"3 2","pages":"e002903"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}