Journal of Global Health最新文献

{"title":"Unveiling the genetic biomarkers for ageing: evidence from a large sample genome-wide association study and in vivo validation.","authors":"Zhikang Cai, Yue Yang, Peng Qu, Sensong Fu, Xu Li","doi":"10.7189/jogh.15.04279","DOIUrl":"10.7189/jogh.15.04279","url":null,"abstract":"<p><strong>Background: </strong>Ageing, marked by cumulative molecular damage, now leaves most adults spending nearly a decade in poor health. To date, no therapies directly target the ageing process. We performed a large-scale genome-wide association study to identify potential drug targets for extending health span.</p><p><strong>Methods: </strong>By combining genetic and experimental evidence, we prioritise therapeutic targets with the potential to extend healthy lifespan. Using two-sample Mendelian randomisation (MR) across 26 152 expression quantitative trait loci instruments, we screened for causal links between 5430 potential drug target genes and four ageing phenotypes - frailty index (n = 175 226), HannumAge (n = 34 710), intrinsic epigenetic age acceleration (n = 34 710), and telomere length (n = 742 174). We re-evaluated high-confidence loci with summary-databased MR (SMR) and validated them by quantitative polymerase chain reaction (qPCR), Nissl staining, and Western blotting in three- and 20-month-old C57BL/6 mice. Finally, replication in a meta genome-wide association study (GWAS) of long-lived individuals vs. controls across 20 diverse cohorts upheld the association. This integrated genetic-experimental strategy prioritises candidate therapeutic targets for interventions aimed at extending healthy lifespan.</p><p><strong>Results: </strong>Two-sample MR mapped 47 gene-ageing links spanning frailty, telomere length, and two epigenetic clocks. The SMR confirmed 11 with consistent directions and heterogeneity in the dependent instrument support. Both qPCR and Western blot in three- and 20-month C57BL/6 mice confirmed age-dependent down-regulation of UBA7, PLA2G4B, and ATP8B4, validating their functional relevance. Finally, replication in a longevity meta-GWAS specifically confirmed the association for UBA7.</p><p><strong>Conclusions: </strong>These findings highlight UBA7, PLA2G4B, and ATP8B4 as promising targets for interventions aimed at extending health span, shedding light on the biological mechanisms of longevity.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04279"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12467474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global prevalence of post-miscarriage anxiety, depression, and stress: a systematic review and meta-analysis.","authors":"Asha Shetty, Alwin Issac, Sanjay Dhiraaj, Vijay Vr, Latha Thimappa, Deepthy Balakrishnan, Bhola Nath, Shruti Sinha, Suyash Singh, Prabakar Mishra, Kurvatteppa Halemani","doi":"10.7189/jogh.15.04245","DOIUrl":"10.7189/jogh.15.04245","url":null,"abstract":"<p><strong>Background: </strong>Mental disorders, ranked as the sixth leading cause of disability-adjusted life years in 2017, present significant challenges to healthcare systems. Anxiety and depression are frequently reported among pregnant women, particularly after experiencing a miscarriage. We aim to evaluate the global prevalence of anxiety, depression, and stress in women following a miscarriage.</p><p><strong>Methods: </strong>We searched electronic databases, including PubMed (MEDLINE), Cochrane, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Web of Science, Scopus, and ClinicalKey, for studies published in English from January 1995 to December 2024. We adhered to the Cochrane Collaboration guidelines and reported it using the PRISMA 2020 statement. Anxiety, depression, and stress were the primary outcomes we assessed.</p><p><strong>Results: </strong>In this systematic review and meta-analysis, we included 29 studies with 35 375 participants. Participants' age ranged from 18 to 45 years. We found that 32.5% of women experienced anxiety, 30.1% depression, and 33.6% stress within six weeks following a miscarriage. Notably, the prevalence of these mental health disorders was higher in low- and middle-income countries.</p><p><strong>Conclusions: </strong>Our findings underscore the impact of mental health on overall well-being, particularly after a miscarriage. Healthcare professionals need to acknowledge the importance of mental health during the six weeks following a miscarriage. Early identification and treatment of mental disorders are crucial for mitigating their effects on women's mental health and improving outcomes in future pregnancies.</p><p><strong>Registration: </strong>PROSPERO: CRD42024578605.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04245"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12467481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood stunting and cognitive development: a meta-analysis.","authors":"Vassilis Sideropoulos, Aisling Draper, Bernardita Munoz-Chereau, Lynn Ang, Julie Elizabeth Dockrell","doi":"10.7189/jogh.15.04257","DOIUrl":"10.7189/jogh.15.04257","url":null,"abstract":"<p><strong>Background: </strong>Childhood stunting is associated with delayed developmental trajectories. While the relationship between childhood stunting and cognitive development has been widely studied, the impact on children's development requires further examination. We aimed to synthesise existing research studies to clarify the relationships between childhood stunting and cognitive development and sub-domains of cognition. Additionally, we sought to examine potential moderating factors influencing the relationship between childhood stunting and cognitive development, and to explore interventions targeted at improving cognitive development for stunted children.</p><p><strong>Methods: </strong>We systematically reviewed literature from 1990 to 2025 in 54 languages. We identified 12 191 studies, of which 35 studies met the inclusion criteria and were analysed. We employed random effect models to calculate pooled effect sizes and assessed heterogeneity using I² statistics. We evaluated publication bias through Egger's test.</p><p><strong>Results: </strong>Our initial model revealed no effects of childhood stunting on overall cognitive development. However, more refined domain-specific analyses showed that childhood stunting was associated with poorer sub-domains, specifically intelligence, executive function, visuo-spatial, cognition, and socio-emotional development in specific geographic regions. Secondary models indicated that the effects of childhood stunting were more pronounced when moderating factors such as demographics, socioeconomic, parent-related and health-related factors were controlled for, demonstrating the critical role of the impact of developmental context. Finally, the exclusive focus on nutritional interventions limited our ability to explore the effects of other intervention types on cognitive development in children who were stunted.</p><p><strong>Conclusions: </strong>Our findings highlight the need for further research to better understand these relationships and for the development of contextual interventions to draw robust conclusions and design targeted interventions. Future research should explore standardised culturally sensitive assessment tools, emphasising the necessity of accurate reporting, and the exploration of moderating effects across cognitive sub-domains.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04257"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12467485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in rural China's caregiver outcomes, behaviours, and health services utilisation following the COVID-19 pandemic: an observational study.","authors":"Isabel Z Wang, Gary L Darmstadt, Andrew Rule, Sarah-Eve Dill, Yunwei Chen, Huan Zhou, Yuju Wu, Scott Rozelle","doi":"10.7189/jogh.15.04203","DOIUrl":"10.7189/jogh.15.04203","url":null,"abstract":"<p><strong>Background: </strong>Under-resourced communities in rural China have long faced limitations in accessing and utilising caregiver and child healthcare (CCH). The COVID-19 pandemic exacerbated health inequities globally, while its precise impacts on CCH remain understudied. We report differences in parental migration, maternal mental health, household and nutrition expenditures, child feeding practices, and prenatal, postnatal, and childbirth care following pandemic lockdowns in rural China.</p><p><strong>Methods: </strong>We compared two groups of families with children who grew to the age of six months either before or during lockdowns. We enrolled eligible households from 80 rural townships, randomly selected from four poverty-designated counties in Sichuan Province, China. We interviewed the control group of primary caregivers in November and December of 2019 (pre-COVID-19), and the case group in May of 2020 (approximately five months into the pandemic). Statistical analyses included t tests and linear regressions with adjustments. P-values <0.05 were considered statistically significant.</p><p><strong>Results: </strong>Compared to the control group, the case group presented significantly lower paternal migration and more favourable maternal mental health. Caregiving behaviours (including household and nutrition expenditures) and child feeding practices did not differ, except for higher spending on infant micronutrient supplements. Prenatal health services utilisation, including home visits, was slightly higher, while postnatal services utilisation was lower.</p><p><strong>Conclusions: </strong>Our findings suggest that many aspects of CCH in rural China were similar or improved during the early pandemic lockdowns. These data highlight the importance of promoting targeted public health interventions, such as mental health support initiatives, accessible perinatal care options, and family-centred education campaigns, in under-resourced communities and during future healthcare crises.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04203"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12467446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Person- and family-centred care in neonatology: a scoping review to identify existing definitions, models of care, and related categories of interventions.","authors":"Andrea Togo, Ornella Lincetto, Jenny Bua, Ilaria Mariani, Marzia Lazzerini","doi":"10.7189/jogh.15.04263","DOIUrl":"10.7189/jogh.15.04263","url":null,"abstract":"<p><strong>Background: </strong>Person- and family-centred care in the field of neonatology (N&FCC) are promoted by many international agencies and scientific societies because of evidence-based benefits for infants, parents and health systems; however, being very broad and evolving concepts, they have not been uniformly defined in operational terms. We conducted a scoping review of literature relevant to N&FCC with the objectives of synthetising: 1) existing definitions; 2) models of care; 3) categories of interventions suggested by each model of care.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE, Embase, Web of Science, and Google Scholar for articles and/or grey literature published until 5 February 2024. For each objective, we considered articles and/or other documents, for any type of newborn.</p><p><strong>Results: </strong>The searches yielded 10 771 records. A total of 91 documents were deemed eligible for inclusion. We identified 40 relevant definitions and 28 different models of care of N&FCC. Both definitions and models of care were categorised in four macro-groups, based on their main focus: newborn and developmental care, parental participation to care, no separation between mother-baby, and miscellanea. Out of the 28 models of care, a total of 51 categories of interventions were identified, with a variable number (range 2-17) reported per each model. These were grouped in five macro-categories: individualised neonatal health care; organisation of care, human resources and policies; physical resources; health professionals (HPs) capacity strengthening and support; family empowerment and support. While most models included individualised neonatal care and family empowerment interventions, HPs were frequently neglected as beneficiaries of the intervention: only 11 models incorporated HPs capacity strengthening, only three proposed a wider support for HPs.</p><p><strong>Conclusions: </strong>We identified and synthetised numerous definitions, models, and categories of interventions, highlighting the need for further conceptualisation and standardisation around the concept of N&FCC, including the perspective from low-middle income countries', and from both parents and staff involved in care.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04263"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145151447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship of sleep problems between eight-year-old South African children and their mothers.","authors":"Mary Jane Rotheram-Borus, Joan Christodoulou, Lauren D Asarnow, Peter P Norwood, Matt Yalch, Steyn L Vogel, Mark Tomlinson","doi":"10.7189/jogh.15.04122","DOIUrl":"10.7189/jogh.15.04122","url":null,"abstract":"<p><strong>Background: </strong>Sleep problems are common among children and mothers. However, little is understood about sleep behaviours in low- and middle-income countries. Here we examine sleep behaviours and predictors among black, low-income, South African mothers and their eight-year-old children over time.</p><p><strong>Methods: </strong>We administered standardised measures of sleep behaviours at eight years post-birth to a population cohort of mothers and children in 24 neighbourhoods of Cape Town, South Africa, in 2009-10. We assessed mothers and children six times over eight years with 84% retention since pregnancy. While 71% remained in Cape Town, about 29% of households moved to the profoundly rural Eastern Cape of South Africa. Mothers completed the Pittsburgh Sleep Quality Index and rated their children on the Children's Sleep Habits Questionnaire.</p><p><strong>Results: </strong>Among mothers, 29.5% reported sleep difficulties based on their global sleep score, with a mean sleep quality score of 3.72 (standard deviation (SD) = 2.6). Children's sleep scores were 64.4 (SD = 4.0), with subscale scores on sleep difficulties higher than documented in high-income countries (HICS). There was a relatively low inverse relationship between the quality of maternal and child sleep (r = -0.201; 95% confidence interval (CI) = -0.264, -0.136), which resulted in an R² value of 0.041 in the simple linear regression model. Problematic maternal sleep was associated with living in the rural Eastern Cape (P = 0.034), experiencing intimate partner violence (P = 0.052), and a higher score on the Edinburgh Postnatal Depression Scale (P < 0.001), but not alcohol use. Children's sleep difficulties decreased by 0.191 points (95% CI = -0.229, -0.152) with a one-unit increase in aggressive behaviour and, similarly, cognitive scores decreased by 0.035 points (95% CI = -0.063, -0.006). Household resources, such as formal vs. informal housing, income, and having water on the premises, were unrelated to sleep difficulties.</p><p><strong>Conclusions: </strong>Counter to hypotheses, a small, inverse relationship existed between mothers' and children's sleep behaviours. Alcohol use, HIV status, and socioeconomic markers were unrelated to sleep, but intimate partner violence and depressive symptoms affect sleep negatively, similar to HICS.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04122"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12471224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing strategies in vaccination and mask-wearing for Chinese medical staff in post-COVID-19 era: a modelling study and cost-effectiveness analysis.","authors":"Yiyu Hu, Meng Jia, Ying Jiang, Rui Zhao, Shu Su","doi":"10.7189/jogh.15.04283","DOIUrl":"10.7189/jogh.15.04283","url":null,"abstract":"<p><strong>Background: </strong>After the comprehensive easing of COVID-19 restrictions in China in December 2022, the emergence of additional virus variants and repeat infections has garnered increased attention, particularly among key populations such as medical staff. Our study aims to evaluate various combinations of vaccination and mask-wearing strategies to identify the optimal strategy for the post-COVID-19 era.</p><p><strong>Methods: </strong>A Markov model simulated a cohort of 100 000 Chinese medical staff five years after the complete lifting of epidemic restrictions. The health care system's perspective was adopted, and parameters were sourced from Chinese government-released data and relevant literature. Strategies with varying vaccination coverage (0/25/50/75%) and mask-wearing coverage (0/30/60/90%) were considered. All costs were expressed as USD with a 3% annual discounting rate, and effectiveness was measured via quality-adjusted life year. Sensitivity analyses were performed to evaluate cost-effectiveness uncertainty.</p><p><strong>Results: </strong>At a willingness-to-pay threshold of one-time gross domestic product per capita in China (12 440 USD), the strategy of 90% mask-wearing and 75% vaccination coverage among medical staff was the most cost-effective (501 USD/quality-adjusted life year). This intervention reduced infection and mortality rates by 24.5% and 24.6%, while minimising health care costs with a cost per reversed infection of 1040 USD. Above 30% mask coverage, higher vaccine coverage further increased cost-effectiveness further. On the 16th day after lifting COVID-19 restrictions in the Markov model, there were 19 586 fewer symptomatic cases of first-time COVID-19 infection compared to the status quo (peak infections on that day = 22 293), with a reinfection circle around 197 days. Sensitivity analysis indicated that monthly mask costs is the most sensitive factor influencing the incremental cost-effectiveness ratio; beyond 6.2 USD/mo, the optimal strategy lost cost-effectiveness.</p><p><strong>Conclusions: </strong>In managing multiple waves of the epidemic, prioritising mask usage over vaccination is recommended for medical staff to achieve optimal cost-effectiveness. Exploring ways to extend vaccine efficacy duration would further enhance protection.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04283"},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12491910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of an artificial intelligence algorithm for interpreting lung sounds from children hospitalised with pneumonia in Malawi.","authors":"Nadia E Hoekstra, Maganizo B Chagomerana, Zachary H Smith, Annapurna Kala, Ian McLane, Charl Verwey, Daniel Olson, W Chris Buck, Justin Mulindwa, Alex Gaudio, Sunaina Kapoor, Holly B Schuh, Msandeni Chiume, Elizabeth Fitzgerald, Mounya Elhilali, Tisungane Mvalo, Mina Hosseinipour, Eric D McCollum","doi":"10.7189/jogh.15.04264","DOIUrl":"10.7189/jogh.15.04264","url":null,"abstract":"<p><strong>Background: </strong>Pneumonia is a leading cause of death in under five year olds globally. World Health Organization (WHO) pneumonia diagnostic guidelines rely on non-specific clinical findings. Lung auscultation could improve pneumonia diagnosis, but conventional stethoscopes have implementation challenges. To address this, we developed an artificial intelligence (AI)-enabled digital auscultation system. We evaluated the system's AI lung sound analysis algorithm in children with severe pneumonia in Malawi.</p><p><strong>Methods: </strong>We enrolled children aged 2-59 months hospitalised with WHO-defined severe pneumonia. A study physician recorded lung sounds with a digital stethoscope at six chest positions. Recordings were de-identified, filtered, and interpreted by a trained and certified physician listening panel. Interpretable recordings were analysed by the AI algorithm. We evaluated the agreement of normal (absence of adventitial lung sounds) vs. abnormal (presence of adventitial lung sounds) classifications, by chest position and by patient, between the AI algorithm and the listening panel using raw percent agreement kappa statistics, both unadjusted and adjusted for chance agreement.</p><p><strong>Results: </strong>We enrolled 100 children and analysed 95 with interpretable recordings. The median age was 12.6 months (interquartile range (IQR) = 5.4, 19.0) and 54% (51 / 95) were female. Among interpretable recordings, 59.2% (294 / 497) of chest positions were abnormal per the listening panel compared to 52.7% (262 / 497) per the AI algorithm. The listening panel and AI algorithm agreed on classifications in 83.1% (413 / 497) of chest positions (unadjusted kappa 0.7; adjusted kappa 0.7) and 91.6% (87/95) of patients (unadjusted kappa 0.7; adjusted kappa 0.8). The AI algorithm's sensitivity and specificity for identifying abnormal lung sounds, compared to the listening panel, were 80.3% and 87.2% for chest positions and 96.3%, and 66.7% for patients.</p><p><strong>Conclusions: </strong>This AI lung sound classification algorithm accurately identified abnormal lung sounds in children with severe pneumonia. Next steps include training the algorithm to identify uninterpretable recordings and different abnormal sounds.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04264"},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical epidemiology of community-acquired pneumonia in children before, during, and after the COVID-19 pandemic, and independent risk factors analysis for severe community-acquired pneumonia.","authors":"Xiaoou Li, Lingzhi Li, Xinjiang An, Jing Tian, Bianba Zhuoga, Lianhua Jin, Huijing Jin, Xufang Li, Ying Liu, Jiamin Li, Wanzhen Mei, Ping Liu, Jinyong Pan, Zhaotang Lin, Yusheng Pang, Xiao Wu, Qian Peng, Xiaoping Hu, Xuewen Su, Xiaoning Wang, Lin Feng, Haitao Zhang, Dehua Zhang, Shutong Yang, Zhenpeng Lu, Wenqian Chen, Bing He","doi":"10.7189/jogh.15.04212","DOIUrl":"10.7189/jogh.15.04212","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic may have created an 'immunity debt', altering the epidemiology and aetiology of paediatric community-acquired pneumonia (CAP). However, multi-centre data on these changes and contemporary risk factors for severe CAP remain limited. We therefore aimed to analyse clinical characteristics and pathogen composition of CAP in children before, during, and after the COVID-19 pandemic, and to identify independent risk factors associated with severe CAP.</p><p><strong>Methods: </strong>We collected clinical data from paediatric inpatients diagnosed with CAP at 13 hospitals in 13 provinces of China between August and October 2018 2018 (before the COVID-19 pandemic), 2020 (during the pandemic), and 2023 (after the pandemic). We used a multivariate COX regression model to identify independent risk factors for severe CAP.</p><p><strong>Results: </strong>Our sample comprised 5180 children hospitalised with CAP, with fever and cough being the main clinical symptoms. The number of school-aged children with CAP was significantly higher after compared to before and during the pandemic, while cellular immune function was significantly reduced (P < 0.05). The proportion of viral infections increased from 7.4% before to 20.1% after the pandemic; mycoplasma infections rose significantly from 36.3% to 41.9%, while other bacterial infections increased from 4.9% to 9.7%. The proportion of bacterial infection was highest among infants (11%) and toddlers (9.4%). Viral infection (18.9%), virus-viral co-infections (3.1%), viral-bacterial co-infections (3.3%), and bacteria-bacterial co-infections (1.8%) were more common among preschool children, while mycoplasma infections (59.8%), mycoplasma-viral co-infections (10.5%), or mycoplasma-bacterial co-infections (4.6%) were more frequent among school-aged children. We identified wheezing (hazard ratio (HR) = 1.551), chest pain (HR = 3.144), haemoptysis (HR = 4.854), Klebsiella pneumoniae (HR = 4.236), Acinetobacter baumannii (HR = 4.432), influenza B virus (HR = 2.338), and adenovirus infection (HR = 2.895) as risk factors for severe CAP.</p><p><strong>Conclusions: </strong>We observed a shift in the epidemiology of CAP in children following the pandemic, with altered immune responses and pathogen profiles. These findings emphasise the need for targeted treatment strategies in paediatric patients in the post-COVID-19 context to reduce the burden of severe CAP.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04212"},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between workplace violence and depressive symptoms among emergency department physicians in China: the mediating role of occupational burnout.","authors":"Ruofan Zhang, Ge Qu, Jing Feng, Yuchao Sun, Xinyan Li, Aoqi Shen, Heng Jiang, Yingbin Luo, Zixin Xu, Xingyue Song, Chuanzhu Lv, Yanli Zuo, Zhong Li, Yong Gan, Zuxun Lu","doi":"10.7189/jogh.15.04259","DOIUrl":"10.7189/jogh.15.04259","url":null,"abstract":"<p><strong>Background: </strong>Workplace violence (WPV) was a global public health issue worldwide. Given the specificity of emergency department physicians' professional roles, the incidence of WPV was significantly higher than that of practitioners in other healthcare groups. Investigating the association between exposure to WPV and psychological health can provide a scientific basis for managers to implement precise interventions on violent incidents, thereby effectively reducing the adverse impacts of WPV.</p><p><strong>Methods: </strong>A multi-stage random sampling method was employed to conduct a questionnaire survey among 14 848 emergency department physicians across 31 provincial-level administrative regions in China from July to September 2019. This survey utilised the WPV Scale, the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the Center for Epidemiological Studies Depression Scale (CES-D) to investigate the levels of WPV, burnout, and depressive symptoms among respondents. Data analysis were performed using STATA 17.0 and Amos 26.0 software.</p><p><strong>Results: </strong>A total of 90.40% of emergency department physicians reported experiencing at least one incident of WPV in the past year. The mean score for depressive symptoms was 16.80 ± 14.78, and the mean score for burnout was 82.94 ± 26.11. The correlation coefficients between WPV and depressive symptoms, WPV and job burnout, and depressive symptoms and job burnout were 0.444, 0.347, and 0.562, respectively (all P < 0.01). Structural equation analysis indicated that the total effect of WPV on depressive symptoms was 0.471, with a mediating effect of burnout at 0.421, accounting for 89.38% of the total effect.</p><p><strong>Conclusions: </strong>Emergency department physicians had a severe level of depressive symptoms and burnout, with burnout playing a mediating role between WPV and depressive symptoms. Therefore, future policy efforts are warranted to build a supportive work environment for emergency department physicians and consequently enhance their well-being.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"15 ","pages":"04259"},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}