BackgroundAccelerated global population aging has increased the urgency of identifying effective non-pharmacological strategies to reduce mortality risk among older adults. Although exercise serves as a key protective factor, industrial air pollution may attenuate its health benefits, and this interaction remains unclear. This study aims to investigate whether county-level industrial air pollution indicators modify the association between exercise and all-cause mortality among older adults.MethodsA longitudinal survival analysis was performed using the Chinese Longitudinal Healthy Longevity Survey (2008–2014) with multistage stratified sampling across 23 provinces. The analysis included 16,954 participants aged ≥ 65 years with three follow-up waves spanning 6 years. Self-reported current exercise habits, survival outcomes, health status, sex, smoking status, baseline age, residence, body mass index, functional status, and comorbidity count were extracted. County-level industrial air pollution indicators (annual soot and SO2 emissions, and removals) were matched to individuals according to their residence. All pollution indicators were standardized, and time-varying covariates were updated at each wave. Cox proportional hazards models were constructed sequentially: univariate models for core variables (exercise habits and industrial air pollution indicators), two-way interaction models, and multivariate models with sequential adjustment for covariates (sex, health status, baseline age, smoking status, residence, BMI, functional status, and comorbidity count).ResultsSelf-reported current exercise habits were significantly associated with lower all-cause mortality risk after multivariate adjustment (fully adjusted HR = 0.835, 95% CI: 0.773–0.902, p < 0.001). SO2 emissions showed a weak association with survival risk in univariate analysis (HR = 1.023, 95% CI: 0.942–1.111, p = 0.585). The association estimate was further attenuated after multivariate adjustment (fully adjusted HR = 1.001, 95% CI: 0.874–1.146, p = 0.992). Soot-related indicators showed no significant mortality associations. The interaction between exercise habits and each of the four industrial air pollution indicators was not significant (all p > 0.05).ConclusionSelf-reported current exercise habits were consistently associated with lower all-cause mortality among Chinese older adults, and this association was robust to adjustment for covariates. No statistically significant multiplicative interaction was detected between exercise habits and any of the four pollution indicators. Continued attention to industrial emission control remains warranted, while promoting habitual exercise among older adults may be beneficial in areas with industrial emissions.
Background:Meteorological factors are key triggers for infectious diseases in high-density cities, yet their influence on the acute disease patterns of influenza, mumps, scarlet fever, and hand-foot-and-mouth disease (HFMD) remains unclear. This study aims to reveal the variations in relative risk and secondary infection associated with meteorological factors, thereby providing clues for further confirmatory research. Methods:We analyzed city-wide incidence data from 2012 to 2020 alongside daily meteorological observations. Distributed lag non-linear models (DLNM) were used to quantify exposure-lag-response relationships. Andersen-Gill models assessed effects on disease recurrence, and Cox models evaluated risks of sequential infections between disease pairs, stratified by season. Results:The peak-risk temperatures were 14.5 °C for influenza, 18.5 °C for mumps, 17 °C for scarlet fever, and 28.5 °C for hand-foot-and-mouth disease (HFMD). Average temperature (AT) increase raised influenza recurrence risk (e.g., 1.3% higher risk per 1 °C in children aged 0-14 years). Greater temperature variability reduced sequential infection risk for influenza after HFMD in the cold season (Hazard Ratio [HR] = 0.16) and warm season (HR = 0.14). Increased diurnal temperature range also lowered this risk in the cold season (HR = 0.09). Higher AT in warm season reduced sequential infection risks from influenza to HFMD (HR = 0.61). Increased relative humidity was protective in the cold season but became a risk factor in the warm season in specific disease. Conclusion:Meteorological factors are pivotal in modulating the dynamics of common infections, and influencing both recurrence and sequential transmission. The protective effect of increased temperature variability against secondary infections highlights a complex climate-susceptibility interaction at the population level.
BackgroundHealth Qigong is widely used for health promotion in older adults. This study aimed to systematically evaluate its effects on physical function, psychological well-being, and quality of life (QoL), alongside the moderating effects of intervention characteristics.MethodsSeven databases were systematically searched (up to May 2025). Twenty-two randomized controlled trials involving 1,791 older adults were included. Risk of bias was assessed using Cochrane RoB, and meta-analyses were performed using RevMan 5.4 and Stata 18.0.ResultsHealth Qigong significantly improved 6-min walk distance (MD = 18.05 m, p = 0.03), balance (SMD = 1.70, p = 0.004), depressive symptoms (SMD = −0.64, p = 0.004), and QoL (SMD = 0.76, p = 0.03), but showed no significant effect on activities of daily living (ADL). Subgroup analyses suggested that while Qigong’s benefits on most outcomes were comparable to conventional exercise, it may have greater potential in enhancing QoL. Additionally, regimens with high frequency (≥3 sessions/week), long duration (≥12 weeks), and moderate session length (<60 min) appeared to maximize benefits for alleviating depression and improving QoL.ConclusionHealth Qigong is an effective intervention for promoting multidimensional health in older adults. While most of its benefits are comparable to conventional exercise, Health Qigong may offer unique advantages in improving QoL. For clinical and community practice, a regular regimen of “high frequency, long duration, and moderate session length” is recommended, with flexible adaptations based on individual health conditions.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251112609.
BackgroundMicroplastics are heterogeneous environmental contaminants whose transport, persistence, and potential biological interactions may depend on particle morphology, size, geometry, and polymer composition. Environmental monitoring studies commonly describe particle occurrence within individual matrices, whereas experimental studies frequently use standardized particles that may not adequately represent environmentally observed configurations.ObjectiveThis study aimed to characterize microplastic morphology, dimensional characteristics, size distribution, and polymer composition in drinking-water and estuarine datasets and to identify environmentally observed particle profiles that may inform future musculoskeletal research.MethodsTwo publicly available environmental datasets were analyzed separately. Overall morphology was summarized across 44,221 San Francisco Bay particle records with valid classifications. For matrix-level analyses, quality-assurance samples were excluded, and sample-level morphology proportions were compared using permutational multivariate analysis of variance based on Bray–Curtis dissimilarities with 9,999 permutations. Homogeneity of multivariate dispersion was assessed using PERMDISP. Particle length and aspect ratio were analyzed using generalized estimating equations accounting for particles clustered within samples and adjusted for environmental matrix. Drinking-water records were analyzed descriptively because of heterogeneity in observational units and analytical methods.ResultsIn the complete archived particle inventory, fibers were the most frequently recorded morphology (49.8%, n = 22,012), followed by fragments (40.3%, n = 17,804). Among 266 environmental or biological samples retained for inferential analysis after exclusion of quality-assurance samples, sample-level morphology profiles differed significantly among matrices (PERMANOVA pseudo-F = 34.14, R2 = 0.344, p < 0.001), although multivariate dispersion also differed (PERMDISP F = 94.31, p < 0.001). In cluster-adjusted models, fibers were approximately 2.51 times longer than fragments (95% CI, 2.35–2.68) and had 24.76 times their aspect ratio (95% CI, 22.70–27.01).ConclusionEnvironmental microplastics occurred as heterogeneous combinations of fibers, fragments, particle sizes, and polymer categories. These environmentally observed combinations of morphology, dimensions, and material identity may provide empirically grounded parameters for selecting more representative particles in future cartilage-, synovium-, and bone-related experimental studies. However, this study does not measure human intake, internal exposure, tissue accumulation, biological responses, or musculoskeletal outcomes and therefore does not establish toxicological risk, clinical association, or causality.
ObjectivePrompt care-seeking after rabies exposure is essential for effective post-exposure prophylaxis (PEP). This study aimed to identify independent factors associated with care-seeking delay and to map the full PEP pathway.MethodsWe retrospectively enrolled 27,930 patients attending the rabies PEP clinic at Santan Hospital, Tianjin, between February 2022 and January 2026. Delay was defined as >12 h from exposure to registration. Multivariable logistic regression, combined with XGBoost and SHAP, identified independent factors for delay and quantified their relative importance. Restricted cubic splines examined the non-linear relationship between age and delay. Subgroup analysis assessed the stability of the association of grade III exposure with more prompt care-seeking. A Sankey diagram traced the PEP pathway.ResultsThe delay rate was 29.7%. Eight independent factors were identified. Adults had a 34% higher risk of delay than children (aOR = 1.34, 95% CI: 1.22–1.47, P < 0.001). Grade III exposure was associated with more prompt care-seeking (aOR = 0.69, 95% CI: 0.65–0.73, P < 0.001). Previous rabies vaccination (aOR = 1.17, 95% CI: 1.11–1.23, P < 0.001) and inadequate wound management (aOR = 1.57, 95% CI: 1.31–1.88, P < 0.001) were associated with higher delay risk. Age showed a non-linear relationship with delay risk, with adults at highest risk. The Sankey diagram showed that inadequate wound management was rare in the PEP pathway, and the two-dose booster schedule achieved a much higher completion rate than the standard schedule.ConclusionsOur findings suggest that adults may face the highest risk of care-seeking delay, and that improving healthcare access for adults and promoting simplified vaccination schedules may be key to improving PEP quality.
Background:Botswana has made substantial progress toward the Joint United Nations Programme on Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) (UNAIDS) 95-95-95 targets. However, migrants were historically excluded from free antiretroviral therapy (ART). In December 2019, Botswana extended free HIV testing and treatment to migrants. Population-level data on ART coverage, viral load testing, and virologic suppression among migrants remain limited. Therefore, the study intends to assess the impact of including migrants in the national HIV treatment program by determining ART coverage, baseline cluster of differentiation 4 (CD4) cell counts at enrollment, and virologic outcomes before and after the policy. Methods:This is a retrospective longitudinal observational dataset of all people living with Human Immunodeficiency Virus (PLWH) enrolled in the national treatment program from 2016 to 2022, with citizen status documented and aged 18 + years. The dataset was classified into two categories of individuals enrolled on ART using enrollment year: pre-2019 (citizen-only policy) and post-2019 (migrant-inclusive policy). The baseline CD4 cell count at ART initiation was compared between pre- and post-2019 eras using a modified Poisson regression and linear regression, adjusted for age, sex, and facility, with a difference-in-differences (DiD) model to provide a controlled comparison. The virologic outcomes and mortality were evaluated using modified Poisson and Cox models, adjusted for age, sex, and baseline CD4 cell counts. Results:Among 87,063 PLWH, 40,165 had baseline CD4 cell count data, while 50,043 individuals had viral load (VL) data. Median baseline CD4 cell counts among migrants were 296 cells/μL and 300 cells/μL, pre-2019 and post-2019, respectively (no significant change; β = 1.8 cells/ mm3, 95% confidence interval [CI]: -14.0 to 17.6; p = 0.819). Advanced HIV disease at ART initiation (CD4 < 200 cells/μL) declined significantly from 22.9 to 17.7% (adjusted relative risk [aRR]: 0.76, 95% CI: 0.63-0.90; p = 0.002). Difference-in-differences models showed more favorable changes post-2019 among migrants vs. citizens in both continuous CD4 cell counts (interaction β = 54.2 cells/mm3, 95% CI: 37.7-70.6; p < 0.001) and advanced disease at initiation (interaction RR = 0.74, 95% CI: 0.62-0.89; p = 0.001). The VL measurement capture among migrants increased from 27.7 to 58.5% at 6 months, 31.1-66.1% at 12 months, 32.0-74.6% at 24 months, and 40.5-82.6% at 36 months (all adjusted RRs: 1.86-2.25; p < 0.001) after the policy shift. Observed virologic suppression (<400 copies/mL) remained high (≥94%) with no significant post-2019 change. Mortality was low and unchanged post-2019 (interaction adjusted hazard ratio [aHR] 1.99, 95% CI: 0.41-9.70; p = 0.393). Conclusion:Extending Botswana's ART program to migrants reduced advanced HIV disease at initiation and significantly improved viral load monitoring and sustained viral suppression. Removing citizenship-based barriers reduces health inequities and supports epidemic control toward the UNAIDS 95-95-95 targets.
Sleep disturbance affects up to 70% of university students globally, yet the comparative effectiveness of different exercise modalities remains poorly understood as existing reviews are limited to single exercise categories or English-only databases. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) identified by searching PubMed, Web of Science, and CNKI from inception to June 2026. Eligible studies examined structured exercise ≥2 weeks versus non-exercise controls in university students, with the Pittsburgh Sleep Quality Index (PSQI) as the primary outcome. Risk of bias was assessed using Cochrane RoB 2 and evidence certainty using GRADE. Twenty-two RCTs (N = 1,446) covering 14 exercise modalities were included. The overall pooled mean difference (MD) was -2.25 (95% CI: -2.83 to -1.68, p < 0.0001, I2 = 93.4%). Modalities with multiple replications showed consistent effects: combined exercise (k = 4, MD = -2.34, I2 = 0%), Tai Chi (k = 4, MD = -2.07), aerobic exercise (k = 2, MD = -2.10, I2 = 0%), and Qigong (k = 2, MD = -1.52, I2 = 0%). HIIT (MD = -4.44) and Baduanjin (MD = -4.37) demonstrated large single-study effects requiring replication. Overall GRADE certainty was low. Exercise interventions produce statistically robust improvements in sleep quality among university students. Combined exercise, Tai Chi, and aerobic exercise are the most consistently supported modalities and represent the strongest candidates for evidence-based implementation in campus wellness programs. Systematic review registration:PROSPERO: CRD420261416062.
Background:Healthcare contributes substantially to climate change, and pharmaceuticals account for a meaningful share of this footprint across manufacturing, distribution, prescribing, and disposal. However, climate-health education and prescribing practices are often addressed separately, leaving limited guidance for integrating climate change, pharmaceuticals, and prescribing patterns within a single framework. This scoping review synthesizes evidence on the intersection of these domains, with attention to how these concepts are incorporated into health professions education (HPE) and clinical practice. Methods:A comprehensive literature search strategy of six databases (PubMed, Embase, CINAHL, ERIC, Health Source: Nursing Academic, and Web of Science) identified peer-reviewed studies published between January 1988 and December 2025 in English or Spanish. Eligible studies addressed climate change in relation to pharmaceutical use or prescribing patterns and included an educational or practice-based component; animal studies, studies without interventions, and non-prescribing studies were excluded. Searches were conducted in December 2023 and updated in April 2025. Data were extracted on study characteristics, clinical domain, educational approach, and directional relationships mapped to the MAMS model dyads (Climate ↔ pharmaceuticals; pharmaceuticals ↔ prescribing patterns; climate ↔ prescribing patterns). Results:From 4,247 citations, 28 studies met inclusion criteria. Studies were conducted across multiple regions, most commonly the United States (n = 6), United Kingdom (n = 5), Australia (n = 5), and Canada (n = 4), with additional single country and multinational collaborations. Clinical domains varied, with the largest representation in anesthesia and perioperative care (n = 8), followed by pharmacy and pharmacology (n = 5), primary care (n = 3), and fewer in other specialties. Studies used single and multi-educational domains, most commonly framework development (n = 16), followed by curricular integration (n = 6). Outcomes included reductions in anesthetic or inhaler related emissions, behavior change, knowledge or awareness, attitudes or satisfaction, and identification of barriers and facilitators. Although individual MAMS dyads were frequently examined, no study operationalized all three domains in an integrated bidirectional tri-dyadic manner. Conclusion:Existing literature on climate-conscious prescribing education is expanding but remains clinically concentrated and largely conceptual, with limited evaluation of instructional strategies. No study operationalized a fully bidirectional, tri-dyadic approach linking climate change, pharmaceuticals, and prescribing patterns, underscoring the need for integrated, outcomes-oriented frameworks to guide HPE and practice change.
Background:Social cognition is a core cognitive domain that is impaired in mild cognitive impairment (MCI), yet the availability and utility of assessment tools for this population in China remain unclear. Objective:This scoping review aimed to systematically map the current evidence on social cognition assessment tools for Chinese older adults with MCI, and to identify gaps in the literature concerning cultural adaptation and psychometric validation. Methods:We systematically searched CNKI, CBM, Wanfang, Weipu, PubMed, and Web of Science up to 23 June 2026. We included original studies that assessed social cognition tools in Chinese MCI patients with controls, extracted data on study design, tools, domains, and results, and conducted a narrative synthesis. Results:Six studies met the inclusion criteria, comprising 198 MCI participants and 197 healthy controls. The assessment tools covered three social cognition domains: empathy, facial emotion recognition, musical emotion recognition, and social perception. All studies reported significant impairments in MCI, particularly in negative emotion recognition (disgust, sadness, fear) and empathy. However, none reported reliability coefficients (e.g., Cronbach's α) or established diagnostic cut-off scores for the Chinese MCI population. Sample sizes were small (range 19-59 per MCI group), and all studies were single-center. Conclusion:Evidence suggests that Chinese MCI patients show social cognition deficits across multiple domains, yet current tools are insufficiently validated and culturally adapted. Future studies may consider multi-center validation, establishing normative data and cut-offs, and developing culturally relevant instruments for China.
Background:Despite rapid economic development in coastal China, the alignment between socioeconomic growth and pediatric eye health remains poorly understood. School-based screening may provide an opportunity to bridge this knowledge gap, yet large-scale, real-world evidence from diverse urban-rural gradients is scarce. Methods:This cross-sectional study analyzed 4.47 million valid screening encounters from Xiamen, Quanzhou, and Zhangzhou (2021-2024). Visual acuity (VA) and spherical equivalent (SE) were assessed. Two-way ANOVA and multivariate logistic regression were employed to identify drivers of visual impairment and uncorrected refractive error, with screening year as a covariate. Generalized Estimating Equations (GEE) with student-level clustering were applied to account for repeated measures. Sensitivity analyses confirmed dataset robustness. Results:Age was the predominant driver of VA variance (η2 = 0.1132), exceeding city-level effects fivefold. Xiamen exhibited the best refractive profile but the highest uncorrected rate (94.0% in primary school), illustrating the "Xiamen Paradox"-where affluence fosters a "visibility-over-correction" bias. Conversely, Quanzhou demonstrated a "pain-driven" model with high correction adherence despite a severe myopia burden (19.0% high myopia). Crucially, county-level SE disparities (up to 1.66 D) eclipsed inter-city gaps. The 5-7-year window marked a critical refractive shift, with myopia prevalence doubling. Among primary school records, only 22.6% of visually impaired children wore spectacles, and merely half achieved adequate correction. Conclusion:Economic prosperity does not automatically translate to optimal visual health. Significant "correction gaps" and intra-regional disparities necessitate a shift from uniform strategies to precision governance. Future interventions must prioritize the 5-7-year window, emphasize correction quality over mere screening volume, and tailor approaches to local socioeconomic contexts to transform economic capital into sustainable ocular health dividends effectively.
IntroductionAs modern households diversify, many family caregivers face multi-generational demands, such as simultaneously caring for grandchildren and aging parents. Despite being the backbone of the care system, caregivers navigate highly varied needs and family dynamics. It is thus crucial to understand who family caregivers are and how they fare in terms of health and wellbeing. This descriptive study provides a profile of U.S. intergenerational caregivers over age 50.MethodsUsing data from 2022 RAND Health and Retirement Study (HRS) and HRS core files, we focus on four primary caregiver types—parent caregivers, spousal caregivers, parents of minor children, and grandchild caregivers. We first estimate the percentage of 15 total caregiver configurations, including those caring for single or multiple categories of family members. We then describe and compare the sociodemographic characteristics across the four primary caregiver types, looking specifically at those caring for parents only, spouses only, children only, or grandchildren only. We also compare self-reported health indicators of these same four groups caring for one generation only after adjusting for age differences.ResultsApproximately 85% of caregivers provided care solely to one generation of care recipients (i.e., parents, spouses, children, or grandchildren), while the remaining 15% provided simultaneous care for multiple generations of recipients. Sociodemographic and health indicators varied by specific caregiver types. Spousal caregivers had worse self-reported health and higher depression scores compared to other caregiver types, even adjusting for age differences.DiscussionWhile family caregiving is common among adults over 50, their demographics and experiences vary significantly. This study underscores a critical need to move beyond a “one-size-fits all” support model. Notably, spousal caregivers remain uniquely vulnerable, requiring targeted clinical interventions. Additionally, the prevalence of multi-generational caregiving requires policy expansions—such as inclusive leave policies—to address overlapping role strains.
Background:Nature exposure is an important determinant of physical, psychological, and social development and well-being. However, it has been suggested that today's youth are less likely to engage with the natural world than generations before. This trend has been attributed, in part, to behavioral and attitudinal shifts exacerbated by the rise of sedentary lifestyles, digital hobbies, and nature disaffection. These factors have been especially pronounced for those living in urban areas. There may be an opportunity to counter this growing nature disconnection by promoting opposing behavioral and attitudinal shifts. Persuasive games offer a promising avenue for achieving this by leveraging game design to encourage nature exposure. Methods:The primary objective of this study will be to understand to what extent a mixed-media gaming intervention can be used to investigate urban nature exposure, while also drawing attention to the therapeutic benefits associated with urban nature exposure, in a population of university-attending youth (18-25 years old). Participants will be assigned to either a control group or a City Safari intervention group, the intervention comprising a persuasive game modeled after "bingo photography". Participants in the intervention group will be tasked with taking pictures of their urban nature surroundings. A select number of participants from the intervention group will be invited to elaborate on their pictures in a semi-structured, one-on-one interview drawing from a modified photovoice methodology. The resultant transcripts will be analyzed through thematic analysis. Discussion:The findings from this project are expected to provide the basis for knowledge communication deliverables targeted to both traditional academic and general non-academic audiences.
BackgroundInternet addiction symptoms have received increasing research attention as a public health concern among adolescents, with well-documented negative impacts on psychological wellbeing and social functioning. Although loneliness has been identified as an important correlate and prospective risk factor for Internet addiction symptoms, the longitudinal mechanisms underlying this relationship remain underexplored. This three-wave longitudinal study examines the mediating role of rumination in the link between loneliness and internet addiction among Chinese adolescents.MethodsA total of 743 Chinese junior high school students (Mage = 13.34, SD = 0.847; 51.7% female) completed measures of loneliness, rumination, and internet addiction at three time points spaced 6 months apart. A random intercept cross-lagged panel model (RI-CLPM) was employed to separate between-person trait variance from within-person temporal dynamics, allowing a more precise examination of reciprocal and mediational processes.ResultsAt the between-person level, the random intercepts of loneliness, rumination, and internet addiction were not significantly correlated. At the within-personmental health crisislevel, significant bidirectional and unidirectional cross-lagged effects emerged. Specifically, higher-than-usual loneliness predicted subsequent increases in rumination and internet addiction. Elevated rumination, in turn, predicted greater subsequent internet addiction. Internet addiction was also prospectively associated with subsequent increases in both loneliness and rumination, suggesting a reciprocal within-person cycle. Longitudinal mediation analyses revealed that rumination significantly mediated the within-person pathway from loneliness to self-reported Internet addiction. However, the standardized indirect effect was modest, suggesting limited practical magnitude. The reverse indirect effect was not significant.ConclusionsBy employing RI-CLPM, this study delineates the dynamic within-person processes associated with adolescent internet addiction at the individual level. These findings identify rumination as a cognitive mechanism linking the emotional experience of loneliness to the development of Internet addiction symptoms. The results suggest the potential value of targeting both loneliness and maladaptive ruminative thinking in prevention and intervention efforts aimed at reducing internet addiction among adolescents.
Short-form video platforms have become a major component of the pre-consultation information environment for patients with cancer in China and may create new challenges for clinical communication. Contemporary shared decision-making (SDM) and patient decision aids (PtDAs) do not explicitly assess or calibrate beliefs formed before consultation. Algorithmic recommendation and emotionally charged narratives may therefore contribute to pre-consultation cognitive anchoring and alter the conditions under which SDM occurs. We use bone tumor care as a sentinel context rather than claiming that these patients are uniquely susceptible to algorithmic influence. Patients with primary bone tumors or bone metastases may receive immune checkpoint inhibitors (ICIs), and some patients with bone metastases also receive bone-modifying agents. Because prevention of medication-related osteonecrosis of the jaw (MRONJ) is most effective before bone-modifying therapy begins, cognition at the initial consultation may be particularly consequential. We hypothesize that pre-consultation anchoring could contribute to delayed reporting of immune-related adverse events (irAEs), gaps in MRONJ prevention, reduced ICI adherence, and more 90-day unplanned visits. The cited studies establish the clinical importance and recognized determinants of these outcomes but do not demonstrate that short-form video exposure causes them. To support future testing, we propose the Digital Exposure-Cognition-Anchoring assessment (DECA) framework: DECA-E records pre-consultation exposure; DECA-C screens and calibrates cognitive anchors; and DECA-L prospectively evaluates longitudinal associations across exposure, cognition, SDM, and clinical safety. DECA is an unvalidated proposal that requires feasibility and outcome evaluation.
Background:Burnout is highly prevalent among hematologists, with rates reported ranging from 40 to 50%, driven by the unique combination of high clinical complexity, frequent exposure to life-threatening conditions, and the rapid evolution of therapeutic strategies. This study aimed to assess the prevalence and associated factors of burnout among hematologists working in the Community of Madrid, and to examine its impact on their professional performance and personal and social well-being. Methods:Cross-sectional observational study based on an online self-administered survey. Hematologists across all professional settings were invited to participate by completing the Copenhagen Burnout Inventory (CBI). Overall CBI scores and subscale scores (personal, work-related, and patient-related burnout) were calculated. Subgroup analyses were performed according to demographic and professional variables. Results:Forty percent (129/320) of the invited hematologists participated in the survey. Respondents reported significant symptoms of exhaustion and an increased risk of burnout, particularly in the work-related domain. Sixty percent of the respondents often or always experienced fatigue, and 23% frequently felt they "cannot take it anymore." Eighty-four percent reported that work was emotionally exhausting at least sometimes, and 39% frequently ended the workday exhausted. In addition, 55% reported having little energy for family and friends. Patient-related burnout was generally moderate, yet over half strongly agreed that working with patients is hard. Physical or verbal aggression increased from 23 to 30% between 2023 and 2024 (n = 44). Mean CBI scores were 43.93 (SD 18.6) for personal, 46.29 (SD 16.0) for work-related, and 45.25 (SD 21.2) for patient-related burnout, with a total score of 45.16 (SD 15.2); 28% of participants reached at least a moderate level of exhaustion on the total score. Thirty-five percent of respondents (18 of the 53 who answered this item) required psychological or psychiatric consultation in 2024. Conclusion:Hematologists in the Community of Madrid reported relevant symptoms of exhaustion across all dimensions assessed. Workload was the factor most frequently cited by respondents as contributing to burnout. These findings underscore the need for organizational interventions to reduce workload and protect work-life balance.
