Effectiveness of mindfulness-based interventions on the well-being of healthcare workers:a systematic review and meta-analysis

Background Growing evidence attests to the efficacy of mindfulness-based interventions(MBIs),but their effectiveness for healthcare workers remains uncertain.Aims To evaluate the evidence for MBIs in improving healthcare workers’psychological well-being.Methods A systematic literature search was conducted on Medline,Embase,Cumulative Index for Nursing and Allied Health Literature,PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords‘healthcare worker’,‘doctor’,‘nurse’,‘allied health’,‘mindfulness’,‘wellness’,‘workshop’and‘program’.Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion.R V.4.0.3 was used for data analysis,with the standardised mean difference as the primary outcome,employing DerSimonian and Laird’s random effects model.Grading of Recommendations,Assessment,Development and Evaluation framework was used to evaluate the quality of evidence.Cochrane’s Risk of Bias 2 tool was used to assess the risk of bias in the included studies.Results A total of 27 studies with 2506 participants were included,mostly from the USA,involving various healthcare professions.MBIs such as stress reduction programmes,apps,meditation and training showed small to large effects on anxiety,burnout,stress,depression,psychological distress and job strain outcomes of the participants.Positive effects were also seen in self-compassion,empathy,mindfulness and well-being.However,long-term outcomes(1 month or longer postintervention)varied,and the effects were not consistently sustained.Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers.The review also highlights limitations such as intervention heterogeneity,reduced power in specific subgroup analyses and variable study quality.

Promoting higher-valent pediatric combination vaccines in China: challenges and recommendations for action

Many countries have adopted higher-valent pediatric combination vaccines to simplify vaccination schedules and minimize health expenditures and social costs.However,China is conservative in the use of pediatric combina-tion vaccines.By reviewing and synthesizing quantitative and qualitative data,in this commentary we identify gaps and challenges to combination vaccine use and make recommendations for promoting use of higher-valent pediatric combination vaccines in China.Challenges are in four dimensions:(1)legislation and regulation,(2)immunization schedule design,(3)vaccine awareness and price,and(4)research and development capacity.To optimize the use of combination vaccines to reduce vaccine-preventable disease burden,we make recommendations that address key challenges:(1)develop policies and regulations to strengthen enforcement of the Vaccine Administration Law and remove regulatory hurdles that hinder combination vaccine research and development,(2)establish an evi-dence-informed policy-making mechanism for combination vaccines,(3)resolve immunization schedule conflicts between monovalent and combination vaccines,and(4)implement effective interventions to increase vaccine awareness and reduce price.

The coverage and challenges of increasing uptake of non-National Immunization Program vaccines in China:a scoping review

Background Non-National Immunization Program (NIP) vaccines have played an important role in controlling vaccine-preventable diseases (VPDs) in China. However, these vaccines are paid out of pocket and there is room to increase their coverage. We focused on four selected non-NIP vaccines in this study, namely Haemophilus influenzae type b (Hib) vaccine, human papillomavirus (HPV) vaccine, pneumococcal conjugate vaccine (PCV), and rotavirus vaccine. We aimed to conduct a scoping review of their vaccination rates and the major barriers faced by health systems, providers, and caregivers to increase coverage.Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We searched five English databases (PubMed, Web of Science, EMBASE, Scopus, and WHO IRIS) and four Chinese databases using the search strategy developed by the study team. Two independent reviewers screened, selected studies, and examined their quality. We summarized the non-NIP vaccine coverage data by vaccine and applied the 5A framework (Access, Affordability, Acceptance, Awareness, Activation) to chart and analyze barriers to increasing coverage.Results A total of 28 articles were included in the analysis (nine pertaining to vaccine coverage, and another 19 reporting challenges of increasing uptake). Among the four selected vaccines, coverage for the Hib vaccine was the highest (54.9-55.9% for 1 dose or more from two meta-analyses) in 2016, while the coverage of the other three vaccines was lower than 30%. Eight of the nine included articles mentioned the regional disparity of coverage, which was lower in under-developing regions. For example, the three-dose Hib vaccination rate in eastern provinces was 38.1%, whereas the rate in central and western provinces was 34.3% and 26.2%, respectively in 2017. Within the 5A framework, acceptance, awareness, and affordability stood out as the most prominent themes. Among the 12 identified sub-themes, high prices, low vaccine awareness, concerns about vaccine safety and efficacy were the most cited barriers to increasing the uptake.Conclusions There is an urgent need to increase coverage of non-NIP vaccines and reduce disparities in access to these vaccines across regions. Concerted efforts from the government, the public, and society are required to tackle the barriers and challenges identified in this study, both on the demand and supply side, to ensure everybody has equal access to life-saving vaccines in China. Particularly, the government should take a prudent approach to gradually incorporate non-NIP vaccines into the NIP step by step, and make a prioritizing strategy based on key factors such as disease burden, financial resources, and market readiness, with special attention to high-risk populations and underdeveloped regions.

Population genomic analysis reveals distinct demographics and recent adaptation in the black flying fox(Pteropus alecto)

As the only mammalian group capable of powered flight,bats have many unique biological traits.Previous comparative genomic studies in bats have focused on long-term evolution.However,the microevolutionary processes driving recent evolution are largely under-explored.Using resequencing data from 50 black flying foxes(Pteropus alecto),one of the model species for bats,we find that black flying fox has much higher genetic diversity and lower levels of linkage disequilibrium than most of the mammalian species.Demographic inference reveals strong population fluctuations(>100 fold)coinciding with multiple historical events including the last glacial change and Toba super eruption,suggesting that the black flying fox is a very resilient species with strong recovery abilities.While long-term adaptation in the black flying fox is enriched in metabolic genes,recent adaptation in the black flying fox has a unique landscape where recently selected genes are not strongly enriched in any functional category.The demographic history and mode of adaptation suggest that black flying fox might be a well-adapted species with strong evolutionary resilience.Taken together,this study unravels a vibrant landscape of recent evolution for the black flying fox and sheds light on several unique evolutionary processes for bats comparing to other mammalian groups.

Distinctive serotypes of SARS-related coronaviruses defined by convalescent sera from unvaccinated individuals

Multiple Omicron sub-lineages have emerged,with Omicron XBB and XBB.1.5 subvariants becoming the dominant variants globally at the time of this study.The key feature of new variants is their ability to escape humoral immunity despite the fact that there are limited genetic changes from their preceding variants.This raises the question of whether Omicron should be regarded as a separate serotype from viruses serologically clustered with the ancestral severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)virus.Here,we present cross-neutralization data based on a pseudovirus neutralization test using convalescent sera from naïve individuals who had recovered from primary infection by SARS-CoV-1 and SARS-CoV-2 strains/variants including the ancestral virus and variants Beta,Delta,Omicron BA.1,Omicron BA.2 and Omicron BA.5.The results revealed no significant cross-neutralization in any of the three-way testing for SARS-CoV-1,ancestral SARS-CoV-2 and SARS-CoV-2 Omicron subvariants.The data argue for the assignment of three distinct serotypes for the currently known human-infecting SARS-related coronaviruses.

Bats and Coronaviruses in the Context of COVID-19

In the Chinese zodiac,2020 was the Year of the Rat.But it was remembered more as a“Year of the Bat”due to the great attention in the general public and scientific community on the role of bats as the reservoir of emerging zoonotic viruses,including severe acute respiratory syndrome coronavirus(SARS-CoV)(1)and the coronavirus disease 2019(COVID-19)virus,also known as SARS-CoV-2(2).Here we provide a summary of our current knowledge on the relationship between bats and viruses,particularly coronaviruses,and discuss the various hypotheses for the origin of the COVID-19 virus.