An optimal energy mix is a sine qua non for sustainable development. However, the global energy mix is sub-optimally dominated by fossils which endangers energy security and threatens the attainment of sustainable development. Understanding the convergence of energy series can assist the transition path to optimal energy mix and sustainable development. Thus, research on the convergence of several energy series has gained prominence in recent years. This study extends this important niche in the literature on the convergence of natural resources and environmental series by examining the convergence in energy diversification along several dimensions for a panel of 79 lower-middle, higher-middle, and high-income countries. As a departure from the existing studies, the study employs a novel methodology that allows abrupt or smooth changes through the Fourier approximation of smooth breaks, while including factor structures to test for the presence of unit roots in the relative energy diversification series. The results provide evidence of convergence of the energy diversification series in the majority of the considered countries, with 90% of the sample demonstrating convergence. A disaggregated country analysis was conducted and the findings show that 93% of the lower-middle-income countries are converging, while 95% of the upper-middle-income countries and 87% of the high-income countries are converging. Policy implications of the findings are also discussed.

BACKGROUND: In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists\' resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic.
METHODS: A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS.
RESULTS: A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = - 0.33; p < .001 and Beta = - 0.21; p = .001), mental (Beta = - 0.29; p < .001 and Beta = - 0.18; p = .006) and emotional (Beta = - 0.31; p < .001 and Beta = - 0.17; p = .008) work fatigue, higher resilience was significantly related to lower PTSS levels. However, for pharmacists with high levels of physical/mental/emotional work fatigue, the association between resilience and PTSS became non-significant.
CONCLUSIONS: This study highlights the complex relationship between work-related fatigue, resilience, and PTSS in pharmacists. It emphasizes the need to address work-related fatigue for pharmacists\' psychological well-being during crises, offering insights for tailored support and interventions.

OBJECTIVE: New epidemiologic approaches are needed to reduce the scientific uncertainty surrounding the association between extremely low frequency magnetic fields (ELF-MF) and childhood leukemia. While most previous studies focused on power lines, the Transformer Exposure study sought to assess this association using a multi-country study of children who had lived in buildings with built-in electrical transformers. ELF-MF in apartments above built-in transformers can be 5 times higher than in other apartments in the same building. This novel study design aimed to maximize the inclusion of highly exposed children while minimising the potential for selection bias.
METHODS: We assessed associations between residential proximity to transformers and risk of childhood leukemia using registry based matched case-control data collected in five countries. Exposure was based on the location of the subject\'s apartment relative to the transformer, coded as high (above or adjacent to transformer), intermediate (same floor as apartments in high category), or unexposed (other apartments). Relative risk (RR) for childhood leukemia was estimated using conditional logistic and mixed logistic regression with a random effect for case-control set.
RESULTS: Data pooling across countries yielded 16 intermediate and 3 highly exposed cases. RRs were 1.0 (95% CI: 0.5, 1.9) for intermediate and 1.1 (95% CI: 0.3, 3.8) for high exposure in the conditional logistic model. In the mixed logistic model, RRs were 1.4 (95% CI: 0.8, 2.5) for intermediate and 1.3 (95% CI: 0.4, 4.4) for high. Data of the most influential country showed RRs of 1.1 (95% CI: 0.5, 2.4) and 1.7 (95% CI: 0.4, 7.2) for intermediate (8 cases) and high (2 cases) exposure.
CONCLUSIONS: Overall, evidence for an elevated risk was weak. However, small numbers and wide confidence intervals preclude strong conclusions and a risk of the magnitude observed in power line studies cannot be excluded.

To monitor relative vaccine effectiveness (rVE) against COVID-19-related hospitalisation of the first, second and third COVID-19 booster (vs complete primary vaccination), we performed monthly Cox regression models using retrospective cohorts constructed from electronic health registries in eight European countries, October 2021-July 2023. Within 12 weeks of administration, each booster showed high rVE (≥ 70% for second and third boosters). However, as of July 2023, most of the relative benefit has waned, particularly in persons ≥ 80-years-old, while some protection remained in 65-79-year-olds.

UNASSIGNED: Frailty has been recognized as a growing issue in older adults, with recent evidence showing that this condition heralds several health-related problems, including cognitive decline. The objective of this work is to determine if frailty is associated with cognitive decline among older adults from different countries.
UNASSIGNED: We analyzed the baseline the Study on Global Ageing and Adult Health (SAGE), that includes six countries (Ghana, South Africa, Mexico, China, Russia, and India). A cross-section analysis was used to assess how Frailty was related with the Clinical Frailty Scale decision tree, while cognitive decline was evaluated using standardized scores of tests used in SAGE.
UNASSIGNED: A total of 30,674 participants aged 50 years or older were included. There was an association between frailty levels and cognitive performance. For example, women had an inverse relationship between frailty levels and cognitive scores, even when comparing robust category with frailty level 2 (RRR = 0.85; p = 0.41), although the relative risks decrease significantly at level 3 (RRR = 0.66; p = 0.03). When controlling for age, the relative risks between frailty levels 4 to 7 significantly decreased as cognitive performance increased (RRR = 0.46, RRR = 0.52, RRR = 0.44, RRR = 0.32; p < 0.001).
UNASSIGNED: Our results show an association between frailty levels measured in a novel way, and cognitive decline across different cultural settings.

What can be done to reduce misperceptions about COVID-19 vaccines? We present results from experiments conducted simultaneously on YouGov samples in 10 countries (N = 10 600), which reveal that factual corrections consistently reduce false beliefs about vaccines. With results from these 10 countries, we find that exposure to corrections increases belief accuracy by 0.16 on a 4-point scale, while exposure to misinformation decreases belief accuracy by 0.09 on the same scale. We are unable to find evidence that either misinformation or factual corrections affect intent to vaccinate or vaccine attitudes. Our findings on effect duration are less conclusive; when we recontacted participants two weeks later, we observed 39% of the initial accuracy increase, yet this result narrowly misses conventional thresholds of statistical significance (p = 0.06). Taken together, our results illustrate both the possibilities and limitations of factual corrections. Evidence from 10 highly diverse populations shows that exposure to factual information reduces belief in falsehoods about vaccines, but has minimal influence on subsequent behaviours and attitudes.

BACKGROUND: This study aimed to provide a structured description of the commonalities and differences in healthcare structures across Africa to establish a reliable basis for the health technology assessment (HTA) of nutrition and nutrition interventions. A ranking of current nutrition conditions in the general population of the participating countries was included to gain a better understanding of the factors influencing hospital malnutrition (HMN), which will inform future multi-country research.
METHODS: A questionnaire on the structure of the health systems was distributed among ten African countries. Subsections were included that inquired about the drivers or barriers to using principles of HTA to assess nutritional care. Analysis and ranking of malnutrition data were based on data from the Global Hunger Index report and two poverty indicators used by the World Bank.
RESULTS: The health system structure of each country was identified and described, whereas questions about HTA could not always be analyzed due to a lack of adequate in-depth knowledge and skills in most countries. Early experience from some countries demonstrates a conceivable route ahead for African countries in strengthening the capacity for and implementing HTA in accordance with distinct national healthcare contexts and social determinants of health.
CONCLUSIONS: Problems related to nutritional care represent one of the major priorities in the surveyed countries. A future HMN multi-country study will provide valuable insight into the potential of low-cost primary prevention orientations.

Macrosomia has increased rapidly worldwide in the past few decades, with a huge impact on health. However, the effect of PM2.5 and extreme high-temperature (EHT) on macrosomia has been ignored.
This study aimed to explore the association between maternal exposure to EHT, PM2.5 and macrosomia based on the Seventh Demographic and Health Survey (DHS) in 14 countries of Africa.
The study included detailed demographic information on 106 382 births and maternal. Satellite inversion models estimated monthly mean PM2.5 and mean surface temperature of 2 m (SMT2m ). Macrosomia was defined as the birth weight ≥ 4000 g. We used a Cox proportional risk regression model to estimate the association between PM2.5 , EHT and macrosomia. We further explored the susceptibility of exposure to EHT and PM2.5 at different pregnancy periods to macrosomia, and plotted the expose-response curve between PM2.5 and macrosomia risk using a restricted cubic spline function. In addition, the Interplot model was used to investigate the interaction between EHT and PM2.5 on macrosomia. Finally, some potential confounding factors were analysed by stratification.
There was the positive association between EHT, PM2.5 and macrosomia, and the risk of macrosomia with the increase in concentrations of PM2.5 without clear threshold. Meanwhile, EHT and PM2.5 had a higher effect on macrosomia in middle/later and early/middle stages of pregnancy, respectively. There was a significant interaction between EHT and PM2.5 on macrosomia.
Maternal exposure to EHT, PM2.5 during pregnancy was associated with an increased risk of macrosomia in Africa.

BACKGROUND: Vaccines are effective and reliable public health interventions against viral outbreaks and pandemics. However, hesitancy regarding the Coronavirus disease (COVID-19) vaccine is evident worldwide. Therefore, understanding vaccination-related behavior is critical in expanding the vaccine coverage to flatten the infection curve. This study explores the public perception regarding COVID-19 vaccination and identifies factors associated with vaccine hesitancy among the general adult populations in six Southeast Asian countries.
METHODS: Using a snowball sampling approach, we conducted a descriptive cross-sectional study among 5260 participants in Indonesia, Malaysia, Myanmar, Philippines, Thailand, and Vietnam between February and May 2021. Binary logistic regression analysis with a backward conditional approach was applied to identify factors associated with COVID-19 vaccine hesitancy.
RESULTS: Of the total, 50.6% were female, and the median age was 30 years (range: 15-83 years). The majority of the participants believed that vaccination effectively prevents and controls COVID-19 (81.2%), and 84.0% would accept COVID-19 vaccines when they become available. They agreed that health providers\' advice (83.0%), vaccination convenience (75.6%), and vaccine costs (62.8%) are essential for people to decide whether to accept COVID-19 vaccines. About half (49.3%) expressed their hesitancy to receive the COVID-19 vaccines. After adjustment for other covariates, COVID-19 vaccine hesitancy was significantly associated with age, residential area, education levels, employment status, and family economic status. Participants from Indonesia, Myanmar, Thailand, and Vietnam were significantly more likely to express hesitancy in receiving COVID-19 vaccines than those from Philippines.
CONCLUSIONS: In general, participants in this multi-country study showed their optimistic perception of COVID-19 vaccines\' effectiveness and willingness to receive them. However, about half of them still expressed their hesitancy in getting vaccinated. The hesitation was associated with several socioeconomic factors and varied by country. Therefore, COVID-19 vaccination programs should consider these factors essential for increasing vaccine uptake in the populations.

Suicide is the fourth leading cause of death worldwide in young people aged 15-19 years. However, little is known about the correlates of multiple suicide attempts in adolescents, especially from a global perspective. Therefore, the aim of the present study was to investigate the association of putative physical, behavioral, and social correlates with multiple suicide attempts among adolescents aged 12-15 years from 61 countries. Data from the Global school-based Student Health Survey (2009-2017) were analyzed. Multiple suicide attempts was classified as having attempted suicide at least twice in the past 12 months. Multivariable logistic regression analyses were conducted to assess the potential correlates. Data on 162,994 adolescents [mean (SD) age 13.8 (0.9) years; 50.8% boys] were analyzed. The overall prevalence of multiple suicide attempts was 4.4% [range 1.2% (Laos) to 13.8% (Ghana)]. Among those who had attempted suicide at least once in the past 12 months, in the overall sample, food insecurity, smoking, alcohol consumption, cannabis use, amphetamine use, sedentary behavior, sexual intercourse, sleep problems, loneliness, no close friends, and bullying victimization were all independently associated with higher odds for multiple suicide attempts although some regional differences were observed. Our study results indicate potential target factors that could be addressed amongst those who had attempted suicide in the past to reduce future suicide attempts and possibly completed suicides. Furthermore, it is possible that region-specific interventions are necessary.