Occupational Stress and Burnout Among Nurse Managers: Coping Pathways and Leadership Adaptation in Postpandemic Healthcare.

Non-communicable diseases (NCDs) are chronic, long-duration conditions arising from the interaction of genetic, physiological, environmental, and behavioural factors. In the context of childhood and adolescence, it is important to distinguish two partially overlapping categories that together constitute the paediatric NCD burden []. The first comprises established paediatric NCDs: conditions with onset or significant clinical manifestation in childhood and adolescence, including type 1 diabetes, childhood cancers, asthma, congenital heart disease, and mental health disorders. The second comprises NCD risk factor trajectories: behavioural, metabolic, and environmental exposures that originate in early life and powerfully determine adult NCD risk, including obesity, dyslipidaemia, hypertension, tobacco initiation, and poor nutrition. Both categories are addressed in this paper, and the distinction matters for policy design: the former demands integrated treatment and transitional care, while the latter demands primary prevention and structural reform. The burden of NCDs among children and adolescents varies globally. Despite significant long-term declines in NCD-related mortality, disability driven by NCDs continues to rise. Data from the Global Burden of Disease (GBD) Study 2019 indicate that NCDs account for 49.8% of total disability-adjusted life years (DALYs) in South-East Asia and 65.1% in the Western Pacific region among adolescents aged 10–24 years, with neoplasms, cardiovascular diseases, and mental disorders as the leading contributors across 42 countries []. In the EU, overall NCD years lived with disability among this age group increased by 1.44% between 1990 and 2019, with the largest growth observed in diabetes and kidney diseases (37.8%), driven primarily by an 80.5% increase in diabetes years lived with disability []. NCD death and DALY rates decrease consistently with increases in the sociodemographic index and universal health coverage effective coverage index [], highlighting the equity dimension of this burden. Behavioural risk factors, such as alcohol consumption, drug use, poor diet, and childhood abuse, show stark gender and regional disparities that drive this burden [,]. In 2021, behavioural risk factors contributed to an estimated 9.0 million DALYs from NCDs globally among adolescents and young adults aged 10–24, with substance use disorders and mental disorders as the leading contributors []. Commercial determinants compound these risks, as large corporations in the ultra-processed food and beverage, tobacco, and digital entertainment industries market harmful products to babies [], children, and adolescents [,]. Importantly, these industries are not homogeneous: their health impacts differ considerably in kind, magnitude, and governance response. Tobacco represents the most comprehensively regulated industry, whereas alcohol and ultra-processed food manufacturers are often identified as potential partners in multisectoral health initiatives. Some sectors have shown partial responsiveness to regulatory pressure, for example, through product reformulation under front-of-pack labelling schemes, whereas others, particularly infant formula marketers and digital food advertisers targeting children, have demonstrated systematic resistance to public health regulation. This variation argues for sector-specific regulatory strategies rather than uniform approaches. Traditional public health efforts for paediatric populations have focused predominantly on infectious diseases and acute conditions, sidelining NCDs [,]. National NCD strategies remain adult-centric, contributing to data gaps, delaying early interventions, and entrenching health inequities [,].