Journal of Occupational Health

Background Playing-related musculoskeletal disorders are highly prevalent among musicians, yet no validated The aim of this study was to translate and culturally adapt the MPIIQM into Japanese and to examine its psychometric properties in students of higher music education institutions (HMEIs). Methods Forward-backward translation followed ISPOR guidelines, with linguistic validation through pilot testing. Psychometric evaluation was conducted in instrumental music majors enrolled at nine HMEIs in Japan, combining in-person and online surveys. Exploratory factor analysis, Cronbach's , and Pearson correlations with the Brief Pain Inventory (BPI), QuickDASH, and QuickDASH Performing Arts Module (PAM) were computed in symptomatic respondents (n = 48). Symptom prevalence in the full HMEIs sample (n = 226) was compared with national data (Ministry of Health, Labour and Welfare in Japan, 2022) using binomial tests with Holm correction. Results Exploratory factor analysis yielded a two-factor structure (pain intensity; pain interference) explaining 76.8% of the variance. Cronbach's was .864 (pain intensity), .890 (pain interference), and .903 (total). The pain intensity subscale correlated strongly with BPI pain severity (r = .71), and the pain interference subscale correlated with the QuickDASH PAM (r = .62). Test-retest reliability could not be computed because only 9 of 30 retest respondents met inclusion criteria. HMEIs students reported significantly higher prevalence than national peers in 25 of 41 symptoms, most markedly stiff shoulders and low back pain. Conclusions The MPIIQM-J demonstrated adequate structural validity, internal consistency, and convergent validity, and is expected to be useful in educational and clinical settings.

Background: Work-related musculoskeletal pain (MSP) is a prevalent concern among factory workers, impacting productivity, absenteeism, and overall quality of life. Factory workers, who perform repetitive tasks and engage in physically demanding work, are particularly susceptible to work-related MSP. Methods: This descriptive cross-sectional quantitative study included 148 factory workers (29 females and 119 males) from two factories in Kigali, surveyed between November 2023 and January 2024. Data were collected using a structured questionnaire that included demographic items, the Modified Nordic Musculoskeletal Questionnaire (M-NMQ) to assess work-related musculoskeletal pain (MSP) symptoms in nine body regions over the previous 12 months and seven days, and questions regarding interference of symptoms with normal work activities. The Coping Strategies Questionnaire (CSQ) was administered to identify coping practices among factory workers. Data analysis comprised descriptive statistics, including mean, frequency, Wilson 95% confidence intervals, and percentage values, calculated using SPSS version 25.0. Results: Participants were predominantly male (119/148, 80.4%), and 98/148 (66.2%) had worked at the factory for more than five years. Overall, 113/148 reported symptoms in at least one body region during the previous 12 months (76.4%, 95% CI 68.9-82.5). The lower back (90/148, 60.8%), shoulders (71/148, 48.0%), neck (61/148, 41.2%), and knees (58/148, 39.2%) were most frequently affected. Symptoms prevented normal work for 41/148 (27.7%, 95% CI 21.1-35.4), and 57/148 reported symptoms during the previous seven days (38.5%, 95% CI 31.1-46.5). Among 113 participants with 12-month symptoms, the most frequent Always responses were seeking medical help (78/113, 69.0%), rest and recovery (75/113, 66.4%), and medication use (59/113, 52.2%); ergonomic adjustment was least frequent (10/113, 8.8%). Conclusion: Self-reported work-related MSP symptoms were common, particularly in the lower back and shoulder, while ergonomic adjustments were uncommon. Frequent medication use highlights the need for comprehensive interventions combining ergonomic training, physiotherapy, and adequate recovery; however, these findings do not establish causation or intervention effectiveness.

Background: Health and administrative professionals in tertiary hospitals face high levels of occupational stress, mental illness, and multimorbidity. The integrated measurement of these multidimensional health aspects is essential for informing effective workplace health promotion strategies. Objective: To describe the general health status of federal public hospital staff and correlate the measured health dimensions to inform institutional health promotion initiatives. Methods: A cross-sectional, online survey study was conducted at Hospital Universitario dos Servidores do Estado (HUSE) between November and December 2025. Data collection was performed via online REDCap questionnaires covering sociodemographic profiles and validated instruments (SRQ-20, MIDAS, AUDIT, WHOQOL-BREF, PHI, WHOQOL-SRPB BREF, CBI, GPAQ, and EPSO). Descriptive statistics, comparisons across employment ties (permanent vs. contracted staff), and Spearman correlation matrices were calculated. Results: Among 197 accesses, 117 completed the informed consent, and 86 finished all questionnaires. Participants were predominantly female, aged 40 to 60 years, and Christian. Screening positivity was 25% for common mental disorders, 21% for headache-related disability, and 10% for harmful drinking. Burnout scores clustered in the second quartile, while quality of life, happiness, and spirituality scores were in the upper third. Median physical activity was 670 min/week. Mental symptoms (SRQ-20), headache (MIDAS), and burnout (CBI) correlated positively with each other and negatively with quality of life, happiness, spirituality, and institutional support (EPSO). Conclusion: The set of instruments proved feasible for situational health diagnosis among hospital staff. Although the sample size was limited in this baseline wave, the initiative fostered workplace health awareness, driving concrete initiatives, including an on-site functional gym and workplace vaccination campaigns.

Background: Vaccine hesitancy and logistical barriers continue to limit influenza vaccination uptake among healthcare personnel. The STRENGTH initiative evaluated employee drivers of influenza vaccine acceptance in healthcare workgroups with lower vaccination compliance. Methods: This mixed-methods program evaluation used a custom Epic electronic medical record dashboard to identify workgroups with lower influenza vaccination rates, followed by focus groups, targeted worksite vaccination clinics, and an anonymous survey. Survey data from 73 respondents were analyzed using descriptive statistics, Mann-Whitney U tests, Kruskal-Wallis tests, chi-square or Fisher exact tests, and Spearman rank correlations. Results: Respondents had a mean age of 44.8 years (SD 11.3); 36 of 70 respondents reporting binary gender were male. Convenience of worksite vaccination received the highest importance ratings (mean 4.72/5), followed by protection from influenza (mean 4.38/5). Both were rated significantly above the neutral midpoint of 3 (Wilcoxon p<0.001). The strongest observed Spearman correlations were between peer pressure and leadership participation (rho=0.47) and between protection from influenza and willingness to receive a future combined influenza/COVID-19 vaccine (rho=0.42). Conclusions: Convenience and perceived protection were the most important vaccination drivers. Employer-sponsored workplace vaccination programs can reduce logistical barriers while providing opportunities for targeted education and trust-building. Keywords: influenza vaccination; healthcare workers; vaccine hesitancy; occupational health; workplace vaccination; employer-sponsored vaccination

Work-related musculoskeletal disorders (WRMSDs) constitute the primary occupational health burden among healthcare professionals (HCPs) globally and directly threaten health workforce sustainability, a critical concern for Sustainable Development Goal 3 (Good Health and Well-being) and SDG 8 (Decent Work and Economic Growth). Despite high prevalence in Cameroon, downstream occupational effects and management strategies across hospital levels remain undocumented. A hospital-based, analytical cross-sectional study was conducted across five referral hospitals in Douala, Cameroon (2019-2022). A total of 561 HCPs were enrolled by stratified random sampling. The Modified Nordic Musculoskeletal Questionnaire and structured interviews assessed WRMSD occupational effects and management strategies. Data were analysed using IBM SPSS v26; chi-square tests and logistic regression assessed associations (p < 0.05). The 12-month WRMSD prevalence was 83.4% (468/561). WRMSDs caused absenteeism in 83.4% of affected HCPs ({chi}2 = 14.414; p < 0.001), reduced daily activity capacity in 55.6%, and job dissatisfaction in 60.4%; 38.9% were considering a career change. Management was predominantly reactive: fitness training (76.3%), rest (41.4%), and non-steroidal anti-inflammatory drugs (NSAIDs; 37.3%). Only 15.0% received physiotherapy referral, and no hospital had a formal WRMSD protocol. WRMSDs impose a substantial and measurable occupational burden on HCPs in Douala. Current management is reactive, non-standardised, and under-integrated with physiotherapy. Evidence-based, multicomponent prevention programmes, physiotherapy integration, and a national occupational health policy are urgently required to protect the healthcare workforce and advance SDG 3 and SDG 8 targets in Cameroon.

ABSTRACT Background: Scapholunate instability (SLI) represents the most prevalent form of carpal instability and is increasingly recognized as a clinically significant occupational condition in manual-labor populations. Repetitive forceful gripping, sustained wrist loading, and awkward joint postures inherent to construction, manufacturing, and heavy industry may predispose workers to progressive scapholunate ligament compromise; however, the specific biomechanical mechanisms underlying dynamic grip force transmission in symptomatic laborers remain poorly characterized. Objective: This study aimed to quantify dynamic grip force profiles and wrist kinematics in manual laborers exhibiting clinical signs of scapholunate instability; compare these biomechanical parameters with asymptomatic worker controls; and identify occupation-specific loading patterns that may contribute to scapholunate ligament compromise. Methods: A cross-sectional observational design was employed. Forty-two male manual laborers, mean age 36.4 (SD 7.2 )years; mean occupational exposure 9.8 (SD 4.1) years, were recruited from construction and surgical instrument manufacturing sites in Sialkot District, Pakistan. Participants were stratified into a symptomatic group (n = 21) based on positive Watson scaphoid shift test, dorsal wrist pain, and functional limitation, and an asymptomatic control group (n = 21). Dynamic grip force was measured using a calibrated Jamar dynamometer across five standardized trials. Wrist kinematics were captured during a simulated gripping task using electrogoniometry. Surface electromyography (sEMG) recorded flexor digitorum superficialis, flexor carpi ulnaris, and extensor carpi radialis longus activity. Scapholunate gap was confirmed radiographically. Statistical analyses included independent samples t-tests, Pearson correlation, and logistic regression ( = 0.05). Results: Symptomatic workers demonstrated significantly reduced grip force (28.4 (SD 5.6) kg versus 41.7 (SD 6.3) kg; p < 0.001) and elevated wrist ulnar deviation during peak gripping (22.3 (SD 4.1) degrees versus 14.6 degrees (SD 3.8) degrees ; p = 0.002) compared with controls. sEMG amplitude of flexor digitorum superficialis was paradoxically elevated in the symptomatic group (mean difference 18.3 microvolts; 95% CI 11.4-25.2), suggesting compensatory hyperactivation. Scapholunate gap correlated positively with years of occupational exposure (r = 0.67; p < 0.001). Logistic regression identified wrist ulnar deviation angle (OR = 2.14; 95% CI 1.43-3.19) and grip force asymmetry (OR = 1.87; 95% CI 1.21-2.89) as independent predictors of instability signs. Conclusions: Manual laborers with work-related scapholunate instability signs exhibit distinct biomechanical signatures during dynamic gripping, including reduced force output, abnormal wrist posture, and compensatory neuromuscular recruitment. Occupational exposure duration is a significant predictor of radiographic scapholunate dissociation. These findings support the integration of ergonomic risk screening and early biomechanical assessment into occupational health protocols for manual labor populations in low- and middle-income settings. Abbreviations: CI: confidence interval, DRUJ: distal radioulnar joint, EMG/sEMG: (surface) electromyography, FCU: flexor carpi ulnaris, FDS: flexor digitorum superficialis, MSD: musculoskeletal disorder, OR: odds ratio, ROM: range of motion, SL/SLI: scapholunate/scapholunate instability, SLIL: scapholunate interosseous ligament, SLAC: scapholunate advanced collapse, WMSDs: work-related musculoskeletal disorders, SD: standard deviation. Keywords: scapholunate instability; dynamic gripping; manual labor; wrist biomechanics; carpal kinematics; occupational ergonomics; grip force; electromyography; Watson scaphoid shift test; work-related musculoskeletal disorders

Background: General illness-related sick leave among teachers represents a relevant public health and workforce management issue. However, long-term population-based evidence describing its distribution and associated factors in Latin American urban educational systems remains limited. This study aimed to characterize the occurrence, distribution, duration, and sociodemographic, occupational, temporal, and territorial factors associated with general illness-related sick leave among public school teachers in Bogota between 2010 and 2025. Methods: A retrospective cohort study was conducted using integrated administrative databases from the Bogota District Department of Education. The primary outcome was the occurrence of at least one general illness-related sick leave episode in a teacher-month observation. Descriptive analyses were performed to characterize sociodemographic and occupational patterns. A multivariable logistic regression model was used to estimate associations. Month and year were included as temporal fixed effects to account for seasonal patterns, academic-calendar effects, pandemic-related disruption, and secular changes. Results: The cohort included 59,697 unique teachers, contributing 537,025 teacher-year observations from teachers with an active employment record between January 1, 2010, and July 31, 2025. Overall, 41.59% of teacher-year observations included at least one general illness-related sick leave episode, and 83.26% of teachers had at least one episode at any time during follow-up. Respiratory diseases accounted for the largest share of episodes, followed by musculoskeletal and infectious diseases. Mean duration varied substantially by diagnostic category, ranging from short respiratory and infectious episodes to longer absences related to neoplasms, circulatory diseases, injuries, and mental health conditions. In the multivariable teacher-month model, sick leave occurrence was associated with age, sex, occupational role, teaching area, contract type, locality, calendar month, and calendar year. Lower odds were observed among male teachers, principals, and teachers with provisional contracts, while temporal and territorial variation was observed across months, years, and localities. Conclusions: General illness-related sick leave among public school teachers in Bogota showed consistent sociodemographic, occupational, temporal, and territorial patterns. Respiratory and musculoskeletal conditions accounted for the largest share of episodes, while chronic, neoplastic, injury-related, circulatory, and mental health conditions were associated with longer durations. These findings provide population-level evidence to inform occupational health surveillance, seasonal preparedness, and workforce planning strategies within urban educational systems.

Background: Lumbar disc herniation, with or without concomitant disc degeneration, is a major cause of lumbar radiculopathy and low back pain, which also a key public musculoskeletal disorder without an exact pathophysiology. Studies have suggested that inflammatory cells and biochemical markers of inflammation also play an important role in lumbar radiculopathy in addition to nerve compression. The aim of the present study was to assess the association of selected circulatory inflammatory markers (CRP, hs-CRP and E-selectin) in patients with lumbar disc herniation without radiological degeneration (LDH) and lumbar disc herniation with radiological degeneration (LDHD). Materials & methods: This case-control study included 208 participants, comprising 104 patients with lumbar disc pathology and 104 controls. Patients were further stratified into LDH (n=67) and LDHD (n=37). Serum CRP, hs-CRP and E-selectin concentrations were measured. Results: Among the patients, 35.6 % presented with LDHD while 64.4 % had only LDH. Significantly increased median hs-CRP (p<0.001) and CRP (p<0.001) were observed in patients groups compared to controls, while CRP showing a consistent independent association across the combined disease (OR=1.68, 95% CI=1.33-2.14, p<0.001), LDHD (OR=1.62, 95% CI=1.16-2.20, p=0.005) and LDH (OR=1.69, 95% CI=1.30-2.20, p<0.001) multivariable models. No significant difference was observed in serum E-selectin between the study groups. Multivariable models incorporating inflammatory and clinical variables demonstrated substantially greater discriminatory performance than individual biomarkers alone. Conclusion: Elevated circulating CRP and hs-CRP concentrations were associated with lumbar disc pathology, with CRP showing a consistent independent association across the combined disease, LDH and LDHD multivariable models, whereas E-selectin showed no significant association. Multivariable models incorporating inflammatory and clinical variables demonstrated greater discriminatory performance than individual biomarkers. These findings support a potential systemic inflammatory component in lumbar disc pathology, although the cross-sectional nature of the measurements does not establish causality or a local inflammatory response within the disc.

Occupational ocular injuries are a preventable yet neglected public health problem, particularly in low- and middle-income countries. Maintenance workers are exposed to diverse ocular hazards daily, yet compliance with protective measures is consistently poor. A descriptive cross-sectional study was conducted among 85 maintenance workers at the Maintenance and Essential Services Organization (MESO) of Kwame Nkrumah University of Science and Technology (KNUST), Ghana, recruited through stratified convenience sampling across seven occupational sections. A structured questionnaire assessed knowledge of ocular hazards and protective equipment, attitudes toward ocular safety, and safety practices. Data were analyzed using IBM SPSS version 26 (IBM Corp., Armonk, NY, USA); chi-square and Fishers exact tests assessed associations (p < 0.05). Participants were predominantly male (84/85, 98.8%), with a mean age of 44.5 {+/-} 10.4 years. Overall knowledge was good (mean 9.40 {+/-} 1.59 out of 11), but attitude and practice scores were average (2.78 {+/-} 0.92 and 3.27 {+/-} 0.93, respectively). Most workers correctly identified goggles and face shields as protective, but only about half recognized that ordinary sunglasses and spectacles offer inadequate protection. Although 97.6% (83/85) recognized the need for ocular protection, only 7.1% (6/85) reported consistent protective eyewear use, and fewer than half (45.9%, 39/85) had received formal ocular safety training. Routine general protective equipment use was significantly associated with ocular protection use (Fishers exact test, p = 0.011). Sand and dust particles were the leading causes of injury and only 25% (5/20) of injured workers sought formal care. Workers demonstrated good knowledge but poor attitudes and practices toward ocular safety, suggesting that knowledge alone does not translate into protective behaviour even within a relatively well-resourced institutional setting. Findings suggest that limited access to task-appropriate protective eyewear may represent an important institutional barrier. Institutional PPE supply and section-specific safety training are essential to bridge this knowledge-practice gap.

Background: Healthcare workers (HCWs) are at increased risk of exposure to vaccine-preventable diseases, including hepatitis B, tuberculosis (TB), and tetanus, due to their occupational environment. Despite the availability of safe and effective vaccines, vaccination coverage among HCWs remains suboptimal in many low- and middle-income countries. This study aimed to determine the vaccination coverage for hepatitis B, tuberculosis, and tetanus among HCWs in district hospitals in Yaounde, Cameroon, and to identify factors associated with incomplete vaccination. Methods: A cross-sectional analytical study was conducted from January to June 2024 across all seven district hospitals in Yaounde. A total of 406 HCWs were enrolled using a structured, self-administered questionnaire. Incomplete vaccination status was defined as nit having received three doses for hepatitis B, at least two doses for TB, and at least three doses for tetanus. Data were analyzed using R Statistics version 4.3.3. Bivariate and multivariate logistic regression models were used to identify predictors of incomplete vaccination, with statistical significance set at p < 0.05. Results: Most of participants were female (75.6%) and aged 30-44 years (65.5%). Full vaccination coverage was 36.2% for hepatitis B, 15.8% for tuberculosis, and 53.4% for tetanus. Unvaccinated proportions were 43.1% for hepatitis B, 0.5% for tuberculosis, and 17.2% for tetanus. Multivariate analysis revealed that HCWs aged 55-66 years were significantly less likely to be incompletely vaccinated against hepatitis B compared to those aged 19-29 years (aOR = 0.07; 95% CI: 0.01-0.39; p = 0.004). Nurses and laboratory technicians were more likely to be incompletely vaccinated than doctors (aOR = 7.06; 95% CI: 3.82-13.6; p < 0.001 and aOR = 3.78; 95% CI: 1.73-8.52; p = 0.001, respectively). Longer professional experience was protective against incomplete vaccination for all three vaccines (p < 0.05). The main barriers to vaccination included high cost, doubts about the need for vaccination, and concerns about side effects. Conclusions: Vaccination coverage for hepatitis B, tuberculosis, and tetanus among HCWs in Yaounde remains suboptimal, particularly for hepatitis B. Addressing financial barriers, improving access to vaccines, and implementing targeted educational interventions are essential to enhance vaccine uptake and protect both HCWs and their patients from preventable occupational infections.

Climate change draws attention to the planetary health perspective in sport and exercise sciences, that is, to physical activity that supports both human wellbeing and environmental sustainability. Active commuting is a sustainable form of physical activity with well-established somatic health benefits. However, more knowledge is needed on its relationship with mental health. We examined dose-response associations between active commuting, anxiety symptoms, and mental wellbeing among Finnish adults, and whether green commuting environment moderates these relationships. We used data from the cross-sectional Environment and Health Survey collected in June-September 2023 in the ten largest cities in Finland. Employed participants with data on anxiety symptoms (Generalized Anxiety Disorder-7, GAD-7), mental wellbeing (World Health Organization-Five Well-Being Index, WHO-5), commuting profile over a year (mode, frequency, distance, and perceived greenness along the commute route), and sociodemographic and lifestyle factors were included (n=1,672; mean age 45.3 years; 53.8% women). Active commuting was defined as travelling the entire commute by walking or cycling (including e-biking) that was converted into approximated annual km/week and MET-h/week. We used linear and logistic regression with restricted cubic splines to evaluate dose-response associations, adjusted for key covariates. The role of perceived greenness was tested using an active commuting x commute greenness interaction term. We found no dose-response relationships between active commuting and anxiety symptoms or mental wellbeing in any of the models. No effect modification by commute greenness was observed. More research on how active commuting may support planetary health from a mental health perspective is needed.

Purpose: Physical behaviors, including physical activity, sedentary time, and sleep, are associated with health and together comprise the 24-hour day. Among working-aged adults, the composition of these 24-hour physical behaviors may vary across occupations, but the extent of these differences remains unknown. This population-based study examined how the composition of 24-hour physical behaviors differs in working-aged adults across occupational groups during work and leisure time. Methods: The study population consisted of 2,809 adults from the Northern Finland Birth Cohort 1966 46-year follow-up study, who wore a hip-worn accelerometer for 14 days. The accelerometry data was combined with self-reported diaries to determine time in bed and work hours. Four occupational groups were aggregated based on occupation type and occupational skill level: high-skill white-collar, low-skill white-collar, high-skill blue-collar and low-skill blue-collar. Time spent on physical behaviors during workdays (including working hours and leisure time separately) and non-workdays were calculated. Differences in physical behavior compositions were assessed using a compositional data analysis approach based on log-ratios of geometric means, with the low-skill blue-collar group as the reference group. Results: Significant differences in 24-hour physical behaviors across occupational groups were mainly observed during workdays. During workday working hours, all other occupational groups had less physical activity (both moderate-to-vigorous and light-intensity physical activity) compared to the reference group. During workday leisure time, significant differences were observed in all physical behaviors, except for sedentary time. On non-working days, the high-skill white collar group had higher moderate-to-vigorous physical activity compared to the reference group. Conclusions: The composition of domain-specific 24-hour physical behaviors differs across occupational groups, particularly during workdays.

Objectives The association between occupational physical activity (OPA) and cardiovascular disease (CVD) may depend on how OPA is classified. This study examined the association between OPA and incident CVD using individual level and occupational group level classifications, and assessed whether factors contributing to attenuation differed. Methods A total of 137,592 employed UK Biobank participants aged 40 to 69 years who were free of CVD at baseline were included. OPA was classified using (i) individual level self reported physical activity at work and (ii) occupational group level two digit Standard Occupational Classification. Associations with incident CVD were examined using Cox proportional hazards models. Attenuation of associations by sociodemographic, lifestyle, health, occupational and psychosocial factors was assessed using univariate adjustments and Heller's coefficient. Results During 1,656,378 person-years of follow up (median 12.6 years), 10,465 incident CVD events occurred. The association between OPA and CVD differed markedly according to exposure classification. High individual level self reported OPA was associated with increased CVD incidence after full adjustment [hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.10 to 1.27]. In contrast, no association was observed when OPA was classified at the occupational-group level using Standard Occupational Classification groupings (HR 1.00, 95% CI 0.94 to 1.06). Sociodemographic and health factors accounted for the greatest attenuation across both classifications, whereas psychosocial factors contributed primarily to associations based on individual-level self-reported OPA. Conclusions The association between occupational physical activity and incident cardiovascular disease differed substantially according to how OPA was classified. These findings highlight exposure classification as a critical consideration when interpreting evidence on the physical activity paradox.

Background: Sacroiliac joint (SIJ) pain is a common musculoskeletal condition among postpartum women due to hormonal, biomechanical, and physiological changes during pregnancy and childbirth. Increased ligament laxity, altered posture, weight gain, and pelvic instability may contribute to sacroiliac joint dysfunction. This condition often leads to pelvic girdle pain, low back pain, and functional limitations that affect daily activities such as walking, sitting, standing, and childcare. Objective: To determine the prevalence of sacroiliac joint pain and assess the level of disability among postpartum females in Sialkot. Materials and Methods: A descriptive cross-sectional study was conducted among 300 postpartum women aged 20-40 years from public and private hospitals in Sialkot. Non-probability convenience sampling approach was employed. Sacroiliac joint pain was assessed using clinical provocation tests including FABER, compression, and distraction tests. Pain intensity was measured using the Numerical Pain Rating Scale (NPRS), and functional disability was evaluated using the Oswestry Disability Index (ODI). Data were analyzed using SPSS version 25. Results: Clinical provocation testing demonstrated positive SIJ pain provocation in 84.0% (n=252) of acute postpartum participants, with severe functional disability observed in 46.0% (n=138). Most women reported moderate pain (74.7%), while 20.7% experienced severe pain. According to the ODI, 46% of participants had severe disability, 37.7% moderate disability, 10.7% minimal disability, and 5.7% were classified as crippled. Conclusion: Sacroiliac joint pain is highly prevalent among postpartum females and is associated with considerable functional disability. Early screening and physiotherapy-based rehabilitation may help reduce pain and improve functional outcomes. Keywords: Sacroiliac joint pain, Postpartum women, Pelvic girdle pain, Functional disability, Oswestry Disability Index.

Aims To explore how workplace environments and racialised hierarchies shape racial inequities in career progression and how the Covid-19 pandemic response influenced these inequities. Design Longitudinal and cross-sectional qualitative study using semi-structured interviews. Methods Semi-structured interviews were conducted with 27 student nurses, healthcare assistants and qualified nurses and 24 senior leaders and management staff recruited in England between January 2019 and March 2021. Data were analysed using thematic analysis. Results Data from 51 healthcare professionals were included in the analysis. Guided by sociological theory on inequality diversions and racialised organisations, three main themes were identified: (1) hidden pipelines to career progression highlights how racial positioning influences unequal career trajectories shaped by informal networks, organisational norms and perceptions of competence; (2) impact of the response to the Covid-19 pandemic illustrates how the pandemic disrupted and reinforced racialised career barriers and (3) psychological effects of racialised inequities on racially minoritised staff captures the emotional burden of navigating these inequities. Conclusion NHS staff perspectives on racialised inequities in career progression highlight the power informal networks have in staff accessing managers who control opportunities. While some staff found new opportunities during the Covid-19 response, others, particularly senior racially minoritised staff, felt redeployments and remote working further hindered their development.

The prevalence of shift work-centric industries and the rise of flexible working render it crucial to investigate the health risks posed by unnatural patterns of work and sleep. Shift working in healthcare has been linked to emotional dysregulation, reduced alertness, and cognitive impacts, with Shift Work Disorder (SWD) classified as a circadian rhythm sleep-wake disorder in the DSM-5. These impacts have historically been attributed to schedule-related sleep disturbances; however certain individuals appear more acutely affected. One measure of individual inflexibility to altered routines is chronotype distinctness, an amplitude dimension of the Caen Chronotype Questionnaire (CCQ). Here, we use Structural Equation Modelling (SEM) to unravel the mechanisms by which sleep and chronotype distinctness govern the neuropsychiatric symptom profiles of a cohort of National Health Service (NHS) shift workers (n=102). We constructed a measurement model, extracting latent constructs from questionnaires for sleep disturbances (PSQI), chronotype distinctness (CCQ), mood disorder (MDQ), depression (PHQ8) and emotional reactivity (ERS), and cognitive assessments. Correlations were identified between constructs, then translated into two SEMs - day and rotating shifts respectively - with sleep and distinctness as predictors of detrimental effects. Models were tested for direct effects, significant paths, and overall model fit. We found that, whilst sleep governed fatigue-based symptoms in day-shift workers, chronotype distinctness determined the severity of adverse effects in rotating-shift workers, including mood disorders and cognitive impairments. We surmise that high chronotype distinctness should be considered a risk factor for adverse effects surrounding night and rotating-shift work, and that interventions should incorporate chronotype-specific remediation.

Aims: The COVID-19 pandemic has significantly impacted global mental health. At the onset of the pandemic (2020), Belgians experienced increased anxiety, depression, and psychological distress compared to 2018 due to the outbreak and the associated public health measures. Understanding the drivers of this distress is crucial for mitigating mental health effects in future crises. This study examines determinants of psychological distress in Belgium during the March 2020 lockdown, using data from the Great Corona Study (GCS). Methods: Data were drawn from the second wave of the GCS, a citizen science initiative conducted in Belgium on March 24, 2020, with 332,169 respondents. Psychological distress was measured using the General Health Questionnaire-12 (GHQ-12), applying a 2/3 cutoff to classify distress levels. To identify predictor variables, a random forest algorithm and literature review reduced 207 initial variables to 16. A generalized linear model was then used to examine associations between predictors and psychological distress Results: Psychological distress was significantly associated with various demographic, social, occupational, and health-related factors. Younger individuals, women, and residents of Wallonia or Brussels exhibited higher odds of distress. Household composition, and the frequency of real-life social interactions significantly influenced distress levels. Occupational status played a key role, with part-time employees and working students exhibiting higher levels of distress. At the same time retired individuals with no current occupation showed lower odds. Perceived workplace safety and compliance with public health measures also significantly impacted distress levels. Lastly, individuals experiencing influenza-like or COVID-19 symptoms had substantially higher odds of psychological distress. Conclusions: Our findings highlight significant sociodemographic, occupational, and health-related predictors of psychological distress during the initial COVID-19 lockdown in Belgium. Young adults, women, individuals with limited in-person interactions, and those experiencing influenza-like illness or COVID-19 symptoms were particularly vulnerable. Additionally, perceptions of others' adherence to preventive measures played a crucial role in mental well-being. These results highlight the complex interplay between individual and environmental factors in shaping psychological distress, providing valuable insights for future public health policies and mental health interventions during crises.

Introduction: High altitude is a physiologically stressful environment due to low barometric pressure and low oxygen availability. This hypoxic stress commonly leads to Acute Mountain Sickness (AMS) during high altitude travel. Additionally, among the physiological adaptations to sustained hypobaric hypoxia, ventilatory acclimatization is characterized by increases in the ventilatory chemoreflex responses to hypoxia and hypercapnia. This study aimed to determine how low-dose prophylactic use of Acetazolamide (ACZ), as utilized for recreational high-altitude travel, impacts these breathing reflexes. Methods: In a double-blind, randomized, placebo-controlled design, participants received 125 mg of ACZ taken twice daily (N=9) or placebo (N=9) starting 2 days prior to ascent to high-altitude (3801 m) and continued until departure. Ventilatory chemoreflex tests were performed at sea level prior to treatment and after 2 days at high altitude. Results: ACZ reduced AMS severity on the first two days at high altitude. ACZ also lowered end-tidal PCO2, indicating elevated baseline alveolar ventilation. Among the ventilatory chemoreflex characteristics, the ventilatory recruitment threshold was significantly lower at high altitude in both groups. We also found a highly significant three-way interaction between location, treatment, and PCO2 on the hypoxic ventilatory response (HVR), indicating that the relationship between PCO2 and the amplitude of the reflex increase in breathing in response to hypoxia is impacted by ACZ. Conclusions: ACZ may sensitize the interaction between the peripheral and central chemoreflex responses. This data provides insight into the mechanisms underlying the beneficial effects of ACZ on sleep quality and AMS symptoms at high altitude.

Objectives: Research on mental health in agriculture has increased in recent years; however, it remains largely focused on farmers themselves and is predominantly male-oriented. The mental health of farm wives and partners, many of whom play integral roles in farm operations, business management, and family life, remains difficult to characterise. This study therefore aims to explore the prevalence and causes of mental health challenges among farm wives and partners, and to investigate their use of, and barriers to, mental health support services. Methods: Quantitative data was collected using over 450 structured questionnaire responses that assessed mental health prevalence, contributing stressors and support service utilisation. Results: Findings indicate that there is a high prevalence of mental ill health amongst farm wives, seemingly due to industry stressors and support role overwhelm. Interpersonal relationships played a significant role in the types of mental distress experienced and highlighted the toll that farm life can take on farm wives' social and emotional connections. Despite a range of formal and informal support services being available, and effective when used, significant barriers to accessing these services were identified, including both practical difficulties and self-stigmatisation due to cultural beliefs. Conclusions: Farm wives and partners experience substantial mental health burdens linked to their diverse and often underrecognized roles within agricultural systems. In future, targeted interventions are needed to reduce stigma, improve service accessibility, and recognize women's contributions within farm enterprises. Further research and dedicated investment are also essential to better understand and help improve the mental health of this overlooked population within agricultural industries.

Background: Medical students face significant mental health challenges, yet psychological distress and post-traumatic stress remain insufficiently characterized in lower-resource settings like Vietnam. Among potential stressors, sexual violence (SV) exposure represents a critical but understudied risk factor. This study evaluated the severity of psychological distress (PD) and post-traumatic stress symptoms (PTSS) among medical students in Northern Vietnam and examined their associations with past-year non-contact and contact SV exposure. Methods: A cross-sectional survey was conducted in May 2025 using REDCap among a probability sample of 555 medical students (years 2 to 5). Mental health outcomes were evaluated using validated instruments: the 21-item Depression, Anxiety, and Stress Scales (DASS-21) for past-week PD and the PTSD Checklist for DSM-5 (PCL-5) for past-month PTSS. Past-year non-contact and contact SV exposures were measured using the Sexual Experiences Survey-Victimization (SES-V). Multivariable linear regression modeled adjusted associations between SV exposure types and mental health symptom severity, testing for sex-specific differences. Results: Overall mental health symptom scores escalated significantly with SV exposure. Median PTSS scores increased from 11 among unexposed students to 20 for non-contact SV and 30 for contact SV (p < 0.001). Similarly, median PD scores increased from 7 (unexposed) to 11.5 (non-contact SV) and 21 (contact SV) (p < 0.001). Adjusted linear models demonstrated robust associations where both non-contact and contact SV exposure were strong independent predictors of heightened PD and PTSS severity, with no significant moderation by sex. In terms of exposure prevalence, 21.26% of students reported non-contact SV (higher in females: 26.24% vs. males: 16.12%) and 10.66% reported contact SV. Conclusions: Vietnamese medical students exposed to sexual violence experience a heavy mental health burden marked by elevated psychological distress and post-traumatic stress symptoms. To protect student mental health in lower resource settings, medical institutions must establish comprehensive trauma-informed psychological support, confidential counseling services, and targeted intervention strategies addressing both contact and non-contact stress exposures. Keywords: psychological distress, post-traumatic stress, non-contact sexual violence, contact sexual violence, university students, Vietnam