Search Results (792)

Frontline workers across health, emergency, and social care sectors are repeatedly exposed to distressing events and chronic stressors as part of their occupational roles. Unlike single-event trauma, these cumulative exposures accrue over time, generating persistent psychological and physiological strain. Traditional diagnostic frameworks, particularly post-traumatic stress disorder (PTSD), were not designed to capture the layered and ongoing nature of this occupational trauma. This commentary introduces the concept of Persistent Traumatic Stress Exposure (PTSE), a framework that reframes trauma among frontline workers as an exposure arising from organisational and systemic conditions rather than solely an individual disorder. It aims to reorient understanding, responsibility, and intervention from a purely clinical lens toward systems, cultures, and organisational duties of care. PTSE is presented as an integrative paradigm informed by contemporary theory and evidence on trauma, moral injury, organisational stress, and trauma-informed systems. The framework synthesises findings from health, emergency, and social care settings, illustrating how repeated exposure, ethical conflict, and institutional pressures contribute to cumulative psychological harm. PTSE highlights that psychological injury may build across shifts, careers, and lifetimes, requiring preventive, real-time, and sustained responses. The framework emphasises that effective support is dependent on both organisational readiness, the structural conditions that enable trauma-informed work, and organisational preparedness, the practical capability to enact safe, predictable, and stigma-free responses to trauma exposure. PTSE challenges prevailing stigma by framing trauma as a predictable occupational hazard rather than a personal weakness. It aligns with modern occupational health perspectives by advocating for systems that strengthen psychological safety, leadership capability and access to support. By adopting PTSE, organisations can shift from reactive treatment models toward proactive cultural and structural protection, honouring the lived realities of frontline workers and promoting long-term wellbeing and resilience. Full article

Background/Objectives: Functional dyspepsia (FD) is a gastrointestinal disorder typically treated by changes in diet and lifestyle. However, in the Colombian population, few studies have addressed its etiology and diagnosis. This exploratory study aimed to identify predictive variables associated with the presence of dyspeptic symptoms (DS). Methods: To address this, a self-survey was conducted evaluating sociodemographic characteristics, clinical history, and dietary habits. A DS index was calculated using participant’s clinical history to explore the characteristics of the groups with more and less DS (MDS and LDS groups). Additionally, a regression model was applied to identify the predictors of higher DS scores. Pooled data from the rolling, cross-sectional eating habits and DS survey between May and July of 2024. We enrolled 102 Colombian participants between 18 and 65 years old. Results: Significant differences were identified between MDS and LDS groups in occupation and dietary habits, with students exhibiting a higher DS index. Moreover, MDS exhibited greater consumption of fatty and fried foods than LDS groups. Regression analysis revealed that high intake of fatty foods and sesame were the best predictors of higher DS index. In contrast, the consumption of Saccharomyces boulardii probiotic and white onion was associated with better gastrointestinal health. Conclusions: Changes in dietary habits are associated with lower DS; the effect and its etiology might also depend on the participants’ occupation and nutritional habits. Full article

Intrinsically disordered regions enable transcription factors (TFs) to undergo structural changes upon ligand binding, facilitating the transduction of environmental signals into gene expression. In this study, we applied molecular modeling methods to explore the hypothesis that unstructured inter-domain and subdomain linkers in bacterial TFs can function as sensors for carbohydrate signaling molecules. We combined molecular dynamics simulations and carbohydrate docking to analyze six repressors with GntR-type DNA-binding domains, including UxuR, GntR and FarR from Escherichia coli, as well as AraR, NagR and YydK from Bacillus subtilis. Protein models obtained from different time points of the dynamic simulations were subjected to sequential carbohydrate docking. We found that the inter-domain linker of the UxuR monomer binds D-fructuronate, D-galacturonate, D-glucose, and D-glucuronate with an affinity comparable to nonspecific interactions. However, these ligands formed multimolecular clusters, a feature absent in the UxuR dimer, suggesting that protein dimerization may depend on linker occupancy by cellular carbohydrates. D-glucose interacted with linkers connecting subdomains of the LacI/GalR-type E-domains in GntR and AraR, forming hydrogen bonds that connected distant structural modules of the proteins, while in NagR, FarR and YydK, it bridged the inter-domain linkers and a β-sheet within the HutC-type E-domains. Hence, our results establish flexible linkers as pivotal metabolic sensors that directly integrate nutritional cues to alter gene expression in bacteria. Full article

We present an adaptive governance engine for blockchain-enabled Vehicular Ad Hoc Networks (VANETs) that regulates the latency–energy–coherence trade-off under rapid topology changes. The core contribution is an Ideal Information Cycle (an operational abstraction of information injection/validation) and a modular VANET Engine implemented as a real-time control loop in NS-3.35. At runtime, the Engine monitors normalized Shannon entropies—informational entropy S over active transactions and spatial entropy $H_{\mathrm{spatial}}$ over occupancy bins (both on $[0,1]$)—and adapts the consensus mode (latency-feasible PoW versus signature/quorum-based modes such as PoS/FBA) together with rigor parameters via calibrated policy maps. Governance is formulated as a constrained operational objective that trades per-block resource expenditure (radio + cryptography) against a Quality-of-Information (QoI) proxy derived from delay/error tiers, while maintaining timeliness and ledger-coherence pressure. Cryptographic cost is traced through counted operations, $E_{\mathrm{crypto}}=e_h{n}_{\mathrm{hash}}+e_{\mathrm{sig}}{n}_{\mathrm{sig}}$, and coherence is tracked using the LCP-normalized definition $D_{\mathrm{ledger}}\left(t\right)$ computed from the longest common prefix (LCP) length across nodes. We evaluate the framework under urban/highway mobility, scheduled partitions, and bounded adversarial stressors (Sybil identities and Byzantine proposers), using 600 s runs with 30 matched random seeds per configuration and 95% bias-corrected and accelerated (BCa) bootstrap confidence intervals. In high-disorder regimes ($S\gtrsim 0.8$), the Engine reduces total per-block energy (radio + cryptography) by more than 90% relative to a fixed-parameter PoW baseline tuned to the same agreement latency target. A consensus-first triggering policy further lowers agreement latency and improves throughput compared with broadcast-first baselines. In the emphasized urban setting under high mobility ($v=30$ m/s), the Engine keeps agreement/commit latency in the sub-100 ms range while maintaining finality typically within sub-150 ms ranges, bounds orphaning (≤10%), and reduces average ledger divergence below $0.07$ at high spatial disorder. The main evaluation is limited to $N\le 100$ vehicles under full PHY/MAC fidelity. PoW targets are intentionally latency-feasible and are not intended to provide cryptocurrency-grade majority-hash security; operational security assumptions and mode transition safeguards are discussed in the manuscript. Full article

Worldwide, prostate cancer (PC) has a rising incidence and is the sixth leading cause of death globally, especially with increasing cases in developing countries. Risk factors for PC include genetic predisposition, family history, race/ethnicity, and various occupational factors like diet, obesity, smoking, and transmitted diseases. The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway can be activated by hormones, cytokines, and growth factors, and it plays a role in many vital biological processes such as cell growth, differentiation, immune regulation, and apoptosis. Dysregulation of JAK/STAT3 can lead to cancer, inflammation, diabetes, and neurodegenerative disorders. In cancers, including PC, STAT3 promotes cell survival, progression, angiogenesis, and metastasis. Inhibitors targeting JAK and STAT3 tested in vivo have shown potential to inhibit malignant cell growth. Additionally, flavonoids are bioactive plant compounds that are important in preventing inflammation, oxidative stress, and cancer. Research indicates that natural flavonoids can be developed into cancer-preventive and therapeutic agents. Experimental studies have demonstrated that some flavonoids can inhibit PC development. The main goal of this review is to present the incidence and risk factors of PC, the JAK/STAT3 pathway and its inhibitors, and how flavonoids may influence this pathology. Full article

Background/Objectives: The aim of this study was to assess the short-term and long-term effectiveness of group voice therapy in changing vocal behaviour and improving voice quality (VQ) among teachers with hyperfunctional voice disorders (HFVD), using both subjective and objective measures. Methods: Thirty-one teachers participated in a structured group voice therapy programme. Participants underwent videoendostroboscopic evaluation of laryngeal morphology and function, perceptual assessment of voice, acoustic analysis of voice samples, and aerodynamic measurements of phonation. Patients’ self-assessment of VQ and its impact on quality of life were measured using a Visual Analogue Scale (VAS) and the Voice Handicap Index-30 (VHI-30). Evaluations were conducted at four time points: pre-therapy (T0), immediately post-therapy (T1), and at 3-month (T3) and 12-month (T12) follow-up visits. Results: Significant improvement was observed between T0 and T1 in perceptual voice evaluations: grade, roughness, asthenia, strain, loudness, fast speaking rate, as well as in neck muscle tension, shimmer, patients’ most harmful vocal behaviours, VHI-30 scores, patients VQ evaluation, and its impact on quality of life (all p < 0.05). Almost all parameters of subjective and objective voice assessment improved over the 12-month observation period, with the greatest improvement between T0 and T12 (all p < 0.05), indicating lasting reduced laryngeal tension and improved phonatory efficiency. Conclusions: Group voice therapy has been shown to be an effective treatment for teachers with HFVD, leading to significant and long-lasting improvements in perceptual, acoustic, and self-assessment outcomes. Therapy also promoted healthier vocal and lifestyle behaviours, supporting its role as a successful and cost-effective rehabilitation and prevention method for occupational voice disorders. Full article

Objectives: This pilot study examined telerehabilitation, which has emerged as a crucial modality in light of recent global challenges such as the COVID-19 pandemic. We examined the effectiveness of a mobile health telerehabilitation intervention developed for older adults with frailty. Methods: Six participants received a telerehabilitation intervention (Rehab Studio) that included exercise training videos. The participants were aged ≥65 years, had no history of dementia or psychiatric disorders, and had mild-to-moderate care needs. For 1 month, the participants received 1 h live online rehabilitation sessions with real-time communication with rehabilitation specialists (physical therapists and occupational therapists: PTs/OTs). The quality of life (QoL) (EuroQol 5 dimensions 5-level [EQ-5D-5L] questionnaire) and self-rated health scores were recorded before and after the intervention, and the data were analyzed using paired t-tests to determine whether the service was effective. Results: Significant differences were found in the total EQ-5D-5L and self-rated health scores (p < 0.05). The mean EQ-5D-5L score increased from 0.63 ± 0.13 before the intervention to 0.77 ± 0.14 after the intervention (p = 0.010), while the mean self-rated health score increased from 66.0 ± 18.0 to 83.3 ± 10.3, respectively (p = 0.019). Conclusions: This study revealed that the mobile health telerehabilitation intervention is safe and can improve QoL for older adults with frailty. However, the effectiveness of the intervention needs to be further investigated in patients with poor performance in daily living activities. Telerehabilitation could help to reduce the burden of nursing care in aging societies with declining birthrates. However, given the extremely small sample size (N = 6), these p-values should be interpreted with considerable caution. Statistical significance in such a small sample does not provide strong evidence for population-level effects, and our findings should be regarded as hypothesis-generating rather than confirmatory. Full article

Emotional dysregulation (ED) reflects a heightened reactivity to stimuli, characterized by excessive negative affect and impulsive behaviors. This study aimed to evaluate ED in workers seeking care for occupational stress and to examine its associations with sociodemographic characteristics, occupational stress, and the severity of anxiety and depressive symptoms. Eighty-seven workers referred for work-related stress were assessed using the Psychological Stress Measure (PSM) and the Job Content Questionnaire (JCQ) for stress, the Beck Depression Inventory-II (BDI-II) and the Self-Rating Anxiety Scale (SAS) for psychopathology, and the RIPoSt-40 for ED. Group comparisons and correlation analyses were conducted using parametric or non-parametric tests, as appropriate. Forty-six percent of participants met criteria for Adjustment Disorders and 54% for Major Depressive Disorder. No significant differences between diagnostic groups emerged for ED or symptom severity. Women reported higher perceived stress and anxiety than men. Negative ED domains—affective instability, negative emotionality, and emotional impulsivity—showed moderate-to-strong positive correlations with stress, anxiety, and depressive symptoms. Affective instability was also related to job stress dimensions, correlating negatively with decision latitude and positively with job demands. Negative emotional dysregulation appears to be a transdiagnostic vulnerability factor for stress-related psychopathology. Screening for ED may support early detection and targeted preventive interventions in occupational settings. Full article

The agri-food supply chain is a relevant contributor to the Italian economy but shows a high incidence of occupational injuries and musculoskeletal disorders, such as lower back pain. Repetitive manual handling and biomechanical overload highlight the need for a prevention-oriented, system-level assessment. This protocol aims to implement a harmonized One Health approach procedure for the multidimensional evaluation of food supply chain workers in real-world settings. The protocol integrates bioelectrical impedance vector analysis (BIVA), nutritional parameters, quality-of-life and psychological measures, and assessments of systemic oxidative stress and systemic serotonin levels. Data from active workers will be compared with those from sedentary individuals. The study will evaluate whether BIVA profiles differ between these groups and examine how the additional indicators contribute to a multidimensional well-being framework. By operationalizing an integrated One Health approach that bridges nutritional, psychological, and biomarker domains, this protocol is designed to guide targeted preventive and educational strategies and inform evidence-based occupational and public health policies across the food supply chain. Trial registration: NCT06896877 (ClinicalTrials.gov), 26 March 2025. Full article

Musculoskeletal disorders (MSDs) remain one of the most persistent occupational health challenges in the U.S. construction industry, where physically demanding tasks such as heavy lifting, kneeling, and working in awkward postures contribute to elevated injury rates. This study aims to identify significant job-related determinants of MSDs in construction-sector occupations. By integrating publicly available datasets from the Survey of Occupational Injuries and Illnesses (SOII) and the Occupational Information Network (O*NET) datasets, a stepwise multiple regression analysis was conducted on 344 occupation-condition observations representing 86 construction occupations, yielding a final model that explained 49% of the variance. Ten significant predictors of MSD events were identified and classified as either risk amplifiers or mitigators. Amplifiers included factors such as exposure to noise, disease, hazardous conditions, and time pressure, all of which heightened MSD risk, while mitigators—such as reduced cramped-space exposure and regulated work environments—were associated with lower risk. MSDs resulting from sprains, strains, or tears accounted for 62.8% of all cases, frequently leading to days away from work (36.3%) or job restrictions (26.5%). The findings underscore that ergonomic risk in construction extends beyond physical strain to include scheduling, equipment design, and work organization. These results provide actionable insights for employers and safety professionals to redesign tools, optimize task rotation, and implement realistic work pacing strategies, ultimately reducing MSD incidence and improving productivity in this high-risk sector. Full article

Background/Objectives: Neck pain is highly prevalent among dentists and has been linked to occupational exposure and cervical degeneration. However, the relationship between cervical MRI findings and symptoms remains inconsistent. This study aimed to explore MRI-based cervical structural profiles in active dentists and examine their associations with neck pain, disability, and participant characteristics. Methods: A cross-sectional study was conducted in 57 practicing dentists. Participants reported neck pain and completed the Numeric Pain Rating Scale and the Neck Disability Index (NDI). Cervical MRI scans were assessed by an experienced musculoskeletal radiologist. An exploratory hierarchical cluster analysis (complete linkage, Euclidean distance) was applied using MRI degenerative variables to identify structural profiles, followed by bivariate comparisons with clinical and occupational factors. Results: Degenerative MRI findings were common (disc bulging, 66.7%; disc herniation, 54.4%). Two MRI-based profiles were identified, one characterized by a higher burden of degenerative findings (including disc and facet changes) (70.2%), and another with fewer/milder degenerative features (29.8%). Neck pain and NDI scores ≥ 20 were more frequent in the higher-degeneration profile (p = 0.001 and p = 0.004, respectively). Age showed a non-linear pattern, with younger dentists reporting pain despite milder MRI changes, whereas older dentists showed more degeneration with fewer symptoms. Conclusions: In this exploratory study, individual MRI findings were not independently associated with neck pain, while a higher overall burden of degenerative changes tended to co-occur with greater symptom reporting and disability. These findings should be interpreted as hypothesis-generating and warrant confirmation in larger, longitudinal studies. Full article

Neurodevelopmental disorders (NDDs) are neurobiological conditions that arise in childhood and affect the personal, social, academic, and occupational development of those who exhibit them. The aim of this study is to analyze scientific research on neurodevelopmental disorders and their relationship to accessibility in cultural heritage, to identify the methodological approaches that currently predominate, and to examine which types of NDD are most studied and which ones are currently overlooked in scientific research. Existing adaptations for people with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) were used as a reference point for the analysis, given their high prevalence in the child population. This study was conducted following the DSM-5-TR criteria and the PRISMA 2020 protocol to select and analyze scientific articles published in the last decade, between 2015 and 2025, obtained from the Scopus database. The results show an increase in the dissemination of scientific literature on access to cultural heritage for people with NDDs, although in a very limited way. Furthermore, within the NDDs themselves, it is ASD that appears to be most represented, with an increase in applied techniques and inclusive experiences. Based on these findings, it is recommended that future research focus on finding educational tools and best practices that promote inclusion and accessibility to cultural heritage for people with other developmental disabilities, such as ADHD. Full article

To address the high incidence of work-related musculoskeletal disorders (WMSDs) at manual edge-banding workstations in furniture factories, and in an effort to tackle the existing research challenges of poor cumulative risk quantification and inconsistent evaluations, this paper proposes a three-stage system for continuous, automated, non-invasive WMSD risk monitoring. First, MediaPipe 0.10.11 is used to extract 33 key joint coordinates, compute seven types of joint angles, and resolve missing joint data, ensuring biomechanical data integrity for subsequent analysis. Second, joint angles are converted into graded parameters via RULA, REBA, and OWAS criteria, enabling automatic calculation of posture risk scores and grades. Third, an Adaptive Pooling Convolutional Neural Network (CNN) and Long Short-Term Memory Network (LSTM) dual-branch hybrid model based on the Efficient Channel Attention (ECA) mechanism is built, which takes nine-dimensional features as the input to predict expert-rated fatigue states. For validation, 32 experienced female workers performed manual edge-banding tasks, with smartphones capturing videos of the eight work steps to ensure authentic and representative data. The results show the following findings: (1) system ratings strongly correlate with expert evaluations, verifying its validity for posture risk assessment; (2) the hybrid model successfully captures the complex mapping of expert-derived fatigue patterns, outperforming standalone CNN and LSTM models in fatigue prediction—by integrating CNN-based spatial feature extraction and LSTM-based temporal analysis—and accurately maps fatigue indexes while generating intervention recommendations. This study addresses the limitations of traditional manual evaluations (e.g., subjectivity, poor temporal resolution, and inability to capture cumulative risk), providing an engineered solution for WMSD prevention at these workstations and serving as a technical reference for occupational health management in labor-intensive industries. Full article

Background: Midwives, despite their health-promoting role, face factors that may disrupt eating behaviours and weight regulation. Little is known about their body weight perception or disordered eating attitudes (DEAs). This study assessed body weight perception and eating attitudes across BMI categories among Polish midwives. Methods: A cross-sectional survey of 568 midwives was conducted. BMI was calculated from self-reported measures and classified according to WHO criteria. Body weight perception was assessed using discrepancies between actual and ideal body weight and between self-perceived ideal body weight and ideal body weight. Long-term weight variability was additionally evaluated using the difference between maximum and minimum adult body weight. Eating attitudes were examined using the Polish version of the EAT-26. Group differences were analysed with the Kruskal–Wallis and χ² tests. Results: Among the participants, 62.9% had normal weight, 23.4% were overweight, and 13.7% were obese. Perceived ideal body weight increased with BMI (p < 0.001). Midwives with overweight and obesity demonstrated higher EAT-26 scores than those with normal BMI, with EAT-26 > 20 observed in 8.3% of overweight and 14.1% of obese participants (p = 0.010). Overweight and obese midwives also showed larger discrepancies between actual and ideal body weight and greater lifetime weight variability, and these groups simultaneously presented higher levels of disturbed eating attitudes. Emotional eating, binge-type episodes, and dieting behaviours were more common among overweight and obese participants, while calorie awareness remained consistently high across groups. Conclusions: Midwives with excess body weight often misperceive their body size and show an elevated risk of DEA. Weight perception appears more strongly related to maladaptive eating patterns than BMI alone. These findings highlight the need for targeted, non-stigmatising interventions addressing weight perception, eating attitudes, and occupational stressors, which may support both midwives’ well-being and their professional effectiveness in delivering nutrition and lifestyle counselling. Full article

It is imperative that society becomes aware of ergonomic risks, not only in an occupational place but also in everyday contexts where they can go unnoticed, such as the educational sector, and in the specific case of students. To identify this risk, an ergonomic assessment was conducted on students in Mexico during remote learning due to COVID-19. To this end, a survey was applied, and the ROSA (Rapid Office Strain Assessment) method was used. According to the survey results, the students reported adopting inappropriate postures during online classes and suffering from musculoskeletal pains. Furthermore, they showed a strong interest in learning about ergonomics and improving their postures. In addition, the application of the ROSA method yielded a significant result 60% of the evaluated students are at high or very high ergonomic risk. Regardless of their profession, ergonomics should be integrated as part of educational programs. This measure would help prevent musculoskeletal disorders once students transition into their respective work environments. Full article