To explore the motivations, barriers and potential solutions from professionals’ perspectives for achieving effective interdisciplinary practice, focusing on communication and collaboration to support work participation and facilitate patients’ return-to-work (RTW).
Qualitative exploratory interview study using thematic analysis.
Primary and work-focused healthcare.
22 healthcare professionals, including occupational physicians (n=5), social insurance physicians (n=5), general practitioners (n=7) and occupational physiotherapists (n=5), were purposively recruited. All participants had at least 1 year of experience and were actively involved in patient care.
None.
Identified motivations, experienced barriers and proposed solutions for improving communication and collaboration across disciplines in work-focused healthcare.
Participating healthcare professionals emphasised the importance of early, proactive and person-centred communication across care domains, particularly in complex or stagnating RTW trajectories. Key barriers included a lack of shared knowledge and common goals, limited understanding of each other’s roles, time constraints, fragmented systems and regulatory restrictions. Proposed solutions focused on clearer coordination of care, improved role clarity and development of a secure, cross-domain digital communication platform to streamline information exchange.
Effective work-focused healthcare requires improved interprofessional communication and patient-centred collaboration. This study highlights when collaboration is most valuable, identifies key barriers and outlines feasible practical solutions. Future research should focus on developing and implementing guidelines that clarify communication pathways and coordination mechanisms within interdisciplinary teams.
Chronic heat stress and recurrent dehydration from strenuous labour in hot environments are recognised drivers of acute kidney injury among agricultural workers in Mesoamerica and may contribute to Chronic Kidney Disease of Unknown Aetiology (CKDu). This study explored how members of a long-term community-based cohort in northwest Nicaragua perceive, experience and adapt to extreme heat, within the broader context of environmental and labour changes.
This qualitative study used focus group discussions with participants from a community-based cohort followed for over a decade and community members. Transcripts were analysed thematically using an interpretative approach, with trustworthiness ensured through peer debriefing, audit trails, triangulation and achievement of thematic saturation.
Rural agricultural communities in northwest Nicaragua participating in a long-term community-based cohort.
Participants were purposively sampled from a prospective community-based cohort and community members were invited to participate. Men and women across different age groups were invited. In total, 91 adults aged ≥18 years participated in 11 face-to-face focus groups, each comprising 8–11 men or women.
Themes describing experiences of heat stress, occupational risk and adaptive responses among agricultural workers.
Participants described worsening heat linked to deforestation, unsafe and inadequate water access and unrealistic production targets that prioritised output over health. In response, workers reported adaptive practices including self-paced labour, hydration routines and peer monitoring. Community solidarity and mutual aid emerged as key sources of resilience despite structural constraints.
Heat stress amplifies occupational hazards and exacerbates health inequities among marginalised agricultural workers. Integrating climate adaptation and equity into labour protections—ensuring access to clean water, adequate shade and fair workloads—can strengthen resilience in agricultural communities facing rising heat-related health risks.
Shift work is associated with disrupted sleep, circadian misalignment and increased risks of adverse health, performance and safety outcomes. Although recommendations for shift workers typically focus on obtaining one long sleep period, many shift workers divide sleep into two episodes, referred to as biphasic sleep. Biphasic sleep may help mitigate sleep loss-related impairments, yet its prevalence, characteristics and potential benefits for shift working populations remain unclear. Existing reviews have examined sleep duration, mental health, or the consequences of shift work broadly, but none have specifically mapped evidence comparing biphasic and monophasic sleep between shifts. This scoping review will identify and summarise the available literature on biphasic sleep among adult shift workers. In addition, we will describe the outcomes and subsequently highlight any possible gaps to inform future research.
This review will follow the Joanna Briggs Institute methodology for scoping reviews and be reported in accordance with the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews guidelines. Biphasic sleep is defined as two distinct sleep episodes within a 24-hour period between work shifts, including two similarly timed sleep periods or one longer sleep combined with a shorter nap. A comprehensive search will be conducted in April 2026 in MEDLINE, Embase, PsycINFO, Web of Science and CENTRAL using controlled vocabulary (eg, Medical Subject Headings) and free-text terms related to shift work and split sleep. Peer-reviewed primary research examining biphasic sleep among adult shift workers will be included, and studies focusing solely on naps during work hours will be excluded. Two reviewers will independently screen titles/abstracts and full texts, with discrepancies resolved through discussion or by consulting a third reviewer. Data will be extracted using a standardised template including study characteristics, sleep parameters and reported outcomes. Results will be summarised descriptively and presented in tables and evidence maps. No statistical synthesis will be performed.
This scoping review will synthesise data from articles published in peer-reviewed journals. As no primary data will be collected and no human participants will be involved, the review is exempted from formal ethical approval. Findings will be disseminated in terms of a peer-reviewed publication and will inform future systematic reviews on sleep strategies among shift workers.
This project is registered with the Open Science Framework accessible at 10.17605/OSF.IO/WY7KJ.
Workplace disclosure of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) identity by healthcare employees is an understudied area and existing reviews of LGBTQ+ disclosure in the healthcare sector focus on patient perspectives, overlooking the unique challenges that healthcare professionals encounter. The aim of this study was to conduct a systematic review and meta-synthesis of existing qualitative studies exploring disclosure experiences of LGBTQ+ healthcare employees.
The literature search integrated current research from 2011 to March 2023 and focused on qualitative studies exploring disclosure experiences of LGBTQ+ healthcare professionals. Ovid served as the primary platform for literature searches, supplemented by forward and backward citation tracking and additional searches in academic databases such as Google Scholar and Scopus. The studies underwent quality evaluation using the Critical Appraisal Skills Programme 2022 checklist and were synthesised using thematic analysis.
The findings revealed seven studies with five prominent themes: (1) risk associated with disclosure, (2) making the decision to disclose, (3) cost of non-disclosure, (4) cost of disclosure and (5) benefit of disclosure. Additionally, five critical factors of disclosure were identified: level, scope, time, elements and method. Finally, the risk–benefit analysis underscored the dilemma and balance between authenticity and conformity, largely influenced by pervasive heteronormativity, resulting in a significant mental toll.
The findings must be interpreted considering certain limitations, such as the lack of generalisability of studies. However, the findings emphasise the critical need for cultivating trusting and accepting healthcare work environments for LGBTQ+ staff.
This study aims to determine the medico-social factors that predicted workers’ low work ability (LWA) leading to long-term absenteeism and permanent medical unfitness for work.
This was a cross-sectional analysis based on a cohort of workers followed up by an occupational health service in the south of France.
Employees visited by the service completed the Work Ability Index (WAI), a self-administered questionnaire. A score of 26 points or more defines high work ability while a score of 25 points or less defines LWA (scoring from 6 to 50 points). Occupational and medico-social data were obtained from computerised medical records. Logistic regression models were applied.
Of the 2104 WAIs completed the baseline questionnaire, the factors most associated with LWA were mental disorders (OR: 3.46), adaptation of the workstation (OR: 2.88) and long/iterative stoppages (OR: 2.87). Blue collar (OR: 2.50), white collar (OR: 2.34), permanent contracts (OR: 1.79), disability (OR: 2.63), recognition as a disabled worker (OR: 2.37), musculoskeletal disorders of the neck (OR: 2.52) and back (OR: 1.69) also appear to be associated with a risk of LWA.
White-collar and blue collar workers affected by mental disorders and musculoskeletal disorders of the neck and back appear to be significantly associated with a risk of LWA. To adjust LWA preventive measures, future studies are needed to discuss further these risk factors.
Traditional epidemiological approaches usually assume a constant relationship between cumulative exposure and disease, which implies that exposure duration and intensity contribute equally to the studied outcome. But individuals with the same cumulative exposure but different temporal exposure patterns may show different risks. Trajectory classification is a good way to assess exposure–risk associations and leads to a better understanding of lifetime variability in exposure levels. Therefore, this study aimed to estimate lung cancer risk according to the exposure trajectory classes on welding fumes and cigarette smoking.
Two population-based German case–control studies.
3498 male lung cancer cases and 3539 male control subjects.
Separate latent class mixed models (LCMM) were determined to identify profiles of exposure trajectories of cigarette smoking and occupational exposure to welding fumes. To investigate the risk of lung cancer by class membership, ORs with 95% CI were estimated via multiple logistic regression analyses.
LCMM each identified four latent classes of smoking and welding-fume exposure. Classes of smokers showed much higher risk of lung cancer compared with never smokers or subjects exposed to welding fumes. Smokers in one class characterised with the highest exposure over the past 10 years had the highest adjusted lung cancer risk (OR=39; 95% CI 29 to 53). For welding, the highest lung cancer risks were found for the class in which exposure to welding fumes in the past 10 years prior to the diagnosis of lung cancer was highest and the duration of welding was also quite high (OR=1.71; 95% CI 0.92 to 3.15).
In summary, LCMM opens a new perspective on dose–effect relationships and could be employed to complement established epidemiological methods.
Healthcare workers (HCWs) are at potential risk of Helicobacter pylori (H. pylori) infection due to occupational exposure, yet epidemiological data in this population remain scarce. This study aimed to investigate the prevalence, risk factors, eradication efficacy and antibiotic resistance patterns of H. pylori infection among HCWs.
Retrospective cohort study.
A tertiary hospital in Beijing, China.
725 HCWs who underwent H. pylori testing via urea breath test between January 2020 and December 2023.
Demographic characteristics, lifestyle factors, symptomatic presentations, treatment regimens and antibiotic resistance profiles were extracted from electronic medical records. Univariate analyses using ² tests identified associations between variables, followed by multivariate logistic regression to adjust for confounders and determine independent predictors of H. pylori eradication failure.
The overall H. pylori positivity rate was 22.9% (166/725). Male gender (OR=1.76, 95% CI 1.20 to 2.59) and alcohol consumption (OR=2.40, 95% CI 1.26 to 4.58) were identified as independent risk factors. Notably, H. pylori-positive individuals had a lower incidence of acid reflux symptoms (9.1% vs 17.3%, p=0.011). The eradication rate was 92.0% (95% CI 84.3% to 96.7%), but clarithromycin resistance reached 47.1% (95% CI 36.4% to 58.0%), with 12.8% (95% CI 6.6% to 21.5%) showing dual resistance to clarithromycin and quinolones.
Targeted screening for male HCWs and alcohol users, along with bismuth-containing quadruple therapy, is recommended. High clarithromycin resistance underscores the need for local antibiotic stewardship.
Workplace violence (WPV) is a significant occupational hazard in healthcare, negatively impacting healthcare workers’ (HCWs) mental health and quality of care. Psychosocial safety climate (PSC), an organisational factor emphasising psychological well-being, may influence how HCWs perceive, experience and cope with WPV. However, its role in shaping HCWs’ coping strategies remains underexplored. This study aims to examine the relationship between PSC and coping mechanisms among HCWs experiencing WPV in public hospitals.
This explanatory sequential mixed-method study comprises two phases. In Phase 1, a multicentre cross-sectional survey will be conducted among at least 440 HCWs working in Malaysian public hospitals that are selected through multistage random sampling. PSC, WPV exposure and coping mechanisms will be assessed using validated tools, including the Psychosocial Safety Climate (PSC-12) scale and the Brief Coping Orientation to Problems Experienced (Brief COPE) questionnaire. Linear regression will examine the association between PSC and coping mechanisms among HCWs exposed to WPV. In Phase 2, 6–12 HCWs with WPV experience in the past year and employed in high-PSC departments will be selected via criterion sampling with maximum variation for in-depth interviews. A semistructured interview guide based on the Transactional Model of Stress and Coping will be developed and pilot tested. Data will undergo thematic analysis until saturation is reached, identifying key themes on how PSC influences coping. Findings from both phases will be integrated using joint display analysis to inform PSC-driven interventions that promote coping and reduce WPV impacts among HCWs.
The study has been approved by the Ministry of Health Medical Research and Ethics Committees and Universiti Teknologi MARA Research Ethics Committee. Informed, written consent will be obtained from all participants. Findings will be disseminated to the Ministry of Health and through peer-reviewed publications.
To investigate the association between occupation and Parkinson’s disease (PD) risk and whether patients with PD change occupation after onset.
A matched case–control study using secondary analysis of the Inpatient Clinico-Occupational Survey of the Rosai Hospital Group in Japan.
A nationwide multicentre inpatient dataset in Japan from 2005 to 2021.
The PD group comprised 2205 inpatients diagnosed with PD (International Statistical Classification of Diseases and Related Health Problems, 10th Revision code G20) and 10 436 matched controls without PD, matched for age, sex, year of admission and hospital.
Associations between the longest-held occupation—classified by industry (blue-collar, service, white-collar) and occupational class (blue-collar workers, service workers, professionals, managers)—and PD risk.
Occupations and industries with increased PD risk; occupational changes before and after diagnosis among participants aged
After adjustment for smoking and alcohol, professionals in the service (OR=2.01, 95% CI 1.24 to 3.25) and white-collar (OR=1.33, 95% CI 1.10 to 1.61) industries had higher PD risk than service workers. Doctors, dentists, veterinarians and pharmacists showed elevated risk. Among 160 PD patients, 47% were unemployed, 20% left voluntarily and 30% continued working after diagnosis. Chemical handling was not associated with PD risk after adjustment of multiple comparisons. Former or current smokers among blue-collar and service workers in blue-collar industry had a decreased risk of PD.
Professionals in the service and white-collar industries, particularly those in healthcare occupations, had a higher risk of PD. Approximately 20% became unemployed after diagnosis.
This study assessed the association between fine particulate matter (PM2.5) exposure during pregnancy and stillbirth in Pakistan. We hypothesised that higher PM2.5 exposure is linked to increased stillbirth risk.
A cross-sectional study using secondary data from the 2017 to 2018 Pakistan Demographic and Health Survey (PDHS), combined with satellite-derived PM2.5 exposure data.
The study covered urban and rural areas across Pakistan, including all four provinces (Punjab, Sindh, Khyber Pakhtunkhwa and Baluchistan) and administrative regions (Gilgit-Baltistan (GB), Islamabad, Federally Administered Tribal Areas and Azad Jammu Kashmir).
The study included 9172 married women aged 15–49 with at least one birth in the past 5 years. Women with incomplete pregnancy outcome data were excluded.
PM2.5 exposure was estimated using satellite data, matching PDHS clusters with the nearest air quality point via MATLAB. Monthly average exposure was categorised into quartiles.
Stillbirth, defined as pregnancy loss at ≥28 weeks gestation.
Multivariable logistic regression was used to assess the association between PM2.5 and stillbirth, adjusting for maternal age, gravidity, wealth index, birth interval, previous adverse pregnancy outcome and region of residence. The stillbirth rate in Pakistan for the most recent pregnancy was 17.0 (14.5–19.9) per 1000 births, with highest rates (28.9) in Baluchistan province. The mean level of PM2.5 exposure in Pakistan was 53.96 (SD 20.42; range 5.9–209.4) µg/m3. PM2.5 exposure was higher for urban (56.43) than rural (51.87) pregnancies, highest in Sindh (78.06) and lowest in GB (13.41) provinces. For every 1 µg/m3 average increase in PM2.5 during the pregnancy period, there was approximately 1% increase in stillbirth.
Increased PM2.5 exposure was strongly associated with stillbirth risk. This underscores the need for targeted public health interventions, such as government regulations, emission controls and clean energy initiatives to protect pregnant women in high-risk areas.
The EPHOR-NIGHT cohort was established to investigate how night shift work influences biological pathways and chronic disease risk using a comprehensive working-life exposome approach, focusing on cardiometabolic, mental health, cognitive and biological ageing outcomes.
The cohort includes 937 workers aged 20–65 years (88% female), primarily from the healthcare sector (96%) in Spain, Sweden, Denmark and the Netherlands. Participants were categorised as permanent day (39%), permanent night (35%) or rotating/other shift workers (26%). Data collection included questionnaires, daily ecological momentary assessments, wearable sensors tracking light, physical activity, heart rate and environmental exposures and biological samples (blood collected once and saliva collected during five points across the day), with harmonised protocols across countries.
From the 937 participants contributing data to the cohort, 708 had complete information from questionnaires, sensors and blood and saliva, with subsets undergoing advanced biological analyses, including genomics, targeted and genome-wide DNA methylation, telomere length and mtDNA copy number, metabolomics, transcriptomics, proteomics, hormone profiling and inflammatory biomarkers and blood metals. Many reported prevalent chronic conditions, including anxiety (27%), depression (18%) and metabolic disturbances. Night shift and rotating shift workers had greater exposure to long shifts and more scheduled rest days compared with day workers. Sleep duration and quality were poorest among permanent night shift workers.
A 2-year follow-up was completed in June 2025, including the collection of additional biomarker data, psychosocial work environment data and data related to female sexual and reproductive health. Findings from the EPHOR-NIGHT study aim to inform prevention strategies and occupational health policies. Data will be made available to support broader research efforts on shift work and health.
To develop a machine learning (ML)-based predictive model to determine the key predictors of dissatisfaction after occupational injury (OI).
A retrospective cohort study.
Nationwide 5-year panel data (2018–2022) from the Panel Study of Workers’ Compensation Insurance in South Korea.
A total of 2298 workers who completed compensation-related medical care in 2017.
Predictive modelling was conducted with extreme gradient (XG) Boost, light gradient boosting machine (GBM), CatBoost and random forest. SHapley Additive Explanations (SHAPs) analysis was conducted to interpret the feature importance. Further, logistic regression was conducted for comparison.
This study evaluated postinjury satisfaction among workers using survey items associated with satisfaction levels. We adopted a 5-year follow-up period.
Of the 2298 participants, 570 were dissatisfied. The logistic regression model indicated that dissatisfaction was significantly associated with unemployment (adjusted OR (aOR) 1.701; 95% CI: 1.296 to 2.233), lack of private health insurance (aOR 1.347; 95% CI 1.042 to 1.741) and lower perceived socioeconomic status (aOR 2.097; 95% CI 1.109 to 3.965). Among the ML models, light GBM exhibited the highest area under the receiver operating characteristics curve (0.770 (95% CI 0.718 to 0.819)), followed by CatBoost (0.768 (95% CI 0.718 to 0.815)), random forest (0.766 (95% CI 0.715 to 0.814)) and XGBoost (0.765 (95% CI 0.717 to 0.811)). The SHAP analysis demonstrated the total number of household members, extent of pain interference with daily life, perceived health status before injury and financial factors as the strongest predictors.
This study developed and demonstrated robust predictive performance of an ML-based model for determining dissatisfaction after OI. The key features included employment status, financial stability, chronic pain and cognitive function, highlighting the multifaceted nature of worker satisfaction.
This study aimed to investigate the evolution of burnout levels and cardiovascular risk among healthcare professionals during the COVID-19 pandemic, identifying associated risk factors, with a particular focus on the impact of working hours, job roles and working units.
A longitudinal, observational study was conducted.
The study was carried out in a medical centre in central Taiwan, encompassing various healthcare settings.
A total of 1502 healthcare workers participated, including nurses, medical technicians, resident doctors, attending physicians and administrative staff. Participants were selected based on consistent completion of a 4-year questionnaire, with exclusion criteria for those who did not complete.
The primary outcome measured was burnout levels using the Chinese version of the Copenhagen Burnout Inventory. The secondary outcome was cardiovascular risk calculated from employees’ health check-up data using the Framingham Risk Score.
Cardiovascular risk showed an upward trend over 4 years. Personal and work-related burnout significantly decreased from 2019 to 2020 but increased from 2020 to 2022, aligning with changes in weekly working hours. Nurses exhibited the most pronounced fluctuations, likely due to their younger average age, shorter professional tenure and frequent direct patient contact, which may heighten vulnerability to pandemic-related stressors. In contrast, attending physicians demonstrated age as a protective factor against burnout, as greater seniority, clinical experience and professional maturity may buffer stress and foster resilience. Participants who worked in COVID-related units generally had elevated burnout levels and working hours. During the initial outbreak in 2020, employees working in COVID-related units had reduced working hours but stable burnout levels, while employees in non-COVID-related units experienced decreased burnout.
This study highlights the critical impact of long working hours on burnout among healthcare professionals during the COVID-19 pandemic. Nurses emerged as a vulnerable group, sensitive to pandemic-induced changes, while attending physicians exhibited more resilience. COVID-related units face greater stress and are less likely to benefit from reductions in patient numbers and working hours during the pandemic. Our findings underscore the urgent need for tailored interventions, such as regulated work hours, flexible scheduling and enhanced organisational and peer support, to protect healthcare workers’ well-being. These strategies can strengthen workforce resilience and sustainability in future public health crises.
To explore how chronic respiratory diseases (CRDs) affect lung health, mobility, frailty and activity levels among young to middle-aged male dairy workers.
This cross-sectional study was conducted from November 2023 to February 2024 across 17 dairy farms in Punjab, Pakistan, involving 380 male dairy workers aged 25–40 years.
Participants were grouped by respiratory health status (chronic respiratory conditions vs healthy workers). Assessments included spirometry (forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), FEV₁/FVC), functional tests (6 Minute Walk Test (6MWT), Timed Up and Go (TUG)), FRAIL (Fatigue, Resistance, Ambulation, Illnesses and Loss of weight) questionnaire and International Physical Activity Questionnaire-Short Form for physical activity. Body mass index was calculated from anthropometric data. Data were analysed using t-tests, ² tests, correlations and regression; a p
Of the 380 male dairy workers enrolled, 365 were included in the final analysis (180 with respiratory conditions, 185 without respiratory conditions). Group A (workers with CRDs, including chronic obstructive pulmonary disease, chronic bronchitis and occupational asthma) demonstrated significantly poorer outcomes compared with group B. Specifically, lung function was markedly reduced in group A (FEV₁: 62.9% vs 91.5%, p=0.002). Functional performance was also impaired, as shown by shorter 6MWT distances (390.7 m vs 479.6 m, p=0.009) and slower TUG times (10.3 s vs 7.7 s, p=0.005). Frailty was almost four times more common in workers with CRDs than in those without (38.9% vs 10.8%, p=0.001). Likewise, low physical activity was substantially higher among workers with respiratory conditions (45.6% vs 10.3%), whereas high activity levels were predominantly observed in those without respiratory conditions (58.9% vs 16.1%). Regression analysis further identified FEV₁, age, frailty status and presence of a respiratory disease as significant predictors of functional capacity.
CRDs among male dairy workers are associated with impaired lung function, decreased physical performance, lower physical activity levels and higher frailty.
Being exposed to adverse psychosocial working conditions contributes to poor mental health in young workers. This study explores whether psychosocial work adversities are a necessary condition for work-related emotional exhaustion in young workers.
Data from the ‘Netherlands Working Condition Survey 2021’ was used. By applying a novel method called Necessary Condition Analysis, we tested two psychosocial work adversities as necessary conditions for high work-related emotional exhaustion in young workers: (1) a composite score of high job demands and low job resources and (2) a composite score of high job demands. Additionally, we tested whether the threshold for job demands as a necessary condition for high work-related emotional exhaustion differed for young workers with low versus high resources.
Secondary data analysis on a national working population-based survey.
The sample included 5791 young workers in the Netherlands (aged
Work-related emotional exhaustion.
A high level of the composite on job demands and job resources is necessary for a high level of work-related emotional exhaustion in young workers (effect size=0.11, p
Both psychosocial work adversities were necessary conditions for high work-related emotional exhaustion in young workers. The necessity threshold for job demands was higher for young workers with high job resources, compared with the group with low resources. This indicates that removing psychosocial work adversities and ensuring the presence of job resources might contribute to the prevention of high work-related emotional exhaustion in young workers.
It has been reported that pregnant women used more cosmetics daily than non-pregnant women. Phenoxyacetic acid is the main metabolite of phenoxyethanol, the most frequent preservative in cosmetics used in Europe, previously associated with reproductive effects (longer time to conception, endocrine disruptors in newborns and poorer verbal comprehension in children). In France, specialised platforms (PREVention ENvIronment Reproduction (PREVENIR)) in university hospital maternity wards are dedicated to evaluating environmental and occupational exposures in patients with pregnancy-related pathologies and supporting targeted prevention efforts. These platforms are composed of occupational health physicians, obstetrician-gynaecologists, midwives, occupational health nurses, and occupational health and environmental engineers. To assess the efficacy of these platforms, we developed a randomised clinical trial, the protocol for which is presented in this paper. The primary objective of the PREVENIR-G Study is to compare the change in urinary phenoxyacetic acid concentrations from baseline to 3 months postintervention between an intervention group and a control group. To date, the intervention has been integrated into routine care in certain facilities; however, its efficacy remains unproven. It is therefore essential to assess the relevance of this intervention, considering both its potential benefits and any adverse effects, such as increased stress or anxiety.
This study is an unblinded, randomised clinical superiority trial with two parallel groups (intervention vs no intervention) in four university maternity hospitals in France. We will include 300 pregnant women (aged 18 years or older) who are under 24 weeks of gestation (150 per group) referred to the participating PREVENIR platforms for management. The intervention will consist of clinical prevention management through the PREVENIR platforms, involving a consultation with an environmental health expert for an assessment of environmental and occupational exposures. During the consultation, targeted prevention messages will be provided based on identified exposures. The no intervention comparator will be a waiting-list control group. At the inclusion visit, patients will receive urine collection vials for samples to be collected at baseline and again at 3 months. Urine samples will be collected twice in a single day, on three separate days, during the collection week at home. In the week following the urine collection period, only participants in the intervention group will engage with the PREVENIR platforms. The primary outcome will be the difference in the urinary phenoxyacetic acid concentration between baseline and 3 months postintervention, compared between the intervention and control groups.
The study has been approved by the hospital ethics committee (CCP Ouest 2, no. 2023-A00941-44). All participants will provide written informed consent. Results will be shared through presentations and publications.
To identify and explore variable groups and individual predictors of long sickness absences outside of well-known predictors such as service use and previous sickness absence using machine learning, explainable artificial intelligence methods and a submodel approach.
Retrospective study of prospectively collected registry data on sickness absences and a questionnaire used in health examinations.
Electronic medical record data of one large occupational health service provider in Finland.
11 533 employees of various occupations who, between 2011 and 2019, had at least once completed a health questionnaire that could be linked to service usage data and who had not had their initial health check within 1 year before or 3 months after completing the questionnaire.
To identify predictors of at least one long sickness absence period (≥30 days) during a 2-year follow-up.
The highest area under the receiver operating characteristic curve (AUROC) values among the submodel groups were for the sickness absence and service use submodels (0.68–0.74). The AUROC values for the submodels of sociodemographic factors, health habits or diseases data category ranged from 0.55 to 0.67 and from 0.55 to 0.67 for the submodels of questionnaire data. The AUROC value of the ensemble model that combined all submodels was 0.79 (95% CI 0.788 to 0.794).
The most important factors predicting long sickness absences based on the submodels were reported pain, number of symptoms and diseases, body mass index and short sleep duration. Additionally, several work and mental health-related variables increased the risk of long sickness absence.
Other variables besides service use and sickness absence increase the accuracy in predicting long sickness absence and providing information for planning interventions that could have a beneficial impact on work disability risk.
Traditional wellness programming focuses on bringing together individual clinicians during personal time for resources and skill building, without a focus on skill building in the contexts and teams they are embedded in daily. We developed a dialectical behaviour therapy (DBT)-informed consultation group, ‘Complex Care Rounds’ (CCR), implemented within the usual workflow of a primary care clinic. The goal of CCR was to facilitate interprofessional team communication and enhance clinician motivation and efficacy, while simultaneously addressing medical and social needs of patients. During the twice-weekly group, team members provided validation and shared feedback while acknowledging the needs of the clinician and patient. The aim of this study was to explore clinician perspectives on participation in CCR and to create a conceptual model to understand CCR’s influence on individual team members as well as team dynamics.
The research was completed at the Comprehensive Care Programme, a primary care programme for patients with Medicare insurance at high risk of hospitalisation at an academic institution in Chicago, Illinois, USA.
This was a qualitative research study examining reflective essays written by participants on how participating in CCR has impacted them. Template analysis, a form of thematic analysis, was applied to code and organise themes.
Participants included 12 clinical team members (physicians, nurses, social service team members) and 7 trainees (AmeriCorps members, medical students) from the Comprehensive Care Programme.
We found that CCR’s shared team frameworks (theme 1) grounded in DBT promoted a practice of self-compassion (theme 2) as well as a validating team environment (theme 3) within our interprofessional team. Improvements to patient care (theme 4) extended from increased personal capacity, support from team members and a structured approach to team interactions.
DBT-informed consultation groups embedded within a clinical practice have the potential to promote a practice and culture of interprofessional team members tending to self and others, while also building one’s own skills and capacity to care for complex patients.
Clinical trial: NCT04489693; Pre-results"
To examine (1) the mediating roles of self-efficacy and future-oriented time perspective (FTP) in the association between workplace culture of health (COH) and diabetes self-management and (2) the moderating effect of diabetes distress on the relationship between self-efficacy and FTP among employees with type 2 diabetes mellitus (T2DM).
A cross-sectional survey.
This study was conducted among employees with T2DM recruited from the Endocrinology Outpatient Departments at three tertiary hospitals in Taiyuan City, Shanxi Province, China, between March and October 2024.
The participants were 462 employees with T2DM who had been employed at their current organisations for at least 3 months following their T2DM diagnosis.
Data on demographics, diabetes-related and work-related factors, workplace COH, self-efficacy, time perspective, diabetes distress and self-management performance were collected via a survey. The moderated mediation effects were examined using Hayes’s PROCESS macro.
Workplace COH was associated with diabetes self-management both directly (β=0.251, 95% CI 0.080 to 0.422, p self-efficacy -> diabetes self-management (indirect effect=0.207, 95% CI 0.110 to 0.308); (2) workplace COH -> self-efficacy -> FTP -> diabetes self-management (indirect effect=0.093, 95% CI 0.051 to 0.144). However, the indirect pathway: workplace COH -> FTP -> diabetes self-management was not significant (indirect effect=0.004, 95% CI –0.055 to 0.063). Additionally, a significant interaction (β=–0.356, 95% CI –0.566 to –0.146, p
This study demonstrated that workplace COH was associated with diabetes self-management both directly and indirectly, specifically through self-efficacy alone and serially through self-efficacy and FTP; it also confirmed that diabetes distress weakens the effect of self-efficacy on FTP, thereby providing a basis for developing interventions to improve self-management among employees with T2DM.
To develop, evaluate and validate the musculoskeletal health climate questionnaire (MHCQ), a multidimensional questionnaire for measuring musculoskeletal health climate.
Cross-sectional test–retest study including systematic scale development and psychometric validation.
The questionnaire was developed following the best practice recommendations for scale development outlined by Boateng et al (2017), including item development, scale development and scale evaluation with input from experts, stakeholders and the target population. Validation was conducted among employees in three physically demanding occupations in Denmark (care workers, slaughterhouse workers and residential painters), where a total of 1420 participants were recruited through labour unions. Of these, 796 completed the retest survey 30 days later. Exploratory and confirmatory factor analyses (EFA and CFA, respectively), internal consistency (Cronbach’s α), test–retest reliability (intraclass correlation coefficients (ICC)) and SEM were used to assess the psychometric properties. Criterion validity was examined via associations with pain points, pain medication use and sickness absence. Construct validity was assessed using correlations with the prevent for work questionnaire (P4Wq).
EFA and CFA supported a four-factor model (supervisor’s practices, workplace practices, worker involvement practices and workers’ pain practices) with good to excellent fit (comparative fit index, 0.96–0.99; root mean square error of approximation, 0.04–0.06). All scales showed high internal consistency (α=0.80–0.88) and excellent test–retest reliability (ICC=0.86–0.92). Associations with musculoskeletal outcomes supported criterion validity. Weak to moderate correlations with the P4Wq subscales (rho
The MHCQ provides a validated, multidimensional tool to assess workplace climate related to musculoskeletal health. It can support workplace assessments and prevention efforts by capturing shared perceptions of leadership, support, involvement and pain-related norms. Further longitudinal research and the use of objective outcome data are needed to assess predictive validity and strengthen the instrument’s applicability across settings.