Shift work schedule patterns and sleep outcomes: results from the SHIFT2HEALTH survey across eight European countries

Introduction: Registered dietitians (RDs) are frequently asked to provide guidance and expertise on dietary supplements; however, few assessment tools are available to objectively evaluate their knowledge in this area. A standardized instrument may help identify educational gaps and support the development of supplement-related competencies within dietetics education and practice. Methods: The 25-item Dietary Supplement Knowledge Assessment Tool for Registered Dietitians (DSKAT-RD) was developed to assess key areas of dietary supplement knowledge, including safety, efficacy, regulation, quality, and evidence-based research. Twelve subject-matter experts independently rated the relevance of each item on a 4-point scale. Item-Level Content Validity Index (I-CVI) values were calculated, with ratings of 3 or 4 considered content valid and ≥0.78 considered acceptable. Quantitative ratings and qualitative feedback guided revisions for clarity, accuracy, relevance, and response-option quality. Revised items were reviewed by a 3-member expert subgroup until consensus was reached. Results: Expert review demonstrated high content validity for the DSKAT-RD. Item-level Content Validity Index (I-CVI) values ranged from 0.75 to 1.00, with 24 of 25 items (96%) meeting the predefined acceptability criterion of ≥0.78. Nineteen items (76%) achieved an I-CVI of 1.00, and the Scale-Level Content Validity Index using the average method (S-CVI/Ave) was 0.97. Six items underwent additional review and revision based on quantitative ratings and qualitative expert feedback related to wording, response options, scientific or regulatory accuracy, and content alignment. Following secondary review by three subject-matter experts, all 25 items were retained in the final instrument. Conclusions: The DSKAT-RD demonstrated strong evidence of content validity and provides a structured method for assessing dietary supplement knowledge among RDs.

Purpose: This study aims to develop and evaluate an adaptive ergonomic framework for reducing Musculoskeletal Disorder (MSD) risks among pre-elderly workers in Micro, Small, and Medium Enterprises (MSMEs). Methodology: This study adopted a sequential quantitative design consisting of two consecutive phases. The first phase involved a cross-sectional ergonomic assessment of 50 pre-elderly MSMEs workers using the Nordic Body Map (NBM), Rapid Entire Body Assessment (REBA), Rapid Upper Limb Assessment (RULA), and Quick Exposure Checklist (QEC). Based on the integrated assessment results, an adaptive ergonomic framework incorporating administrative controls, engineering controls, ergonomic personal protective equipment (PPE), and anthropometry-based workstation redesign was developed. The second phase evaluated the framework through a 14-day before–after intervention study in five selected MSMEs. Results: Most workers were exposed to moderate-to-very high ergonomic risks, with musculoskeletal complaints predominantly affecting the lower back, back, wrists, neck, and lower extremities. Following implementation, QEC exposure scores decreased across the five MSMEs from 68.7–84.5% before intervention to 46.3–63.2% after intervention, accompanied by reductions in REBA/RULA risk classifications and lower NBM complaint levels. Conclusion: The proposed framework effectively reduced ergonomic risks and musculoskeletal complaints among pre-elderly MSMEs workers through practical and low-cost interventions. Originality: This study contributes a comprehensive and context-specific adaptive ergonomic framework that integrates risk assessment, workstation redesign, administrative controls, and ergonomic PPE recommendations tailored to the characteristics of pre-elderly workers in resource-constrained MSMEs.

Objective This study aimed to estimate the prevalence of musculoskeletal symptoms and work-related musculoskeletal disorders (WMSDs) among orthopedic nurses, identify demographic, occupational, and lifestyle characteristics associated with WMSDs, and explore whether routinely collected characteristics could discriminate nurses with WMSDs from those without. Method A single-center cross-sectional study was conducted among nurses at a tertiary orthopedic specialty hospital in China between March and November 2023. Conventional analyses included multivariable logistic regression, modified Poisson regression with robust standard errors, and negative binomial regression. Logistic regression as a benchmark, elastic-net logistic regression, random forest, XGBoost, and support vector machine were compared using repeated 5-fold cross-validation with fold-specific preprocessing. Prediction performance was assessed using AUC with bootstrap 95% CIs, PR-AUC, Brier score, calibration intercept and slope, and descriptive threshold metrics; TreeSHAP was used for model interpretation. Result Among 948 nurses with valid questionnaires, 654 reported musculoskeletal symptoms in the previous 12 months, irrespective of work attribution (68.99%). After excluding 44 participants with uncertain work-related attribution, 604/904 participants were classified as having work-related WMSDs (66.81%). Each 1-point increase in the strict ergonomic risk score was associated with WMSDs in logistic regression (adjusted OR = 2.631, 95% CI 2.039–3.432; p < 0.001) and modified Poisson regression (adjusted PR = 1.283, 95% CI 1.203–1.369; p < 0.001). The highest observed AUC was 0.752 (95% CI 0.721–0.791) for the domain random forest model; the domain XGBoost model had the highest PR-AUC (0.841). Conclusion Musculoskeletal symptoms and WMSDs were common among orthopedic nurses in this single-center sample. Occupational exposure and postural load were associated with WMSDs. The exploratory prediction models showed limited-to-moderate discrimination and warrant prospective multicenter external validation before practical application.

Executive functions (EF) predict school readiness and later adjustment. The cultural-historical tradition gives play a central place in preschool education, yet it remains unclear which types of play, under what conditions, and through which pathways support EF between the ages of 3 and 6. This article aims to critically analyze the evidence on play and EF in this age range, distinguishing between efficacy, association, and mechanism. The method was a systematic review with narrative synthesis, reported according to PRISMA 2020. Of 88 records (2000–2026), 21 primary studies provided direct evidence and 26 works provided complementary evidence. Rule-based games and pretend play showed favorable effects in studies with active control conditions, particularly on inhibitory control. However, the largest-scale curricular study found no effects, and block play showed no main effects. Benefits tend to be concentrated among children with initial disadvantages, and evidence on working memory, cognitive flexibility, and transfer to the classroom is scarce. In conclusion, play appears to be a promising context rather than an effective intervention in itself; its effects depend on executive demand, adult mediation, progression, and implementation fidelity.

Background Cognitive differences across badminton performance levels may be task-specific rather than reflect broad executive-function advantages. Methods Ninety-six participants (33 high-level players, 31 recreational players and 32 non-badminton participants) completed word-color matching, task switching, 1-back and Raven testing. Analyses adjusted for sex, age and Raven score. Task-level MANCOVAs used Pillai’s trace, with HC3-adjusted RT models and binomial mixed models for follow-up comparisons. Additional models distinguished 1-back timeouts from accuracy among answered trials. Results Overall group effects were significant for word-color matching ( p < 0.001) and 1-back ( p = 0.011), but not task switching ( p = 0.592). High-level players responded faster in both word-color conditions than both comparison groups. Condition, response hand and response frequency were confounded, preventing an isolated interpretation of the condition RT contrast. In 1-back, timeout rates were 40.45%, 36.92% and 48.21% in the high-level, recreational and non-badminton groups; both badminton groups had lower adjusted timeout rates than the non-badminton group in both conditions. Accuracy among answered trials showed no clear group differences, and correct-response RT did not differ significantly ( p = 0.572). All-trial accuracy findings were sensitive to model specification. Conclusion High-level players showed faster word-color matching, and both badminton groups had fewer timeouts in the deadline-constrained 1-back task. The findings indicate task-specific performance differences rather than a broad executive-function advantage.