Introduction: Emergency medical personnel (EMP) face high levels of occupational stress and are at risk of work-related musculoskeletal disorders (WMSDs) due to the physical demands of their work. Objective: This study explored and telemonitored the relationship between occupational stress, burnout, and WMSDs in EMP. Methods: This cross-sectional descriptive study collected data from 430 EMPs working in emergency medical services in Maha Sarakham province, Thailand, using an online questionnaire that included questions about work-related stress, burnout, and musculoskeletal injuries. Results: The findings revealed that most emergency medical personnel reported their stress levels as normal (36.98.4%), followed by mild stress (25.12%). Some workers experienced high levels of stress (14.42%) and a high prevalence of burnout, with emotional exhaustion (47.44%). The most frequently reported musculoskeletal disorders were back pain (49.77%), neck pain (24.19%), and shoulder pain (22.09%). We found a significant relationship between occupational stress and WMSDs (p<0.05) (r= 0.113, p-value 0.019), indicating the association between stress and experiencing musculoskeletal pain and injuries. Conclusion: This study concludes that stress management and applying ergonomic principles may help reduce the occurrence of WMSDs and improve the overall well-being of emergency medical personnel.

Context: Flooding poses ongoing risks to Thai communities, particularly in low-lying areas such as Tha Song Khon Subdistrict in Northeastern Thailand. While government agencies provide some support, gaps persist in early response, health infrastructure, and community preparedness. Climate change has exacerbated these vulnerabilities, highlighting the need for scalable, community-based disaster preparedness models. Objectives: To develop and evaluate the effectiveness of a participatory, community-based flood disaster preparedness model as a climate change adaptation strategy. Design: Participatory action research guided by the Plan–Do–Check–Act framework is implemented in 4 phases: assessment, planning, implementation, and evaluation. Setting: Fourteen flood-prone villages in Tha Song Khon Subdistrict, Maha Sarakham Province, Northeastern Thailand. Participants: A total of 298 individuals, including 200 flood-affected residents, 48 village health volunteers, 28 community representatives, 14 local leaders, 6 rescue officers, and 2 public health staff. Intervention: Implementation of a community-based flood preparedness model, including training of Community Trainers and Community Emergency Response Volunteers (CERVs), establishment of 2 pilot learning centers, and provision of educational materials and first aid equipment. Main Outcome Measure: Changes in disaster preparedness knowledge and skills, community engagement in flood response, and sustainability of preparedness activities 6 months post-intervention. Results: Participants demonstrated improved emergency response and first aid skills. Six months post-intervention, 2 of 14 villages continued model activities and maintained preparedness resources. However, gaps remained in sanitation awareness and access to emergency medical equipment. Conclusions: Participatory, community-based models can enhance flood preparedness and resilience. The approach shows promise for adaptation and scaling in other climate-vulnerable regions.

Background/Objectives: Depressive symptoms, malnutrition and falls are common geriatric syndromes with shared risk factors, yet they are usually studied separately. We aimed to identify latent subgroups defined by their co-occurrence among older adults in Northeast Thailand and the factors associated with membership. Methods: In this cross-sectional survey (October–December 2025), 12,115 community-dwelling adults aged ≥60 years in 39 subdistricts of Maha Sarakham Province were interviewed. Latent class indicators were the Thai 9-item depression scale, Mini Nutritional Assessment Short-Form, calf circumference, recent falls and gait impairment. Associated factors and concurrent correlates were estimated with bias-adjusted three-step models and cluster-robust standard errors. Results: Depressive symptoms affected 8.4%, malnutrition risk 24.5% and fall risk 17.0%; all three co-occurred in 2.2%, 6.2 times more often than expected under independence, mainly reflecting pairwise associations. Three classes emerged: robust (77.3%), nutritional risk (16.2%) and complex multidomain (6.5%). The complex multidomain class featured gait impairment (78.2%) and malnutrition risk (70.2%), with elevated depressive symptoms (40.9%) and recent falls (26.8%). Membership was associated with age ≥80 years (adjusted odds ratio 4.39, 95% CI 2.68–7.18), not working (4.23, 2.59–6.90), high household debt (2.45, 1.29–4.65), ≥2 chronic conditions (3.54, 2.23–5.64), polypharmacy (2.45, 1.73–3.47) and per additional home hazard (1.44, 1.29–1.61). Members more often rated their health as worse than peers (38.6% vs. 1.8% in the robust class). Conclusions: An estimated 6.5% of older adults (5.0–8.5% across closely agreeing specifications) formed a subgroup characterised by mobility impairment, malnutrition risk and socioeconomic disadvantage. Interpreting existing screening results jointly may help target integrated primary care, social welfare and home-modification support; prospective evaluation is needed.

Introduction: Emergency medical services are at high risk of musculoskeletal disorders (MSDs). However, no study has examined the prevalence and impact of these disorders on EMS personnel. Objective: This study aimed to determine the prevalence of work-related musculoskeletal disorders (WMSDs) among EMS personnel in Maha Sarakham Province and its associated factors. Methods: This cross-sectional design was conducted during the period when 614 EMS personnel responded to a survey. There were 430 in the Presence of WMSDs Symptoms group and 184 in the Non-Presence of WMSDs Symptoms group. Thus, the incidence of WMSDs accounted for 70%. The result that male EMS personnel were significantly more likely to experience WMSDs (OR = 5.18, 95% CI: 3.20– 8.40). Personnel with 9 years or less of work experience had a lower risk of WMSDs compared to those with more experience (OR = 0.43, 95% CI: 0.26–0.70). Those who had not received refresher training in patient lifting and handling were at a much higher risk (OR = 5.75, 95% CI: 3.20–10.40). Working more than 13 hours per day also increased the likelihood of WMSDs (OR = 2.40, 95% CI: 1.50–3.78), as did lifting more than 23 kgs. per instance (OR = 5.13, 95% CI: 2.61–10.06). Interestingly, Spending more than 57 minutes per emergency response was associated with a higher risk (OR = 0.26, 95% CI: 0.15–0.43). WMSDs among EMS personnel are caused by a mix of personal, job-related, and ergonomic factors, highlighting the importance of well-rounded prevention strategies like adequate training, workload control, and ergonomic improvements.