Prevalence of depressive symptoms among seafarers is higher than the general population because of their unique work conditions. Factors that can be changed must be considered and promptly addressed in order to decrease the prevalence of depression. This study aims to clarify the prevalence of depressive symptoms and its related factors among Thai seafarers in an effort to contribute to policies and to prevent depression among Thai seafarers.
This cross-sectional study was conducted among 381 male seafarers working onboard ocean-going vessels of five Thai shipping companies. The questionnaire items comprised of personal factors, working factors and depressive symptoms. Depressive symptoms were assessed using the Thai version of the Patient Health Questionnaire-9. First, the chi-square test was used for univariate analysis. Then, variables significantly associated by the chi-square test were used for multivariate logistic regression analysis (employing the stepwise method) as independent variables.
The average age of participants in this study was 36.4 years. Prevalence of depressive symptoms was 19.5%. One half of the participants (58.3%) reported subjective sleep problems, and most (75.1%) experienced poor coping behaviors. Two thirds (67.5%) were officers, and 10.1% of participants reported that they sometimes or never performed occupational safety behaviors. Regarding work environments, 62.2% reported that their work was disturbed from performing repetitive tasks. Multivariate logistic regression analysis showed two personal factors; sleep problems (Adjusted Odds Ratio (AOR) = 7.97, 95% Confidence interval (CI) = 3.52-18.05) and poor coping behaviors (AOR = 4.46, 95%CI = 1.61-12.34), and three working factors; job assignment (AOR = 2.50, 95%CI = 1.33-4.70), inadequate occupational safety behaviors (AOR = 4.51, 95%CI = 1.85-11.01) and performing repetitive task (AOR = 2.27, 95%CI = 1.16-4.45), were significantly associated with depression.
During COVID-19 pandemic, 19.5% of Thai male seafarers had depressive symptoms. Personal and working factors including subjective sleep problems, poor coping behaviors, job assignment, performing inadequate occupational safety behaviors and performing repetitive tasks were risk factors of depressive symptoms among Thai male seafarers. Monitoring work environment rigorously and coping with work-related stress of the occupational safety behaviors program should be suggested.

UNASSIGNED: Fatigue is an important factor for the safety of ships. In order to alleviate fatigue of the seafarers, the STCW Convention (International Convention on Standards of Training, Certification, and Watchkeeping for Seafarers) has made many regulations on the working time of seafarers. At present, if a crew member takes only one day off at home before returning to work on the ship, the working time on the ship must be re-calculated again. If the time spent at home is not sufficient to allow the crew to recover, the regulations of only stipulating the working time, not stipulating the home vacation time, cannot guarantee the crew\'s fatigue been well controlled. The aim of present study is to explore the relationship between vacation schedule and fatigue of the seafarers.
UNASSIGNED: In present study, a simplified stress scale developed by the Ministry of Labor of Japan has been used as a measurement tool. The method of stratified sampling was adopted. Data collection mainly came from domestic ocean-going seafarers (n = 165). Analysis was conducted using the Cross (chi-square) analysis and hierarchical multiple regression analysis methods.
UNASSIGNED: We found that there was no difference between crew members of different positions in terms of average vacation time and on-board service time (p > 0.05). The length of last vacation time and this service time for seafarers of different positions showed obvious differences (p < 0.01). The rank has a significant effect on the length of the last vacation (χ2 = 101.560, p = 0.000 < 0.01) and the length of this service time (χ2 = 75.624, p = 0.000 < 0.01). Also, the results showed that there was a significant negative correlation between the duration of vacation and overall fatigue (t = -7.160, p = 0.000 < 0.01), while there was a significant positive correlation between the length of service time on board and overall fatigue (t = 3.474, p = 0.001 < 0.01).
UNASSIGNED: The results indicated that a reasonable vacation schedule was crucial for the relief of the seafarers\' fatigue, and also played a positive role in the state of working on the ship again.

Physically and mentally healthy seafarers with professional knowledge and skills are needed for maritime transportation to be safe and sustainable. Mental problems experienced by seafarers can lead to negative consequences, such as bullying, substance dependency, assault, murder and suicide. Accordingly, this study examined the effects of differences between the socio-demographic characteristics of Turkish seafarers on their depression, which is an important criterion for determining mental disorders. Data collected from 403 participants through quantitative research methods were analyzed using SPSS version 25.0 and AMOS version 23.0. Although periodic physical and mental health checks are performed on seafarers, it was found from the analysis results that 33.2% of Turkish seafarers experience mental issues. Moreover, the study determined that the socio-demographic characteristics of seafarers made some differences in their depression levels.

OBJECTIVE: Today, measures to economise in the operation of ships can cause either an effort-reward imbalance or health impairments. The goal of this study was to assess the risk of effort-reward imbalance including overcommitment among officers and ratings on merchant vessels during their assignments and to evaluate lifestyle factors of seafarers as well as the health-promoting conditions on board.
METHODS: A study sample of 308 male seafarers was examined during a total of 20 sea voyages on German container ships (participation rate 91.9%).
RESULTS: Only 11 seafarers were identified as having an increased health risk of an effort-reward imbalance (ER ratio > 1). Officers tended to have a higher risk of an elevated ratio than ratings (4.4% vs. 3.1%) and also showed a significantly higher risk of an ER ratio above the median (58.8% vs. 41.8%; p = 0.022). Compared to land-based populations, the average overcommitment score of seafarers was high (17.9)-particularly among officers (20.3 vs. 16.5; p = 0.031). This corresponded to an elevated risk of overcommitment among officers compared to ratings (OR 2.14; 95% CI 1.78-2.37). This elevated risk remained significant after adjustment for age (OR 2.11; 95% CI 1.76-2.35) and job-related stressors.
CONCLUSIONS: Although an elevated risk of effort-reward imbalance was only observed in few seafarers, this study revealed a high prevalence of overcommitment particularly among officers. In the course of time, overcommitment can lead to mental exhaustion. Therefore, shipboard health-promoting conditions need to be optimised.

One of the main occupational hazards for seafarers is the long exposure to sunlight. This study aimed to determine the efficacy of a mobile phone-based text message intervention in adopting skin cancer preventive behaviors among a sample of seafarers in Genaveh port located in Bushehr province, Iran.
In this randomized controlled trial, 136 seafarers were randomly selected and assigned to the intervention (n = 68) or a control groups (n = 68). As a theoretical basis, we followed the Protection Motivation Theory (PMT) variables to develop the text messages. The data related to PMT variables and skin cancer preventive behaviors were collected through a questionnaire. Forty-five text messages were designed, pre-tested and sent to the seafarers\' phones in the intervention group in 45 days. Both groups were followed up 1 month after the intervention. Data collected in the two stages were analyzed using paired-samples t-test, ANCOVA, and Chi-square tests.
Following the intervention, the mean scores of adopting skin cancer preventive behaviors (p = 0.001), perceived self-efficacy (p = 0.01), protection motivation (p = 0.02), and fear (p = 0.001) were significantly higher in the intervention group than the control group. There was significant reduction in the response costs (p = 0.05) and perceived rewards (p = 0.01) scores in the intervention group compared with the control group after the intervention. However, there were no significant differences in the perceived vulnerability (p = 0.14), perceived severity (p = 0.09), and response efficacy (p = 0.64) between the two groups after the intervention.
The results of the study indicated the effectiveness of mobile phone-based text message intervention for increasing skin cancer preventive behaviors in Iranian seafarers.
Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/7572 ). Registered 16 July, 2016. Prospectively registered.

The well-being of the world\'s 1.65 million seafarers is expected to be secured by the rights established under the Maritime Labour Convention (MLC), 2006 with active monitoring of its implementation by the flag administrations through the International Maritime Organisation (IMO) and International Labour Organisation (ILO). However, the substantial gains achieved since entry into force of MLC in August 2013 appear to have been severely dented by the COVID-19 global pandemic. The aim of the study was to examine, on a pilot basis, the disruptions and challenges to the observance of seafarers\' rights to shore leave, repatriation and medical assistance as an immediate consequence of COVID-19.
The impact of COVID-19 on seafarers\' rights was examined in three dimensions - shore leave, repatriation and medical assistance. Questionnaires were administered online from June to August 2020 to 450 seafarers, top 10 ship-management companies, 35 shipping companies and maritime administrations of top 5 seafarer supplying countries. The paper discusses the results of the survey.
The research revealed a previously unknown majority preference for shore leave, that diminished sharply during COVID-19. Impact on work-performance and well-being of seafarers was revealed with only a fifth of the seafarers having willingly agreed to an extension of contract. This study revealed incidence rates at 6 months into the pandemic of several parameters - delayed repatriations (21.44%) that includes crew with contract extensions (12.48%), crew with completed contract awaiting repatriation (8.96%) and crew that had exceeded 12-month continuous service (0.82%). Compensation, if provided, is meagre and was affecting ratings the most. Deprivation of medical assistance was also revealed.
The well being of seafarers would likely remain vulnerable to breaches, unless measures are put in place to safeguard the rights assured under MLC in the face of uncertainties caused by a pandemic such as COVID-19.

UNASSIGNED: Overweight and cardiovascular risk factors are a common phenomenon in seafarers. According to internal observation particularly crew members from the Pacific Island State of Kiribati are exposed to a high risk. However, in mixed crews, cultural background plays an important role, influencing food choice, and the actual risk.
UNASSIGNED: The Seafarer Nutrition Study (SeaNut study) compared dietary factors in 48 Kiribati and 33 European male seafarers recruited from four merchant ships with a high level of Kiribati manning within a German shipping company. Analysis encompassed the assessment of dietary quality on board, satisfaction with prepared dishes, and individual food intake obtained from 24-h recalls in comparison with nutritional recommendations.
UNASSIGNED: The overall supply of meat, fat and eggs was more than double, whereas the proportions of fruits, vegetables, dairy products and cereals were much lower than recommended. Based on the reported food choices, both groups, but notably Kiribati seafarers, did not reach reference values as to macronutrient, micronutrient and fiber intake. In addition, satisfaction with the meals served, food preferences and knowledge about a healthy diet varied markedly between Kiribati and Europeans.
UNASSIGNED: The present analysis of the SeaNut study revealed the necessity of future health intervention programs, including the quality of the food supply as well as information about a healthy diet and adequate food selection. In mixed crews, culture-specific differences should be considered, in order to facilitate the long-term success of interventions.
UNASSIGNED: German Clinical Trials Registry DRKS00010819 retrospectively. Registered 18 July 2016 (www.germanctr.de).

BACKGROUND: Overweight and obesity is quite prevalent among seafarers. The present study examined differences in BMI and their association with weight, shape and nutrition related attitudes and perceptions among seafarer from Kiribati, a Pacific Island Group, and European origin.
METHODS: The Seafarer Nutrition Study compared 48 Kiribati and 33 European male seafarers from 4 commercial merchant ships. BMI was calculated from measured weight and height. Attitudes to weight, shape and nutrition and disinhibition of control as a characteristic of eating behavior were assessed in a structured interview. Differences between the two groups were examined using t-tests and Chi-square-tests as appropriate. Associations between the variables were examined using Multiple Regression Analysis (MRA) and correlations.
RESULTS: Kiribati seafarer had significantly higher BMI than Europeans (30.3 ± 4.2 vs. 25.6 ± 3.4; p < 0.001). However, MRA indicated that Kiribati were choosing thinner shapes as being \"most similar\" to their appearance than Europeans with the same BMI (B = - 1.14; p < 0.05). In addition, Kiribati had significantly higher scores of disinhibition than Europeans (5.6 ± 2.2 vs. 4.3 ± 2.1; p < 0.01), and disinhibition correlated with BMI in the Kiribati (r = 0.39; p < 0.01), but not in the European group (r = 0.17; n.s.).
CONCLUSIONS: For Kiribati seafarers the nutrition situation on board represents a highly tempting westernized food environment. Their tendency to disinhibited eating facilitates overconsumption and weight gain, and self-evaluation of their shapes as being thinner than comparable Europeans may hamper appropriate weight control behavior.

The functional connectome derived from BOLD resting-state functional magnetic resonance imaging data represents meaningful functional organizations and a shift between distinct cognitive states. However, the body of knowledge on how the long-term career experience affects the brain\'s functional plasticity is still very limited. In this study, we used a dynamic functional connectome characterization (DBFCC) model with the automatic target generation process K-Means clustering to explore the functional reorganization property of resting brain states, driven by long-term career experience. Taking sailors as an example, DBFCC generated seventeen reproducibly common atomic connectome patterns (ACP) and one reproducibly distinct ACP, i.e., ACP14. The common ACPs indicating the same functional topology of the resting brain state transitions were shared by two control groups, while the distinct ACP, which mainly represented functional plasticity and only existed in the sailors, showed close relationships with the long-term career experience of sailors. More specifically, the distinct ACP14 of the sailors was made up of four specific sub-networks, such as the auditory network, visual network, executive control network, and vestibular function-related network, which were most likely linked to sailing experience, i.e., continuously suffering auditory noise, maintaining balance, locating one\'s position in three-dimensional space at sea, obeying orders, etc. Our results demonstrated DBFCC\'s effectiveness in revealing the specifically functional alterations modulated by sailing experience and particularly provided the evidence that functional plasticity was beneficial in reorganizing brain\'s functional topology, which could be driven by career experience.

. Cargo ships are medically isolated, yet neglected environments. We aimed to know about medical events onboard cargo ships.
We reviewed all the medical events onboard a large commercial 471-cargo ship company for 4 years. Medical events were recorded within 20 categories as routinely used by Medical Maritime Consulting Centers, using a 4-level medical gravity score. The χ 2 test and logistic regression and correspondence analyses were used for the analysis of qualitative variables.
Excluding wounds and burns, a total of 322 illness events were notified by onboard health officers for 471 ships totalizing 46 navigation/months. 250 non-infectious events and 72 cases of infection yielded an incidence of 7.75 medical events for 1000 person-years. Infections comprised 25 digestive tract infections, 17 skin infections, 8 urinary tract infections, 5 dental infections, 4 isolated fevers, 3 Ear-Nose-Throat and respiratory tract infections, 2 ocular infections, myalgia and orchitis and 1 case of mediastinal infection. The mean age for sailors diagnosed with infection (37.7 ± 10.5 years) was significantly younger than the mean age of sailors diagnosed with non-infectious disease (40.8 ± 11.2 years) ( P  = 0.04). In affected sailors, the proportion of death and hospitalization among infectious disease cases (26/69, 37.7%) was significantly higher than the proportion of death and hospitalization for non-infectious disease cases (48/242, 19.8%) ( P   =  0.02). The correspondence analysis showed that the routes may be classified according to two main independent risks, digestive infections and skin infections. We observed a statistically significant correlation between the severity of medical events and the maritime route \"North Europe-OI-Australia-India-North Europe\".
These data illustrate a previously underreported variability of the medical risks in various maritime routes; and help promoting targeted medical interventions including the implementation of onboard point-of-care laboratories, to further increase the rapidity of the diagnosis and the medical management onboard cargo ships.