Search results for: occupational%20diseases
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 527

Search results for: occupational%20diseases

77 Yoga as a Tool for Public Health

Authors: Divya Kanchibhotla

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Of all the major health threats to emerge, none has challenged the very foundation of public health so profoundly as the rise of non-communicable diseases (NCD). Encouraging a holistic health approach encompasses the community’s well-being. Competent public health grounded with holistic health approach can lay a better foundation in the modern world. Yoga has been increasingly explored as an adjunct therapy to major disorders. This study explores the efficacy of Yoga as a tool for public health. A survey was administered to 5500 adults, and 300 teens were selected from 25 states of India. The study explored the differences in health, happiness, and sustainable living between Yoga-practitioners and Non-yoga practitioners. The study also explored the practice and habits of yoga practitioners (frequency, place, reasons to practice) and Health, Happiness, and Sustainable Living. The subjects were grouped based on age, education, experience in yoga (years of practice), and occupational background. The study population comprised of 54% males and 46% females. Majority of the respondents (59%) were from 18 to 30 years age group. The study indicated that 96.4% of the total respondents have heard of Yoga. However, only 46.8% of the total study population practice yoga (YP) and the rest 53.2% were non-practitioners (NP). From a perspective of how Yoga and health, 72.7% yoga practitioners asserted a peaceful and happy life, 71.9% yoga practitioners felt satisfaction in life, and 70.2 % yoga practitioners had satisfactory health. 61.9% of yoga practitioners report being vegetarian, not eating junk food, and not drinking alcohol than 38.1% Non-Practitioners population. 47% of yoga practitioners found themselves to be more sensitive to the environment compared to only 40% of non-practitioners. India has been witnessing an unprecedented rise in the NCDs, accounting for 61% deaths. The importance of yoga as an adjunct therapy for various disorders and diseases is gaining momentum across the globe. There are various studies on yoga that have indicated benefits of yoga as a unique holistic approach towards lifestyle and a consistent, complementary solution that could be adopted for long-term viability for a well being. The comprehensive study is the first of its kind that takes a holistic look at the prevalence of Yoga for public health in India. Our study is unique and stands out as it is detailed in its outlook with extensive coverage of almost the whole country (surveying 25 out of 29 states) and contemplates on the benefits to an individual at the grass-root level – physical, mental and social outlook. The insights from the study will enable the health care systems and grassroots organizations to make the holistic practice of Yoga accessible to spread sustainable living for a healthy community.

Keywords: non-communicable disease (NCD), sustainable development goal (SDG 3), public health, healthy living

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76 The Effect of Bisphenol A and Its Selected Analogues on Antioxidant Enzymes Activity in Human Erythrocytes

Authors: Aneta Maćczak, Bożena Bukowska, Jaromir Michałowicz

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Bisphenols are one of the most widely used chemical compounds worldwide. They are used in the manufacturing of polycarbonates, epoxy resins and thermal paper which are applied in plastic containers, bottles, cans, newspapers, receipt and other products. Among these compounds, bisphenol A (BPA) is produced in the highest amounts. There are concerns about endocrine impact of BPA and its other toxic effects including hepatotoxicity, neurotoxicity and carcinogenicity on human organism. Moreover, BPA is supposed to increase the incidence the obesity, diabetes and heart disease. For this reason the use of BPA in the production of plastic infant feeding bottles and some other consumers products has been restricted in the European Union and the United States. Nowadays, BPA analogues like bisphenol F (BPF) and bisphenol S (BPS) have been developed as alternative compounds. The replacement of BPA with other bisphenols contributed to the increase of the exposure of human population to these substances. Toxicological studies have mainly focused on BPA. In opposite, a small number of studies concerning toxic effects of BPA analogues have been realized, which makes impossible to state whether those substituents are safe for human health. Up to now, the mechanism of bisphenols action on the erythrocytes has not been elucidated. That is why, the aim of this study was to assess the effect of BPA and its selected analogues such as BPF and BPS on the activity of antioxidant enzymes, i.e. catalase (EC 1.11.1.6.), glutathione peroxidase (E.C.1.11.1.9) and superoxide dismutase (EC.1.15.1.1) in human erythrocytes. Red blood cells in respect to their function (transport of oxygen) and very well developed enzymatic and non-enzymatic antioxidative system, are useful cellular model to assess changes in redox balance. Erythrocytes were incubated with BPA, BPF and BPS in the concentration ranging from 0.5 to 100 µg/ml for 24 h. The activity of catalase was determined by the method of Aebi (1984). The activity of glutathione peroxidase was measured according to the method described by Rice-Evans et al. (1991), while the activity of superoxide dismutase (EC.1.15.1.1) was determined by the method of Misra and Fridovich (1972). The results showed that BPA and BPF caused changes in the antioxidative enzymes activities. BPA decreased the activity of examined enzymes in the concentration of 100 µg/ml. We also noted that BPF decreased the activity of catalase (5-100 µg/ml), glutathione peroxidase (50-100 µg/ml) and superoxide dismutase (25-100 µg/ml), while BPS did not cause statistically significant changes in investigated parameters. The obtained results suggest that BPA and BPF disrupt redox balance in human erythrocytes but the observed changes may occur in human organism only during occupational or subacute exposure to these substances.

Keywords: antioxidant enzymes, bisphenol A, bisphenol a analogues, human erythrocytes

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75 Safer Staff: A Survey of Staff Experiences of Violence and Aggression at Work in Coventry and Warwickshire Partnership National Health Service Trust

Authors: Rupinder Kaler, Faith Ndebele, Nadia Saleem, Hafsa Sheikh

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Background: Workplace related violence and aggression seems to be considered an acceptable occupational hazard for staff in mental health services. There is literature evidence that healthcare workers in mental health settings are at higher risk from aggression from patients. Aggressive behaviours pose a physical and psychological threat to the psychiatric staff and can result in stress, burnout, sickness, and exhaustion. Further evidence informs that health professionals are the most exposed to psychological disorders such as anxiety, depression and post-traumatic stress disorder. Fear that results from working in a dangerous environment and exhaustion can have a damaging impact on patient care and healthcare relationship. Aim: The aim of this study is to investigate the prevalence and impact of aggressive behaviour on staff working at Coventry and Warwickshire Partnership Trust. Methodology: The study methodology included carrying out a manual, anonymised, multi-disciplinary cross-sectional survey questionnaire across all clinical and non-clinical staff at CWPT from both inpatient and community settings. Findings: The unsurprising finding was that of higher prevalence of aggressive behaviours in in-patients in comparison to community staff. Conclusion: There is a high rate of verbal and physical aggression at work and this has a negative impact on the staff emotional and physical well- being. There is also a higher reliance on colleagues for support on an informal basis than formal organisational support systems. Recommendations: A workforce that is well and functioning is the biggest resource for an organisation. Staff safety during working hours is everyone's responsibility and sits with both individual staff members and the organisation. Post-incident organisational support needs to be consolidated, and hands-on, timely support offered to help maintain emotionally well staff on CWPT. The authors recommend development of preventative and practical protocols for aggression with patient and carer involvement. Post-incident organisational support needs to be consolidated, and hands-on, timely support offered to help maintain emotionally well staff on CWPT.

Keywords: safer staff, survey of staff experiences, violence and aggression, mental health

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74 Reaching New Levels: Using Systems Thinking to Analyse a Major Incident Investigation

Authors: Matthew J. I. Woolley, Gemma J. M. Read, Paul M. Salmon, Natassia Goode

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The significance of high consequence, workplace failures within construction continues to resonate with a combined average of 12 fatal incidents occurring daily throughout Australia, the United Kingdom, and the United States. Within the Australian construction domain, more than 35 serious, compensable injury incidents are reported daily. These alarming figures, in conjunction with the continued occurrence of fatal and serious, occupational injury incidents globally suggest existing approaches to incident analysis may not be achieving required injury prevention outcomes. One reason may be that, incident analysis methods used in construction have not kept pace with advances in the field of safety science and are not uncovering the full range system-wide contributory factors that are required to achieve optimal levels of construction safety performance. Another reason underpinning this global issue may also be the absence of information surrounding the construction operating and project delivery system. For example, it is not clear who shares the responsibility for construction safety in different contexts. To respond to this issue, to the author’s best knowledge, a first of its kind, control structure model of the construction industry is presented and then used to analyse a fatal construction incident. The model was developed by applying and extending the Systems Theoretic and Incident Model and Process method to hierarchically represent the actors, constraints, feedback mechanisms, and relationships that are involved in managing construction safety performance. The Causal Analysis based on Systems Theory (CAST) method was then used to identify the control and feedback failures involved in the fatal incident. The conclusions from the Coronial investigation into the event are compared with the findings stemming from the CAST analysis. The CAST analysis highlighted additional issues across the construction system that were not identified in the coroner’s recommendations, suggested there is a potential benefit in applying a systems theory approach to incident analysis in construction. The findings demonstrate the utility applying systems theory-based methods to the analysis of construction incidents. Specifically, this study shows the utility of the construction control structure and the potential benefits for project leaders, construction entities, regulators, and construction clients in controlling construction performance.

Keywords: construction project management, construction performance, incident analysis, systems thinking

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73 Human Factors as the Main Reason of the Accident in Scaffold Use Assessment

Authors: Krzysztof J. Czarnocki, E. Czarnocka, K. Szaniawska

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Main goal of the research project is Scaffold Use Risk Assessment Model (SURAM) formulation, developed for the assessment of risk levels as a various construction process stages with various work trades. Finally, in 2016, the project received financing by the National Center for Research and development according to PBS3/A2/19/2015–Research Grant. The presented data, calculations and analyzes discussed in this paper were created as a result of the completion on the first and second phase of the PBS3/A2/19/2015 project. Method: One of the arms of the research project is the assessment of worker visual concentration on the sight zones as well as risky visual point inadequate observation. In this part of research, the mobile eye-tracker was used to monitor the worker observation zones. SMI Eye Tracking Glasses is a tool, which allows us to analyze in real time and place where our eyesight is concentrated on and consequently build the map of worker's eyesight concentration during a shift. While the project is still running, currently 64 construction sites have been examined, and more than 600 workers took part in the experiment including monitoring of typical parameters of the work regimen, workload, microclimate, sound vibration, etc. Full equipment can also be useful in more advanced analyses. Because of that technology we have verified not only main focus of workers eyes during work on or next to scaffolding, but we have also examined which changes in the surrounding environment during their shift influenced their concentration. In the result of this study it has been proven that only up to 45.75% of the shift time, workers’ eye concentration was on one of three work-related areas. Workers seem to be distracted by noisy vehicles or people nearby. In opposite to our initial assumptions and other authors’ findings, we observed that the reflective parts of the scaffoldings were not more recognized by workers in their direct workplaces. We have noticed that the red curbs were the only well recognized part on a very few scaffoldings. Surprisingly on numbers of samples, we have not recognized any significant number of concentrations on those curbs. Conclusion: We have found the eye-tracking method useful for the construction of the SURAM model in the risk perception and worker’s behavior sub-modules. We also have found that the initial worker's stress and work visual conditions seem to be more predictive for assessment of the risky developing situation or an accident than other parameters relating to a work environment.

Keywords: accident assessment model, eye tracking, occupational safety, scaffolding

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72 Design and Validation of the 'Teachers' Resilience Scale' for Assessing Protective Factors

Authors: Athena Daniilidou, Maria Platsidou

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Resilience is considered to greatly affect the personal and occupational wellbeing and efficacy of individuals; therefore, it has been widely studied in the social and behavioral sciences. Given its significance, several scales have been created to assess resilience of children and adults. However, most of these scales focus on examining only the internal protective or risk factors that affect the levels of resilience. The aim of the present study is to create a reliable scale that assesses both the internal and the external protective factors that affect Greek teachers’ levels of resilience. Participants were 136 secondary school teachers (89 females, 47 males) from urban areas of Greece. Connor-Davidson Resilience Scale (CD-Risc) and Resilience Scale for Adults (RSA) were used to collect the data. First, exploratory factor analysis was employed to investigate the inner structure of each scale. For both scales, the analyses revealed a differentiated factor solution compared to the ones proposed by the creators. That prompt us to create a scale that would combine the best fitting subscales of the CD-Risc and the RSA. To this end, the items of the four factors with the best fit and highest reliability were used to create the ‘Teachers' resilience scale’. Exploratory factor analysis revealed that the scale assesses the following protective/risk factors: Personal Competence and Strength (9 items, α=.83), Family Cohesion Spiritual Influences (7 items, α=.80), Social Competence and Peers Support (7 items, α=.78) and Spiritual Influence (3 items, α=.58). This four-factor model explained 49,50% of the total variance. In the next step, a confirmatory factor analysis was performed on the 26 items of the derived scale to test the above factor solution. The fit of the model to the data was good (χ2/292 = 1.245, CFI = .921, GFI = .829, SRMR = .074, CI90% = .026-,056, RMSEA = 0.43), indicating that the proposed scale can validly measure the aforementioned four aspects of teachers' resilience and thus confirmed its factorial validity. Finally, analyses of variance were performed to check for individual differences in the levels of teachers' resilience in relation to their gender, age, marital status, level of studies, and teaching specialty. Results were consistent to previous findings, thus providing an indication of discriminant validity for the instrument. This scale has the advantage of assessing both the internal and the external protective factors of resilience in a brief yet comprehensive way, since it consists 26 items instead of the total of 58 of the CD-Risc and RSA scales. Its factorial inner structure is supported by the relevant literature on resilience, as it captures the major protective factors of resilience identified in previous studies.

Keywords: protective factors, resilience, scale development, teachers

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71 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London

Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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70 Co-Development of an Assisted Manual Harvesting Tool for Peach Palm That Avoids the Harvest in Heights

Authors: Mauricio Quintero Angel, Alexander Pereira, Selene Alarcón

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One of the elements of greatest importance in agricultural production is the harvesting; an activity associated to different occupational health risks such as harvesting in high altitudes, the transport of heavy materials and the application of excessive muscle strain that leads to muscular-bone disorders. Therefore, there is an urgent necessity to improve and validate interventions to reduce exposition and risk to harvesters. This article has the objective of describing the co-development under the ergonomic analysis framework of an assisted manual harvesting tool for peach palm oriented to reduce the risk of death and accidents as it avoid the harvest in heights. The peach palm is a palm tree that is cultivated in Colombia, Perú, Brasil, Costa Rica, among others and that reaches heights of over 20 m, with stipes covered with spines. The fruits are drupes of variable size. For the harvesting of peach palm, in Colombia farmers use the “Marota” or “Climber”, a tool in a closed X shape built in wood, that has two supports adjusted at the stipe, that elevate alternately until reaching a point high enough to grab the bunch that is brought down using a rope. An activity of high risk since it is done at a high altitude without any type of protection and safety measures. The Marota is alternated with a rod, which as variable height between 5 and 12 Meters with a harness system at one end to hold the bunch that is lowered with the whole system (bamboo bunch). The rod is used from the ground or from the Marota in height. As an alternative to traditional tools, the Bajachonta was co-developed with farmers, a tool that employs a traditional bamboo hook system with modifications, to be able to hold it with a rope that passes through a pulley. Once the bunch is hitched, the hook system is detached and this stays attached to the peduncle of the palm tree, afterwards through a pulling force being exerted towards the ground by tensioning the rope, the bunch comes loose to be taken down using a rope and the pulley system to the ground, reducing the risk and efforts in the operation. The bajachonta was evaluated in tree productive zones of Colombia, with innovative farmers, were the adoption is highly probable, with some modifications to improve its efficiency and effectiveness, keeping in mind that the farmers perceive in it an advantage in the reduction of death and accidents by not having to harvest in heights.

Keywords: assisted harvesting, ergonomics, harvesting in high altitudes, participative design, peach palm

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69 Long-Term Exposure, Health Risk, and Loss of Quality-Adjusted Life Expectancy Assessments for Vinyl Chloride Monomer Workers

Authors: Tzu-Ting Hu, Jung-Der Wang, Ming-Yeng Lin, Jin-Luh Chen, Perng-Jy Tsai

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The vinyl chloride monomer (VCM) has been classified as group 1 (human) carcinogen by the IARC. Workers exposed to VCM are known associated with the development of the liver cancer and hence might cause economical and health losses. Particularly, for those work for the petrochemical industry have been seriously concerned in the environmental and occupational health field. Considering assessing workers’ health risks and their resultant economical and health losses requires the establishment of long-term VCM exposure data for any similar exposure group (SEG) of interest, the development of suitable technologies has become an urgent and important issue. In the present study, VCM exposures for petrochemical industry workers were determined firstly based on the database of the 'Workplace Environmental Monitoring Information Systems (WEMIS)' provided by Taiwan OSHA. Considering the existence of miss data, the reconstruction of historical exposure techniques were then used for completing the long-term exposure data for SEGs with routine operations. For SEGs with non-routine operations, exposure modeling techniques, together with their time/activity records, were adopted for determining their long-term exposure concentrations. The Bayesian decision analysis (BDA) was adopted for conducting exposure and health risk assessments for any given SEG in the petrochemical industry. The resultant excessive cancer risk was then used to determine the corresponding loss of quality-adjusted life expectancy (QALE). Results show that low average concentrations can be found for SEGs with routine operations (e.g., VCM rectification 0.0973 ppm, polymerization 0.306 ppm, reaction tank 0.33 ppm, VCM recovery 1.4 ppm, control room 0.14 ppm, VCM storage tanks 0.095 ppm and wastewater treatment 0.390 ppm), and the above values were much lower than that of the permissible exposure limit (PEL; 3 ppm) of VCM promulgated in Taiwan. For non-routine workers, though their high exposure concentrations, their low exposure time and frequencies result in low corresponding health risks. Through the consideration of exposure assessment results, health risk assessment results, and QALE results simultaneously, it is concluded that the proposed method was useful for prioritizing SEGs for conducting exposure abatement measurements. Particularly, the obtained QALE results further indicate the importance of reducing workers’ VCM exposures, though their exposures were low as in comparison with the PEL and the acceptable health risk.

Keywords: exposure assessment, health risk assessment, petrochemical industry, quality-adjusted life years, vinyl chloride monomer

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68 Nursing Professionals’ Perception of the Work Environment, Safety Climate and Job Satisfaction in the Brazilian Hospitals during the COVID-19 Pandemic

Authors: Ana Claudia de Souza Costa, Beatriz de Cássia Pinheiro Goulart, Karine de Cássia Cavalari, Henrique Ceretta Oliveira, Edineis de Brito Guirardello

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Background: During the COVID-19 pandemic, nursing represents the largest category of health professionals who were on the front line. Thus, investigating the practice environment and the job satisfaction of nursing professionals during the pandemic becomes fundamental since it reflects on the quality of care and the safety climate. The aim of this study was to evaluate and compare the nursing professionals' perception of the work environment, job satisfaction, and safety climate of the different hospitals and work shifts during the COVID-19 pandemic. Method: This is a cross-sectional survey with 130 nursing professionals from public, private and mixed hospitals in Brazil. For data collection, was used an electronic form containing the personal and occupational variables, work environment, job satisfaction, and safety climate. The data were analyzed using descriptive statistics and ANOVA or Kruskal-Wallis tests according to the data distribution. The distribution was evaluated by means of the Shapiro-Wilk test. The analysis was done in the SPSS 23 software, and it was considered a significance level of 5%. Results: The mean age of the participants was 35 years (±9.8), with a mean time of 6.4 years (±6.7) of working experience in the institution. Overall, the nursing professionals evaluated the work environment as favorable; they were dissatisfied with their job in terms of pay, promotion, benefits, contingent rewards, operating procedures and satisfied with coworkers, nature of work, supervision, and communication, and had a negative perception of the safety climate. When comparing the hospitals, it was found that they did not differ in their perception of the work environment and safety climate. However, they differed with regard to job satisfaction, demonstrating that nursing professionals from public hospitals were more dissatisfied with their work with regard to promotion when compared to professionals from private (p=0.02) and mixed hospitals (p< 0.01) and nursing professionals from mixed hospitals were more satisfied than those from private hospitals (p= 0.04) with regard to supervision. Participants working in night shifts had the worst perception of the work environment related to nurse participation in hospital affairs (p= 0.02), nursing foundations for quality care (p= 0.01), nurse manager ability, leadership and support (p= 0.02), safety climate (p< 0.01), job satisfaction related to contingent rewards (p= 0.04), nature of work (p= 0.03) and supervision (p< 0.01). Conclusion: The nursing professionals had a favorable perception of the environment and safety climate but differed among hospitals regarding job satisfaction for the promotion and supervision domains. There was also a difference between the participants regarding the work shifts, being the night shifts, those with the lowest scores, except for satisfaction with operational conditions.

Keywords: health facility environment, job satisfaction, patient safety, nursing

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67 Common Health Problems of Filipino Overseas Household Service Workers: Implications for Wellness

Authors: Veronica Ramirez

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For over 40 years now, the Philippines has been supplying Household Service Workers (HSWs) globally. As a requirement of the Philippine Overseas Employment Agency (POEA), all Filipinos applying for overseas work undergo medical examination and a certificate of good health is submitted to the foreign employer before hiring. However, there are workplace-related health problems that develop during employment such as musculoskeletal strain or injury, back pain, hypertension and other illnesses. Some workers are in good working conditions but are on call more than 12 hours per day. There are also those who experience heavy physical work with short rest periods or time off. They can also be easily exposed to disease outbreaks and epidemics. It was the objective of this study to determine the common health problems of Filipino Overseas Service Workers and analyze their implications to wellness in the workplace. Specifically, it sought to describe the work conditions of HSWs and determine the work-related factors affecting their health. It also identified the medical care they avail of and how they perceive their health and wellness as determinants of well-being. Finally, it proposes ways to promote wellness among HSWs. This study focused on physical illnesses and does not include mental problems experienced by HSWs. Using a questionnaire, primary data were gathered online and through survey of HSW rehires who were retaking Pre-Departure Orientation Seminar at recruitment agencies. The 2010 Health Benefit Availment data from the Overseas Workers Welfare Administration (OWWA) was also utilized. Descriptive analysis was employed on the data gathered. Key stakeholders in the migration industry were also interviewed. Previous research studies, reports and literature on migration and wellness were used as secondary data. The study found that Filipino overseas HSWs are vulnerable to physical injury and experience body pains such as back, hip and shoulder pain. Long hours of work, work hazards and lack of rest due to poor accommodations can aggravate their physical condition. Although health insurance and health care are available, HSWs are not aware how to avail them. On the basis of the findings, a Wellness Program can be designed that include health awareness, health care availment, occupational ergonomics, safety and health, work and leisure balance, developing emotional intelligence, anger management and spirituality.

Keywords: health, household service worker, overseas, wellness

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66 Functional Neurocognitive Imaging (fNCI): A Diagnostic Tool for Assessing Concussion Neuromarker Abnormalities and Treating Post-Concussion Syndrome in Mild Traumatic Brain Injury Patients

Authors: Parker Murray, Marci Johnson, Tyson S. Burnham, Alina K. Fong, Mark D. Allen, Bruce McIff

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Purpose: Pathological dysregulation of Neurovascular Coupling (NVC) caused by mild traumatic brain injury (mTBI) is the predominant source of chronic post-concussion syndrome (PCS) symptomology. fNCI has the ability to localize dysregulation in NVC by measuring blood-oxygen-level-dependent (BOLD) signaling during the performance of fMRI-adapted neuropsychological evaluations. With fNCI, 57 brain areas consistently affected by concussion were identified as PCS neural markers, which were validated on large samples of concussion patients and healthy controls. These neuromarkers provide the basis for a computation of PCS severity which is referred to as the Severity Index Score (SIS). The SIS has proven valuable in making pre-treatment decisions, monitoring treatment efficiency, and assessing long-term stability of outcomes. Methods and Materials: After being scanned while performing various cognitive tasks, 476 concussed patients received an SIS score based on the neural dysregulation of the 57 previously identified brain regions. These scans provide an objective measurement of attentional, subcortical, visual processing, language processing, and executive functioning abilities, which were used as biomarkers for post-concussive neural dysregulation. Initial SIS scores were used to develop individualized therapy incorporating cognitive, occupational, and neuromuscular modalities. These scores were also used to establish pre-treatment benchmarks and measure post-treatment improvement. Results: Changes in SIS were calculated in percent change from pre- to post-treatment. Patients showed a mean improvement of 76.5 percent (σ= 23.3), and 75.7 percent of patients showed at least 60 percent improvement. Longitudinal reassessment of 24 of the patients, measured an average of 7.6 months post-treatment, shows that SIS improvement is maintained and improved, with an average of 90.6 percent improvement from their original scan. Conclusions: fNCI provides a reliable measurement of NVC allowing for identification of concussion pathology. Additionally, fNCI derived SIS scores direct tailored therapy to restore NVC, subsequently resolving chronic PCS resulting from mTBI.

Keywords: concussion, functional magnetic resonance imaging (fMRI), neurovascular coupling (NVC), post-concussion syndrome (PCS)

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65 Exploitation behind the Development of Home Batik Industry in Lawean, Solo, Central Java

Authors: Mukhammad Fatkhullah, Ayla Karina Budita, Cut Rizka Al Usrah, Kanita Khoirun Nisa, Muhammad Alhada Fuadilah Habib, Siti Muslihatul Mukaromah

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Batik industry has become one of the leading industries in the economy of Indonesia. Since the recognition of batik as one of cultural wealth and national identity of Indonesia by UNESCO, batik production keeps increasing as a result of increasing demands for batik, whether from domestically or abroad. One of the rapid development batik industries in Indonesia is batik industry in Lawean Village, Solo, Central Java, Indonesia. This batik industry generally uses putting-out system where batik workers work in their own houses. With the implementation of this system, therefore employers don’t have to prepare Environmental Impact Analysis (EIA), social security for workers, overtime payment, space for working, and equipment for working. The implementation of putting-out system causes many problems, starting from environmental pollution, the loss of social rights of workers, and even exploitation of workers by batik entrepreneurs. The data used to describe this reality is the primary data from qualitative research with in-depth interview data collection technique. Informants were determined purposively. The theory used to perform data interpretation is the phenomenology of Alfred Schutz. Both qualitative and phenomenology are used in this study to describe batik workers exploitation in terms of the implementation of putting-out system on home batik industry in Lawean. The research result showed that workers in batik industry sector in Lawean were exploited with the implementation of putting-out system. The workers were strictly employed by the entrepreneurs, so that their job cannot be called 'part-time' job anymore. In terms of labor and time, the workers often work more than 12 hours per day and they often work overtime without receiving any overtime payment. In terms of work safety, the workers often have contact with chemical substances contained in batik making materials without using any protection, such as clothes work, which is worsened by the lack of standard or procedure in work that can cause physical damage, such as burnt and peeled off skin. Moreover, exposure and contamination of chemical materials make the workers and their families vulnerable to various diseases. Meanwhile, batik entrepreneurs did not give any social security (including health cost aid). Besides that, the researchers found that batik industry in home industry sector is not environmentally friendly, even damaging ecosystem because industrial waste disposed without EIA.

Keywords: exploitation, home batik industry, occupational health and safety, putting-out system

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64 Evaluation of Occupational Doses in Interventional Radiology

Authors: Fernando Antonio Bacchim Neto, Allan Felipe Fattori Alves, Maria Eugênia Dela Rosa, Regina Moura, Diana Rodrigues De Pina

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Interventional Radiology is the radiology modality that provides the highest dose values to medical staff. Recent researches show that personal dosimeters may underestimate dose values in interventional physicians, especially in extremities (hands and feet) and eye lens. The aim of this work was to study radiation exposure levels of medical staff in different interventional radiology procedures and estimate the annual maximum numbers of procedures (AMN) that each physician could perform without exceed the annual limits of dose established by normative. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were positioned in different body regions of the interventional physician (eye lens, thyroid, chest, gonads, hand and foot) above the radiological protection vests as lead apron and thyroid shield. Attenuation values for lead protection vests were based on international guidelines. Based on these data were chosen as 90% attenuation of the lead vests and 60% attenuation of the protective glasses. 25 procedures were evaluated: 10 diagnostics, 10 angioplasty, and 5-aneurysm treatment. The AMN of diagnostic procedures was 641 for the primary interventional radiologist and 930 for the assisting interventional radiologist. For the angioplasty procedures, the AMN for primary interventional radiologist was 445 and for assisting interventional radiologist was 1202. As for the procedures of aneurism treatment, the AMN for the primary interventional radiologist was 113 and for the assisting interventional radiologist were 215. All AMN were limited by the eye lens doses already considering the use of protective glasses. In all categories evaluated, the higher dose values are found in gonads and in the lower regions of professionals, both for the primary interventionist and for the assisting, but the eyes lens dose limits are smaller than these regions. Additional protections as mobile barriers, which can be positioned between the interventionist and the patient, can decrease the exposures in the eye lens, providing a greater protection for the medical staff. The alternation of professionals to perform each type of procedure can reduce the dose values received by them over a period. The analysis of dose profiles proposed in this work showed that personal dosimeters positioned in chest might underestimate dose values in other body parts of the interventional physician, especially in extremities and eye lens. As each body region of the interventionist is subject to different levels of exposure, dose distribution in each region provides a better approach to what actions are necessary to ensure the radiological protection of medical staff.

Keywords: interventional radiology, radiation protection, occupationally exposed individual, hemodynamic

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63 Comparisons of Depressive Symptoms and Cognitive Appraisals in Different Age Groups under Abusive Leadership

Authors: Shao-Ying Wang, Shin-I Shih, Chi-Cheng Wu

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Background: By following to the maturity theory about age, the manifestation of depression in different age groups under occupational stressors still remains unclear. Therefore, the aim of this study was to examine the depression within four main symptoms clusters: cognition, affect, physical complaints and interpersonal difficulty among the different age groups. Additionally, this study also used the stress appraisal theory, through the examination of challenge and hindrance appraisals, the effects of cognitive factors were expected to give therapeutic indication for the future treatment of depression under abusive leadership. Methods (Participants and Procedure): The data were collected in two waves from employees of local companies in Taiwan. The participants (58 males and 167 females) were native Chinese speakers, ranging in age from 20 to 59 years (M= 36.51). Up to 80% educational level of participants were above senior high. The married population was approximately at 43%. Measures; 1. Abusive Leadership: To measure abusive leadership, we used 15-item scale of abusive supervision which anchored on a 7-point Likert-type scale. (α= .96) 2. Depression: We used Taiwanese Depression Scale to measure the 4 clusters (cognition, affect, physical complaints and interpersonal difficulty) of symptoms. Participants responded for depression anchored on a 7-point Likert-type scale (α= .96). 3. Stress Appraisal Scale: To measure challenge and hindrance types of appraisal, participants responded to 33-item measure anchored on a 7-point Likert-type scale. (Challenge appraisal; α= .90; hindrance appraisal α= .87). Results: The results of correlation showed that there was a significant and negative correlation between abusive leadership and age (r = - .21, p < .01). Abusive leadership was positive correlated significantly with hindrance appraisal (r = .52, p < .01) and depression (r = .20, p < .01). The results also showed that hindrance appraisal was correlated to depression positively (r = .36, p < .01). A one-way ANOVA was conducted to compare the effect of lower/middle/order age groups on each cluster of depressive symptoms. The results showed that the effect of age groups on cognition was significant F (2, 157) =3.66, P < .05. Older age group (M=13.43 SD=6.84) reported less cognitive symptoms of depression than the middle (M=16.77 SD=7.49) and lower age (M=16.91 SD=6.97) groups. Besides, the effect of age groups on affect was also significant F (2,157)= 4.09 P < .05. Older age group (M=18.68 SD=8.98) reported less affective symptoms of depression than the middle (M=22.01 SD=7.96) and lower age (M=23.56 SD=7.67) groups. Moreover, the main effect of hindrance appraisal was found F (2, 157) =3.81, P < .05. Older age group (M=9.44 SD=2.89) reported fewer score on hindrance appraisals than the middle (M=11.06 SD=4.02) and lower age (M=9.62 SD=3.17) groups. To conclude, the severity of depression symptoms varies across different age groups. Maturity seems to be the protective factor to depression, accompanying with lower hindrance appraisals.

Keywords: abusive leadership, affective commitment, depression symptoms, psychological well-being

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62 The Usefulness and Usability of a Linkedin Group for the Maintenance of a Community of Practice among Hand Surgeons Worldwide

Authors: Vaikunthan Rajaratnam

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Maintaining continuous professional development among clinicians has been a challenge. Hand surgery is a unique speciality with the coming together of orthopaedics, plastics and trauma surgeons. The requirements for a team-based approach to care with the inclusion of other experts such as occupational, physiotherapist and orthotic and prosthetist provide the impetus for the creation of communities of practice. This study analysed the community of practice in hand surgery that was created through a social networking website for professionals. The main objectives were to discover the usefulness of this community of practice created in the platform of the group function of LinkedIn. The second objective was to determine the usability of this platform for the purposes of continuing professional development among members of this community of practice. The methodology used was one of mixed methods which included a quantitative analysis on the usefulness of the social network website as a community of practice, using the analytics provided by the LinkedIn platform. Further qualitative analysis was performed on the various postings that were generated by the community of practice within the social network website. This was augmented by a respondent driven survey conducted online to assess the usefulness of the platform for continuous professional development. A total of 31 respondents were involved in this study. This study has shown that it is possible to create an engaging and interactive community of practice among hand surgeons using the group function of this professional social networking website LinkedIn. Over three years the group has grown significantly with members from multiple regions and has produced engaging and interactive conversations online. From the results of the respondents’ survey, it can be concluded that there was satisfaction of the functionality and that it was an excellent platform for discussions and collaboration in the community of practice with a 69 % of satisfaction. Case-based discussions were the most useful functions of the community of practice. This platform usability was graded as excellent using the validated usability tool. This study has shown that the social networking site LinkedIn’s group function can be easily used as a community of practice effectively and provides convenience to professionals and has made an impact on their practice and better care for patients. It has also shown that this platform was easy to use and has a high level of usability for the average healthcare professional. This platform provided the improved connectivity among professionals involved in hand surgery care which allowed for the community to grow and with proper support and contribution of relevant material by members allowed for a safe environment for the exchange of knowledge and sharing of experience that is the foundation of a community practice.

Keywords: community of practice, online community, hand surgery, lifelong learning, LinkedIn, social media, continuing professional development

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61 The Correlation between Musculoskeletal Disorders and Body Postures during Playing among Guitarists

Authors: Navah Z. Ratzon, Shlomit Cohen, Sigal Portnoy

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This work focuses on posture and risk factors for the musculoskeletal disorder in guitarists, which constitutes the largest group of musicians today. The source of the problems experienced by these musicians is linked to physical, psychosocial and personal risk factors. These muscular problems are referred to as Playing Related Musculoskeletal Disorder (PRMD). There is not enough research that specifically studies guitar players, and to the extent of our knowledge, there is almost no reference to the characteristics of their movement patterns while they play. This is in spite of the high prevalence of PRMD in this population. Kinematic research may provide a basis for the development of a prevention plan for this population and their unique characteristics of playing patterns. The aim of the study was to investigate the correlation between risk factors for PRMD among guitar players and self-reporting of pain in the skeletal muscles, and specifically to test whether there are differences in the kinematics of the upper body while playing in a sitting or standing posture. Twenty-five guitarists, aged 18-35, participated in the study. The methods included a motion analysis using a motion capture system, anthropometric measurements and questionnaires relating to risk factors. The questionnaires used were the Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms and the Demand Control Support Questionnaire, as well as a questionnaire of personal details. All of the study participants complained of musculoskeletal pain in the past year; the most frequent complaints being in the left wrist. Statistically significant correlations were found between biodemographic indices and reports of pain in the past year and the previous week. No significant correlations were found between the physical posture while playing and reports of pain among professional guitarists. However, a difference was found in several kinematic parameters between seated and standing playing postures. In a majority of the joints, the joint angles while playing in a seated position were more extreme than those during standing. This finding may suggest a higher risk for musculoskeletal disorder while playing in a seated position. In conclusion, the results of the present research highlight the prevalence of musculoskeletal problems in guitar players and its correlation with various risk factors. The finding supports the need for intervention in the form of prevention through identifying the risk factors and addressing them. Relating to the person, to their occupation and environment, which are the basis of proper occupational therapy, can help meet this need.

Keywords: body posture, motion tracking, PRMD, guitarists

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60 Influencing Factors for Job Satisfaction and Turnover Intention of Surgical Team in the Operating Rooms

Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

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Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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59 'It Is a Sin to Be in Love with a Disabled Woman': Stigma, Rejection and Intersections of Womanhood and Violence among Physically Disabled Women Living in South Africa

Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Commonly, womanhood is defined as the qualities considered to be natural to or characteristic of a woman. However, womanhood is not a static concept; it is contextual and negotiable. For women with disabilities, gender roles or ‘qualities’ of womanhood are often overstated or contradicted because of assumptions of weakness, passivity, asexuality and infertility. Currently, little is known about how disability stigma intersects with notions of womanhood to make women with disabilities vulnerable to violence, or how women navigate this intersection to prevent or protect themselves from violence. Objective: To describe how the stigmatized constructions of womanhood and disability promote women with physical disabilities’ exposure to or protection from violence. Methods: Qualitative data for this paper comes from a doctoral study involving women with disabilities living in Cape Town, South Africa. It presents data from repeat in-depth interviews with 30 women with a range of physical impairments. Women attending protective workshops, rehabilitative centers and residential care facilities for people living with disabilities were invited to participate. Consent procedures and interviews were conducted by the first author (who is herself a woman living with a physical disability), and a female research assistant/translator who is a qualified occupational therapist. Reasonable accommodation is central to the methodology and the study as a whole. Findings: Descriptive and thematic analyses reveal how stigma and local constructions around womanhood, as well as women’s self-image and physical limitations, promotes women’s exposure to psychological, physical and sexual violence. It reveals how disabled women feel they are presumed incapable of living up to expectations of a ‘proper’ woman. This plays out as psychological violence, with women reporting that they feel ‘devalued,' ‘rejected’ and deprived of lasting intimate relationships. Furthermore, forms of psychological violence perpetuate physical and sexual violence. Women also discuss using strategies to prevent violence; by refusing to date, avoiding certain places or avoiding isolation, creating awareness, hiding their physical impairments, and exaggerating their ‘femininity.' Implications: Service providers need to be made aware of women’s violence experiences, and provide a range of accessible psychological and mental health services to women living with disabilities, as well as raising awareness around disability, and violence prevention, among caregivers, men, and women. Violence awareness and prevention interventions need to involve disability experts, researchers and people with disabilities.

Keywords: disability, gender, stigma, violence awareness and prevention interventions

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58 Subjective Temporal Resources: On the Relationship Between Time Perspective and Chronic Time Pressure to Burnout

Authors: Diamant Irene, Dar Tamar

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Burnout, conceptualized within the framework of stress research, is to a large extent a result of a threat on resources of time or a feeling of time shortage. In reaction to numerous tasks, deadlines, high output, management of different duties encompassing work-home conflicts, many individuals experience ‘time pressure’. Time pressure is characterized as the perception of a lack of available time in relation to the amount of workload. It can be a result of local objective constraints, but it can also be a chronic attribute in coping with life. As such, time pressure is associated in the literature with general stress experience and can therefore be a direct, contributory burnout factor. The present study examines the relation of chronic time pressure – feeling of time shortage and of being rushed, with another central aspect in subjective temporal experience - time perspective. Time perspective is a stable personal disposition, capturing the extent to which people subjectively remember the past, live the present and\or anticipate the future. Based on Hobfoll’s Conservation of Resources Theory, it was hypothesized that individuals with chronic time pressure would experience a permanent threat on their time resources resulting in relatively increased burnout. In addition, it was hypothesized that different time perspective profiles, based on Zimbardo’s typology of five dimensions – Past Positive, Past Negative, Present Hedonistic, Present Fatalistic, and Future, would be related to different magnitudes of chronic time pressure and of burnout. We expected that individuals with ‘Past Negative’ or ‘Present Fatalist’ time perspectives would experience more burnout, with chronic time pressure being a moderator variable. Conversely, individuals with a ‘Present Hedonistic’ - with little concern with the future consequences of actions, would experience less chronic time pressure and less burnout. Another temporal experience angle examined in this study is the difference between the actual distribution of time (as in a typical day) versus desired distribution of time (such as would have been distributed optimally during a day). It was hypothesized that there would be a positive correlation between the gap between these time distributions and chronic time pressure and burnout. Data was collected through an online self-reporting survey distributed on social networks, with 240 participants (aged 21-65) recruited through convenience and snowball sampling methods from various organizational sectors. The results of the present study support the hypotheses and constitute a basis for future debate regarding the elements of burnout in the modern work environment, with an emphasis on subjective temporal experience. Our findings point to the importance of chronic and stable temporal experiences, as time pressure and time perspective, in occupational experience. The findings are also discussed with a view to the development of practical methods of burnout prevention.

Keywords: conservation of resources, burnout, time pressure, time perspective

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57 Ergonomic Assessment of Workplace Environment of Flour Mill Workers

Authors: Jayshree P. Zend, Ashatai B. Pawar

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The study was carried out in Parbhani district of Maharashtra state, India with the objectives to study environmental problems faced by flour mill workers, prevalence of work-related health hazards and the physiological cost of workers while performing work in flour mill in traditional method as well as improved method. The use of flour presser, dust controlling bag and noise and dust controlling mask developed by AICRP College of Home Science, VNMKV, Parbhani was considered as an improved method. This investigation consisted survey and experiment which was conducted in the respective locations of flour mills. Healthy, non-smoking 30 flour mill workers ranged between the age group of 20-50 yrs comprising 16 female and 14 male working at flour mill for 4-8 hrs/ day and 6 days/ week and had minimum five years experience of work in flour mill were selected for the study. Pulmonary function test of flour mill workers was carried out by trained technician at Dr. ShankarraoChavan Government Medical College, Nanded by using Electronic Spirometer. The data regarding heart rate (resting, working and recovery), energy expenditure, musculoskeletal problems and occupational health hazards and accidents were recorded by using pretested questionnaire. Scientific equipment used in the experiment were polar sport test heart rate monitor, Hygrometer, Goniometer, Dialed Thermometer, Sound Level Meter, Lux Meter, Ambient Air Sampler and Air Quality Monitor. The collected data were subjected to appropriate statistical analysis such as 't' test and correlation coefficient test. Results indicated that improved method i.e. use of noise and dust controlling mask, flour presser and dust controlling bag were effective in reducing physiological cost of work of flour mill workers. Lung function test of flour mill workers showed decreased values of all parameters, hence the results of present study support paying attention to use of personal protective noise and dust controlling mask by flour mill workers and also to the working conditions in flour mill especially ventilation and illumination level needs to be enhanced in flour mill. The study also emphasizes the need to develop some mechanism for lifting load of grains and unloading in the hopper. It is also suggested that the flour mill workers should use flour presser suitable to their height to avoid frequent bending and should use dust controlling bag to flour outlet of machine to reduce inhalable flour dust level in the flour mill.

Keywords: physiological cost, energy expenditure, musculoskeletal problems

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56 Development of an Innovative Mobile Phone Application for Employment of Persons With Disabilities Toward the Inclusive Society

Authors: Marutani M, Kawajiri H, Usui C, Takai Y, Kawaguchi T

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Background: To build the inclusive society, the Japanese government provides “transition support for employment system” for Persons with Disabilities (PWDs). It is, however, difficult to provide appropriate accommodations due to their changeable health conditions. Mobile phone applications (App) are useful to monitor their health conditions and their environments, and effective to improve reasonable accommodations for PWDs. Purpose: This study aimed to develop an App that PWDs input their self-assessment and make their health conditions and environment conditions visible. To attain the goal, we investigated the items of the App for the first step. Methods: Qualitative and descriptive design was used for this study. Study participants were recruited by snowball sampling in July and August 2023. They had to have had minimum of five-years of experience to support PWDs’ employment. Semi-structured interviews were conducted on their assessment regarding PWDs’ conditions of daily activities, their health conditions, and living and working environment. Verbatim transcript was created from each interview content. We extracted the following items in tree groups from each verbatim transcript: daily activities, health conditions, and living and working. Results: Fourteen participants were involved (average years of experience: 10.6 years). Based on the interviews, tree item groups were enriched. The items of daily activities were divided into fifty-five. The example items were as follows: “have meals on one’s style” “feel like slept well” “wake-up time, bedtime, and mealtime are usually fixed.” “commute to the office and work without barriers.” Thirteen items of health conditions were obtained like “feel no anxiety” “relieve stress” “focus on work and training” “have no pain” “have the physical strength to work for one day.” The items of categories of living and working environments were divided into fifteen-two. The example items were as follows: “have no barrier in home” “have supportive family members” “have time to take medication on time while at work” “commute time is just right” “people at the work understand the symptoms” “room temperature and humidity are just right” “get along well with friends in my own way.” The participants also mentioned the styles to input self-assessment like that a face scale would be preferred to number scale. Conclusion: The items were enriched existent paper-based assessment items in terms of living and working environment because those were obtained from the perspective of PWDs. We have to create the app and examine its usefulness with PWDs toward inclusive society.

Keywords: occupational health, innovatiove tool, people with disability, employment

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55 Integrated Management System Applied in Dismantling and Waste Management of the Primary Cooling System from the VVR-S Nuclear Reactor Magurele, Bucharest

Authors: Radu Deju, Carmen Mustata

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The VVR-S nuclear research reactor owned by Horia Hubulei National Institute of Physics and Nuclear Engineering (IFIN-HH) was designed for research and radioisotope production, being permanently shut-down in 2002, after 40 years of operation. All amount of the nuclear spent fuel S-36 and EK-10 type was returned to Russian Federation (first in 2009 and last in 2012), and the radioactive waste resulted from the reprocessing of it will remain permanently in the Russian Federation. The decommissioning strategy chosen is immediate dismantling. At this moment, the radionuclides with half-life shorter than 1 year have a minor contribution to the contamination of materials and equipment used in reactor department. The decommissioning of the reactor has started in 2010 and is planned to be finalized in 2020, being the first nuclear research reactor that has started the decommissioning project from the South-East of Europe. The management system applied in the decommissioning of the VVR-S research reactor integrates all common elements of management: nuclear safety, occupational health and safety, environment, quality- compliance with the requirements for decommissioning activities, physical protection and economic elements. This paper presents the application of integrated management system in decommissioning of systems, structures, equipment and components (SSEC) from pumps room, including the management of the resulted radioactive waste. The primary cooling system of this type of reactor includes circulation pumps, heat exchangers, degasser, filter ion exchangers, piping connection, drainage system and radioactive leaks. All the decommissioning activities of primary circuit were performed in stage 2 (year 2014), and they were developed and recorded according to the applicable documents, within the requirements of the Regulatory Body Licenses. In the presentation there will be emphasized how the integrated management system provisions are applied in the dismantling of the primary cooling system, for elaboration, approval, application of necessary documentation, records keeping before, during and after the dismantling activities. Radiation protection and economics are the key factors for the selection of the proper technology. Dedicated and advanced technologies were chosen to perform specific tasks. Safety aspects have been taken into consideration. Resource constraints have also been an important issue considered in defining the decommissioning strategy. Important aspects like radiological monitoring of the personnel and areas, decontamination, waste management and final characterization of the released site are demonstrated and documented.

Keywords: decommissioning, integrated management system, nuclear reactor, waste management

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54 Increasing the Dialogue in Workplaces Enhances the Age-Friendly Organisational Culture and Helps Employees Face Work-Related Dilemmas

Authors: Heli Makkonen, Eini Hyppönen

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The ageing of employees, the availability of workforce, and employees’ engagement in work are today’s challenges in the field of health care and social services, and particularly in the care of older people. Therefore, it is important to enhance both the attractiveness of the work in the field of older people’s care and the retention of employees in the field, and also to pay attention to the length of careers. The length of careers can be affected, for example, by developing an age-friendly organisational culture. Changing the organisational culture in a workplace is, however, a slow process which requires engagement from employees and enhanced dialogue between employees. This article presents an example of age-friendly organisational culture in an older people’s care unit and presents the results of the development of this organisational culture to meet the identified development challenges. In this research-based development process, cycles used in action research were applied. Three workshops were arranged for employees in a service home for older people. The workshops worked as interventions, and the employees and their manager were given several consecutive assignments to be completed between them. In addition to workshops, the employees benchmarked two other service homes. In the workshops, data was collected by observing and documenting the conversations. After that, thematic analysis was used to identify the factors connected to an age-friendly organisational culture. By analysing the data and comparing it to previous studies, some dilemmas we recognised that were hindering or enhancing the attractiveness of work and the retention of employees in this nursing home. After each intervention, the process was reflected and evaluated, and the next steps were planned. The areas of development identified in the study were related to, for example, the flexibility of work, holistic ergonomics, the physical environment at the workplace, and the workplace culture. Some of the areas of development were taken over by the work community and carried out in cooperation with e.g. occupational health care. We encouraged the work community, and the employees provided us with information about their progress. In this research project, the focus was on the development of the workplace culture and, in particular, on the development of the culture of interaction. The workshops showed employees’ attitudes and strong opinions, which can be a challenge from the point of view of the attractiveness of work and the retention of employees in the field. On the other hand, the data revealed that the work community has an interest in developing the dialogue in the work community. Enhancing the dialogue gave the employees the opportunity and resources to face even challenging dilemmas related to the attractiveness of work and the retention of employees in the field. The psychological safety was also enhanced at the same time. The results of this study are part of a broader study that aims at building a model for extending older employees’ careers.

Keywords: age-friendliness, attractiveness of work, dialogue, older people, organisational culture, workplace culture

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53 The Impact of Sports Employees' of Perceptions of Organizational Climate and Organizational Trust on Work Motivation

Authors: Bilal Okudan, Omur F. Karakullukcu, Yusuf Can

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Work motivation is one of the fundamental elements that determine the attitudes and performance of employees towards work. In this sense, work motivation depends not only on individual and occupational factors but also on employees' perception of organizational climate and organizational trust. Organizations that are aware of this have begun to do more research on work motivation in recent years to ensure that employees have the highest possible performance. In this framework of the purpose of this study is to examine the effect of sports employees' perceptions of organizational climate and organizational trust on work motivation. In the study, it has also been analyzed if there is any significant difference in the department of sports services’ employees’ organizational climate and organizational trust perception, and work motivation levels in terms of gender, age, duty status, year of service and level of education. 278 sports managers, who work in the department of sports service’s central and field organization at least as a chief in the manager position, have been chosen with random sampling method and they have voluntarily participated in the study. In the study, the organizational climate scale which was developed by Bilir (2005), organizational trusts scale developed by koksal (2012) and work motivation scale developed by Mottaz J. Clifford (1985) have been used as a data collection tool. The questionnaire form used as a data collection tool in the study includes a personal information form consisting of 5 questions; questioning gender, age, duty status, years of service and level of education. In the study, Pearson Correlation Analysis has been used for defining the correlation among organizational climate, organizational trust perceptions and work motivation levels in sports managers and regression analysis has been used to identify the effect of organizational climate and organizational trust on work motivation. T-test for binary grouping and ANOVA analysis have been used for more than binary groups in order to determine if there is any significant difference in the level of organizational climate, organizational trust perceptions and work motivations in terms of the participants’ duty status, year of service and level of education. According to the research results, it has been found that there is a positive correlation between the department of sports services’ employees’ organizational climate, organizational trust perceptions and work motivation levels. According to the results of the regression analysis; it is understood that the sports employees’ perception of organizational climate and organizational trust are two main factors which affects the perception of work motivation. Also, the results show that there is a significant difference in the level of organizational climate and organizational trust perceptions and work motivations of the department of sports services’ employees in terms of duty status, year of service, and level of education; however, the results reveal that there is no significant difference in terms of age groups and gender.

Keywords: sports manager, organizational climate, organizational trust, work motivation

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52 Reintegrating Forensic Mental Health Service Users into Communities in the Western Cape, South Africa

Authors: Zolani Metu

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The death of more than 140 psychiatric patients who were unethically deinstitutionalized from the Life Esidimeni hospital Johannesburg, in 2016, shined a light on South Africa’s failing public mental healthcare system. Compounded by insufficient research evidence on African deinstitutionalization, this necessitates inquiries into deinstitutionalized mental healthcare, reintegration and community-based mental healthcare within the South African context. This study employed a quantitative research approach which utilized a cross-sectional research design, to investigate experiences with the reintegration of institutionalized forensic mental health service users into communities in the Western Cape, South Africa. A convenience sample of 100 mental health care workers from different occupational and organizational backgrounds in the Western Cape was purposively selected using the Western Cape Health Directorate as a sampling frame. A self-administered questionnaire (SAQ) was used as the data collection instrument. The results of the study indicate that criminogenic factors such as substance use, history of violent behaviour, criminal history and disruptive social behaviour complicate the reintegration of forensic mental health service users into communities. The current extent of reintegration of forensic mental health service users was found to be 'poor' (46%; n= 46); and financial difficulties, criminogenic factors and limited Community-Based Care (CBC) facilities were identified as key barriers to the reintegration process. 56% of all job applications for forensic mental health service users were unsuccessful, and 53% of all applications for their admission into CBC facilities were declined. Although social support (informal) was found to be essential for successful reintegration, institutional support (formal) through assertive community treatment (35%; n= 35) and CBC facilities (21%) and the disability grant (DG=50%) was found to be more important for family coping and reintegration. Moreover, 72% of respondents had positive perceptions about the process of reintegration; no statistically significant relationship was found between years of experience and perceptions about reintegration (P-value = 0.062); and perceptions were not found to be a barrier to reintegration. No statistically significant relationship was found between years of working experience and understanding the legislative framework of deinstitutionalization (P-Value =.0.061). However, using a Chi-square test, a significant relationship (P-value = 0.021) was found between sex and understanding the legal framework involved in the process of reintegration. The study recommends a post-2020 deinstitutionalization agenda that factors-in criminogenic realities associated with forensic mental health service users, and affirms the strengthening of PHC and community based care systems as precedents of successful deinstitutionalization and reintegration of mental health service users.

Keywords: forensic mental health, deinstitutionalization, reintegration, mental health service users

Procedia PDF Downloads 158
51 Challenges & Barriers for Neuro Rehabilitation in Developing Countries

Authors: Muhammad Naveed Babur, Maria Liaqat

Abstract:

Background & Objective: People with disabilities especially neurological disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. There are not sufficient epidemiological studies from Pakistan which assess barriers to neurorehabilitation and ways to counter it. Objectives: The objective of the study was to determine the challenges and to evaluate the barriers for neuro-rehabilitation services in developing countries. Methods: This is Exploratory sequential qualitative study based on the Panel discussion forum in International rehabilitation sciences congress and national rehabilitation conference 2017. Panel group discussion has been conducted in February 2017 with a sample size of eight professionals including Rehabilitation medicine Physician, Physical Therapist, Speech Language therapist, Occupational Therapist, Clinical Psychologist and rehabilitation nurse working in multidisciplinary/Interdisciplinary team. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of two separate coders. Results: After extraction of two separate coders following results are emerged. General category themes are disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. Barriers identified at the level are high cost, stigma, lengthy course of recovery. Hospital related barriers are lack of social support and individually tailored goal setting processes. Organizational barriers identified are lack of basic diagnostic facilities, lack of funding and human resources. Recommendations given by panelists were investment in education, capacity building, infrastructure, governance support, strategies to promote communication and realistic goals. Conclusion: It is concluded that neurorehabilitation in developing countries need attention in following categories i.e. disease profile, demographic profile, training and education, research, barriers, governance, global funding, informal care, resources and cultural beliefs and public awareness. This study also revealed barriers at the level of patient, hospital, organization. Recommendations were also given by panelists.

Keywords: disability, neurorehabilitation, telerehabilitation, disability

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50 Relationship between Institutional Perspective and Safety Performance: A Case on Ready-Made Garments Manufacturing Industry

Authors: Fahad Ibrahim, Raphaël Akamavi

Abstract:

Bangladesh has encountered several industrial disasters (e.g. fire and building collapse tragedies) leading to the loss of valuable human lives. Irrespective of various institutions’ making effort to improve the safety situation, industry compliance and safety behaviour have not yet been improved. Hence, one question remains, to what extent does the institutional elements efficient enough to make any difference in improving safety behaviours? Thus, this study explores the relationship between institutional perspective and safety performance. Structural equation modelling results, using survey data from 256 RMG workers’ of 128 garments manufacturing factories in Bangladesh, show that institutional facets strongly influence management safety commitment to induce workers participation in safety activities and reduce workplace accident rates. The study also found that by upholding industrial standards and inspecting the safety situations, institutions facets significantly and directly affect workers involvement in safety participations and rate of workplace accidents. Additionally, workers involvement to safety practices significantly predicts the safety environment of the workplace. Subsequently, our findings demonstrate that institutional culture, norms, and regulations enact play an important role in altering management commitment to set-up a safer workplace environment. As a result, when workers’ perceive their management having high level of commitment to safety, they are inspired to be involved more in the safety practices, which significantly alter the workplace safety situation and lessen injury experiences. Due to the fact that institutions have strong influence on management commitment, legislative members should endorse, regulate, and strictly monitor workplace safety laws to be exercised by the factory owners. Further, management should take initiatives for adopting OHS features and conceive strategic directions (i.e., set up safety committees, risk assessments, innovative training) for promoting a positive safety climate to provide a safe workplace environment. Arguably, an inclusive public-private partnership is recommended for ensuring better and safer workplace for RMG workers. However, as our data were under a cross-sectional design; the respondents’ perceptions might get changed over a period of time and hence, a longitudinal study is recommended. Finally, further research is needed to determine the impact of improvement mechanisms on workplace safety performance, such as how workplace design, safety training programs, and institutional enforcement policies protect the well-being of workers.

Keywords: institutional perspective, management commitment, safety participation, work injury, safety performance, occupational health and safety

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49 The Validation and Reliability of the Arabic Effort-Reward Imbalance Model Questionnaire: A Cross-Sectional Study among University Students in Jordan

Authors: Mahmoud M. AbuAlSamen, Tamam El-Elimat

Abstract:

Amid the economic crisis in Jordan, the Jordanian government has opted for a knowledge economy where education is promoted as a mean for economic development. University education usually comes at the expense of study-related stress that may adversely impact the health of students. Since stress is a latent variable that is difficult to measure, a valid tool should be used in doing so. The effort-reward imbalance (ERI) is a model used as a measurement tool for occupational stress. The model was built on the notion of reciprocity, which relates ‘effort’ to ‘reward’ through the mediating ‘over-commitment’. Reciprocity assumes equilibrium between both effort and reward, where ‘high’ effort is adequately compensated with ‘high’ reward. When this equilibrium is violated (i.e., high effort with low reward), this may elicit negative emotions and stress, which have been correlated to adverse health conditions. The theory of ERI was established in many different parts of the world, and associations with chronic diseases and the health of workers were explored at length. While much of the effort-reward imbalance was investigated in work conditions, there has been a growing interest in understanding the validity of the ERI model when applied to other social settings such as schools and universities. The ERI questionnaire was developed in Arabic recently to measure ERI among high school teachers. However, little information is available on the validity of the ERI questionnaire in university students. A cross-sectional study was conducted on 833 students in Jordan to measure the validity and reliability of the ERI questionnaire in Arabic among university students. Reliability, as measured by Cronbach’s alpha of the effort, reward, and overcommitment scales, was 0.73, 0.76, and 0.69, respectively, suggesting satisfactory reliability. The factorial structure was explored using principal axis factoring. The results fitted a five-solution model where both the effort and overcommitment were uni-dimensional while the reward scale was three-dimensional with its factors, namely being ‘support’, ‘esteem’, and ‘security’. The solution explained 56% of the variance in the data. The established ERI theory was replicated with excellent validity in this study. The effort-reward ratio in university students was 1.19, which suggests a slight degree of failed reciprocity. The study also investigated the association of effort, reward, overcommitment, and ERI with participants’ demographic factors and self-reported health. ERI was found to be significantly associated with absenteeism (p < 0.0001), past history of failed courses (p=0.03), and poor academic performance (p < 0.001). Moreover, ERI was found to be associated with poor self-reported health among university students (p=0.01). In conclusion, the Arabic ERI questionnaire is reliable and valid for use in measuring effort-reward imbalance in university students in Jordan. The results of this research are important in informing higher education policy in Jordan.

Keywords: effort-reward imbalance, factor analysis, validity, self-reported health

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48 Interdisciplinary Evaluations of Children with Autism Spectrum Disorder in a Telehealth Arena

Authors: Janice Keener, Christine Houlihan

Abstract:

Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

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