Search results for: inequality of opportunity in health

Authors: Adadu Yahaya, Abdullahi Erunke Canice

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The study sets out to examine the interface that tends to exist in the relationship between gender policy and Nigeria’s socio-economic development. Despite Nigeria’s ratification of virtually all international instruments on the protection and promotion of gender rights and equality, it appears that the practice is honored in the breach than in observance; hence, these policies have not been adequately domesticated and implemented. The implication of this is that the women folks have generally been isolated from mainstream politics and their political rights and privileges truncated in the scheme of things. The paper observes that gender inequality and marginalization in Nigeria has practically occasioned the unwholesome subjugation of Nigerian women to the background, hence poses more critical questions and challenges to the national question. The consequence of this, to this paper, is that Nigeria’s development process will be adversely affected if this trend is not checked. The paper sums up with appropriate policy options which are believed to have the potentials of giving women the right pride of place in the socio-economic and political dynamics in the 21st century Nigeria and beyond.

Keywords: development, equality, gender, policy

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Authors: M. Bukowski, K. Kreissl

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Social and environmental pressures in our times bear threats that often cross-border in scale, such as climate change, poverty-driven migration, demographic change as well as socio-economic developments. One of the hot topics is prevailing in many societies across Europe and worldwide, concerns 'affordable housing' and poverty-driven international and domestic migration (including displacements through gentrification processes), focusing here on the urban and regional context. The right to adequate housing and shelter is one of the recognized in the Universal Declaration of Human rights and International Covenant on Economic, Social and Cultural Rights, and as such considered as a human right of the second generation. The decreasing supply of affordable housing, especially in urban areas, has reached dimensions that have led to an increasing 'housing crisis'. This crisis, which has even reached middle-income homes, has an even more devastating impact on low income and poor households raising poverty levels. Therefore, the understanding of the connection between housing and poverty is vital to integrate and support the different stakeholders in order to tackle poverty. When it comes to issues of inequalities and poverty within the SDG framework, multi-faceted stakeholders with different claims, distribution of resources and interactions with other development goals (spill-over and trade-offs) account for a highly complex context. To contribute to a sustainable and fair society and hence to support the UN Sustainable Development Goals, the University of Salzburg participates in the Austrian-wide universities' network 'UniNEtZ'. Our joint target is to develop an options report for the Austrian Government regarding the seventeen SDGs, so far hosted by 18 Austrian universities. In this vein, the University of Salzburg; i.e., the Centre for Ethics and Poverty Research, the departments of Geography and Geology and the Department of Sociology and Political Science are focusing on the SDG 1 (No Poverty) and SDG 10 (Reduced Inequalities). Our target and research focus is to assess and evaluate the status of SDG 1 and 10 in Austria, to find possible solutions and to support stakeholders' integration. We aim at generating and deducing appropriate options as scientific support, from interdisciplinary research studies to 'Sustainability Developing Goals and their Targets' in action. For this reason, and to deal with the complexity of the Agenda 2030, we have developed a special Model for Inequalities and Poverty Assessment (IPAM). Through the example of 'affordable housing' we provide insight into the situation focusing on sustainable outcomes, including ethical and justice perceptions. The IPAM has proven to be a helpful tool in detecting the different imponderables on the Agenda 2030, assessing the situation, showing gaps and options for ethical SDG actions combining different SDG targets. Supported by expert and expert group interviews, this assessment allows different stakeholders to overview a complex and dynamic SDG challenge (here housing) which is necessary to be involved in an action finding process.

Keywords: affordable housing, inequality, poverty, sustainable development goals

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Authors: Wasaporn Techapeeraparnich

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Bringing private investor involving in providing public infrastructure have been increasingly used worldwide, and there is no exception for developing countries like Thailand. Recently, there is a huge investment opportunity for public-private partnership (PPP) in Thailand, especially in the transportation sector. This paper analyses the development of the PPP since the early beginning of PPP in different service sectors. It also summarizes the development of PPP and its application in terms of usage, opportunities and trends particularly in the transport sector. The results are aimed to draw some lessons learned for future development.

Keywords: case study, public-private partnership, transportation, Thailand

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Authors: Tessalyn Morrison, Alexis Dinno, Taurica Salmon

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Sex and gender conflation continue to perpetuate the invisibility of gender minorities and obscure information about the ways that biological sex and gender affect health. The misuse of sex and gender terms, and their respective binaries, can yield inaccurate results. But more importantly, it contributes to the erasure of sex and gender minority health experiences. This paper discusses ways in which public health researchers can use sex and gender terms correctly and center the health experiences of intersex, transgender, non binary, and a-gender individuals. It includes promoting sensitivity in approaching minority communities, improving survey questions, and collaborating with sex and gender minority communities to improve research quality and participant experiences. Improving our standards for the quality of sex and gender term usage and centering sex and gender minorities in public health research are imperative to address the health inequalities faced by sex and gender minorities.

Keywords: epidemiology, gender, intersex, research methods, sex, transgender

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Authors: S. McLean, J. A. Scott

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The research topic is focusing on improving sustainable operation through recovery and reuse of waste heat in process water streams, an area in the mining industry that is often overlooked. There are significant advantages to the application of this topic, including economic and environmental benefits. The smelting process in the mining industry presents an opportunity to recover waste heat and apply it to alternative uses, thereby enhancing the overall process. This applied research has been conducted at the Sudbury Integrated Nickel Operations smelter site, in particular on the water cooling towers. The aim was to determine and optimize methods for appropriate recovery and subsequent upgrading of thermally low-grade heat lost from the water cooling towers in a manner that makes it useful for repurposing in applications, such as within an acid plant. This would be valuable to mining companies as it would be an opportunity to reduce the cost of the process, as well as decrease environmental impact and primary fuel usage. The waste heat from the cooling towers needs to be upgraded before it can be beneficially applied, as lower temperatures result in a decrease of the number of potential applications. Temperature and flow rate data were collected from the water cooling towers at an acid plant over two years. The research includes process control strategies and the development of a model capable of determining if the proposed heat recovery technique is economically viable, as well as assessing any environmental impact with the reduction in net energy consumption by the process. Therefore, comprehensive cost and impact analyses are carried out to determine the best area of application for the recovered waste heat. This method will allow engineers to easily identify the value of thermal resources available to them and determine if a full feasibility study should be carried out. The rapid scoping model developed will be applicable to any site that generates large amounts of waste heat. Results show that heat pumps are an economically viable solution for this application, allowing for reduced cost and CO₂ emissions.

Keywords: environment, heat recovery, mining engineering, sustainability

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Authors: Valentina Talu, Giulia Tola

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Current researches and applications aimed at exploring the role of spatial configuration as a means for improving the autonomy of people with ASD (Autism Spectrum Disorder), almost exclusively focus on the definition of criteria for the design of closed, separated, private spaces devoted only to people - mainly children - with ASD. In fact, very few researches specifically investigate the relation between the city and people with autism, focusing on their sensory experiences related to the interaction with the urban environment. The growing incidence of ASD and the need to guarantee during adulthood the actual opportunity to exercise the achieved level of autonomy and independency, emphasizes the necessity to ‘broaden’ the research perspective by investigating also the specific contribution of urban mobility policies and urban design to the enhancement of the quality of life of people with ASD. Starting from these considerations, the paper describes an ongoing research focused on the relation between the city and people with autism spectrum disorder, with the specific aim of promoting their possibility of walking across the city at the neighborhood scale, thus making the access to relevant urban spaces and services possible. In the first part, the paper proposes a framework for illustrating the commonly recurring problems that people with ASD face in their daily life when they interact with the urban environment (with reference to the capability approach). Subsequently, with the support of an in depth analysis of existing contributions (researches and projects) and an exchange with different experts (neuropsychiatrists, teachers, parents), are identified two urban requirements, then 'translated' into an integrated system of urban mobility policies and extra-small tactical project aimed at enhancing the actual possibility for people with ASD of walking through the city autonomously and safely. According to this vision, the promotion of the autonomy of people with ASD through the adoption of mobility policies and micro tactical urban projects can represent an opportunity for promoting and improving the overall quality of urban life.

Keywords: city and people with ASD, quality of urban life of disadvantaged people, urban capabilities, urban design

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Authors: Macdonald Kanyangale, Sandram Naluso

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Globally, researchers have struggled over time to adequately define the notion of health system to inform research. This study is significant because it proposes an integrative framework for a robust definition of the health system. The objective of this article is to examine major pitfalls in definitions of health system used in prior literature and implications of these for research and management. The study used methodological steps of a scoping review proposed by Arksey and O'Malley to identify and examine 24 definitions of a health system in articles selected from six databases and web search engines. Thematic analysis was used to delineate and categorise definitional pitfalls into broader themes. There are a plethora of five major pitfalls in the extant definitions of a health system which may easily scupper any unsuspecting researcher if not avoided or addressed in research. These definitional pitfalls are reductionist assumptions which ignore dynamic and complex connections, overly wide boundary and lack of specification of levels in a health system, and limited focus on process in a health system. In addition, there is the tendency of treating different components of the health system as equal and simplifying of the ontological complexity of the health system. Future scholars are advised to avoid or address the identified five major pitfalls if they are to develop robust definitions of an HS. The use of an integrative framework for a robust definition of a health system is recommended, while implications of the pitfalls are discussed as a basis and catalyst for complexity-informed research and managing interactively.

Keywords: complexity management, health system, pitfalls, reductionism, research

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Authors: Maria Luisa Jaramillo, Alvaro Turriago Hoyos, Ulf Thoene

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Financial inclusion has become a crucially important factor in debates on economic inequality posing challenges to the financial systems of countries around the world. Nowadays, governments and banks are concerned about creating products that allow access to wide sectors of the population. The creation of banking products by the financial sector for people with low incomes tends to lead to improvements in the quality of life of vulnerable parts of the population. In countries with notable social and economic inequalities financial inclusion is a key aspect for equitable economic growth. This study is based on the case of Colombia, which is a country with a strong record of economic growth over the past decade. Nevertheless, corruption, unemployment, and poverty contribute to uncertainty regarding the country’s future growth prospects. This study wants to explain the situation of financial exclusion and financial inclusion with respect to the Colombian case. Financial inclusion is going to be studied from the perspective of social innovation.

Keywords: Colombia, financial exclusion, financial inclusion, social innovation

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Authors: Jukka Torronen

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Introduction: Alcohol consumption and health are areas where gender binaries have persisted. By intoxication, men have displayed their masculinity as strong, while matters of health have formed a feminine undertaking. However, in recent years young people’s alcohol consumption has declined and been challenged by competing activities, including the rising health trend. This makes the comparison of young people’s masculinities and femininities in health and heavy drinking an important case to study. Methods: The data consists of semi-structured interviews about alcohol, health, and leisure activities among young people aged between 15 and 19 (N=56). By drawing on Butler’s work on “gender as performative” and Connell’s understanding of gendered identities as “configurations of practices,” the paper analyzes how the interviewees are doing masculinities and femininities in relation to health and heavy drinking, and how their gender performances are dichotomous, naturalized and contested. Results: The interviewees approach health from two perspectives, which are called “social health” and “physical health” approaches. They are both gendered. Especially in the “social health” approach, in which intoxication and risk-taking are used to increase well-being, the interviewees perform stereotypical gender binaries. The interviewees’ gendered performances in the “physical health” approach show more variability and are more reflective and critical. In contrast to intoxication, in relation to which the interviewees perform biologically driven gender binaries, they perform culturally driven genders in relation to health. Conclusions: Health seems to provide for the interviewees a field in which they feel more liberated to perform flexible and alternative genders.

Keywords: young people, decline in drinking, qualitative interviews, gender, health, risk-taking

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Authors: Ruttana Phetsitong, Patama Vapattanawong, Malee Sunpuwan, Marc Voelker

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The majority of care for older people at home in Thai society falls upon caregivers resulting in caregiver’s mental health problem. Beyond individual characteristics, household factors might have a profound effect on the caregiver’s mental health. But reliable data capturing this at the household level have been limited to date. The objectives of the present study were to explore the levels of Thai caregiver’s mental health and to investigate the factors affecting the mental health at household level. Data were obtained from the 2011 National Survey of Thai Older Persons conducted by the National Statistical Office of Thailand. Caregiver’s mental health was measured by using the 15- items-short version of the Thai Mental Health Indicator (TMHI-15) developed by the Department of Mental Health, the Ministry of Public Health. Multivariate logistic regression models were used to explore the impact of potential factors on caregiver’s mental health. The THMI-15 produced an overall average caregiver mental health score of 30.9 out of 45 (SD 5.3). The score can be categorized into good (34.02-45), fair (27.01-34), and poor (0-27). Duration of care for older people, household wealth, and functional dependency of the older people significantly predicted total caregiver’s mental health. Household economic factor was key in predicting better mental health. Compared to those poorest households, the adjusted effect of the fifth quintile household wealth was high (OR=2.34; 95%CI=1.47-3.73). The findings of this study provide a fuller picture to a better understanding of the level and factors that cause the mental health of Thai caregivers. Health care providers and policymakers should consider these factors when designing interventions aimed at alleviating caregiver’s psychological burden when provided care for older people at home.

Keywords: caregiver’s mental health, household, older people, Thailand

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Authors: Yuki Irie, Shota Ogawa, Hitomi Kosugi, Hiromitsu Shinozaki

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Background: Dropout from higher educational institutions is a major problem both for students and institutions, and poor mental health is one of the risk factors. Medical college students are at higher risk of poor mental health than general students because of their hard academic schedules. On the other hand, food insecurity has negative impacts on mental health. The healthcare college of the project site is located heavily snowy area. The students without own vehicles may be at higher risk of food insecurity, especially in the winter season. Therefore, they have many risks to mental health. The aim of the study is to clarify the relationship between mental health and its risk factors to promote students’ mental well-being. Method: A cross-sectional design was used to investigate the relationship between mental health status and lifestyle, including diet and food security among the students (n=421, 147 male, 274 females; 20.7 ± 2.8 years old). Participants were required to answer 3 questionnaires which consisted of diet, lifestyle, food security, and mental health. The survey was conducted during the snowy season from Dec. 2022 to Jan. 2023. Results: Mean mental score was 6.7±4.6 (max. score 27, a higher score means worse mental health). Significant risk factors in mental health were breakfast habit (p=0.02), subjective dietary habit (p=0.00), subjective health (p=0.00), exercise habit (p=0.02), food insecurity in the winter season (p=0.01), and vitamin A intakes (p=0.03). Conclusions: Nutrients intakes are not associated with mental health except vitamin A; however, some other lifestyle factors are significantly associated with mental health. Nutrition doesn’t lead to poor mental health directly; however, the promotion of a healthy lifestyle and improved food security in winter may be effective in better mental health.

Keywords: mental health, winter, lifestyle, students

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Authors: Sharmila Rathee

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Individuals with disability/ies often face negative attitudes, discrimination, exclusion, and inequality of treatment due to stigmatization and stigmatized treatment. While a significant number of studies in field of stigma suggest that group-identification has positive consequences for stigmatized individuals, ironically very miniscule empirical work in sight has attempted to investigate in-group identification as a coping measure against stigma, humiliation and related experiences among disability group. In view of death of empirical research on in-group identification among disability group, through present work, an attempt has been made to examine the experiences of stigma, humiliation, and in-group identification among disability group. Results of the study suggest that use of in-group identification as a coping strategy is not uniform across members of disability group and degree of in-group identification differs across different sub-groups of disability groups. Further, in-group identification among members of disability group depends on variables like degree and impact of disability, factors like onset of disability, nature, and visibility of disability, educational experiences and resources available to deal with disabling conditions.

Keywords: disability, stigma, in-group identification, social identity

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Authors: Amy Williamson, Kerry Armstrong, Jason Edwards, Patricia Obst

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Australian national policy endorses a responsive approach to work health and safety (WHS) regulation, combining positive motivators (education and guidance), with compliance monitoring and enforcement to encourage and secure compliance with legislation. Despite theoretical support for responsive regulation, there is limited evidence regarding how to achieve best results in practice. Using positive psychology as a novel paradigm, this study aims to investigate how non-punitive regulatory interactions can be improved to further encourage regulatory compliance in the construction industry. As part of a larger project, semi-structured interviews were conducted with 35 inspectorate staff and 11 managers in the Australian (Queensland) construction industry. Using an inductive, grounded approach, an in-depth qualitative investigation was conducted to identify the positive psychological principles which underpin effective use of the non-punitive aspects of responsive regulation. Results highlighted the importance of effective engagement between inspectors and industry managers. This involved the need to interact cooperatively and encourage compliance with WHS legislation. Several strategies were identified that assisted regulatory interactions and the ability of inspectors to engage. The importance of communication and interpersonal skills was reported to be critical to any interaction, regardless of the nature of the visit and regulatory tools used. In particular, the use of clear and open communication fostered trust and rapport which facilitated more positive interactions. The importance of respect and empathy was also highlighted. The need for provision of guidance and direction on how to achieve compliance was also reported. This related to ensuring companies understand their WHS obligations, providing specific advice regarding how to rectify a breach and meet compliance requirements, and ensuring sufficient follow up to confirm that compliance is successfully achieved. In the absence of imminent risk, allowing companies the opportunity to comply before further action is taken was also highlighted. Increased proactive engagement with industry to educate and promote the vision of safety at work was also reported. Finally, provision of praise and positive feedback was reported to assist interactions and encourage the continuation of good practices. Evidence from positive psychology and organisational psychology was obtained to support the use of each strategy in practice. In particular, the area of positive leadership provided a useful framework to consider the factors and conditions that drive positive interactions within the context of work health and safety and the specific relationship between inspectors and industry managers. This study provides fresh insight into key psychological principles which support non-punitive regulatory interactions in the area of workplace health and safety. The findings of this research contribute to a better understanding of how inspectors can enhance the efficacy of their regulatory interactions to improve compliance with legislation. Encouraging and assisting compliance through effective non-punitive activity offers a sustainable pathway for promoting safety and preventing fatalities and injuries in the construction industry.

Keywords: engagement, non-punitive approaches to compliance, positive interactions in the workplace, work health and safety compliance

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Authors: Aikaterini Tsalampouni

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The European Union has long been the most developed model of economic and political integration that has brought a common market, a common currency and a standardization of national policies in certain areas in consistent with EU values and principles. To this direction, there is a parallel process of social integration that effect public policy decisions of member states. Even though social policy, i.e. social protection and moreover healthcare policy, still remains in state's responsibility to develop, EU applies different mechanisms in order to influence health policy systems, since from a more federalist point of view, EU ought to expand its regulatory and legislative roles in as many policy areas as possible. Recently, the pandemic has become a turning point for health care provision and at the same time has also highlighted the need to strengthen the EU’s role in coordinating health care. This paper analyses the EU health policy in general, as well as the response to COVID-19 pandemic with an attempt to identify indications of interaction between EU policies and the promotion of sustainable and resilient health systems. More analytically, the paper investigates the EU binding legal instruments, non-binding legal instruments, monitoring and assessment instruments and instruments for co-financing concerning health care provision in member states and records the evolution of health policies before and during the COVID-19 pandemic. The paper concludes by articulating some remarks regarding the improvement of health policy in EU. Since the ability to deal with a pandemic depends on continuous and increased investment in health systems, the involvement of the EU can lead to a policy convergence, necessary for the resilience of the systems, maintaining at the same time, a strong health policy framework in Europe.

Keywords: EU health policy, EU response to COVID-19, European Health Union, health systems in Europe

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Authors: Cheng Wen, Zhang Jianhua

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This paper aims to probe into the general rules of industry specialization or diversification in a region during its process of economic growth and the specific reasons for the difference of industry specialization development in the eastern, central and western regions of China. It is found in this paper that the changes of regional industry specialization in China, like most of countries in the world, also present the U-shaped curve. Regional industrial structure is diversified in the first place. And when the per capita income exceeds a certain level, distribution of economic resources in this region will be concentrated again. From the perspective of rising total factor productivity and falling of transaction cost in the process of economic development, this paper comes up with a theoretical model to explain the U-shaped curve. Through the empirical test of China's provincial panel data, this paper explains the factors that cause the inequality of the industry specialization development in the eastern, central and western regions of China.

Keywords: u-shaped curve, regional industrial specialization, technological progress, transaction costs

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Authors: Benet Reid, Nina Laurie, Matt Baillie-Smith

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Trans-national and tropical medicine, historically associated with colonial power and missionary activity, is now central to discourses of global health and development, thrust into mainstream media by events like the 2014 Ebola crisis and enshrined in the Sustainable Development Goals. Research in this area remains primarily the province of health professional disciplines, and tends to be framed within a simple North-to-South model of development. The continued role of voluntary work in this field is bound up with a rhetoric of partnering and partnership. We propose, instead, the idea of International Voluntary Health Networks (IVHNs) as a means to de-centre global-North institutions in these debates. Drawing on our empirical work with IVHNs in countries both North and South, we explore geographical and sociological theories for mapping the multiple spatial and conceptual dynamics of power manifested in these phenomena. We make a radical break from conventional views of health as a de-politicised symptom or corollary of social development. In studying health work as it crosses between cultures and contexts, we demonstrate the inextricably political nature of health and health work everywhere.

Keywords: development, global health, power, volunteering

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Authors: Maryam Bakhtyar-Pegah Akrami

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The relationship between spiritual health and spirituality is one of the important is that in recent years, the research about it is expanding and due to the rich heritage of the in this field of study and research in this important field more than before and we will come to spiritual life and healthier than before. In this research, we provide the following and the basics of Islamic Mysticism in the realm of spiritual health thoughts. This research is based on a descriptive method and comparison with analytical-method to data collected. The findings show that human beings due to this pivotal topic of full Islamic slab, and mental and physical education with the sought to reach the human place are complete, we can provide the basics along with new discussions of spiritual health help human beings to spiritual education along with our faiths in the reconstruction of the spiritual foundations of spiritual health are extremely helpful

Keywords: spirituality, health, Islam, mysticism, perfect human

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Authors: Peter R. Reuter

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Health professionals play important roles in helping patients use Complementary and Alternative Medicine (CAM) practices safely and accurately. Consequently, it is important for future health professionals to learn about CAM practices during their time in undergraduate and graduate programs. To satisfy this need for education, teaching CAM in nursing and medical schools and other health professions programs is becoming more prevalent. Our study was the first to look specifically at the knowledge of, and attitude toward CAM of undergraduate health professions students at a university in the U.S. Students were invited to participate in one of two anonymous online surveys depending on whether they were pre-health professions students or graduating health professions seniors. Of the 763 responses analyzed, 71.7% were from pre-health professions students, and 28.3% came from graduating seniors. The overall attitude of participants toward and interest in learning about CAM practices was generally fairly positive with graduating seniors being more positive than pre-health professions students. Yoga, meditation, massage therapy, aromatherapy, and chiropractic care were the practices most respondents had personal experience with. Massage therapy, yoga, chiropractic care, meditation, music therapy, and diet-based therapy received the highest ratings from respondents. Three-quarters of respondents planned on including aspects of holistic medicine in their future career as a health professional. The top five practices named were yoga, meditation, massage therapy, diet-based therapy, and music therapy. The study confirms the need to educate health professions students about CAM practices to give them the background information they need to select or recommend the best practices for their patients' needs.

Keywords: CAM education, health professions, health professions students, pre-health professions students

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Authors: Mona Nikidehaghani, Freda Hui

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In Australia, one-third of mental health carers provide 40 hours or more of unpaid care per week. These hidden workers contribute significantly to the Australian mental health workforce by providing unpaid services both direct and indirect to people in their care. However, carers are often neglected in the healthcare system because Government services focus on those with a mental health condition rather than those supporting them. The aim of this study is to evaluate the perceptions of mental health carers on the effectiveness of community services designed for carers and how these services could be improved. We collaborated with One Door Mental Health, a community organisation that supports mental health carers. Through semi-structured interviews with 27 mental health carers residing in the Illawarra region (NSW), we documented their daily challenges and evaluated outcomes of the current programs for carers. Our findings demonstrate that services such as education programs enable capacity building and improve the social life and mental health of carers. Drawing on the perceptions of mental health carers, this study maps pathways for making meaningful changes in the lives of carers and proposes an outcome framework to evaluate the impact of a community organisation on the lives of their clients. The framework prepared by this project would be replicable, allowing other community organisations to measure the outcomes and improve their services.

Keywords: capacity building, community development, community service, mental health carers

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Authors: Lu Yu Jyun

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Background: Health education is important nursing work aiming to strengthen patients’ self-caring ability and family members. Our department educates through three methods, including speech education, flyer and demonstration video education. The satisfaction rate of health education tool use is 54.3% in nursing staff. The main reason is there hadn’t been a storage area for flyers, causing extra workload in assessing flyers. The satisfaction rate of health education in patients and families is 70.7%. We aim to improve this situation between 13th April and 6th June 2021. Method: We introduce the ECRS method to erase repetitive and redundant actions. We redesign the health education tool usage workflow to improve nursing staffs’ efficiency and further enhance nursing staffs care quality and working satisfaction. Result: The satisfaction rate of health education tool usage in nursing staff elevated from 54.3% to 92.5%. The satisfaction rate of health education in patients and families elevated from 70.7% to 90.2%. Conclusion: The assessment time of health care tools dropped from 10minutes to 3minutes. This significantly reduced the nursing staffs’ workload. 1213 paper is saved in one month and 14,556 a year in the estimate; we save the environment via this action. Health education map implemented in other nursing departments since October due to its’ high efficiency and makes health care tools more humanize.

Keywords: health, education tools, satisfaction, nursing staff

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Authors: Duygu Çelgin

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Until the new Occupational Health and Safety Law of Turkey, most of the workers were excluded from the mandatory occupational health and safety services. This new law, made the OHS services mandatory for all workers from all sectors including both public and private. However, in the application some problems and disadvantageous cases are occurred and the government also considered these cases. In this study, the new OHS law of Turkey and the regulations prepared according to the law are studied with the literature search.

Keywords: occupational health and safety in Turkey, OHS servicing in Turkey, safety experts, OHS support

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Authors: Suantak Demkhosei Vaiphei

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Mental illness is still considered as an illness not to be treated, resulting India becoming the most depressed country in the world. At present, 150 million Indians are suffering from mental illness and desperately in need of immediate care assessment for their mental health condition. However, only 0.06 per cent of India’s health budget is devoted to mental health treatment, in which the available data suggests that the state of spending the sanctioned budget in this regard is abysmal. Lack of awareness, ignorance, social stigma, and discriminations becomes the underlying factors for worsening the individual mental health conditions. Unfortunately, India becomes the most depressed country in the world, which is hugely affected by anxiety, schizophrenia, and bipolar disorder followed by China and USA as per the latest World Health Organization report. The National Care of Medical Health stated that at least 6.5 per cent of the Indian populations are under serious mental disorder both in the rural and the urban areas’Mental health is the integral part of health and can be affected by a range of psychosocial-economic factors that need comprehensive strategically approach for promotion, prevention, treatment, and recovery. In a low- and middle-income country like India, the advance progress in mental health service is visible consistently slow and minimal. Some of the major barriers can be seen in the existing public health priorities and its influence on funding; challenges to delivery of basic mental health care in the primary care settings; the minimal numbers of well-trained professionals in the area of mental health care; and lack of mental health perspective in public-health leadership. The existing barriers according to WHO (2007) are; lack of funding for mental health services is the core barrier in implementing quality mental health services, including inadequate coordinated and consensus based national mental health advocacy and plans, the absence of mental health in major donor priorities, marketing of expensive pharmaceuticals by industry, cost-effectiveness information on mental health services that is unknown to senior decision-makers and social stigma among others. Moreover, lack of strong mental health advocacy in countries to increase resources for mental health services and the role of social stigma and the view that mental health is a private responsibility are also the two barriers to mental health.

Keywords: mental health, depression, stigma, barriers

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Authors: Sandrine Andriantsimietry, Hantanirina Ravaosendrasoa

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Madagascar, in 2018, set up the first best available technology, autoclave, to treat the health care waste in public hospitals according the best environmental practices in health care waste management. Incineration of health care waste, frequently through open burning is the most common practice of treatment and elimination of health care waste across the country. Autoclave is a best available technology for non-incineration of health care waste that permits recycling of treated waste and prevents harm in environment through the reduction of unintended persistent organic pollutants from the health sector. A Global Environment Fund project supported the introduction of the non-incineration treatment of health care waste to help countries in Africa to move towards Stockholm Convention objectives in the health sector. Two teaching hospitals in Antananarivo and one district hospital in Manjakandriana were equipped respectively with 1300L, 250L and 80L autoclaves. The capacity of these model hospitals was strengthened by the donation of equipment and materials and the training of the health workers in best environmental practices in health care waste management. Proper segregation of waste in the wards to collect the infectious waste that was treated in the autoclave was the main step guaranteeing a cost-efficient non-incineration of health care waste. Therefore, the start-up of the switch of incineration into non-incineration treatment was carried out progressively in each ward with close supervision of hygienist. Emissions avoided of unintended persistent organic pollutants during these four months of autoclaves use is 9.4 g Toxic Equivalent per year. Public hospitals in low income countries can be model in best environmental practices in health care waste management but efforts must be made internally for sustainment.

Keywords: autoclave, health care waste management, model hospitals, non-incineration

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Authors: Yafa Haron, Hanna Adami

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Background: World Health Organization emphasizes the contribution of nurses in planning and implementing health policies and reforms. Aim: To evaluate nursing students’ attitudes towards nurses’ involvement in health policy issues. Methods: Mixed-methods; qualitative and quantitative – a descriptive study. Participants - nursing students who were enrolled in their last year in the undergraduate program (BSN). Qualitative data included two open-ended questions: What is health policy and what is the importance of studying health policy, and 18 statements on the Likert Scale range 1-5. Results: Qualitativeanalysisrevealed that the majority of students defined health policy as a set of rules and regulations that defined procedures, borders, and proper conduct. 73% of students responded that nurses should be active in policymaking, but only 22% thought that nurses were currently involved in political issues. 28% thought that nurses do not have the knowledge and the time needed (60%) for political activity. 77% thought that the work environment did not encourage nurses to be politically active. Nursing students are aware of the importance towards nurses’ involvement in health policy issues, however, they do not have role models based on their low evaluation regarding nurses’ involvement in the health policy decision making process at the local or national level. Conclusions: Results emphasize the importance and the need of implementation the recommendation to include “advance policy changes” as core competency in nursing education and practice.

Keywords: health policy, nursing education, health systems, student perceptions

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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Authors: Elżbieta Antczak

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Cities offer important opportunities for economic development and for expanding access to basic services, including health care and education, for large numbers of people. Moreover, green areas (as an integral part of sustainable urban development) present a major opportunity for improving urban environments, quality of lives and livelihoods. This paper examines, using spatial concentration and spatial taxonomic measures, regional diversification of greenery in the cities of Poland. The analysis includes location quotients, Lorenz curve, Locational Gini Index, and the synthetic index of greenery and spatial statistics tools: (1) To verify the occurrence of strong concentration or dispersion of the phenomenon in time and space depending on the variable category, and, (2) To study if the level of greenery depends on the spatial autocorrelation. The data includes the greatest Polish cities, categories of the urban greenery (parks, lawns, street greenery, and green areas on housing estates, cemeteries, and forests) and the time span 2004-2015. According to the obtained estimations, most of cites in Poland are already taking measures to become greener. However, in the country there are still many barriers to well-balanced urban greenery development (e.g. uncontrolled urban sprawl, poor management as well as lack of spatial urban planning systems).

Keywords: greenery, urban areas, regional spatial diversification and concentration, spatial taxonomic measure

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Authors: Kanda Janyam, Piyaporn Vijit

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Background: As a consequence of sustained declines in fertility and mortality during the last three decades of the 20th century, Thailand faces a rapidly growing population of older persons. This demographic change directly affect Thailand workforce. Therefore, the study of health promotion behaviour of the older employees will benefit the employers as they can then develop the preparation for promoting well-being in older persons. Purpose: The current study aims to investigate health promotion behaviour and factors related to health promotion behaviour of older employees in factory. Methodology: The research instrument was questionnaire on health promotion behaviour and semi-structured interviews. The questionnaire was launched with 326 employees aged between 45-59 years in three factories in Songkhla Province, southern Thailand. The data collection started in December 2011. The data were analysed with mean, standard deviation, and correlation. Results: The results revealed that overall health promotion behaviour of the older employees in factory was at a high level. Moreover, when considered by aspect, it was found that their responsibility for health, nutrition, success in life, interpersonal relationship were at a high level while stress management, and exercise were at a moderate level. The results from correlation analysis indicated that the overall health promotion behaviour was positively related to knowledge of health promotion behaviour, attitude toward health promotion behaviour, health perception, the policy of health promotion, participation in health promotion activities, convenience in obtaining health promotion services, health resources, advice from people supporting health, and information received from the media. In addition, the results of the interviews with four key informants helped to confirm the factors related to health promotion behaviour of older employees in factory. Therefore, health promotion for elderly employees in factory is likely to be successful, if the support is given to the four health promotion factors that are divided into: leading factors consisting of attitude toward health promotion behaviour, and health perception, and supporting factors consisting of advice from other people, and information on health from various media. Practical implications: The results of the study identified the factors related to health promotion behaviour of older employees in factory. Such information will benefit employers as they can then develop specific strategies to increase their staffs’ well-being and, hence, presumably enhance the organization productivity.

Keywords: health promotion behavior, older, employee, factory

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Authors: Vera Lúcia Raposo

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The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

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Authors: Jade Fersterer, Tristan Snell, Mark Rickinson

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This paper is designed to provide a review of the literature concerning the impact of natural environments on student learning and wellbeing in Australia. Specific areas of interest include how child-led and teacher-led pedagogies differ in outdoor learning settings, and the impact of each approach on children’s well-being, behavior, relationships with others as well as educational outcomes. The review will include links to possibilities for future research, including a Ph.D. currently being undertaken in Australia, which aims to fulfill a considerable gap in psychological, educational and outdoor learning research, regarding how natural environments are being used by teachers to improve learning and wellbeing among primary school students. The proposed study aims to understand if children’s experience of learning, 1. in a natural environment, and 2. in a child-led way, can support and strengthen their skills across several areas of development, including those required for positive educational outcomes. Data will be collected from a sample of primary school students and teachers via both quantitative and qualitative methods, including a pre- and post-questionnaire, direct observation, and semi-structured interviews. The study will have valuable implications for the provision of quality education as well as the promotion of good health and wellbeing. The implications of the research will be useful not only for teachers and parents but also for Psychologists working with children and young people in both a school and clinical setting. Understanding the impacts and implications of child-led learning and exposure to natural environments provides the opportunity to build on the current school curriculum. The inclusion of child-led experiences in nature may provide a simple way to build enthusiasm for school and learning, cultivating skills for life and relationships as well as meeting current curriculum requirements and building capacity for ongoing academic pursuits. In addition, understanding the impact of learning in a natural environment on wellbeing will assist in the development and dissemination of an educational model that could help mitigate the negative health outcomes associated with reduced physical activity and decreasing contact with nature among children.

Keywords: child-led learning, educational outcomes, natural environments, wellbeing

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Authors: Pedro G. Rodrigues, Maria J. Bárrios, Sara A. Ambrósio

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The digitalisation of health is a profoundly transformative economic, political, and social process. As is often the case, such processes need to be carefully managed if misunderstandings, policy misalignments, or outright conflicts between the government and a wide gamut of stakeholders with competing interests are to be avoided. Thus, ensuring open lines of communication where all parties know what each other’s concerns are is key to good governance, as well as efficient and effective policymaking. This project aims to make a small but still significant contribution in this regard in that we seek to determine the extent to which health managers’ perceptions of what is a priority for digital health in Portugal are aligned with official policy perspectives. By applying state-of-the-art artificial intelligence technology first to the indexed literature on digital health and then to a set of official policy documents on the same topic, followed by a survey directed at health managers working in public and private hospitals in Portugal, we obtain two priority rankings that, when compared, will allow us to produce a synthesis and toolkit on digital health policy in Portugal, with a view to identifying areas of policy convergence and divergence. This project is also particularly peculiar in the sense that sophisticated digital methods related to text analytics are employed to study good governance aspects of digitalisation applied to health care.

Keywords: digital health, health informatics, text analytics, governance, natural language understanding

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