Search results for: risk factors for mental health

Authors: Wee Tong Liaw, Elaine Wong Yee Sing

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The main objective and focus of this study are to establish the significance of a sustained health promoting workplace on stock and portfolio returns focusing on companies listed on the Singapore stock exchange, using a two-factor model comprising of the single factor CAPM and a 'health promoting workplace' factor. The 'health promoting workplace' factor represents the excess returns derived between two portfolios of component stocks that, when combined, would represent a top tier stock market index in Singapore, namely the STI index. The first portfolio represents companies that are independently assessed by the Singapore’s Health Award, SHA, to have a sustained and comprehensive health promoting workplace (SHA-STI portfolio) and the second portfolio represents companies that had not been independently assessed (Non-SHA STI portfolio). Since 2001, many companies in Singapore have voluntarily participated in the bi-annual Singapore HEALTH Award initiated by the Health Promotion Board of Singapore (HPB). The Singapore HEALTH Award (SHA), is an industry-wide award and assessment process. SHA assesses and recognizes employers in Singapore for implementing a comprehensive and sustainable health promotion programme at their workplaces. When using a ten year holding period instead of a one year holding period, excess returns in the SHA-STI portfolio over Non-SHA STI portfolio were consistently being observed over all test periods, during 2001 to 2013. In addition, when applied to the SHA-STI portfolio, results from the Two Factor Model consistently revealed higher explanatory powers across all test periods for the portfolio as well as all the individual component stocks in SHA-STI portfolio, than the single factor CAPM model. However, with respect to attaining higher level of achievement in the Singapore Health Award, this study did not show any incentive for selecting listed companies that have achieved a higher level of award. Results from this study would give further insights to investors and fund managers alike who intend to consider health promoting workplace as a risk factor in their stock or portfolio selection process, in particular for investors who have a preference for STI’s component stocks and with a longer investment horizon. Key micro factors like management abilities, business development strategies and production capabilities that meet the needs of market would create the demand for a company’s product(s) or service(s) and consequently contribute to its top line and profitability. Thereafter, the existence of a sustainable health promoting workplace would be a key catalytic factor in sustaining a productive workforce needed to support the continued success of a profitable business.

Keywords: asset pricing model, company's performance, stock returns, financial risk factor, sustained health promoting workplace

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Authors: Armaghan Moravej Aleali, Seyed Bahman Ghaderian, Homeira Rashidi, Mahmoud Mapar

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Background and Objective The metabolic syndrome (MetS) is considered the most important public health threat of the 21st century. This syndrome is characterized by a cluster of cardiovascular risk factors including increased central abdominal obesity, elevated triglycerides, reduced high-density lipoprotein, high blood pressure, increased fasting glucose, and hyperinsulinemia. MetS has been associated with hypogonadism and erectile dysfunction (ED), and MetS may be considered a risk factor for ED. The aim of this study was finding an association between metabolic syndrome and hypogonadism in Khouzestan, Iran. Subjects and Methods: In this study, 60 patients divided into two groups consisted of 30 cases (with metabolic syndrome) and 30 controls. Total and free Serum Testosterone and FBS in all of them were measured. Data was analyzed with SPSS20 program. Results: There was a significant difference between two groups about free Testosterone (P=0.01), FBS (P=0.002) and LH (P=0.03). Conclusion: According to this finding, it is thought the prevalence of hypogonadism in men with metabolic syndrome is more than the general population.

Keywords: metabolic syndrome, fasting blood sugar, hypogonadism, testosterone

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Authors: Mwenya Mubanga, Sula Mazimba

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Background: In Zambia, much of the focus on nutrition and health has been on reducing micronutrient deficiencies, wasting and underweight malnutrition and not on the rising global projections of trends in obesity and type 2 diabetes. The aim of this review was to identify and collate studies on the prevalence of obesity, diabetes and diabetes-related cardiovascular disease conducted in Zambia, to summarize their findings and to identify areas that need further research. Methods: The Medical Literature Analysis and Retrieval System (MEDLINE) database was searched for peer-reviewed articles on the prevalence of, and factors associated with obesity, type 2 diabetes, and diabetes-related cardiovascular disease amongst Zambian residents using a combination of search terms. The period of search was from 1 January 2000 to 31 December 2016. We expanded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of peer-reviewed articles. Results: In Zambia, the current prevalence of Obesity and Type 2 diabetes is estimated at 13%-16% and 2.0 – 3.0% respectively. Risk factors such as the adoption of western dietary habits, the social stigmatization associated with rapid weight loss due to Tuberculosis and/ or the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and rapid urbanization have all been blamed for fueling the increased risk of obesity and type 2 diabetes. However, unlike traditional Western populations, those with no formal education were less likely to be obese than those who attained secondary or tertiary level education. Approximately 30% of those surveyed were unaware of their diabetes diagnosis and more than 60% were not on treatment despite a known diabetic status. Socio-demographic factors such as older age, female sex, urban dwelling, lack of tobacco use and marital status were associated with an increased risk of obesity, impaired glucose tolerance and type 2 diabetes. We were unable to identify studies that specifically looked at diabetes-related cardiovascular disease. Conclusion: Although the prevalence of Obesity and Type 2 diabetes in Zambia appears low, more representative studies focusing on parts of the country outside of the main industrial zone need to be conducted. There also needs to be research on diabetes-related cardiovascular disease. National surveillance, monitoring and evaluation on all non-communicable diseases need to be prioritized and policies that address underweight, obesity and type 2 diabetes developed.

Keywords: type 2 diabetes, Zambia, obesity, cardiovascular disease

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Authors: Mohammad Karimizadehardakani, Hooman Minoonejad, Reza Rajabi, Ali Sharifnejad

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Background: Ankle sprain is one of the most important risk factor of anterior cruciate ligament (ACL) injury. Also, functional ankle instability (FAI) population has alterations in lower extremity sagittal plane biomechanics during landing task. We want to examine whether biomechanical alterations demonstrated by FAI patients are associated with the mechanism of ACL injury during high risk and sport related tasks. Methods: Sixteen basketball player with FAI and 16 non-injured control performed a single-leg cross drop landing. Knee sagittal and frontal (ATSF) was calculated. Independent t-tests, multiple linear regression, and Pearson correlation were used for analysis data. Result: Subject with FAI showed more peak ATFS, posterior ground reaction force (GRF) and less knee flexion, compared to the controls (P= 0.001, P= 0.004, P= 0.011). Knee flexion (r= −0.824, P = 0.011) and posterior GRF (r= 0.901, P = .001) were correlated with ATSF; Posterior GRF was factor that most explained the variance in ATSF (R2= 0.645; P = .001) in the FAI group. Conclusions: Result of our study showed there is a potential biomechanical relationship between the presence of FAI and risk factors associated with ACL injury mechanism.

Keywords: functional ankle instability, anterior cruciate ligament, biomechanics, risk factor

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Authors: Chanya Jetsukontorn

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Dengue hemorrhagic fever is the most important Mosquito-borne disease and the major public health problem in Thailand. The most important vector is Aedes aegypti. Environmental factors such as temperature, relative humidity, and biting rate affect dengue virus infection. The most effective measure for prevention is controlling of vector mosquitoes. In addition, surveillance of field-caught mosquitoes is imperative for determining the natural vector and can provide an early warning sign at risk of transmission in an area. In this study, Aedes aegypti mosquitoes were collected in Amphur Muang, Phetchabun Province, Thailand. The mosquitoes were collected in the rainy season and the dry season both indoor and outdoor. During mosquito’s collection, the data of environmental factors such as temperature, humidity and breeding sites were observed and recorded. After identified to species, mosquitoes were pooled according to genus/species, and sampling location. Pools consisted of a maximum of 10 Aedes mosquitoes. 70 pools of 675 Aedes aegypti were screened with RT-PCR for flaviviruses. To confirm individual infection for determining True infection rate, individual mosquitoes which gave positive results of flavivirus detection were tested for dengue virus by RT-PCR. The infection rate was 5.93% (4 positive individuals from 675 mosquitoes). The probability to detect dengue virus in mosquitoes at the neighbour’s houses was 1.25 times, especially where distances between neighboring houses and patient’s houses were less than 50 meters. The relative humidity in dengue-infected villages with dengue-infected mosquitoes was significantly higher than villages that free from dengue-infected mosquitoes. Indoor biting rate of Aedes aegypti was 14.87 times higher than outdoor, and biting times of 09.00-10.00, 10.00-11.00, 11.00-12.00 yielded 1.77, 1.46, 0.68mosquitoes/man-hour, respectively. These findings confirm environmental factors were related to Dengue infection in Thailand. Data obtained from this study will be useful for the prevention and control of the diseases.

Keywords: Aedes aegypti, Dengue virus, environmental factors, one health, PCR

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Authors: Razan Salem

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Men and women have different approaches towards investing, both in terms of strategies and risk attitudes. This study aims to focus mainly on investigating the financial risk behaviors of Arab women investors and to examine the financial risk tolerance levels of Arab women relative to Arab men investors. Using survey data on 547 Arab men and women investors, the results of Wilcoxon Signed-Rank (One-Sample) test Mann-Whitney U test reveal that Arab women are risk-averse investors and have lower financial risk tolerance levels relative to Arab men. Such findings can be explained by the fact of women's nature and lower investment literacy levels. Further, the current political uncertainty in the Arab region may be considered as another explanation of Arab women’s risk aversion behavior. The study's findings support the existing literature by validating the stereotype of “women are more risk-averse than men” in the Arab region. Overall, when it comes to investment and financial behaviors, women around the world behave similarly.

Keywords: Arab region, culture, financial risk behavior, gender differences, women investors

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Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew

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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.

Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease

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Authors: Katarzyna Pasternak

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Experiencing the meaning of life is widely recognised as a vital element of well-being and central human motivation. Studies have shown that a higher meaning of life is associated, among other things, with a higher quality of life, higher levels of happiness and better declared health. The subject of the study is the meaning in life measured with The Meaning in Life Questionnaire and the presence of such emotions as nostalgia, awe and hope, and the content of imaginations measured after temporal mental simulations in Americans and Poles. The respondents had to imagine themselves in future, in 40 years and describe two events that would take place at that time. Next, participants assessed the importance of the events described by them, recognised whether during their journey through time they felt awe, hope and nostalgia, and answered the questionnaire examining the meaning in life. 204 (102 from Poland 102 from the USA ) people aged 21 to 60 participated in the study. The study checked whether there were differences in the content of the imaginations of the respondents from Poland and USA, and whether there were statistically significant difference between the declared sense of meaning in life among participants from both countries. The result of the study hane shown that there were no differences in the overall result obtained by the participants in The Meaning in Life Questionnaire , while there were statistically significant differences among the subscales of the questionnaire. It turned out that Americans have a higher presence of meaning in life than Poles, but they obtained lower results in searching of meaning in life. Studies have also shown that there was a statistically significant difference between Poles and Americans in feeling awe after a mental simulation. Poles felt higher level of awe. Images about the future differed between Poles and Americans. Poles judged that the events they described were very important to them. Interestingly, the content of American participants’ imaginations was dominated by topics related to the future of the world, ecology and world peace. There were also ideas about nice moments spent with friends and family. Among Poles, ideas related to professional career and development as well as family events dominated. Research shows that despite the lack of differences in the general meaning in life, Poles are more focused on searching for meaning in life than Americans. The study shows interesting differences between the two cultures.

Keywords: meaning in life, mental simulations, imaginations, temporal mental simulations, future, cultural differences

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Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker

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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.

Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia

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Authors: Olga A. Momot, Boris I. Synzynys, Alla A. Oudalova

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Obninsk is situated in the Kaluga region 100 km southwest of Moscow on the left bank of the Protva River. Several enterprises utilizing nuclear energy are operating in the town. A special attention in the region where radiation-hazardous facilities are located has traditionally been paid to radioactive gas and aerosol releases into the atmosphere; liquid waste discharges into the Protva river and groundwater pollution. Municipal intakes involve 34 wells arranged 15 km apart in a sequence north-south along the foot of the left slope of the Protva river valley. Northern and southern water intakes are upstream and downstream of the town, respectively. They belong to river valley intakes with mixed feeding, i.e. precipitation infiltration is responsible for a smaller part of groundwater, and a greater amount is being formed by overflowing from Protva. Water intakes are maintained by the Protva river runoff, the volume of which depends on the precipitation fallen out and watershed area. Groundwater contamination with tritium was first detected in a sanitary-protective zone of the Institute of Physics and Power Engineering (SRC-IPPE) by Roshydromet researchers when realizing the “Program of radiological monitoring in the territory of nuclear industry enterprises”. A comprehensive survey of the SRC-IPPE’s industrial site and adjacent territories has revealed that research nuclear reactors and accelerators where tritium targets are applied as well as radioactive waste storages could be considered as potential sources of technogenic tritium. All the above sources are located within the sanitary controlled area of intakes. Tritium activity in water of springs and wells near the SRC-IPPE is about 17.4 – 3200 Bq/l. The observed values of tritium activity are below the intervention levels (7600 Bq/l for inorganic compounds and 3300 Bq/l for organically bound tritium). The risk has being assessed to estimate possible effect of considered tritium concentrations on human health. Data on tritium concentrations in pipe-line drinking water were used for calculations. The activity of 3H amounted to 10.6 Bq/l and corresponded to the risk of such water consumption of ~ 3·10-7 year-1. The risk value given in magnitude is close to the individual annual death risk for population living near a NPP – 1.6·10-8 year-1 and at the same time corresponds to the level of tolerable risk (10-6) and falls within “risk optimization”, i.e. in the sphere for planning the economically sound measures on exposure risk reduction. To estimate the chemical risk, physical and chemical analysis was made of waters from all springs and wells near the SRC-IPPE. Chemical risk from groundwater contamination was estimated according to the EPA US guidance. The risk of carcinogenic diseases at a drinking water consumption amounts to 5·10-5. According to the classification accepted the health risk in case of spring water consumption is inadmissible. The compared assessments of risk associated with tritium exposure, on the one hand, and the dangerous chemical (e.g. heavy metals) contamination of Obninsk drinking water, on the other hand, have confirmed that just these chemical pollutants are responsible for health risk.

Keywords: radiation-hazardous facilities, water intakes, tritium, heavy metal, health risk

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Authors: Amir Ikram, Faisal Ijaz, Qin Su

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The empirical study was undertaken to explore the determinants of non-performing loans (NPLs) of small and medium enterprises (SMEs) sector held by the commercial banks. Primary data was collected through well-structured survey questionnaire from credit analysts/bankers of 42 branches of 9 commercial banks, operating in the district of Lahore (Pakistan), for 2014-2015. Selective descriptive analysis and Pearson chi-square technique were used to illustrate and evaluate the significance of different variables affecting NPLs. Branch age, duration of the loan, and credit policy were found to be significant determinants of NPLs. The study proposes that bank-specific and SME-specific microeconomic variables directly influence NPLs, while macroeconomic factors act as intermediary variables. Framework exhibiting causal nexus of NPLs was also drawn on the basis of empirical findings. The results elaborate various origins of NPLs and suggest that they are primarily instigated by the loan sanctioning procedure of the financial institution. The paper also underlines the risk management practices adopted by the bank at branch level to averse the risk of loan default. Empirical investigation of bank-specific microeconomic factors of NPLs with respect to Pakistan’s economy is the novelty of the study. Broader strategic policy implications are provided for credit analysts and entrepreneurs.

Keywords: commercial banks, microeconomic factors, non-performing loans, small and medium enterprises

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Authors: Ciwang Teyra, A. H. Y. Lai

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Introduction: Indigenous LGBTQ individuals face with significant life stress such as racial and gender discrimination and microaggressions, which may lead to negative impacts of their mental health. Although studies relevant to Taiwanese indigenous LGBTQpeople gradually increase, most of them are primarily conceptual or qualitative in nature. This research aims to fulfill the gap by offering empirical quantitative evidence, especially investigating the impact of racial and gender microaggressions on mental health among Taiwanese indigenous LGBTQindividuals with an intersectional perspective, as well as examine whether social support can help them to cope with microaggressions. Methods: Participants were (n=200; mean age=29.51; Female=31%, Male=61%, Others=8%). A cross-sectional quantitative design was implemented using data collected in the year 2020. Standardised measurements was used, including Racial Microaggression Scale (10 items), Gender Microaggression Scale (9 items), Social Support Questionnaire-SF(6 items); Patient Health Questionnaire(9-item); and Generalised Anxiety Disorder(7-item). Covariates were age, gender, and perceived economic hardships. Structural equation modelling (SEM) was employed using Mplus 8.0 with the latent variables of depression and anxiety as outcomes. A main effect SEM model was first established (Model1).To test the moderation effects of perceived social support, an interaction effect model (Model 2) was created with interaction terms entered into Model1. Numerical integration was used with maximum likelihood estimation to estimate the interaction model. Results: Model fit statistics of the Model 1:X2(df)=1308.1 (795), p<.05; CFI/TLI=0.92/0.91; RMSEA=0.06; SRMR=0.06. For Model, the AIC and BIC values of Model 2 improved slightly compared to Model 1(AIC =15631 (Model1) vs. 15629 (Model2); BIC=16098 (Model1) vs. 16103 (Model2)). Model 2 was adopted as the final model. In main effect model 1, racialmicroaggressionand perceived social support were associated with depression and anxiety, but not sexual orientation microaggression(Indigenous microaggression: b = 0.27 for depression; b=0.38 for anxiety; Social support: b=-0.37 for depression; b=-0.34 for anxiety). Thus, an interaction term between social support and indigenous microaggression was added in Model 2. In the final Model 2, indigenous microaggression and perceived social support continues to be statistically significant predictors of both depression and anxiety. Social support moderated the effect of indigenous microaggression of depression (b=-0.22), but not anxiety. All covariates were not statistically significant. Implications: Results indicated that racial microaggressions have a significant impact on indigenous LGBTQ people’s mental health. Social support plays as a crucial role to buffer the negative impact of racial microaggression. To promote indigenous LGBTQ people’s wellbeing, it is important to consider how to support them to develop social support network systems.

Keywords: microaggressions, intersectionality, indigenous population, mental health, social support

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Authors: Siti Nor Amira Bt. Mohamad, Mohamad Yazis B. Ali Basah, Muhammad Ridhwan B. Ab. Aziz, Khairil Faizal B. Khairi, Mazlynda Bt. Md. Yusuf, Hisham B. Sabri

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The understanding of risk and the concept of it occurs associated in Islamic financing was well-known in the financial industry by the using of Profit-and-Loss Sharing (PLS). It was presently in any Islamic financial transactions in order to comply with shariah rules. However, the existence of risk in Murabahah contract of financing is an ability that the counterparty is unable to complete its obligations within the agreed terms. Therefore, it is called as credit or default risk. Credit risk occurs when the client fails to make timely payment after the bank makes complete delivery of assets. Thus, it affects the growth of the bank as the banking business is in no position to have appropriate measures to cover the risk. Therefore, the bank may impose penalty on the outstanding balance. This paper aims to highlight the credit risk determinant and issues surrounding in Islamic bank in Malaysia in terms of Murabahah financing and how to manage it by using the proper techniques. Finally, it explores the credit risk management concept that might solve the problems arise. The study found that the credit risk can be managed properly by improving the use of comprehensive reference checklist of business partners on their character and past performance as well as their comprehensive database. Besides that, prevention of credit risk can be done by using collateral as security against the risk and we also argue on the Shariah guidelines and procedures should be implement coherently by the banking business because so that the risk would be control by having an effective instrument for Islamic modes of financing.

Keywords: Islamic banking, credit risk, Murabahah financing, risk mitigation

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Authors: Sumara Khanzada

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This research investigated how much stress is induced by various study-related factors, in undergraduate students belonging to a renowned university in Karachi along with the unhealthy coping strategy the students use to manage the stress. The study related factors considered for the purpose of the study were curriculum and instruction based stress, teacher-student relationship, assessment system and different components related to academic work. A survey in which questionnaires were administered to hundred students was conducted. The data were analyzed quantitatively to determine the percentages of stress induced by the various factors. The study found that student-teacher relationship is the strongest factor that causes stress in the undergraduate students specifically when teachers do not deliver the lectures effectively and give assignments and presentations to students without clear guidelines and instructions. The second important factor that causes stress was the different components of academic life, such as, parental expectations and pressures to achieve one's goals. Assessment system was found to be the third key factor inducing stress and affecting students' cognitive and psychological functioning. The most commonly used unhealthy coping strategy for stress management was procrastination. In light of the findings, it is recommended that importance be given to teacher training to ensure that instruction is proper and healthy teacher student relationship exists. Effective support programs, workshops, seminars, and different awareness programs should be arranged for promoting awareness regarding mental health in educational institutions. Moreover, additional zero credit courses should be offered to teach students how to learn stress management and healthy coping skills. Sumara Khanzada Clinical Psychologist [email protected]

Keywords: Stress, coping stretigies, acadamic stress, relationship

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Authors: Muhammad Kamran Hanif Khan, Fahad Mushtaq

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Background: In both developed and underdeveloped countries, coronary artery disease (CAD) is a serious cause of death and disability. Cardiovascular disease (CVD) is becoming more prevalent in emerging countries like Pakistan due to the spread and acceptance of Western lifestyles. Material and Methods: An observational cross-sectional investigation was conducted, and data collection relied on a random cluster sampling method. The sample size for this cross-sectional study was calculated using the following factors: estimated true proportion of 17.5%, desired precision of 2%, and confidence interval of 95%. The data for this study was collected from a sample of 1387 adults. Results: The average age of those living in rural areas is 55.24 years, compared to 52.60 years for those living in urban areas. The mean fasting blood glucose of the urban participants is 105.28 mg/dL, which is higher than the mean fasting blood glucose of the rural participants, which is 102.06 mg/dL. The mean total cholesterol of the urban participants is 192.20 mg/dL, which is slightly higher than the mean total cholesterol of the rural participants, which is 191.97 mg/dL. CAD prevalence is greater in urban areas than in rural areas. ECG abnormalities prevalence is 16.1% in females compared to 12.5% in men. Conclusion: The prevalence of CAD is more common in urban areas than in rural ones for all of the measures of CAD used in the study.

Keywords: CVD prevalence, CVD risk factors, rural area, urban area

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Authors: Christodoulou Christos, Politis Anastasios

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The utilization of Wireless Body Area Network (WBAN) is experiencing a notable surge in popularity as a result of its widespread implementation in the field of smart health. WBANs utilize small sensors implanted within the human body to monitor and record physiological indicators. These sensors transmit the collected data to hospitals and healthcare facilities through designated access points. Bio-sensors exhibit a diverse array of shapes and sizes, and their deployment can be tailored to the condition of the individual. Multiple sensors may be strategically placed within, on, or around the human body to effectively observe, record, and transmit essential physiological indicators. These measurements serve as a basis for subsequent analysis, evaluation, and therapeutic interventions. In conjunction with physical health concerns, numerous smartwatches are engineered to employ artificial intelligence techniques for the purpose of detecting mental health conditions such as depression and anxiety. The utilization of smartwatches serves as a secure and cost-effective solution for monitoring mental health. Physiological signals are widely regarded as a highly dependable method for the recognition of emotions due to the inherent inability of individuals to deliberately influence them over extended periods of time. The techniques that WBANs employ to recognize emotions are thoroughly examined in this article.

Keywords: emotion recognition, wireless body area network, WBAN, ERC, wearable devices, psychological signals, emotion, smart-watch, prediction

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Authors: Asma Ammar, Nabiha Bouafia , Asma BenCheikh, Mohamed Mahjoub, Olfa Ezzi, Wadiaa Bannour, Radhia Helali, Mansour Njah

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Background: The objective of the present study was to identify factors associated with vaccination against Hepatitis B virus (HBV) among healthcare workers (HWs) in the University Hospital Center (UHC) Farhat Hached Sousse, Tunisia. Methods: We conducted a descriptive cross-sectional study all licensed physicians (n= 206) and a representative sample of paramedical staff (n= 372) exercising at UHC Hached Sousse (Tunisia) during two months (January and February 2014). Data were collected using a self-administered and pre-tested questionnaire, which composed by 21 questions. In order to determinate factors associated with vaccination against hepatitis B among HWs, this questionnaire was based on the Health Belief Model, one of the most classical behavior theories. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify the determinants of the use of vaccination against HBV. Results: The response rates were 79.8%. Fifty two percent believe that HBV is frequent in our healthcare units and 60.6% consider it a severe infection. The prevalence of HWs vaccination was 39%, 95% CI [34.49%; 43.5%]. In multivariate analysis, determinants of the use of vaccination against HBV among HWs were young age (p=10-4), male gender (p = 0. 006), high or very high importance accorded to health (p = 0.035), perception membership in a risk group for HBV infection (p = 0.038) and very favorable or favorable opinion about vaccination against HVB (p=10-4). Conclusion: The results of our study should be considered in any strategy for preventing VHB infection in HWs. In the mean time, coverage with standard vaccines should be improved also by supplying complete information on the risks of VHB infection and on the safety and efficacy of vaccination.

Keywords: Hepatitis B virus, healthcare workers, prevalence, vaccination

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Authors: Byeongju Choi, Sanggil Lee, Kyung-Eun Lee

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Introduction: In the republic of Korea, the number of workers in the beauty industry has been increasing. Because the prevalence of hepatitis B carriers in Korea is higher than in other countries, the risk of blood-borne infection including viral hepatitis B and C, among the workers by using the sharp and contaminated instruments during procedure can be expected among beauty salon workers. However, the health care policies for the workers to prevent the blood-borne infection are not established due to the lack of evidences. Moreover, the workers in hair and nail salon were mostly employed at small businesses, where national mandatory systems or policies for workers’ health management are not applied. In this study, the risk of the viral hepatitis B and C from the job experiencing the hair and nail procedures in the mortality was assessed. Method: We conducted a retrospective review of the job histories and causes of death in the female deaths from 2006-2016. 132,744 of female deaths who had one more job experiences during their lifetime were included in this study. Job histories were assessed using the employment insurance database in Korea Employment Information Service (KEIS) and the causes of death were in death statistics produced by Statistics Korea. Case group (n= 666) who died from viral hepatitis was classified the death having record involved in ‘B15-B19’ as a cause of deaths based on Korean Standard Classification of Diseases(KCD) with the deaths from other causes, control group (n=132,078). The group of the workers in the beauty service industry were defined as the employees who had ever worked in the industry coded as ‘9611’ based on Korea Standard Industry Classification (KSIC) and others were others. Other than job histories, birth year, marital status, education level were investigated from the death statistics. Multiple logistic regression analysis were used to assess the risk of deaths from viral hepatitis in the case and control group. Result: The number of the deaths having ever job experiences at the hair and nail salon was 255. After adjusting confounders of age, marital status and education, the odds ratio(OR) for deaths from viral hepatitis was quite high in the group having experiences with working in the beauty service industry with 3.14(95% confidence interval(CI) 1.00-9.87). Other associated factors with increasing the risk of deaths from viral hepatitis were low education level(OR=1.34, 95% CI 1.04-1.73), married women (OR=1.42, 95% CI 1.02-1.97). Conclusion: The risk of deaths from viral hepatitis were high in the workers in the beauty service industry but not statistically significant, which might attributed from the small number of workers in beauty service industry. It was likely that the number of workers in beauty service industry could be underestimated due to their temporary job position. Further studies evaluating the status and the incidence of viral infection among the workers with consideration of the vertical transmission would be required.

Keywords: beauty service, viral hepatitis, blood-borne infection, viral infection

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Authors: Harini Chakkera

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Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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Authors: Tatjana Pekmezovic, Milica Jecmenica-Lukic, Igor Petrovic, Vladimir Kostic

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Background: A group of atypical parkinsonian syndromes (APS) includes a variety of rare neurodegenerative disorders characterized by reduced life expectancy, increasing disability, and considerable impact on health-related quality of life (HRQoL). Aim: In this study we wanted to answer two questions: a) which demographic and clinical factors are main contributors of HRQoL in our cohort of patients with APS, and b) how does quality of life of these patients change over 1-year follow-up period. Patients and Methods: We conducted a prospective cohort study in hospital settings. The initial study comprised all consecutive patients who were referred to the Department of Movement Disorders, Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade (Serbia), from January 31, 2000 to July 31, 2013, with the initial diagnoses of ‘Parkinson’s disease’, ‘parkinsonism’, ‘atypical parkinsonism’ and ‘parkinsonism plus’ during the first 8 months from the appearance of first symptom(s). The patients were afterwards regularly followed in 4-6 month intervals and eventually the diagnoses were established for 46 patients fulfilling the criteria for clinically probable progressive supranuclear palsy (PSP) and 36 patients for probable multiple system atrophy (MSA). The health-related quality of life was assessed by using the SF-36 questionnaire (Serbian translation). Hierarchical multiple regression analysis was conducted to identify predictors of composite scores of SF-36. The importance of changes in quality of life scores of patients with APS between baseline and follow-up time-point were quantified using Wilcoxon Signed Ranks Test. The magnitude of any differences for the quality of life changes was calculated as an effect size (ES). Results: The final models of hierarchical regression analysis showed that apathy measured by the Apathy evaluation scale (AES) score accounted for 59% of the variance in the Physical Health Composite Score of SF-36 and 14% of the variance in the Mental Health Composite Score of SF-36 (p<0.01). The changes in HRQoL were assessed in 52 patients with APS who completed 1-year follow-up period. The analysis of magnitude for changes in HRQoL during one-year follow-up period have shown sustained medium ES (0.50-0.79) for both Physical and Mental health composite scores, total quality of life as well as for the Physical Health, Vitality, Role Emotional and Social Functioning. Conclusion: This study provides insight into new potential predictors of HRQoL and its changes over time in patients with APS. Additionally, identification of both prognostic markers of a poor HRQoL and magnitude of its changes should be considered when developing comprehensive treatment-related strategies and health care programs aimed at improving HRQoL and well-being in patients with APS.

Keywords: atypical parkinsonian syndromes, follow-up study, quality of life, APS

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Authors: Sohanur Rahman, Elisabeth Sinnewe, Larelle (Ellie) Chapple, Sarah Osborne

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Greater political attention to global climate change exposes firms to a higher level of political uncertainty, which can lead to adverse capital market consequences. However, a higher level of discourse on environment-specific political risk (EPR) between management and investors can mitigate information asymmetry, followed by less stock price crash risk. This study examines whether EPR discourse in discourse in the earnings conference calls (ECC) reduces firm-level stock price crash risk in the US market. This research also explores if adverse disclosures via media channels further moderates the association between EPR on crash risk. Employing a dataset of 28,933 firm-year observations from 2002 to 2020, the empirical analysis reveals that EPR discourse in ECC reduces future stock price crash risk. However, adverse disclosures via media channels can offset the favourable effect of EPR discourse on crash risk. The results are robust to the potential endogeneity concern in a quasi-natural experiment setting.

Keywords: earnings conference calls, environment, environment-specific political risk discourse, environmental disclosures, information asymmetry, reputation risk, stock price crash risk

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Authors: Mariana Mangas, Yaroslava Martins, M. Suárez, Célia Santos, Ana Matos Pires

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Baixo Alentejo is a region of Portugal characterized by an aging population, geographic isolation, social deprivation and a lack of medical staff. It is one of the most problematic regions in regards to mental health, particularly due to the factors mentioned. The aim of this study is a presentation of liaison psychiatry in Hospital José Joaquim Fernandes; a sample of the work done, the current situation and future perspectives. The aim is to present a retrospective study of internal psychiatric emergencies from January 1st, 2016 to August 31st, 2016. Liaison psychiatry of Department of Psychiatry and Mental Health (Psychiatry Service) of ULSBA includes the following activities: internal psychiatry emergencies, HIV consultation (comprised in the general consultation) and liaison psychology (oncology and pain), consisting of a total of 111 internal psychiatry emergencies during the identified period. Gender distribution was uniform. The most prevalent age group was 71-80 years, and 66,6% of patients were 60 years old and over. The majority of the emergency observations was requested by hospital services of medicine (56,8%) and surgery (24,3%). The most frequent reasons for admission were: respiratory disease (18,0%); tumors (15.3%); other surgical and orthopedic pathology (14,5%) and stroke (11,7%). The most frequent psychiatric diagnoses were: neurotic and organic depression (24,3%); delirium (26,1%) and adjustment reaction (14,5%). Major psychiatric pathology (schizophrenia and affective disorders) was found in 10,8%. Antidepressive medication was prescribed in 37,8% patients; antipsychotics in 34,2%. In 9.9% of the cases, no psychotropic drug was prescribed, and 5,4% of patients received psychologic support. Regarding hospital discharge, 42,4% of patients were referred to the general practitioner or to the medical specialist; 22,5% to outpatient gerontopsychiatry; 17,1% to psychiatric outpatient and 14,4% deceased. A future perspective is to start liaison in areas of HIV and psycho oncology in multidisciplinary approach and to improve collaboration with colleagues of other specialties for refining psychiatric referrals.

Keywords: psychiatry, liaison, internal emergency, psychiatric referral

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Authors: Paulo Rocha

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Once in touch with the Criminal Justice System, offenders with mental disorder tend to return to custody more often than nondisordered individuals, which suggests they have not been receiving appropriate treatment in prison. In this scenario, diverting individuals into care as early as possible in their trajectory seems to be the appropriate approach to rehabilitate mentally unwell offenders and alleviate overcrowded prisons. This paper builds on an ethnographic research investigating the challenges encountered by practitioners working to divert offenders into care while attempting to establish cross-boundary interactions with professionals in the Criminal Justice System and Mental Health Services in the UK. Drawing upon the findings of the study, this paper suggests the development of adequate tools to enable liaison between agencies which ultimately results in successful interventions.

Keywords: criminogenic needs, interagency collaboration, liaison and diversion, recidivism

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Authors: Olayinka Ariba, Abe Oudshoorn, Steve Rolfe, Carrie Anne Marshall, Deanna Befus, Jason Gilliland, Miranda Crockett, Susana Caxaj, Sarah McLean, Amy Van Berkum, Natasha Thuemler

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Background: Secure housing is a platform for health and well-being. Those who struggle with housing stability have complex life and health histories and often require some support services such as the provision of permanent supportive housing. Poor access to supportive resources creates an exacerbation of chronic homelessness, particularly affecting individuals who need immediate access to mental health and addiction supports. This paper presents the first phase of a three-part study examining how on-site support impacts housing stability for recently-re-housed persons. Method: This study utilized a community-based participatory research methodology. Twenty in-depth interviews were conducted with permanent supportive housing residents from a single-site dwelling. Interpretative description analysis was used to draw common themes and understand the experiences and challenges of housing support. Results: Three interconnected themes were identified: 1) Available and timely supports; 2) Affordability; and 3) Community, but with independence as desired. These interconnected components are helping residents transition from homelessness or long-term mental health inpatient care to live in the community. Despite some participant concerns about resident conflicts, staff availability, and affordability, this has been a welcome and successful move for most. Conclusion: Supportive housing is essential for successful tenancies as a platform for health and well-being among Canada’s most vulnerable and, from the perspective of persons recently re-housed, permanent supportive housing is a worthwhile investment.

Keywords: homelessness, supportive housing, rehoused, housing stability

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Authors: Fereshteh Darash

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Reflective tax management corresponds to the Agency Theory since it determines the motivation of managers for tax management actions and short-term and long-term consequences. Therefore, selection of tax strategy contributes to the tax and financial position of the firm in the future. The aim of the present research is to evaluate the effect of tax management components on risk-taking of firms listed in Tehran stock exchange by using regression analysis method. Results show that tax effective rate, tax risk and tax planning have no significant effect on the firm's future risk. Results suggest that stakeholders assess the effective tax rate and delay in tax payment in line with their benefits. They tend to accept the higher risk cost for reduction of tax payments and benefits of higher liquidity in current period. Hence, effective tax rate and tax risk have no significant effect on future risk of the firm. Moreover, tax planning yields no information regarding the predictability of the future profits and as a result, it has no significant effect on the future risk of the firm since specific goals of financial reporting are in priority for the stakeholders and regardless of the firm’s data analysis, they take investment decisions and they less intend to purchase the stocks in a rational manner.

Keywords: tax management, tax effective rate, tax risk, tax planning, firm risk

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Authors: Muhammad Arzim Naim, Saiful Azhar Rosly, Mohamad Sahari Nordin

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The objective of this study is to investigate the factors affecting the rise of Shariah non-compliance risk that can bring Islamic banks to succumb to monetary loss. Prior literatures have never analyzed such risk in details despite lots of it arguing on the validity of some Shariah compliance products. The Shariah non-compliance risk in this context is looking to the potentially failure of the facility to stand from the court test say that if the banks bring it to the court for compensation from the defaulted clients. The risk may also arise if the customers refuse to make the financing payments on the grounds of the validity of the contracts, for example, when relinquishing critical requirement of Islamic contract such as ownership, the risk that may lead the banks to suffer loss when the customer invalidate the contract through the court. The impact of Shariah non-compliance risk to Islamic banks is similar to that of legal risks faced by the conventional banks. Both resulted into monetary losses to the banks respectively. In conventional banking environment, losses can be in the forms of summons paid to the customers if they won the case. In banking environment, this normally can be in very huge amount. However, it is right to mention that for Islamic banks, the subsequent impact to them can be rigorously big because it will affect their reputation. If the customers do not perceive them to be Shariah compliant, they will take their money and bank it in other places. This paper provides new insights of risks faced by credit intensive Islamic banks by providing a new extension of knowledge with regards to the Shariah non-compliance risk by identifying its individual components that directly affecting the risk together with empirical evidences. Not limited to the Islamic banking fraternities, the regulators and policy makers should be able to use findings in this paper to evaluate the components of the Shariah non-compliance risk and make the necessary actions. The paper is written based on Malaysia’s Islamic banking practices which may not directly related to other jurisdictions. Even though the focuses of this study is directly towards to the Bay Bithaman Ajil or popularly known as BBA (i.e. sale with deferred payments) financing modality, the result from this study may be applicable to other Islamic financing vehicles.

Keywords: Islamic banking, Islamic finance, Shariah Non-compliance risk, Bay Bithaman Ajil (BBA), principal axis factoring

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Authors: Mark Linden, Rachel Leonard, Trisha Forbes, Michael Brown, Lynne Marsh, Stuart Todd, Nathan Hughes, Maria Truesdale

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Background: Current interventions which aim to improve the mental health of family carers are often face to face, which can create barriers to full participation. Online interventions can offer flexibility in delivery compared to face to face approaches. The primary objective of this study is to determine the feasibility of delivering the Carers-ID online intervention, while the secondary outcome is to improve the mental health of family carers of people with intellectual disabilities. Methods: Family carers (n = 120) will be randomised to receive the intervention (n=60) or assigned to a wait-list control (n=60) group. The intervention (www.Carers-ID.com) consists of fourteen modules which cover topics including promoting resilience, providing peer support, reducing anxiety, managing stress, accessing local supports, managing family conflict and information for siblings who are carers. Primary outcomes for this study include acceptability and feasibility of the outcome measures, recruitment, participation and retention rates and effect sizes. Secondary outcomes will be completed at three time points (baseline, following intervention completion and three months after completion). Secondary outcomes include, depression, anxiety, stress, well-being , resilience and social connectedness. Participants (n=12) who have taken part in the intervention arm of the research will be invited to participate in semi-structured interviews as part of the process evaluation. Discussion: To determine whether a full-scale randomised controlled effectiveness trial is warranted, feasibility testing of the intervention and trial procedures is a necessary first step. The Carers-ID intervention provides an accessible resource for family carers to support their mental health and well-being.

Keywords: intellectual disability, family carer, feasibility trial, online intervention

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Authors: Timothy A. Oloyede

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The study assessed the influence of playing field, climatic conditions, rate of exposure to matches, skill level and competition level on the occurrence and severity of football injuries. The prospective outline of the study was as follows: after a baseline examination and measurements were performed ascertaining possible predictors of injury, all players were followed up weekly for one year to register subsequent injuries and complaints. Four hundred and thirty-five out of 455 subjects completed the weekly follow-ups over one year. Multiple regression analysis was employed to analyse the data collected. Results showed that playing field, climatic conditions, rate of exposure to matches skill level and competition level were predictors of injuries among the professional footballer. Playing on natural grass, acclimatization, reduction of physical overload, among others, were strategies postulated for preventing injuries.

Keywords: sports’ injuries, predictors of sports’ injuries, intrinsic risk factors, extrinsic risk factors, injury mechanism, professional footballer

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Authors: Raju Singh, Shikha Singh

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This article is note for managing Autistic Child during the Corona time line. It becomes very critical for the primary caregiver as corona pandemic poses new challenges and completely variety of threats to line of treatment, growth, socialization, mental health for children with autism spectrum disorder (ASD), and, so for the family of the children. It is a highly distressful situation, where the line of treatment has shrunken, physical contact has reduced and therapies footprints reduced in several parts of the world. As children with ASD already face socialization challenges, isolation rules imposed by individuals (or social groups), government agencies have only made the situation worse for the children with ASD and their family. This note will try to touch the basics on understanding the ASD and related development disorders, challenges, impact, and suggest approaches to deal with such situation. This document also covers data analysis, deep dive into the increasing impact of ASD on children. This document can also act as a baseline for many researchers, psychiatrists, psychologists, therapists to view the problem statement and measure its impact.

Keywords: autism spectrum disorder, mental health, applied behavior therapy, occupational therapy, social anxiety

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Authors: Nabila Farhin, Israt Jahan

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Despite the feminisation of the global health force, women mostly engage in nursing, midwifery and community health workers (HWs), and the posts like surgeons, doctors, and specialists are generally male-dominated. It is also prominent in Bangladesh, where female HWs witness systematic workplace inequalities, discrimination, and underpayment. The Covid-19 pandemic put unsurmountable pressure on HWs as they had to serve in high-risk workplaces as frontliners. The already disadvantaged female HWs shouldered the same burden, were overworked without adequate occupational health and safety measures (OSH) and risked their lives. Acknowledging their vulnerable workplace conditions, the World Health Organization (WHO) and International Labour Organization (ILO) circulated a few specialised guidelines amid the peril. Bangladesh tried to adhere to international guidelines while formulating pandemic management strategies. In reality, the already weak and understaffed health sector collapsed with the patient influx and many HWs got infected and died in the line of duty, exposing the high-risk nature of the work. Unfortunately, the gender-segregated data of infected HWs are absent. This qualitative research investigates whether the existing laws of Bangladesh are adequate in protecting female HWs as frontliners in high-risk workplaces during the Covid-19 pandemic. The paper first examines international labour laws safeguarding female frontline HWs. It also analyses the specialised Covid-19 pandemic guidelines protecting their interests. Finally, the research investigates the compliance of Bangladesh as per international legal guidance during the pandemic. In doing so, it explores the domestic laws, professional guidelines for HWs and pandemic response strategies. The paper critically examines the primary sources like international and national statutes, rules, regulations and guidelines. Secondary sources like authoritative journal articles, books and newspaper reports are contextually analysed in line with the objective of the paper. The definition of HW is ambiguous in the labour laws of Bangladesh. It leads to confusion regarding the extent of legal protection rendered to female HWs at private hospitals in high-risk situations. The labour laws are not applicable in Public hospitals, as the employees follow the public service rules. Unfortunately, the country has no specialised law to protect HWs in high-risk workplaces, and the professional guidelines for HWs also remain inadequate in this regard. Even though the pandemic management strategies highlight some protective measures in high-risk situations, they only deal with HWs who are pregnant or have underlying health issues. No specialised protective guidelines can be found for female HWs as frontliners. Therefore, the laws are insufficient and failed to render adequate legal protection to female frontline HWs during the pandemic. The country also lacks comprehensive health legislation and uniform institutional and professional guidelines, preventing them from accessing grievance mechanisms. Hence, the female HWs felt victimised while duty-bound to serve in high-risk workplaces without adequate safeguards. Bangladesh should clarify the definition of HWs and standardise the service rules for providing medical care in high-risk workplaces. The research also recommends adequate health legislation and specialised legal protection to safeguard female HWs in future emergencies.

Keywords: female health workers (HWs), high-risk workplaces, Covid-19 pandemic, Bangladesh

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