Search results for: health facility

Authors: Ayman M. Arfaj, Jose Lauro M. Llamas, Saleh Y Qahtani

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Sulfur Loading Operation (SLO) is an operation that poses risk of exposure to toxic gases such as Hydrogen Sulfid and Sulfur Dioxide during molten sulfur loading operation. In this operation molten sulfur is loaded into a truck tanker in a liquid state and the temperature of the tanker must maintain liquid sulfur within a 43-degree range — between 266 degrees and 309 degrees Fahrenheit in order for safe loading and unloading to occur. Accordingly, in this study, the e potential risk of occupational exposure to the airborne toxic gases was assessed at three sulfur loading facilities. The concentrations of toxic airborne substances such as Hydrogen Sulfide (H2S) and Sulfur Dioxide (SO2), were monitored during operations at the different locations within the sulfur loading operation facilities. In addition to extensive real-time monitoring, over one hundred and fifty samples were collected and analysed at internationally accredited laboratories. The concentrations of H2S, and SO2 were all found to be well below their respective occupational exposure limits. Very low levels of H2S account for the odours observed intermittingly during mixing and application operations but do not pose a considerable health risk and hence these levels are considered a nuisance. These results were comparable to those reported internationally. Aside from observing the usual general safe work practices such as wearing safety glasses, there are no specific occupational health related concerns at the examined sulfur loading facilities.

Keywords: exposure assessment, sulfur loading operation, health risk study, molten sulfur, toxic airborne substances, air contaminants monitoring

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Authors: S. Gustafsson

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The aim of this paper is to explore the connection between gender, agency, and health on personal and social levels over time. The use of gender as an analytical tool for health research has been shown to be useful to explore thoughts and ideas that are taken for granted, which have relevance for health. The paper highlights the following three issues. There are multiple forms of femininity and masculinity. Agency and social structure are closely related and referred to in this paper as 'gender agency'. Gender is illuminated as a product of history but also treated as a social factor and a producer of history. As a prominent social factor in the process of shaping living conditions, gender is highlighted as being significant for understanding health. To make health explicit as a dynamic and complex concept and not merely the opposite of disease requires a broader alliance with feminist theory and a post-Bourdieusian framework. A personal story, included with other ethnographic material about women’s networking in rural Sweden, is used as an empirical illustration. Ethnographic material was chosen for its ability to illustrate historical, local, and cultural ways of doing gendered and capitalized health. New concepts characterize ethnography, exemplified in this study by 'processes of transformation'. The semi-structured interviews followed an interview guide drafted with reference to the background theory of gender. The interviews lasted about an hour and were recorded and transcribed verbatim. The transcribed interviews and the author’s field notes formed the basis for the writing up of this paper. Initially, the participants' interests in weaving, sewing, and various handicrafts became obvious foci for networking activities and seemed at first to shape compliance with patriarchy, which generally does the opposite of promoting health. However, a significant event disrupted the stability of this phenomenon. What was permissible for the women began to crack and new spaces opened up. By exploiting these new spaces, the participants found opportunities to try out alternatives to emphasized femininity. Over time, they began combining feminized activities with degrees of masculinity, as leadership became part of the activities. In response to this, masculine enactment was gradually transformed and became increasingly gender neutral. As the tasks became more gender neutral the activities assumed a more formal character and the women stretched the limits of their capacity by enacting gender agency, a process the participants referred to as 'personal growth' and described as health promotion. What was described in terms of 'personal growth' can be interpreted as the effects of a raised status. Participation in women’s networking strengthened the participants’ structural position. More specifically, it was the gender-neutral position that was rewarded. To clarify the connection between gender, agency, and health on personal and social levels over time the concept processes of transformation is used. This concept is suggested as a dynamic equivalent to habitus. Health is thus seen as resulting from situational access to social recognition, prestige, capital assets and not least, meanings of gender.

Keywords: a cross-gender bodily hexis, gender agency, gender as analytical tool, processes of transformation

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Authors: Rebecca Oakes

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In the New Zealand public health system, work has been taking place to use electronic systems to convey data from the ‘floor to the board’ that makes patient needs, and therefore nursing work, visible. For nurses, these developments in health information technology puts us in a very new and exciting position of being able to articulate the work of nursing through a language understood at all levels of an organisation, the language of acuity. Nurses increasingly have a considerable stake-hold in patient acuity data. Patient acuity systems, when used well, can assist greatly in demonstrating how much work is required, the type of work, and when it will be required. The New Zealand Safe Staffing Unit is supporting New Zealand nurses to create a culture of shared governance, where nursing data is informing policies, staffing methodologies and forecasting within their organisations. Assisting organisations to understand their acuity data, strengthening user confidence in using electronic patient acuity systems, and ensuring nursing and midwifery workload is accurately reflected is critical to the success of the safe staffing programme. Nurses and midwives have the capacity via an acuity tool to become key informers of organisational planning. Quality patient care, best use of health resources and a quality work environment are essential components of a safe, resilient and well resourced organisation. Nurses are the key informers of this information. In New Zealand a national level approach is paving the way for significant changes to the understanding and use of patient acuity and nursing workload information.

Keywords: nursing workload, patient acuity, safe staffing, New Zealand

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Authors: Xi Vivien Wu, Emily Neo Kim Ang, Yi Jung Tung, Wenru Wang

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Background and Objective: The increase in life expectancy and emphasis on self-reliance for the older adults are global phenomena. As such, lifelong learning in the community is considered a viable means of promoting successful and active aging. This systematic review aims to examine various lifelong learning programs for community-dwelling older adults and to synthesize the contents and outcomes of these lifelong learning programs. Methods: A systematic search was conducted in July to December 2016. Two reviewers were engaged in the process to ensure creditability of the selection process. Narrative description and analysis were applied with the support of a tabulation of key data including study design, interventions, and outcomes. Results: Eleven articles, which consisted of five randomized controlled trials and six quasi-experimental studies, were included in this review. Interventions included e-health literacy programs with the aid of computers and the Internet (n=4), computer and Internet training (n=3), physical fitness programs (n=2), music program (n=1), and intergenerational program (n=1). All studies used objective measurement tools to evaluate the outcomes of the study. Conclusion: The systematic review indicated lifelong learning programs resulted in positive outcomes in terms of physical health, mental health, social behavior, social support, self-efficacy and confidence in computer usage, and increased e-health literacy efficacy. However, the lifelong learning programs face challenges such as funding shortages, program cuts, and increasing costs. A comprehensive lifelong learning program could be developed to enhance the well-being of the older adults at a more holistic level. Empirical research can be done to explore the effectiveness of this comprehensive lifelong learning program.

Keywords: community-dwelling older adults, e-health literacy program, lifelong learning program, the wellbeing of the older adults

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Authors: Rezky Rifaini, Raden Bagus Fajriya Hakim

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This research was conducted at the Bolo primary health Care in Bima Regency. The purpose of the research is to find out the association pattern that is formed of medical record database from Bolo Primary health care’s patient. The data used is secondary data from medical records database PHC. Sequential pattern mining technique is the method that used to analysis. Transaction data generated from Patient_ID, Check_Date and diagnosis. Sequential Pattern Discovery Algorithms Using Equivalent Classes (SPADE) is one of the algorithm in sequential pattern mining, this algorithm find frequent sequences of data transaction, using vertical database and sequence join process. Results of the SPADE algorithm is frequent sequences that then used to form a rule. It technique is used to find the association pattern between items combination. Based on association rules sequential analysis with SPADE algorithm for minimum support 0,03 and minimum confidence 0,75 is gotten 3 association sequential pattern based on the sequence of patient_ID, check_Date and diagnosis data in the Bolo PHC.

Keywords: diagnosis, primary health care, medical record, data mining, sequential pattern mining, SPADE algorithm

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Authors: A. Drong, K. S. Kerkhoff

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Migration affects women’s sexual and reproductive health and rights. This paper reports on the social constructs of gender, and livelihood pursuits as beauty parlours workers amongst the young Garo women in Bangladesh, and studies changes in their accessibility to the healthcare services due to migration and livelihood. The paper is based on in-depth interviews and participant-led group discussions with 30 women working in various beauty parlours across the city. The data indicate that social perceptions of ‘good’, ‘bad’ and ‘respectable’ determine the expression of sexuality, and often dictates sexual and reproductive practices for these women. This study also reveals that unregulated work conditions, and the current cost of local healthcare services, have a strong impact on the women’s accessibility to the healthcare services; thus often limiting their choices to only customary and/or unqualified practitioners for abortions and child-births. Development programmes on migrant indigenous women’s health must, therefore, take the contextual gender norms and livelihood choices into account.

Keywords: gender, indigenous women, reproductive rights, sexual rights, Garo, migration, livelihood, healthcare

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Authors: Stanzin Gawa, Nalini Ranjan Kumar, Gohar Bilal Wani, Vinay Maruti Hatte, A. Vinay

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Rainbow trout (Oncorhynchus mykiss) and Brown trout (Salmo trutta fario) are the two species of trout which were once introduced by British in waters of Kashmir has well adapted to favorable climatic conditions. Cold water fisheries are one of the emerging sectors in Kashmir valley and trout holds an important place Jammu and Kashmir fisheries. Realizing the immense potential of trout culture in Kashmir region, the state fisheries department started privatizing trout culture under the centrally funded scheme of RKVY in which they provide 80 percent subsidy for raceway construction and supply of feed and seed for the first year since 2009-10 and at present there are 362 private trout farms. To cater the growing demand for trout in the valley, it is important to understand the bottlenecks faced in the propagation of trout culture. Value chain analysis provides a generic framework to understand the various activities and processes, mapping and studying linkages is first step that needs to be done in any value chain analysis. In Kashmir, it is found that trout hatcheries play a crucial role in insuring the continuous supply of trout seed in valley. Feed is most limiting factor in trout culture and the farmer has to incur high cost in payment and in the transportation of feed from the feed mill to farm. Lack of aqua clinic in the Kashmir valley needs to be addressed. Brood stock maintenance, breeding and seed production, technical assistance to private farmer, extension services have to be strengthened and there is need to development healthier environment for new entrepreneurs. It was found that trout farmers do not avail credit facility as there is no well define credit scheme for fisheries in the state. The study showed weak institutional linkages. Research and development should focus more on applied science rather than basic science.

Keywords: trout, Kashmir, value chain, linkages, culture

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Authors: Andres Frederic

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We present the MindFlow system supporting the detection and the diagnosis of stresses. The heart of the system is a knowledge synthesis engine allowing occupational health stakeholders (psychologists, occupational therapists and human resource managers) to formulate queries related to stress and responding to users requests by recommending a pattern of stress if one exists. The stress pattern diagnosis is based on expert knowledge stored in the MindFlow stress ontology including stress feature vector. The query processing may involve direct access to the MindFlow system by occupational health stakeholders, online communication between the MindFlow system and the MindFlow domain experts, or direct dialog between a occupational health stakeholder and a MindFlow domain expert. The MindFlow knowledge model is generic in the sense that it supports the needs of psychologists, occupational therapists and human resource managers. The system presented in this paper is currently under development as part of a Dutch-Japanese project and aims to assist organisation in the quick diagnosis of stress patterns.

Keywords: occupational stress, stress management, physiological measurement, accident prevention

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Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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Authors: Muhammad Abubakar Alhassan, Diane Pennington

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Social networking sites have become a space for people to discuss public health issues such as non-suicidal self-injury (NSSI). There are thousands of tweets containing self-harm and self-injury hashtags on Twitter. It is difficult to distinguish between different users who participate in self-injury discussions on Twitter and how their opinions change over time. Also, it is challenging to understand the topics surrounding NSSI discussions on Twitter. We retrieved tweets using #selfham and #selfinjury hashtags and investigated those from the United kingdom. We applied inductive coding and grouped tweeters into different categories. This study used the Latent Dirichlet Allocation (LDA) algorithm to infer the optimum number of topics that describes our corpus. Our findings revealed that many of those participating in NSSI discussions are non-professional users as opposed to medical experts and academics. Support organisations, medical teams, and academics were campaigning positively on rais-ing self-injury awareness and recovery. Using LDAvis visualisation technique, we selected the top 20 most relevant terms from each topic and interpreted the topics as; children and youth well-being, self-harm misjudgement, mental health awareness, school and mental health support and, suicide and mental-health issues. More than 50% of these topics were discussed in England compared to Scotland, Wales, Ireland and Northern Ireland. Our findings highlight the advantages of using the Twitter social network in tackling the problem of self-injury through awareness. There is a need to study the potential risks associated with the use of social networks among self-injurers.

Keywords: self-harm, non-suicidal self-injury, Twitter, social networks

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Authors: Laura Valdés-Santiago, José Luis Castro-Guillén, Jorge Noé García-Chávez, Rosalba Alonso-Rodríguez, Rafael Vargas-Bernal

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The quality and availability of the water contained in dams (artificial bodies of water) are at risk due to the presence of uncontrolled growths of cyanobacteria capable of producing cyanotoxins that affect the ecosystem and harm the health of humans and animals. The physicochemical properties were measured, and the degree of eutrophy of four dams from Guanajuato was determined. They presented a pH of 6.1 to 8.4, conductivity of 121 to 415 μS/cm², chlorophyll of 0.43-42.43 μg/L, NO₃- 0-1.2 mg/L and PO₄3- 0.11 to 0.84 mg/L; considering these parameters, the prey most prone to the development of cyanobacterial blooms were El Palote dam, La Purísima dam, and Allende dam, but not El Conejo dam. The potentially toxic cyanobacteria identified were Planktothrix agardhii, Oscillatoria sp., Raphidiopsis sp., and Microcystis sp., Microcystin-LR, Nodularin, and Cylindrospermopsin were quantified, presenting values between 0.08-0.42 and 0.02-2.05 ppb, respectively, the water bodies with the highest concentration were El Palote dam and La Purísima dam. Microcystin-LR and/or Nodularin levels are within the guideline values for human consumption in drinking water established by the World Health Organization for Microcystin-LR and for Cylindrospermopsin by the Oregon Health Authority (OHA) in all dams. This work is relevant due to the use of these bodies of water for agriculture and human consumption in the state, and the presence of toxin-producing cyanobacteria can represent an environmental, ecotoxicological, and health problem, so it is recommended to establish a program of frequent monitoring of cyanobacteria and cyanotoxins in the state's dams.

Keywords: Planktrothrix agardhii, Raphidiopsis sp., Microcystis sp., Cyanobacterial blooms, Cyanotoxins

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Authors: Folorunsho J. O., Umar M. A.

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Access to potable water supply in both the rural and urban regions of the world has been neglected, and this has severely affected man and the aesthetics of the natural environment of man. This has further worsened the issue of diseases prevalence. This study considered the effects of inadequate domestic water supply on human health in selected neighbourhoods of Lokoja. The study used descriptive statistics such as relative frequencies, percentages and inferential statistics to analyse the data obtained through the use of structured questionnaire. The results revealed that the females and male constituted 56% and 44% of the respondents respectively; 62% of the respondents married and 32% are unmarried; respondents between ages 31 and 40 years constitute majority of the study population, while respondents with tertiary education constituted 35%, and those with secondary education were 32% of the total respondents. Furthermore, civil servants constituted 40% and unemployed 16% of the total respondents. In terms of monthly income, 40% of the respondents was found to earn between ₦31,000 - 40,000 monthly. On the perception of households on the availability and adequacy of domestic water supply, the study revealed that 64.7% of the respondents have pipe-borne water as their main source of water supply, with only 28.5% out of the 64.7% have pipe-borne water supply daily. On the relationship between water supply characteristics and health status among households, the result shows that 76% of the respondents perceived a strong relationship between water supply and health status. Cumulatively, 67% of the respondents confirm that both the quality and quantity of water supplied play a critical role in determining health status of residents of the study area. The respondents also reported skin diseases (96%), diarrhoea (96%), malaria (91%), cholera (67%), dysentery (67%), and respiratory diseases (67%) as the most perceived and experienced in the area, the disease rate in the prevalence order of malaria (81%), diarrhoea (61%), skin diseases (58%), cholera (34%), dysentery (31%) and respiratory disease (14%) respectively. Finally, the results further showed how households cope with inadequate water supply with 52% of the respondents confirm that they regularly treat their water before it was deployed for domestic uses, while 35%, 26%, 25%, 10% and 4% of the 52% respectively, adopted boiling, addition of alums, filtering with fabrics, chlorination and bleaching as the preferred treatment methods. The study thus recommended policy options that will aggressively launch adequate potable water supply infrastructure in the study area.Keywords: Potable Water, Supply, Human Health, Perception, Chlorination

Keywords: potable water, human health, perception, chlorination

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Authors: Liam Martin, Martha Watson

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Patients with learning disabilities (LD) are at increased risk of physical and mental illness due to health inequality. To address this, NICE recommends that people from the age of 14 with a learning disability should have an annual LD health check. This consultation should include a holistic review of the patient’s physical, mental and social health needs with a view of creating an action plan to support the patient’s care. The expected standard set by the Quality and Outcomes Framework (QOF) is that each general practice should review at least 75% of their LD patients annually. During COVID-19, there have been barriers to primary care, including health anxiety, the shift to online general practice and the increase in GP workloads. A surgery in North London wanted to assess whether they were falling short of the expected standard for LD patient annual reviews in order to optimize care post Covid-19. A baseline audit was completed to assess how many LD patients were receiving their annual reviews over the period of 29th September 2020 to 29th September 2021. This information was accessed using EMIS Web Health Care System (EMIS). Patients included were aged 14 and over as per QOF standards. Doctors were not notified of this audit taking place. Following the results of this audit, the creation of learning disability clinics was recommended. These clinics were recommended to be on the ground floor and should be a dedicated time for LD reviews. A re-audit was performed via the same process 6 months later in March 2022. At the time of the baseline audit, there were 71 patients aged 14 and over that were on the LD register. 54% of these LD patients were found to have documentation of an annual LD review within the last 12 months. None of the LD patients between the ages of 14-18 years old had received their annual review. The results were discussed with the practice, and dedicated clinics were set up to review their LD patients. A second pass of the audit was completed 6 months later. This showed an improvement, with 84% of the LD patients registered at the surgery now having a documented annual review within the last 12 months. 78% of the patients between the ages of 14-18 years old had now been reviewed. The baseline audit revealed that the practice was not meeting the expected standard for LD patient’s annual health checks as outlined by QOF, with the most neglected patients being between the ages of 14-18. Identification and awareness of this vulnerable cohort is important to ensure measures can be put into place to support their physical, mental and social wellbeing. Other practices could consider an audit of their annual LD health checks to make sure they are practicing within QOF standards, and if there is a shortfall, they could consider implementing similar actions as used here; dedicated clinics for LD patient reviews.

Keywords: COVID-19, learning disability, learning disability health review, quality and outcomes framework

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Authors: Hiroaki Hirose, Hiroshi Ikeda, Isao Takeda

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The Japanese version of the SF-36 has been employed to assess individuals’ health-related QOL (HRQOL). This study aimed to clarify the HRQOL of motorists with a spinal cord injury, in order to compare these individuals' SF-36 scores and national standard values. A total of 100 motorists with a spinal cord injury participated in this study. Participants’ HRQOL was evaluated using the Japanese version of the SF-36 (second edition). The score for each subscale was standardized based on data on the Japanese population. The average scores for NPF, NRP, NBP, NGH, NVT, NSF, NRE, and NMH were 10.9, 41.8, 45.9, 47.1, 46.1, 46.7, 46.0, and 47.4 points, respectively. Subjects showed significantly lower scores for NPF and NRP compared with national standard values, which were both ≤ 45.0 points, but relatively normal scores for the other items: NBP, NGH, NVT, NSF, NRE and NMH (> 45.0 points). The average scores for PCS, MCS and RCS were 21.9, 56.0, and 50.0 points, respectively. Subjects showed a significantly lower PCS score (≤ 20.0 points); however, the MCS score was higher (> 55.0 points) along with a relatively normal RCS score in these individuals (= 50.0 points).

Keywords: health-related QOL, HRQOL, SF-36, motorist, spinal cord injury, Japan

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Authors: Pei-Chih Wu, Hsin-Chih Lai, Yung-Lung Lee, Yun-Yao Chi, Ching-Yi Horng, Hsien-Chang Wang

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The impact of climate change to health has always been well documented. Amongst them, water-borne infectious diseases, chronic adverse effects or cancer risks due to chemical contamination in flooding or drought events are especially important in river basin. This study therefore utilizes GIS and different models to integrate demographic, land use, disaster prevention, social-economic factors, and human health assessment in the Erren River basin. Therefore, through the collecting of climatic, demographic, health surveillance, water quality and other water monitoring data, potential risks associated with the Erren River Basin are established and to understand human exposure and vulnerability in response to climate extremes. This study assesses the temporal and spatial patterns of melioidosis (2000-2015) and various cancer incidents in Tainan and Kaohsiung cities. The next step is to analyze the spatial association between diseases incidences, climatic factors, land uses, and other demographic factors by using ArcMap and GeoDa. The study results show that amongst all melioidosis cases in Taiwan, 24% cases (115) residence occurred in the Erren River basin. The relationship between the cases and in Tainan and Kaohsiung cities are associated with population density, aging indicator, and residence in Erren River basin. Risks from flooding due to heavy rainfall and fish farms in spatial lag regression are also related. Through liver cancer, the preliminary analysis in temporal and spatial pattern shows an increases pattern in annual incidence without clusters in Erren River basin. Further analysis of potential cancers connected to heavy metal contamination from water pollution in Erren River is established. The final step is to develop an assessment tool for human exposure from water contamination and vulnerability in response to climate extremes for the second year.

Keywords: climate change, health impact, health adaptation, Erren River Basin

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Authors: Neelam Rashid, Muhammad Zafar, Mushtaq Ahmad, Khafsa Malik, Syed Nasar Shah

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The present study was conducted to study the role of medicinal plants used to cure different ailments in Azad Kashmir. Various ethno medicinal surveys were carried out during 2016 to enlist the uses of plants against various ailments by rural communities of the area. Information was obtained from 60 local people including 45 males (10 traditional health practitioners) and 15 females by semi structured interviews and group discussions. 65 plant species belonging to 45 families were reported. The dominant plant habit was herbaceous (56%) while decoction was the most common method of utilization (40%). The most cited turmoil was the gastrointestinal disorders. The data obtained were analyzed using ethno medicinal indices such as FL, UV, ICF, FC, and RFC. Results revealed that various species had numerous uses in curing of diseases. So conservation of biodiversity of these medicinal plants and traditional knowledge can play important role in improving the local health conditions of rural people and modern drug discovery and development.

Keywords: medicinal plants, ailments, drug, health, traditional

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Authors: Kathleen Canul

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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

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Authors: Silvia Carla Da Silva André, Angela Maria Magosso Takayanagui

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Introduction: The Medical Waste (MW) are responsible per 2% of total waste generated for a city and has merited attention due the risks that offers to the public health and environment, representing an important aspect in waste management. In Brazil, the Resolution 306/04 of the National Health Surveillance Agency classifies the MW into 5 groups as follows: Group A (GA) biological, Group B (GB) chemical, Group C (GC) radioactive waste, Group D (GD) common, and Group E (GE) sharps. Objective: This study aimed to determine the amount of waste generated in hospitals of Ribeirão Preto, São Paulo, Brazil. Material and Methods: This is a field research, exploratory, using quantitative variables. The survey was conducted in 11 hospitals in Ribeirão Preto, located in the State of São Paulo, Brazil. It is noted that the study sample included general hospitals, skilled, university, maternity, and psychiatric; public, private, and philanthropic; and large, medium, and small. To quantify the MW, the weighing of the waste was held for six days, following methodology adapted from PAHO. Data were analyzed using descriptive statistics, determining the average global generation of MW and for each group. This research was carried out after approval by the Ethics in Research of the University of São Paulo. Thus, in order to comply with the ethical principles of research, to present the results hospitals were numbered from 1 to 11. Results: The data revealed a greater generation of biological waste among teaching hospitals, which can be justified by the use of materials for the realization of techniques.

Keywords: environmental health, management of medical waste, medical waste, public health

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Authors: Retty Ratnawati, Santi Sri Wulandari, Tulus Sabrina

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Feminine and masculine gender role stress could occur in some work situation. Being manager in health services that is known to be more women’ role in Indonesia, has expected to have feminine stereotype role. In the communities, this has been done in the program kesejahteraan keluarga (welfare family program) since the 1970s, for example through family planning program. The aim of the study was to explore the experience of being a motherhood managerial in health services. Our auto ethnographic study has revealed that motherhood managerial, even though running by a woman, could have some stress conditions whether she has realized or has not. The challenge would occur when the manager did not realize that she needed the eustress. The autonomy concept for a woman to be a manager could be a complex cycle that needs open communication continually and understanding the four elements surround her life. In conclusion, there is a demand to have the eustress when the manager does not realize that she has to be an autonomy person. However, it does not need eustress when the manager understands about how to deal with the complex cycle of being autonomy.

Keywords: motherhood managerial, eustress, feminine gender role stress, masculine gender role stress, autonomy concept in women

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Authors: Ndivhudzannyi Rembuluwani, Francis Dacosta, Emmanuel Mhlongo

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The small-scale rock aggregate sector of the mining industry is a major source of employment for a significant number of people, particularly in remote rural areas, where alternative livelihoods are rare. It contributes to local economy by generating income and producing major and essential materials for the building, construction, and other industries. However, the sector is confronted with many challenges that hamper productivity and growth. The problems that confront this sector includes: health and safety, environmental impacts, low production and low adherence to mining legislations. This study investigated the challenges confronting selected small-scale rock aggregate mines in the Vhembe District of Limpopo province of South Africa, assesses the health, safety, low production and environmental impacts associated with aggregate production and to develop an integrated approach of addressing the multi-faceted challenges.

Keywords: health and safety, legislative framework, productivity, rock aggregate, small-scale mining

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Authors: Trieu Anh Ngoc, Nguyen Quang Kim

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Located at the downstream of the Mekong Delta, the Vietnamese Mekong Delta is well-known as 'rice bowl' of Vietnam. The Vietnamese Mekong Delta experiences widespread flooding annually where is habitat for about 17 million people. The economy of this region mainly depends on the agricultural productivities. The suspended sediment load in the Mekong River plays an important role in carrying contaminants and nutrients to the delta and changing the geomorphology of the delta river system. In many past decades, flooding and suspended sediment were considered as indispensable factors in agricultural cultivations. Although flooding in the wet season caused serious inundation in paddy field and affected livelihoods, it is an effective facility for flushing acid and saline to this area - alluvial soil heavily contaminated with acid and salt intrusion. In addition, sediment delivery to this delta contained rich-nutrients distributed and deposited on the fields through flooding process. In recent decades, the changing of flow and sediment transport have been strongly and clearly occurring due to upstream dam development and climate change. However, effects of sediment delivery on agricultural cultivations were less attention. This study investigated the impacts of upstream flow on sediment distribution in the Vietnamese Mekong Delta. Flow fluctuation and sediment distribution were simulated by the Mike 11 model, including hydrodynamics model and advection-dispersion model. Various scenarios were simulated based on anticipated upstream discharges. Our findings indicated that sediment delivery into the Vietnamese Mekong Delta come from not only Tien River but also border of Cambodia floodplains. Sediment distribution in the Vietnamese Mekong Delta is dramatically changed by the distance from the main rivers and the secondary channels. The dam development in the upstream is one of the major factors leading a decrease in sediment discharge as well as sediment deposition. Moreover, sea level rise partially contributed to decrease in sediment transport and change of sediment distribution between upstream and downstream of the Vietnamese Mekong Delta.

Keywords: sediment transport, sea level rise, climate change, Mike Model

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Authors: B. Parchem, M. Watanabe, D. Modrakovic, L. Mathew, A. Franklin, M. Cao, R. E. Broudy

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Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

Keywords: executive functioning, cognitive-behavioral therapy, dialectical behavior therapy, mindfulness, adult group therapy

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Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Rebecca Keyte, Helen Egan, Michail Mantzios

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It is well acknowledged that ongoing adherence is a major concern within CF. However recently literature has indicated that non-adherence should not be viewed just in terms of medical regimens. There are other damaging behaviours that some chronically ill patients engage in which can be viewed as a form of non-adherence, such as risky behaviours. Risky behaviours are a major concern within CF, as they can have adverse health effects on patients regardless of patients adherence to medical regimens. The risky behaviours this research is predominantly focusing on are smoking, excessive alcohol consumption, illicit drug use and risky sexual behaviour. This research investigates patient’s beliefs about their CF and the impact their CF has upon their life, exploring rationales for why some patients engage in risky behaviours. This research utilises qualitative semi-structured interviews taking an interpretive perspective. Twenty-four adult participants have been recruited (16 male, age range 19–66 yrs) from two UK regional CF centres, with a median FEV1 61.77% predicted. Participants were recruited via clinician guidance, with 13 participants identified by clinicians as partaking in risky behaviours. However, during the interviews 17 participants were identified as partaking in risky behaviours, illustrating that not all patients offer full disclosure of engagement in such behaviours to their clinicians. Preliminary findings illustrate a variety of reasons as to why some CF patients engage in risky behaviours, with many participants stating that one challenge in terms of living with CF is accepting their illness. Disclosure of illness was also an issue, the desire to be seen as ‘normal’ was important to many. It is often possible for CF patients to hide their illness as they do not always appear to be unwell. However, literature indicates a desire for normalcy can be accompanied with the engagement of normalised risky behaviours, enabling patients to retaliate against their illness identity. There was also evidence of a life-orientated perspective amongst participants, with some reporting that their desire for fun and enjoyment was the reason for why they were engaging in risky behaviours. Some participants did not acknowledge the impact their risky behaviours could have upon their CF, and others rationalised their continuation with the behaviours by suggesting that they were in fact beneficial to their health. There was an apparent lack of knowledge around the implications of risky behaviours, with participants indicating that they had not been informed of such potential consequences by their clinicians. Given the adverse health effects of risky behaviours within CF, more effective health promotion measures are needed to both reduce and more importantly prevent these behaviours. Due to the initiation of risky behaviours within the CF population commonly occurring during adolescence, the researcher now proposes to conduct semi-structured interviews with paediatric patients to investigate their awareness and beliefs towards risky behaviours. Overall, this research will highlight reasons why some CF patients engage in risky behaviours, in order to inform interventions aimed to prevent the initiation in risky behaviours by increasing patient awareness.

Keywords: cystic fibrosis, health beliefs, preliminary findings, risky health behaviours

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Authors: Ragy Raafat Gaber Attaalla

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health.

Keywords: low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: Bagweneza Vedaste, Rugema Joselyne, Twagirayezu Innocent, Nikuze Bellancille, Nyirazigama Alice, Ishimwe Bazakare Marie Laetitia, Kaberuka Gerard, Mukeshimana Madeleine

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Background: Teen pregnancies have dramatically increased across the country in the past few years. Teen mothers usually face difficulties accessing the reproductive health (RH) services due to different reasons that include fear of getting discriminated or seen by other people. Some teen mothers do not also know their rights regarding the RH services, and they sometimes get discriminated. Little is known in Rwanda regarding how these teen mothers access the RH services compared to the general population, and views of teen mothers on their rights to access these services have not been clearly documented in the country. Specific Aims: To explore baseline information about SRH services among teen mothers; to explore factors that contribute to the use of SRH services among teen mothers; to identify strategies to increase awareness on SRHR (Sexual and Reproductive Health and Rights) among teen mothers in targeted area; and to explore views of teen mothers on rights for SRH services. Research design/Methodology: The qualitative exploratory descriptive research will be used among the teen mothers in five selected health centers of Rwamagana district. The study will use the qualitative descriptive study design. Setting: The study will be conducted in five selected health centers of Rwamagana district, which has been chosen due to a higher number of adolescent pregnancies in Eastern Province according to the DHS 2019-2020. Participants: The participants in this study will be teenage mothers who conceived after turning 11 but have delivered before turning 19. As the upper age for teenage is 19 years, this means that the researchers anticipated that those conceiving at 19 years may deliver in their twenties, which was the upper age limit in this study. Data collection measures: A semi-structured interview guide will be used to gather information from the respondents in focus group discussions. Significance: The findings of this study will provide a picture regarding the access of teen mothers to SRHS and their rights to SRH services. They will increase their awareness regarding SRH services and rights. Finally, the findings may help to address barriers faced by teen mothers to reach, pay and utilize SRHS.

Keywords: sexual and reproductive health services, inclusiveness, qualitative study, adolescent mothers

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Authors: Mili Dutta, Lokender Prashad

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Introduction: Population ageing is a phenomenon that can be observed around the globe. The health-related quality of life (HRQOL) is a measurement of health status of an individual, and it describes the effect of physical and mental health disorders on the well-being of a person. The present study is aimed to describe the influence of socio-economic characteristics of elderly on their health-related quality of life in India. Methods: EQ-5D instrument and population-based EQ-5D index score has been measured to access the HRQOL among elderly. Present study utilized the Study on Global Ageing and Adult Health (SAGE) data which was conducted in 2007 in India. Multiple Logistic Regression model and Multivariate Linear Regression model has been employed. Result: In the present study, it was found that the female are more likely to have problems in mobility (OR=1.41, 95% Cl: 1.14 to 1.74), self-care (OR=1.26, 95% Cl: 1.01 to 1.56) and pain or discomfort (OR=1.50, 95% Cl: 1.16 to 1.94). Elderly residing in rural area are more likely to have problems in pain/discomfort (OR=1.28, 95% Cl: 1.01 to 1.62). More older and non-working elderly are more likely whereas higher educated and highest wealth quintile elderly are less likely to have problems in all the dimensions of EQ-5D viz. mobility, self-care, usual activity, pain/discomfort and anxiety/depression. The present study has also shown that oldest old people, residing in rural area and currently not working elderly are more likely to report low EQ-5D index score whereas elderly with high education level and high wealth quintile are more likely to report high EQ-5D index score than their counterparts. Conclusion: The present study has found EQ-5D instrument as the valid measure for assessing the HRQOL of elderly in India. The study indicates socio-economic characteristics of elderly such as female, more older people, residing in rural area, non-educated, poor and currently non-working as the major risk groups of having poor HRQOL in India. Findings of the study will be helpful for the programmes and policy makers, researchers, academician and social workers who are working in the field of ageing.

Keywords: ageing, HRQOL, India, EQ-5D, SAGE, socio-economic characteristics

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Authors: Jakub Vávra, Milan Valenta, Petr Kosek

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This article presents a perspective on the conduct of the dramatherapy process with persons with addictive behaviours with regard to the directiveness of the process. Although drama therapy as one of the creative arts approaches is rather non-directive in nature, depending on the clientele, there may be a need to structure the process more and, depending on the needs of the clients, to guide the process more directive. The specificity for people with addictive behaviours is discussed through the prism of the dramatherapeutic perspective, where we can find both a psychotherapeutic component as well as a component touching on expression and art, which is rather non-directive in nature. Within the context of practice with clients, this theme has repeatedly emerged and dramatherapists themselves have sought to find ways of coping with clients' demands and needs for structure and guidance within the dramatherapy process. Some of the outcomes from the supervision work also guided the research. Based on this insight, the research questions were approached. The first research question asks: in what ways is directive in dramatherapy manifested and manifested in the process? The second research question then complements the first and asks: to which phenomena are directivity in dramatherapy linked? In relation to the research questions, data were collected using focus groups and field notes. The qualitative approach of Content analysis and Relational analysis was chosen as the methodology. For analyzing qualitative research, we chose an Inductive coding scheme: Open coding, Axial coding, Pattern matching, Member checking, and Creating a coding scheme. In the presented partial research results, we find recurrent schemes related to directive coding in drama therapy. As an important element, directive leadership emerges in connection with safety for the client group, then in connection with the clients' order and also the department of the facility, and last but not least, to the personality of the drama therapist. By careful analysis and looking for patterns in the research results, we can see connections that are impossible to interpret at this stage but already provide clues to our understanding of the topic and open up further avenues for research in this area.

Keywords: dramatherapy, directivity, personal approach, aims of dramatherapy process, safetyness

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Authors: Paul Lam, Chi Him Chan, Alan Tse

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Language laboratories have been widely used in language learning, starting in the middle of the last century as one of the earliest forms of educational technology. They are designed to assist students’ language learning with technological innovations. Traditional language laboratories provide individual workstations that allow students to access multimedia language resources. In this type of facility, students can train their listening and speaking abilities, and teachers can also assess the performance of an individual student. Although such a setting promotes a student-centered pedagogy by encouraging students to work at their own pace and according to their own needs, it still favours a traditional, behaviourist language learning pedagogy which focuses on repetitive drilling. The change of pedagogies poses challenges to both the teachers and the facilities. The peer-learning pedagogy advocates that language learning should focus on the social aspect, which emphasizes the importance of everyday communication in language learning. The self-access, individual workstation language laboratories may not be able to provide the flexibility for interaction in the new pedagogies. Modern advancement in technology is another factor that drove our language laboratory renovation. In particular, mobile and wireless technology enabled the use of smaller and more flexible devices, making possible much clever use of space. The Chinese University of Hong Kong (CUHK) renovated nine existing language laboratories to provide lighter and more advanced equipment, movable tables, and round desks. These facilities allow more flexibility and encourage students’ interaction. It is believed that the renovated language laboratories can serve different peer learning activities and thus support peer-learning pedagogies in language teaching and learning. A survey has been conducted to collect comments from the teachers who have used the renovated language laboratories and received forty-four response. The teachers’ comments reveal that they experienced different challenges in using the renovated language laboratories, and there is a need to provide guidance to teachers during the technological and pedagogical transition. For example, teachers need instruction on using the newly installed devices such as touch-monitor and visualizer. They also need advice on planning new teaching and learning activities. Nevertheless, teachers appreciated that the renovated language laboratories are flexible and provide more spaces for different learning activities.

Keywords: language laboratories, language learning, peer-learning, student interaction

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Authors: B. Rakjarit, S. Athichanagorn

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Double displacement process is a method in which gas is injected at an updip well to displace the oil bypassed by waterflooding operation from downdip water injector. As gas injection is costly and a large amount of gas is needed, gas dump-flood from multiple gas reservoirs is an attractive alternative. The objective of this paper is to demonstrate the benefits of the novel approach of double displacement process via gas dump-flood from multiple gas reservoirs. A reservoir simulation model consisting of a dipping oil reservoir and several underlying layered gas reservoirs was constructed in order to investigate the performance of the proposed method. Initially, water was injected via the downdip well to displace oil towards the producer located updip. When the water cut at the producer became high, the updip well was shut in and perforated in the gas zones in order to dump gas into the oil reservoir. At this point, the downdip well was open for production. In order to optimize oil recovery, oil production and water injection rates and perforation strategy on the gas reservoirs were investigated for different numbers of gas reservoirs having various depths and thicknesses. Gas dump-flood from multiple gas reservoirs can help increase the oil recovery after implementation of waterflooding upto 10%. Although the amount of additional oil recovery is slightly lower than the one obtained in conventional double displacement process, the proposed process requires a small completion cost of the gas zones and no operating cost while the conventional method incurs high capital investment in gas compression facility and high-pressure gas pipeline and additional operating cost. From the simulation study, oil recovery can be optimized by producing oil at a suitable rate and perforating the gas zones with the right strategy which depends on depths, thicknesses and number of the gas reservoirs. Conventional double displacement process has been studied and successfully implemented in many fields around the world. However, the method of dumping gas into the oil reservoir instead of injecting it from surface during the second displacement process has never been studied. The study of this novel approach will help a practicing engineer to understand the benefits of such method and can implement it with minimum cost.

Keywords: gas dump-flood, multi-gas layers, double displacement process, reservoir simulation

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