Search results for: health economy

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: 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: Huma Sarwar, Muhammad Ishtiaq Ishaq, Junaid Aftab

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The hospitality sector contributes significantly to the global economy but it is also responsible for imposing adverse influences both environmentally and socially. The objective of this research is two-fold: (1) examining the direct impact of internal CSR and external CSR and indirect impact via organizational identification on creative performance and organizational citizenship behavior (OCB), and (2) determining the moderating role of ethical leadership in the relationships of internal- and external- CSR with organizational identification in a cross-cultural context. The data was were collected using multi-respondents and time-lagged data from 260 Pakistani and 239 UK respondents working in upscale hotels of the United Kingdom and Pakistan. The results demonstrate significant differences in both cultures as external CSR has a more substantial impact on organizational identification in the UK, whereas organizational identification has a relatively stronger influence on OCB and creative performance in collectivistic culture (i.e., Pakistan). The findings also confirmed that ethical leadership significantly moderates the relationship of internal- and external - CSR on organizational identification.

Keywords: Huma Sarwar, Muhammad Ishtiaq Ishaq, Junaid Aftab

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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: Mohammed Muzafar, Darshan Ruikar

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BIM, an acronym for Building Information Modelling relates to the practice of creating a computer generated model which is capable of displaying the planning, design, construction and operation of a structure. The resulting simulation is a data-rich, object-oriented, intelligent and parametric digital representation of the facility, from which views and data, appropriate to various users needs can be extracted and analysed to generate information that can be used to make decisions and to improve the process of delivering the facility. BIM also refers to a shift in culture that will influence the way the built environment and infrastructure operates and how it is delivered. One of the main issues of concern in the construction industry at present in the UK is its record on Health & Safety (H&S). It is, therefore, important that new technologies such as BIM are developed to help improve the quality of health and safety. Historically the H&S record of the construction industry in the UK is relatively poor as compared to the manufacturing industries. BIM and the digital environment it operates within now allow us to use design and construction data in a more intelligent way. It allows data generated by the design process to be re-purposed and contribute to improving efficiencies in other areas of a project. This evolutionary step in design is not only creating exciting opportunities for the designers themselves but it is also creating opportunity for every stakeholder in any given project. From designers, engineers, contractors through to H&S managers, BIM is accelerating a cultural change. The paper introduces the concept behind a research project that mitigates the H&S risks associated with the construction, operation and maintenance of assets through the adoption of BIM.

Keywords: building information modeling, BIM levels, health, safety, integration

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Authors: Zulkiflee Abd Latif, Sitinor Atikah Nordin, Alawi Sulaiman

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Different tree species possess different and various benefits. Arenga Pinnata tree species own several potential uses that is valuable for the economy and the country. Mapping vegetation using remote sensing technique involves various process, techniques and consideration. Using satellite imagery, this method enables the access of inaccessible area and with the availability of near infra-red band; it is useful in vegetation analysis, especially in identifying tree species. Pixel-based and object-based classification technique is used as a method in this study. Pixel-based classification technique used in this study divided into unsupervised and supervised classification. Object based classification technique becomes more popular another alternative method in classification process. Using spectral, texture, color and other information, to classify the target make object-based classification is a promising technique for classification. Classification of Arenga Pinnata trees is overlaid with elevation, slope and aspect, soil and river data and several other data to give information regarding the tree character and living environment. This paper will present the utilization of remote sensing technique in order to map Arenga Pinnata tree species

Keywords: Arenga Pinnata, pixel-based classification, object-based classification, remote sensing

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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: Haymanot Gebre-Amlak, Selamawit Gebre-Amlak

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Since its original declaration in the 18th century, Karl Marx and Friedrich Engels's Communist Manifesto has become one of the most influential political tracts. Socialism is a political path that leads towards communism by fostering a cooperative economy through the creation of cooperative enterprises, common ownership, state ownership, or shared equity. The ultimate objective of communism is to bring everyone working toward the same collective goal of a healthy, happy, and free society. The European establishment of 19-century colonial rule over the continent of Africa reinforced inflows of European investment and forced a profound change in the operation of labor and land markets. The colonial era and forced labor schemes in Africa lasted for several decades. When exiting from colonialism, these African countries were attracted to socialism’s ideology to bridge the social gap and freedom to their society. In this paper, we compare a pre and post socialist ideology and the impact in various African countries. We analyse the different aspects, which led to inconsistent outcomes. Our finding indicates that while they have some facets in common, each African country had a unique interpretation and influence from the socialist ideology.

Keywords: African politics, socialism in Africa, African history, Africa

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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: Lala Rukh, Muhammad Abbas Choudhary, Saddam Akber Abbasi

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In Pakistan, the privatization of major sector of the national economy i.e. power, telecom, and gas is very strongly advocated since 80s. With varying degree of progress made in these sectors, it has been the government’s approach that the privatization accelerates the sectorial growth, increases operational efficiency and attracts the foreign investment and is of special significance for developing economies. The gas sector was not an exception and the privatization in this sector has moved through various stages during this time within the realms of socio-political agenda. This paper presents the overview of the gas sector in the country. The Oil and Gas Regulatory Authority (OGRA) Ordinance and privatization commission policy position as depicted in the press briefings provides philosophical foundations to the privatization and sectorial restructuring in this paper. The role of the major players from privatization perspective is discussed with special reference to the importance of natural gas sector. The case study further discusses the economic regulations that are being adopted by utility regulators in Pakistan and elsewhere in the world and some issues that the Regulatory Authority will be concerned are outlined. Major operators in the gas sector including Oil & Gas Development Corporation (OGDC), Sui Northern Gas Pipelines Limited (SNGPL), Sui Southern Gas Pipelines Limited (SSGPL) is also presented.

Keywords: privatization, economic regulation, OGDCL, SSGCL, SNGPL

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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: Akor Omachile Opaluwah

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Entrepreneurs are heralded as a very vital force in the growth of economies. This is because they create businesses, employ people, have direct access to the local consumer, and primarily utilize local sources of raw materials, have an understanding of the immediate need of consumers, and they have the capacity to keep in motion the economy. The rise of social enterprises takes these advantages further beyond the business and economic benefits. These Social enterprises help address developmental issues in the society while maintaining a profit for their investors and shareholders. These combined roles create a unique synergy between the civil society and the market, therefore placing the social enterprise in a position where they can access directly, the benefits of the market while meeting the needs of the citizens and their environment. With such a unique position, social enterprises hold a place in the development discourse that has previously been left unexplored. This hybridisation of the functions of civil societies and the market can provide to development, practices, and benefits that have previously been only available in trace amounts. It, therefore, is imperative to understand the efficacy of social enterprises. With the discourse of social enterprises still in its early stages. This paper looks at selected social enterprise cases in Nigeria and analyses their approach and contribution to development.

Keywords: business, civil society, development, entrepreneurs, innovation, market, Nigeria, social enterprise

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Authors: Athanasios A. Tountas, Geoffrey A. Ozin, Mohini M. Sain

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Renewable hydrogen (H₂) carriers such as methanol (MeOH), dimethyl ether (DME), oxymethylene dimethyl ethers (OMEs), and conceivably ammonia (NH₃) can be reformed back into H₂ and are fundamental chemical conversions for the long-term viability of the H₂ economy due to their higher densities and ease of transportability compared to H₂. MeOH is an especially important carrier as it is a simple C1 chemical that can be produced from green solar-PV-generated H₂ and direct-air-captured CO₂ with a current commercially practical solar-to-fuel efficiency of 10% from renewable solar energy. MeOH steam reforming (MSR) in stationary systems next to H₂ fuel-cell filling stations can eliminate the need for onboard mobile reformers, and the former systems can be more robust in terms of attaining strict H₂ product specifications, and MeOH is a safe, lossless, and compact medium for long-term H₂ storage. Both thermal- and photo-catalysts are viable options for achieving the stable, long-term performance of stationary MSR systems.

Keywords: fuel-cell vehicle filling stations, methanol steam reforming, hydrogen transport and storage, stationary reformer, liquid hydrogen carriers

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Authors: Vesna Lukovic

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Online platforms as new business models play an important role in today’s economy and the functioning of the EU’s internal market. In the travel industry, algorithms used by online platforms for short-stay accommodation provide suggestions and price information to travelers. Those suggestions and recommendations are displayed in search results via recommendation (ranking) systems. There has been a growing consensus that the current legal framework was not sufficient to resolve problems arising from platform practices. In order to enhance the potential of the EU’s Single Market, smaller businesses should be protected, and their rights strengthened vis-à-vis large online platforms. The Regulation (EU) 2019/1150 of the European Parliament and of the Council on promoting fairness and transparency for business users of online intermediation services aims to level the playing field in that respect. This research looks at Airbnb through the lenses of this regulation. The research explores key determinants and finds that although regulation is an important step in the right direction, it is not enough. It does not entail sufficient clarity obligations that would make online platforms an intermediary service which both accommodation providers and travelers could use with ease.

Keywords: algorithm, online platforms, ranking, consumers, EU regulation

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Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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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: Riyadh Alsultani, Ali Majdi

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It is necessary to develop a design methodology that includes the possibility of seismic events occurring in a region, the vulnerability of the civil hydraulic structure, and the effects of the occurrence hazard on society, environment, and economy in order to evaluate the flood and earthquake risks of coastal bridge networks. This paper presents a design approach for the assessment of the risk and sustainability of coastal bridge networks under time-variant flood-earthquake conditions. The social, environmental, and economic indicators of the network are used to measure its sustainability. These consist of anticipated loss, downtime, energy waste, and carbon dioxide emissions. The design process takes into account the possibility of happening in a set of flood and earthquake scenarios that represent the local seismic activity. Based on the performance of each bridge as determined by fragility assessments, network linkages are measured. The network's connections and bridges' damage statuses after an earthquake scenario determine the network's sustainability and danger. The sustainability measures' temporal volatility and the danger of structural degradation are both highlighted. The method is shown using a transportation network in Baghdad, Iraq.

Keywords: sustainability, Coastal bridge networks, flood-earthquake risk, structural design

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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: Parma Chakravartti

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The impact of government spending and taxation on economic growth has remained a central issue of fiscal policy analysis. There is a wide range of opinions over the strength of fiscal policy’s effect on macroeconomic variables. It can be argued that the impact of fiscal policy depends on the structure and economic condition of the economy. This study makes an attempt to examine the effect of fiscal policy shocks on growth in India using the structural vector autoregressive model (SVAR), considering data from 1950 to 2019. The study finds that government spending is an important instrument of growth in India, where the share of revenue expenditure to capital expenditure plays a key role. The optimum composition of total expenditure is important for growth and it is not necessarily true that capital expenditure multiplier is more than revenue expenditure multiplier. The study also finds that the impact of public economic activities on private economic activities for both consumption expenditure and gross capital formation of government crowds in private consumption expenditure and private gross capital formation, respectively, thus indicating that government expenditure complements private expenditure in India.

Keywords: government spending, fiscal policy, multiplier, growth

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Authors: Chutikarn Sriwiboon

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The purposes of this paper were to study the production problems of basketry in the central region and to study the development of potential in skilled labourers in producing basketry in three provinces: Suphanburi, Ayuthaya, and Aungthong. A quota sampling was utilized to get 486 respondents from 243 basketry communities that were registered with OTOP project. A focus group was also used with a connoisseurship model to study knowledge and factors that related to the development of potential in skilled labourers in producing basketry. The findings revealed that the process getting service is the major problem for customers to get service. Also, there should be more of a variety of knowledge for customers. In terms of technology, the variety of information was rated as the most important problem. In terms staff's ability, the knowledge of staff was the most important problem. For the development of potential in high skilled labours for basketry, the findings revealed that having proper tools was considered the most important factor. In terms of economy, the findings revealed that the basketry job must provide sufficient income was considered the most important factor. In terms of using natural resources, efficiency is the most important factor. In terms of mentality, integrity is the most important factor. Finally, in terms of society and culture, help in the local activities is the most important factor.

Keywords: basketry, development, potential, skilled labours

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