Search results for: Health Sector

Authors: António Marques, Graça Guedes

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The Portuguese footwear industry had in the last five years a remarkable performance in the exportation values, the trade balance and others economic indicators. After a long period of difficulties and with a strong reduction of companies and employees since 1994 until 2009, the Portuguese footwear industry changed the strategy and is now a success case between the international players of footwear. Only the Italian industry sells footwear with a higher value than the Portuguese and the distance between them is decreasing year by year. This paper analyses how the Portuguese footwear companies innovate and make innovation, according the classification proposed by the Oslo Manual. Also, analyses the strategy follow in the innovation process and shows the linkage between the type of innovation and the strategy of innovation. The research methodology was qualitative and the strategy for data collection was the case study. The qualitative data will be analyzed with the MAXQDA software. The economic results of the footwear companies studied shows differences between all of them and these differences are related with the innovation strategy adopted. The companies focused in product and marketing innovation, oriented to their target market, have higher ratios “turnover per worker” than the companies focused in process innovation. However, all the footwear companies in this “low-tech” industry create value and contribute to a positive foreign trade of 1.310 million euros in 2013. The growth strategies implemented has the participation of the sectorial organizations in several innovative projects. And it’s obvious that cooperation between all of them is a critical element to the performance achieved by the companies and the innovation observed. The Portuguese footwear sector has in the last years an excellent performance (economic results, exportation values, trade balance, brands and international image) and his performance is strongly related with the strategy in innovation followed, the type of innovation and the networks in the cluster. A simplified model, called “Ace of Diamonds”, is proposed by the authors and explains the way how this performance was reached by the seven companies that participate in the study (two of them are the leaders in the setor), and if this model can be used in others traditional and “low-tech” industries.

Keywords: Footwear industry, innovation strategy, low-tech industry, Oslo Manual.

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Authors: A. Rezazadeh, B Damari, S. Riazi-Esfahani, M. Hajian

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The consumption of junk food in Iran is alarmingly increasing. This study aimed to investigate the influencing factors of junk food consumption and amendable interventions that are criticized and approved by stakeholders, in order to presented to health policy makers. The articles and documents related to the content of study were collected by using the appropriate key words such as junk food, carbonated beverage, chocolate, candy, sweets, industrial fruit juices, potato chips, French fries, puffed corn, cakes, biscuits, sandwiches, prepared foods and popsicles, ice cream, bar, chewing gum, pastilles and snack, in scholar.google.com, pubmed.com, eric.ed.gov, cochrane.org, magiran.com, medlib.ir, irandoc.ac.ir, who.int, iranmedex.com, sid.ir, pubmed.org and sciencedirect.com databases. The main key points were extracted and included in a checklist and qualitatively analyzed. Then a summarized abstract was prepared in a format of a questionnaire to be presented to stakeholders. The design of this was qualitative (Delphi). According to this method, a questionnaire was prepared based on reviewing the articles and documents and it was emailed to stakeholders, who were asked to prioritize and choose the main problems and effective interventions. After three rounds, consensus was obtained.            Studies revealed high consumption of junk foods in the Iranian population, especially in children and adolescents. The most important affecting factors include availability, low price, media advertisements, preference of fast foods taste, the variety of the packages and their attractiveness, low awareness and changing in lifestyle. Main interventions recommended by stakeholders include developing a protective environment, educational interventions, increasing healthy food access and controlling media advertisements and putting pressure from the Industry and Mining Ministry on producers to produce healthy snacks. According to the findings, the results of this study may be proposed to public health policymakers as an advocacy paper and to be integrated in the interventional programs of Health and Education ministries and the media. Also, implementation of supportive meetings with the producers of alternative healthy products is suggested.

Keywords: Junk foods, situation, qualitative study, Iran.

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Authors: W. Kongnoo, J. Loysongkroa, S. Chotivichien, N. Viriyautsahakul, N. Saiwongse

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Obesity, stunting and wasting problems among Thai school-aged children are increasing due to inappropriate food consumption behavior and poor environments for desirable nutritional behavior. Because of a low school lunch budget of only 0.40 USD per person per day, food quality is not up to nutritional standards. Therefore, the Health Department with the Education Ministry and the Thai Health Promotion Foundation have developed a quality school lunch project during 2009–2013. The program objectives were development and management of public policy to increase school lunch budget. The methods used a healthy public policy motivation process and movement in 241 local administrative organizations and 538 schools. The problem and solution research was organized to study school food and nutrition management, create a best practice policy mobilization model and hold a public hearing to motivate an increase of school meal funding. The results showed that local public policy has been motivated during 2009-2011 to increase school meal budget using local budgets. School children with best food consumption behavior and exercise increased from 13.2% in 2009 to 51.6% in 2013 and stunting decreased from 6.0% in 2009 to 4.7% in 2013. As the result of national policy motivation (2012-2013), the cabinet meeting on October 22, 2013 has approved an increase of school lunch budget from 0.40 USD to 0.62 USD per person per day. Thus, 5,800,469 school children nationwide have benefited from the budget increase.

Keywords: Public policy, Quality school lunch, Thailand.

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Authors: Saeed Rezaeian, M. Rezaee Boroon

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Nitrogen accumulates in soils during the process of fertilizer addition to promote the plant growth. When the organic matter decomposes, the form of available nitrogen produced is in the form of nitrate, which is highly mobile. The most significant health effect of nitrate ingestion is methemoglobinemia in infants under six months of age (blue baby syndrome). The mobile nutrients, like nitrate nitrogen, are not stored in the soil as the available forms for the long periods and in large amounts. It depends on the needs for the crops such as vegetables. On the other hand, the vegetables will compete actively for nitrate nitrogen as a mobile nutrient and water. The mobile nutrients must be shared. The fewer the plants, the larger this share is for each plant. Also, this nitrate nitrogen is poisonous for the people who use these vegetables. Nitrate is converted to nitrite by the existing bacteria in the stomach and the Gastro-Intestinal (GI) tract. When nitrite is entered into the blood cells, it converts the hemoglobin to methemoglobin, which causes the anoxemia and cyanosis. The increasing use of pesticides and chemical fertilizers, especially the fertilizers with nitrates compounds, which have been common for the increased production of agricultural crops, has caused the nitrate pollution in the (soil, water, and environment). They have caused a lot of damage to humans and animals. In this research, the nitrate accumulation in different kind of vegetables such as; green pepper, tomatoes, egg plants, watermelon, cucumber, and red pepper were observed in the suburbs of Mashhad, Neisabour, and Sabzevar cities. In some of these cities, the information forms of agronomical practices collected were such as; different vegetable crops fertilizer recommendations, varieties, pesticides, irrigation schedules, etc., which were filled out by some of our colleagues in the research areas mentioned above. Analysis of the samples was sent to the soil and water laboratory in our department in Mashhad. The final results from the chemical analysis of samples showed that the mean levels of nitrates from the samples of the fruit crops in the mentioned cities above were all lower than the critical levels. These fruit crop samples were in the order of: 35.91, 8.47, 24.81, 6.03, 46.43, 2.06 mg/kg dry matter, for the following crops such as; tomato, cucumber, eggplant, watermelon, green pepper, and red pepper. Even though, this study was conducted with limited samples and by considering the mean levels, the use of these crops from the nutritional point of view will not cause the poisoning of humans.

Keywords: Environmental pollution, human health, nitrate accumulations, nitrate fertilizers.

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Authors: S. Mahalakshmi, B. Senthil Arasu

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As per the recent changes happening in the global policies, climate related changes and the impact it causes across every sector are viewed as green swan events – in essence, climate related changes can happen often and lead to risk and lot of uncertainty, but need to be mitigated instead of considering them as black swan events. This brings about a question on how this risk can be computed, so that the financial institutions can plan to mitigate it. Climate related changes impact all risk types – credit risk, market risk, operational risk, liquidity risk, reputational risk and others. And the models required to compute this have to consider the different industrial needs of the counterparty, as well as the factors that are contributing to this – be it in the form of different risk drivers, or the different transmission channels or the different approaches and the granular form of data availability. This brings out to the suggestion that the climate related changes, though it affects Pillar I risks, will be a Pillar II risk. This has to be modeled specifically based on the financial institution’s actual exposure to different industries, instead of generalizing the risk charge. And this will have to be considered as the additional capital to be met by the financial institution in addition to their Pillar I risks, as well as the existing Pillar II risks. In this paper, we present a risk assessment framework to model and assess climate change risks - for both credit and market risks. This framework helps in assessing the different scenarios, and how the different transition risks affect the risk associated with the different parties. This research paper delves on the topic of increase in concentration of greenhouse gases, that in turn causing global warming. It then considers the various scenarios of having the different risk drivers impacting credit and market risk of an institution, by understanding the transmission channels, and also considering the transition risk. The paper then focuses on the industry that’s fast seeing a disruption: automobile industry. The paper uses the framework to show how the climate changes and the change to the relevant policies have impacted the entire financial institution. Appropriate statistical models for forecasting, anomaly detection and scenario modeling are built to demonstrate how the framework can be used by the relevant agencies to understand their financial risks. The paper also focuses on the climate risk calculation for the Pillar II capital calculations, and how it will make sense for the bank to maintain this in addition to their regular Pillar I and Pillar II capital.

Keywords: Capital calculation, climate risk, credit risk, pillar II risk, scenario modeling.

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Authors: Atul Khurana, Rajul Rastogi, Hans-Joachim Gamperl

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The pharmaceutical companies are getting more inclined towards patient support programs (PSPs) which assist patients and/or healthcare professionals (HCPs) in more desirable disease management and cost-effective treatment. The utmost objective of these programs is patient care. The PSPs may include financial assistance to patients, medicine compliance programs, access to HCPs via phone or online chat centers, etc. The PSP has a crucial role in terms of customer acquisition and retention strategies. During the conduct of these programs, Marketing Authorisation Holder (MAH) may receive information related to concerned medicinal products, which is usually reported by patients or involved HCPs. This information may include suspected adverse reaction(s) during/after administration of medicinal products. Hence, the MAH should design PSP to comply with regulatory reporting requirements and avoid non-compliance during PV inspection. The emergence of wireless health devices is lowering the burden on patients to manually incorporate safety data, and building a significant option for patients to observe major swings in reference to drug safety. Therefore, to enhance the adoption of these programs, MAH not only needs to aware patients about advantages of the program, but also recognizes the importance of time of patients and commitments made in a constructive manner. It is indispensable that strengthening the public health is considered as the topmost priority in such programs, and the MAH is compliant to Pharmacovigilance (PV) requirements along with regulatory obligations.

Keywords: Drug safety, good pharmacovigilance practice, patient support program, pharmacovigilance.

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Authors: M. Adamczak-Retecka, O. Hołub-Śniadach

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Dangerous of climate change is now global problem and as such has a strategic priority also for the European Union. Europe and European citizens try to do their best to cut greenhouse gas emissions, moreover they substantially encourage other nations and regions to follow the same way. The European Commission and a number of Member States have developed adaptation strategies in order to help strengthen EU's resilience to the inevitable impacts of climate change. The EU has long been a driving force in international negotiations on climate change and was instrumental in the development of the UN Framework Convention on Climate Change. As the world's leading donor of development aid, the EU also provides substantial funding to help developing countries tackle climate change problem. Global warming influences human health, biodiversity, ecosystems but also many social and economic sectors. The aim of this paper is to focus on impact of claimant change on for food security. Food security challenges are directly related to globalization, climate change. It means that current and future food policy is exposed to all cross-cutting and that must be linked with environmental and climate targets, which supposed to be achieved. In the 7th EAP —The new general Union Environment Action Program to 2020, called “Living well, within the limits of our planet” EU has agreed to step up its efforts to protect natural capital, stimulate resource efficient, low carbon growth and innovation, and safeguard people’s health and wellbeing– while respecting the Earth’s natural limits.

Keywords: Climate change, EU law, food policy, food security.

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Authors: Bill D. Geis, Frederick Newman

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Suicide and wrongful death forensic cases are the fastest rising tort in mental health law. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from US state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. But suicide ideation, in the matter of suicide risk determination, may be a necessary but insufficient target of lethal suicide risk assessment. Assessment of near-term suicide risk—assessment that goes beyond verbalized suicide ideation and relates to acute crisis variables—is likely needed. Specifically, such other or additional suicide risk variable assessment may be required in the context of lethal suicide risk situations, as opposed to the discernment of general, nonlethal suicide behavior as a standard of practice (whether a patient is having suicidal thoughts or exhibiting an ambivalent suicide attempt potential). In the current study, verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The Lethal Suicide Risk Assessment, Acute Model, and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training and become the legal standard of care for expected clinical behavior. Without this expanded clinical assessment perspective, the standard of care for suicide assessment is out of sync with current knowledge—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: Forensic evaluation, standard of care, suicide, suicide assessment, wrongful death.

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Authors: Niwatchai Namwichisirikul

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Due to the emergence of “Humanized Healthcare" introduced by Professor Dr. Prawase Wasi in 2003[1], the development of this paradigm tends to be widely implemented. The organizations included Healthcare Accreditation Institute (public organization), National Health Foundation, Mahidol University in cooperation with Thai Health Promotion Foundation, and National Health Security Office (Thailand) have selected the hospitals or infirmaries that are qualified for humanized healthcare since 2008- 2010 and 35 of them are chosen to be the outstandingly navigating organizations for the development of humanized healthcare, humanized healthcare award [2]. The research aims to study the current issue, characteristics and patterns of hospital administration contributing to humanized healthcare system in Thailand. The selected case studies are from four hospitals including Dansai Crown Prince Hospital, Leoi; Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and Prathai Hospital, Nakhonrachasima. The methodology is in-depth interviewing with 10 staffs working as hospital executive directors, and representatives from leader groups including directors, multidisciplinary hospital committees, personnel development committees, physicians and nurses in each hospital. (Total=40) In addition, focus group discussions between hospital staffs and general people (including patients and their relatives, the community leader, and other people) are held by means of setting 4 groups including 8 people within each group. (Total=128) The observation on the working in each hospital is also implemented. The findings of the study reveal that there are five important aspects found in each hospital including (1) the quality improvement under the mental and spiritual development policy from the chief executives and lead teams, leaders as Role model and they have visionary leadership; (2) the participation hospital administration system focusing on learning process and stakeholder- needs, spiritual human resource management and development; (3) the relationship among people especially staffs, team work skills, mutual understanding, effective communication and personal inner-development; (4) organization culture relevant to the awareness of patients- rights as well as the participation policy including spiritual growth achieving to the same goals, sharing vision, developing public mind, and caring; and (5) healing structures or environment providing warmth and convenience for hospital staffs, patients and their relatives and visitors.

Keywords: Hospital administration, Humanized healthcare.

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Authors: Kyu Jin Kim, Byung Kwan Oh, Hyo Seon Park

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The seismic responses-based structural health monitoring system has been performed to prevent seismic damage. Structural seismic damage of building is caused by the instantaneous stress concentration which is related with dynamic characteristic of earthquake. Meanwhile, seismic response analysis to estimate the dynamic responses of building demands significantly high computational cost. To prevent the failure of structural members from the characteristic of the earthquake and the significantly high computational cost for seismic response analysis, this paper presents an artificial neural network (ANN) based prediction model for dynamic responses of building considering specific time length. Through the measured dynamic responses, input and output node of the ANN are formed by the length of specific time, and adopted for the training. In the model, evolutionary radial basis function neural network (ERBFNN), that radial basis function network (RBFN) is integrated with evolutionary optimization algorithm to find variables in RBF, is implemented. The effectiveness of the proposed model is verified through an analytical study applying responses from dynamic analysis for multi-degree of freedom system to training data in ERBFNN.

Keywords: Structural health monitoring, dynamic response, artificial neural network, radial basis function network, genetic algorithm.

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Authors: Tamara Kelly

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The past decade has witnessed a good opportunities for city development schemes in UK. The government encouraged restoration of city centers to comprise mixed use developments with high density residential apartments. Investments in regeneration areas were doing well according to the analyses of Property Databank (IPD). However, more recent analysis by IPD has shown that since 2007, property in regeneration areas has been more vulnerable to the market downturn than other types of investment property. The early stages of a property market downturn may be felt most in regeneration where funding, investor confidence and occupier demand would dissipate because the sector was considered more marginal or risky when development costs rise. Moreover, the Bank of England survey shows that lenders have sequentially tightened the availability of credit for commercial real estate since mid-2007. A sharp reduction in the willingness of banks to lend on commercial property was recorded. The credit crunch has already affected commercial property but its impact has been particularly severe in certain kinds of properties where residential developments are extremely difficult, in particular city centre apartments and buy-to-let markets. Commercial property – retail, industrial leisure and mixed use were also pressed, in Birmingham; tens of mixed use plots were built to replace old factories in the heart of the city. The purpose of these developments was to enable young professionals to work and live in same place. Thousands of people lost their jobs during the recession, moreover lending was more difficult and the future of many developments is unknown. The recession casts its shadow upon the society due to cuts in public spending by government, Inflation, rising tuition fees and high rise in unemployment generated anger and hatred was spreading among youth causing vandalism and riots in many cities. Recent riots targeted many mixed used development in the UK where banks, shops, restaurants and big stores were robbed and set into fire leaving residents with horror and shock. This paper examines the impact of the recession and riots on mixed use development in UK.

Keywords: Diversity, mixed use development, outdoor comfort, public realm, safe places, safety by design.

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Authors: F. O Anugom

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The general functions of the university amongst other things include teaching, research and community service. Universities are recognized as the apex of learning, accumulating and imparting knowledge and skills of all kinds to students to enable them to be productive, earn their living and to make optimum contributions to national development. This is equivalent to the production of human capital in the form of high level manpower needed to administer the educational society, be useful to the society and manage the economy. Quality has become a matter of major importance for university education in Nigeria. Accreditation is the systematic review of educational programs to ensure that acceptable standards of education, scholarship and infrastructure are being maintained. Accreditation ensures that institution maintain quality. The process is designed to determine whether or not an institution has met or exceeded the published standards for accreditation, and whether it is achieving its mission and stated purposes. Ensuring quality assurance in accreditation process falls in the hands of university management which justified the need for this study. This study examined accreditation and quality assurance: the management imperative. Three research questions and three hypotheses guided the study. The design was a correlation survey with a population of 2,893 university administrators out of which 578 Heads of department and Dean of faculties were sampled. The instrument for data collection was titled Programme Accreditation Exercise scale with high levels of reliability. The research questions were answered with Pearson ‘r’ statistics. T-test statistics was used to test the hypotheses. It was found among others that the quality of accredited programme depends on the level of funding of universities in Nigeria. It was also indicated that quality of programme accreditation and physical facilities of universities in Nigeria have high relationship. But it was also revealed that programme accreditation is positively related to staffing in Nigerian universities. Based on the findings of the study, the researcher recommend that academic administrators should be included in the team of those who ensure quality programs in the universities. Private sector partnership should be encouraged to fund programs to ensure quality of programme in the universities. Independent agencies should be engaged to monitor the activities of accreditation teams to avoid bias.

Keywords: Accreditation, quality assurance, NUC, physical facilities, staffing.

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Authors: M. S. Said, J. A. Ghani, Che Hassan C. H., N. N. Wan, M. A. Selamat, R. Othman

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Metal matrix composites (MMCs) attract considerable attention as a result from its ability in providing a high strength, high modulus, high toughness, high impact properties, improving wear resistance and providing good corrosion resistance compared to unreinforced alloy. Aluminium Silicon (Al/Si) alloy MMC has been widely used in various industrial sectors such as in transportation, domestic equipment, aerospace, military, construction, etc. Aluminium silicon alloy is an MMC that had been reinforced with aluminium nitrate (AlN) particle and become a new generation material use in automotive and aerospace sector. The AlN is one of the advance material that have a bright prospect in future since it has features such as lightweight, high strength, high hardness and stiffness quality. However, the high degree of ceramic particle reinforcement and the irregular nature of the particles along the matrix material that contribute to its low density is the main problem which leads to difficulties in machining process. This paper examined the tool wear when milling AlSi/AlN Metal Matrix Composite using a TiB2 (Titanium diboride) coated carbide cutting tool. The volume of the AlN reinforced particle was 10% and milling process was carried out under dry cutting condition. The TiB2 coated carbide insert parameters used were at the cutting speed of (230, 300 and 370m/min, feed rate of 0.8, Depth of Cut (DoC) at 0.4m). The Sometech SV-35 video microscope system used to quantify of the tool wear. The result shown that tool life span increasing with the cutting speeds at (370m/min, feed rate of 0.8mm/tooth and DoC at 0.4mm) which constituted an optimum condition for longer tool life lasted until 123.2 mins. Meanwhile, at medium cutting speed which at 300m/m, feed rate of 0.8mm/tooth and depth of cut at 0.4mm we found that tool life span lasted until 119.86 mins while at low cutting speed it lasted in 119.66 mins. High cutting speed will give the best parameter in cutting AlSi/AlN MMCs material. The result will help manufacturers in machining process of AlSi/AlN MMCs materials.

Keywords: AlSi/AlN Metal Matrix Composite milling process, tool wear, TiB2 coated cemented carbide tool.

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Authors: Gülden Küçükakça, Şefika Dilek Güven, Rahşan Kolutek, Seçil Taylan

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Objective: Nursing students face with stress factors affecting academic performance and quality of life as from first moments of their educational life. Stress causes health problems in students such as physical, psycho-social, and behavioral disorders and might damage formation of professional identity by decreasing efficiency of education. In addition to determination of stress experienced by nursing students during their education, it was aimed to help review theoretical and clinical education settings for bringing stress of nursing students into positive level and to raise awareness of educators concerning their own professional behaviors. Methods: The study was conducted with 315 students studying at nursing department of Semra and Vefa Küçük Health High School, Nevşehir Hacı Bektaş Veli University in the academic year of 2015-2016 and agreed to participate in the study. “Personal Information Form” prepared by the researchers upon the literature review and “Nursing Education Stress Scale (NESS)” were used in this study. Data were assessed with analysis of variance and correlation analysis. Results: Mean NESS Scale score of the nursing students was estimated to be 66.46±16.08 points. Conclusions: As a result of this study, stress level experienced by nursing undergraduate students during their education was determined to be high. In accordance with this result, it can be recommended to determine sources of stress experienced by nursing undergraduate students during their education and to develop approaches to eliminate these stress sources.

Keywords: Stress, nursing education, nursing student, nursing education stress.

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Authors: Ilelabayo I. Adebisi, Yetunde R. Okeyinka, Abdulrasaq K. Ayinla

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Architectural design is a complex process especially when the issue of user’s comfort, building sustainability and energy efficiency needs to be addressed. The current energy challenge and the seek for an environment where users will have a more physiological and psychological comfort in this part of the world have led various researchers to constantly explore the concept of passive design techniques. Passive techniques are design strategies used in regulating building indoor climates and improving users comfort without the use of energy driven devices. This paper describes and analyses the significance of passive techniques on indoor climates and their impact on thermal comfort of building users using LAUTECH College of health sciences Ogbomoso as a case study. The study aims at assessing the appropriateness of the passive strategies used in achieving comfort in their buildings with a view to evaluate their adequacy and effectiveness and suggesting how comfortable their building users are. This assessment was carried out through field survey and questionnaires and findings revealed that strategies such as Orientation, Spacing, Courtyards, window positioning and choice of landscape adopted are inadequate while only fins and roof overhangs are adequate. The finding also revealed that 72% of building occupants feel hot discomfort in their various spaces and hence have the urge to get fresh air from outside during work hours. The Mahoney table was used to provide appropriate architectural design recommendations to guide future designers in the study area.

Keywords: Energy challenge, passive cooling, techniques, thermal comfort, users comfort.

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Authors: E. Grochowska-Niedworok, K. Brukało, M. Hadasik, M. Kardas

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Consumption of vegetables by school children and adolescents is essential for their normal growth, development and health, but a significant minority of the world's population consumes the right amount of these products. The aim of the study was to evaluate the preferences and frequency of consumption of vegetables by school children and adolescents. It has been assumed that effectively implemented nutrition education programs should have an impact on increasing the frequency of vegetable consumption among the recipients. The study covered 514 students of five schools in the Opole Voivodeship aged 9 years to 22 years. The research tool was an author's questionnaire, which consisted of closed questions on the frequency of vegetable consumption and the use of 10 ways to treat them. Preferences and frequencies are shown in percentages, while correlations were estimated on the basis of Cramer`s V and gamma coefficients. In each of the examined age groups, the relationship between sex and vegetable consumption (the Cramer`s V coefficient value was 0.06 to 0.38) was determined and the various methods of culinary processing were used (V Craméra was 0.08 to 0.34). For both sexes, the relationship between age and frequency of vegetable consumption was shown (gamma values ranged from ~ 0.00 to 0.39) and different cooking methods (gamma values were 0.01 to 0.22). The most important determinant of nutritional choices is the taste and availability of products. The fact that they have a positive effect on their health is only in third position. As has been shown, obesity prevention programs can not only address nutrition education but also teach about new flavors and increase the availability of healthy foods. In addition, the frequency of vegetable consumption can be a good indicator reflecting the healthy behaviors of children and adolescents.

Keywords: Children and adolescents, frequency, welfare rate, vegetables.

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Authors: Megumi Nishida, Naoya Motegi, Takurou Kikuchi, Tomoko Tokumura

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In recent years, the power system has been changed and a flexible power pricing system such as demand response has been sought in Japan. The demand response system works simply in the household sector and the owner as the decision-maker, can benefit from power saving. On the other hand, the execution of demand response in the office building is more complex than in the household because various people such as owners, building administrators and occupants are involved in the decision-making process. While the owners benefit from demand saving, the occupants are exposed to restricted benefits of a demand-saved environment. One of the reasons is that building systems are usually under centralized management and each occupant cannot choose freely whether to participate in demand response or not. In addition, it is unclear whether incentives give occupants the motivation to participate. However, the recent development of IT and building systems enables the personalized control of the office environment where each occupant can control the lighting level or temperature individually. Therefore, it can be possible to have a system which each occupant can make a decision of whether or not to participate in demand response in the office building. This study investigates personal responses to demand response requests, under the condition where each occupant can adjust their brightness individually in their workspace. Once workers participate in the demand response, their desk-lights are automatically turned off. The participation rates in the demand response events are compared among four groups, which are divided by different motivation, the presence, or absence of incentives and the method of participation. The result shows that there are significant differences of participation rates in demand response event between four groups. The method of participation has a large effect on the participation rate. The “Opt-out” groups where the occupants are automatically enrolled in a demand response event if they do not express non-participation have the highest participation rate in the four groups. Incentives also have an effect on the participation rate. This study also reports on the impact of low illumination office environment on the occupants, such as stress or fatigue. The electrocardiogram and the questionnaire are used to investigate the autonomic nervous activity and subjective fatigue symptoms of the occupants. There is no big difference between dim workspace during demand response event and bright workspace in autonomic nervous activity and fatigue.

Keywords: Demand response, illumination, questionnaire, electrocardiograph.

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Authors: Dalyah Y. Al-Jamal, Maryam H. Eshtaiwi, Liyakathunisa Syed

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Connecting health services with technology has a huge demand as people health situations are becoming worse day by day. In fact, engaging new technologies such as Internet of Things (IOT) into the medical services can enhance the patient care services. Specifically, patients suffering from chronic diseases such as cardiac patients need a special care and monitoring. In reality, some efforts were previously taken to automate and improve the patient monitoring systems. However, the previous efforts have some limitations and lack the real-time feature needed for chronic kind of diseases. In this paper, an improved process model for patient monitoring system specialized for cardiac patients is presented. A survey was distributed and interviews were conducted to gather the needed requirements to improve the cardiac patient monitoring system. Business Process Model and Notation (BPMN) language was used to model the proposed process. In fact, the proposed system uses the IOT Technology to assist doctors to remotely monitor and follow-up with their heart patients in real-time. In order to validate the effectiveness of the proposed solution, simulation analysis was performed using Bizagi Modeler tool. Analysis results show performance improvements in the heart monitoring process. For the future, authors suggest enhancing the proposed system to cover all the chronic diseases.

Keywords: Business process model and notation, cardiac patient, cardiac monitoring, heart monitoring, healthcare, internet of things, remote patient monitoring system, process model, telemedicine, wearable sensors.

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Authors: Najaf Hedayat

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Food and fibre production in arid and semi-arid regions has emerged as one of the major challenges for various socio-economic and political reasons such as the food security and self-sufficiency. Productive use of the renewable water resources has risen on top ofthe decision-making agenda. For this reason, efficient operation and maintenance of modern irrigation and drainage schemes become part and parcel and indispensible reality in agricultural policy making arena. The aim of this paper is to investigate the complexity of operating and maintaining such schemes, mainly focussing on challenges which enhance and opportunities that impedsustainable food and fibre production. The methodology involved using secondary data complemented byroutine observations and stakeholders views on issues that influence the O&M in the Dez command area. The SPSS program was used as an analytical framework for data analysis and interpretation.Results indicate poor application efficiency in most croplands, much of which is attributed to deficient operation of conveyance and distribution canals. These in turn, are reportedly linked to inadequate maintenance of the pumping stations and hydraulic structures like turnouts,flumes and other control systems particularly in the secondary and tertiary canals. Results show that the aforementioned deficiencies have been the major impediment to establishing regular flow toward the farm gates which subsequently undermine application efficiency and tillage operationsat farm level. Results further show that accumulative impact of such deficiencies has been the major causes of poorcrop yield and quality that deem production system in these croplands uneconomic. Results further show that the present state might undermine the sustainability of agricultural system in the command area. The overall conclusion being that present water management is unlikely to be responsive to challenges that the sector faces. And in the absence of coherent measures to shift the status quo situation in favour of more productive resource use, it would be hard to fulfil the objectives of the National Economic and Socio-cultural Development Plans.

Keywords: renewable water resources, Dez scheme, irrigationand drainage, sustainable crop production, O&M

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Authors: Lucy Ampaw-Asiedu, Terri R. Norton

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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: Disaster management, safe spaces, structural design, tornado, vulnerability.

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Authors: M. A. Abou Donia, A. A. K. Abou-Arab, Nevin E. Sharaf, A. K. Enab, Sherif R. Mohamed

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Lead (Pb) poisoning is one of the most common and preventable environmental health problems. There are different sources of environmental pollution with lead as lead alkyl additives in petrol and manufacturing processes. Pb in the atmosphere can be deposited in urban soils, and may then be re-suspended to re-enter the atmosphere. This could increase human exposure to Pb and cause long-term health effects. Thus, monitoring Pb pollution is considered one of the major tasks in controlling pollution. Scalp hair can be utilized for the determination of lead (Pb) concentration. It provides a lasting record of metal intakes of weeks or even months, and for most metals, their accumulation in hair reflects their accumulation in the whole body. This work was conducted to investigate the concentration of lead in male scalp hair of Cairo (residential-traffic and residential-industrial) and rural residents after twenty years of phasing out of leaded gasoline. Results indicated that the mean concentration of lead in hair of residential-traffic (9.7552 μg/g ±0.71) and residential-industrial (12.3288 μg/g ±1.13) was significantly higher than that in rural residents (4.7327 μg/g ±0.67). The mean concentration of lead in hair of resident’s industrial areas was the highest among Cairo residents and not the traffic areas as it was before phasing out of leaded gasoline. Twenty years of phasing out of leaded gasoline in Cairo has greatly improved the lead pollution among residents of traffic areas, but industrial areas residents were still suffering from lead pollution, which needs more efforts to control the sources of lead pollution.

Keywords: Heavy metals, lead, hair, biological sample, urban pollution, rural pollution.

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Authors: Trina Isabel D. Santiago, Daniel C. Chua, Jumee F. Tayaban, Joseph Daniel S. Timbol, Joshua M. Yanes

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Numerous instances of human rights violations on healthcare workers have been reported during the COVID-19 pandemic in the Philippines. This paper aims to explore these civil and political rights violations and propose recommendations to address these. Our review shows that a wide range of civic and political human rights violations have been committed by individual citizens and government agencies on individual healthcare workers and health worker groups. These violations include discrimination, red-tagging, evictions, illegal arrests, and acts of violence ranging from chemical attacks to homicide. If left unchecked, these issues, compounded by the pandemic, may lead to the exacerbations of the pre-existing problems of the Philippine healthcare system. Despite all pre-existing reports by human rights groups and public media articles, there still seems to be a lack of government action to condemn and prevent these violations. The existence of government agencies which directly contribute to these violations with the lack of condemnation from other agencies further propagate the problem. Given these issues, this policy brief recommends the establishment of an interagency task force for the protection of human rights of healthcare workers as well as the expedited passing of current legislative bills towards the same goal. For more immediate action, we call for the establishment of a dedicated hotline for these incidents with adequate appointment and training of point persons, construction of clear guidelines, and closer collaboration between government agencies in being united against these issues.

Keywords: COVID-19 pandemic, healthcare workers, human rights violations, Philippines.

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Authors: Hirbod Varasteh, Hamidreza Gohari Darabkhani

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The global warming and its impact on climate change is one of main challenges for current century. Global warming is mainly due to the emission of greenhouse gases (GHG) and carbon dioxide (CO₂) is known to be the major contributor to the GHG emission profile. Whilst the energy sector is the primary source for CO₂ emission, Carbon Capture and Storage (CCS) are believed to be the solution for controlling this emission. Oxyfuel combustion (Oxy-combustion) is one of the major technologies for capturing CO₂ from power plants. For gas turbines, several Oxy-combustion power cycles (Oxyturbine cycles) have been investigated by means of thermodynamic analysis. NetPower cycle is one of the leading oxyturbine power cycles with almost full carbon capture capability from a natural gas fired power plant. In this manuscript, sensitivity analysis of the heat exchanger design in NetPower cycle is completed by means of process modelling. The heat capacity variation and supercritical CO₂ with gaseous admixtures are considered for multi-zone analysis with Aspen Plus software. It is found that the heat exchanger design has a major role to increase the efficiency of NetPower cycle. The pinch-point analysis is done to extract the composite and grand composite curve for the heat exchanger. In this paper, relationship between the cycle efficiency and the minimum approach temperature (∆Tmin) of the heat exchanger has also been evaluated.  Increase in ∆Tmin causes a decrease in the temperature of the recycle flue gases (RFG) and an overall decrease in the required power for the recycled gas compressor. The main challenge in the design of heat exchangers in power plants is a tradeoff between the capital and operational costs. To achieve lower ∆Tmin, larger size of heat exchanger is required. This means a higher capital cost but leading to a better heat recovery and lower operational cost. To achieve this, ∆Tmin is selected from the minimum point in the diagrams of capital and operational costs. This study provides an insight into the NetPower Oxy-combustion cycle’s performance analysis and operational condition based on its heat exchanger design.

Keywords: Carbon capture and storage, oxy-combustion, netpower cycle, oxyturbine power cycles, heat exchanger design, supercritical carbon dioxide, pinch point analysis.

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Authors: C. C. Alamanjo, A. O. Adepoju, H. Martin, R. N. Baines

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Peri-urban agriculture in Jos Nigeria serves as a major means of livelihood for both urban and peri-urban poor, and constitutes huge commercial inclination with a target market that has spanned beyond Plateau State. Yet, the sustainability of this sector is threatened by intensive application of urban refuse ash contaminated with heavy metals, as a result of the highly heterogeneous materials used in ash production. Hence, this research aimed to understand the current fertilizer employed by farmers, their perception and acceptability in utilization of household sewage sludge for agricultural purposes and their capacity in mitigating risks associated with such practice. Mixed methods approach was adopted, and data collection tools used include survey questionnaire, focus group discussion with farmers, participants and field observation. The study identified that farmers maintain a complex mixture of organic and chemical fertilizers, with mixture composition that is dependent on fertilizer availability and affordability. Also, farmers have decreased the rate of utilization of urban refuse ash due to labor and increased logistic cost and are keen to utilize household sewage sludge for soil fertility improvement but are mainly constrained by accessibility of this waste product. Nevertheless, farmers near to sewage disposal points have commenced utilization of household sewage sludge for improving soil fertility. Farmers were knowledgeable on composting but find their strategic method of dewatering and sun drying more convenient. Irrigation farmers were not enthusiastic for treatment, as they desired both water and sludge. Secondly, household sewage sludge observed in the field is heterogeneous due to nearness between its disposal point and that of urban refuse, which raises concern for possible cross-contamination of pollutants and also portrays lack of extension guidance as regards to treatment and management of household sewage sludge for agricultural purposes. Hence, farmers concerns need to be addressed, particularly in providing extension advice and establishment of decentralized household sewage sludge collection centers, for continuous availability of liquid and concentrated sludge. Urgent need is also required for the Federal Government of Nigeria to increase commitment towards empowering her subsidiaries for efficient discharge of corporate responsibilities.

Keywords: Ash, farmers, household, peri-urban, refuse, sewage, sludge, urban.

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Authors: I. Szer, J. Szer, K. Czarnocki, E. Błazik-Borowa

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People on construction scaffoldings work in dynamically changing, often unfavourable climate. Additionally, this kind of work is performed on low stiffness structures at high altitude, which increases the risk of accidents. It is therefore desirable to define the parameters of the work environment that contribute to increasing the construction worker occupational safety level. The aim of this article is to present how changes in microclimate parameters on scaffolding can impact the development of dangerous situations and accidents. For this purpose, indicators based on the human thermal balance were used. However, use of this model under construction conditions is often burdened by significant errors or even impossible to implement due to the lack of precise data. Thus, in the target model, the modified parameter was used – apparent environmental temperature. Apparent temperature in the proposed Scaffold Use Risk Assessment Model has been a perceived outdoor temperature, caused by the combined effects of air temperature, radiative temperature, relative humidity and wind speed (wind chill index, heat index). In the paper, correlations between component factors and apparent temperature for facade scaffolding with a width of 24.5 m and a height of 42.3 m, located at south-west side of building are presented. The distribution of factors on the scaffolding has been used to evaluate fitting of the microclimate model. The results of the studies indicate that observed ranges of apparent temperature on the scaffolds frequently results in a worker’s inability to adapt. This leads to reduced concentration and increased fatigue, adversely affects health, and consequently increases the risk of dangerous situations and accidental injuries

Keywords: Apparent temperature, health, safety work, scaffoldings.

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Authors: Sanjeev Sharma, Suman Lata

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With the availability of diverse printed, electronic literature and web sites on medical and health related information, it is impossible for the medical professional to get the information he seeks in the shortest possible time. For all these problems information literacy is the only solution. Thus, information literacy is recognized as an important aspect of medical education. In the present study, an attempt has been made to know the information literacy skills of the faculty and students at medical colleges of Haryana, Punjab and Chandigarh. The scope of the study was confined to the 12 selected medical colleges of three States (Haryana, Punjab, and Chandigarh). The findings of the study were based on the data collected through 1018 questionnaires filled by the respondents of the medical colleges. It was found that Online Medical Websites (such as WebMD, eMedicine and Mayo Clinic etc.) were frequently used by 63.43% of the respondents of Chandigarh which is slightly more than Haryana (61%) and Punjab (55.65%). As well, 30.86% of the respondents of Chandigarh, 27.41% of Haryana and 27.05% of Punjab were familiar with the controlled vocabulary tool; 25.14% respondents of Chandigarh, 23.80% of Punjab, 23.17% of Haryana were familiar with the Boolean operators; 33.05% of the respondents of Punjab, 28.19% of Haryana and 25.14% of Chandigarh were familiar with the use and importance of the keywords while searching an electronic database; and 51.43% of the respondents of Chandigarh, 44.52% of Punjab and 36.29% of Haryana were able to make effective use of the retrieved information. For accessing information in electronic format, 47.74% of the respondents rated their skills high, while the majority of respondents (76.13%) were unfamiliar with the basic search technique i.e. Boolean operator used for searching information in an online database. On the basis of the findings, it was suggested that a comprehensive training program based on medical professionals information needs should be organized frequently. Furthermore, it was also suggested that information literacy may be included as a subject in the health science curriculum so as to make the medical professionals information literate and independent lifelong learners.

Keywords: Information, information literacy, medical colleges, medical professionals.

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Authors: Pradip Kumar Das

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As the entire world continues its rapid move towards industrialization, it has seriously threatened mankind’s ability to maintain an ecological balance. Geographical and natural forces have a significant influence on the location of industries. Industrialization is the foundation stone of the development of any country, while the unplanned industrialization and discharge of waste by industries is the cause of environmental pollution. There is growing degree of awareness and concern globally among nations about environmental degradation or pollution. Environmental resources endowed by the gift of nature and not manmade are invaluable natural resources of a country like India. Any developmental activity is directly related to natural and environmental resources. Economic development without environmental considerations brings about environmental crises and damages the quality of life of present, as well as future generation. As corporate sectors in the global market, especially in India, are becoming anxious about environmental degradation, naturally more and more emphasis will be ascribed to how environment-friendly the outcomes are. Maintaining accounts of such environmental and natural resources in the country has become more urgent. Moreover, international awareness and acceptance of the importance of environmental issues has motivated the development of a branch of accounting called “Environmental Accounting”. Environmental accounting attempts to detect and focus the resources consumed and the costs rendered by an industrial unit to the environment. For the sustainable development of mankind, a healthy environment is indispensable. Gradually, therefore, in many countries including India, environment matters are being given top most priority. Accounting and disclosure of environmental matters have been increasingly manifesting as an important dimension of corporate accounting and reporting practices. But, as conventional accounting deals with mainly non-living things, the formulation of valuation, and measurement and accounting techniques for incorporating environment-related matters in the corporate financial statement sometimes creates problems for the accountant. In the light of this situation, the conceptual analysis of the study is concerned with the rationale of environmental accounting on the economy and society as a whole, and focuses the failures of the traditional accounting system. A modest attempt has been made to throw light on the environmental awareness in developing nations like India and discuss the problems associated with the implementation of environmental accounting. The conceptual study also reflects that despite different anomalies, environmental accounting is becoming an increasing important aspect of the accounting agenda within the corporate sector in India. Lastly, a conclusion, along with recommendations, has been given to overcome the situation.

Keywords: Environmental accounting, environmental degradation, environmental management, environmental resources.

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Authors: Pegah Farokhzad

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Family has a crucial role in maintaining the physical, social and mental health of the children. Most of the mental and anxiety problems of children reflect the complex interpersonal situations among family members, especially parents. In other words, anxiety problems of the children are correlated with deficit relationships of family members and improper childrearing styles. The parental child rearing styles leads to positive and negative consequences which affect the children’s mental health. Therefore, the present research was aimed to compare the parental childrearing styles and anxiety of children with stuttering and normal population. It was also aimed to study the relationship between parental child rearing styles and anxiety of children. The research sample included 54 boys with stuttering and 54 normal boys who were selected from the children (boys) of Tehran, Iran in the age range of 5 to 8 years in 2013. In order to collect data, Baum-rind Childrearing Styles Inventory and Spence Parental Anxiety Inventory were used. Appropriate descriptive statistical methods and multivariate variance analysis and t test for independent groups were used to test the study hypotheses. Statistical data analyses demonstrated that there was a significant difference between stuttering boys and normal boys in anxiety (t = 7.601, p< 0.01); but there was no significant difference between stuttering boys and normal boys in parental childrearing styles (F = 0.129). There was also not found significant relationship between parental childrearing styles and children anxiety (F = 0.135, p< 0.05). It can be concluded that the influential factors of children’s society are parents, school, teachers, peers and media. So, parental childrearing styles are not the only influential factors on anxiety of children, and other factors including genetic, environment and child experiences are effective in anxiety as well. Details are discussed.

Keywords: Anxiety, Childrearing Styles, Stuttering.

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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Authors: A. E. Mukhametov, M. T. Yerbulekova, D. R. Dautkanova, G. A. Tuyakova, G. Aitkhozhayeva

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The accumulation of heavy metals in food is a constant problem in many parts of the world. Vegetable oils are widely used, both for cooking and for processing in the food industry, meeting the main dietary requirements. One of the main chemical pollutants, heavy metals, is usually found in vegetable oils. These chemical pollutants are carcinogenic, teratogenic and immunotoxic, harmful to consumption and have a negative effect on human health even in trace amounts. Residues of these substances can easily accumulate in vegetable oil during cultivation, processing and storage. In this article, the content of the concentration of heavy metal ions in vegetable oils of Kazakhstan production is studied: sunflower, rapeseed, safflower and linseed oil. Heavy metals: arsenic, cadmium, lead and nickel, were determined in three repetitions by the method of flame atomic absorption. Analysis of vegetable oil samples revealed that the largest lead contamination (Pb) was determined to be 0.065 mg/kg in linseed oil. The content of cadmium (Cd) in the largest amount of 0.009 mg/kg was found in safflower oil. Arsenic (As) content was determined in rapeseed and safflower oils at 0.003 mg/kg, and arsenic (As) was not detected in linseed and sunflower oil. The nickel (Ni) content in the largest amount of 0.433 mg/kg was in linseed oil. The heavy metal contents in the test samples complied with the requirements of regulatory documents for vegetable oils. An assessment of the health risk of vegetable oils with a daily consumption of 36 g per day shows that all samples of vegetable oils produced in Kazakhstan are safe for consumption. But further monitoring is needed, since all these metals are toxic and their harmful effects become apparent only after several years of exposure.

Keywords: Kazakhstan, oil, safety, toxic metals.

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