Biography:

ChunlinJin, Professor, Ph.D. of Tokyo University. Executive Deputy Director of SHDRC, Director of Shanghai Medical Information Center, and Director of Shanghai Population and Development Research Center. Dr. Jin's main research areas are health economics related administrative research and hospital management. He has been the primary investigator of more than 40 research projects, published over 160 papers, 70 of which as the first author. The research findings Dr. Jin involved had won the Bronze Prize of Shanghai Science & Technology Progress, Silver Prize of Shanghai Municipal Government Decision-Making Advisory, Bronze Prize of China Hospital Association for Science & Technology Innovation, Bronze Prize of Shanghai Medical Science & Technology Award and Silver Prize of East China Science & Technology Information Achievements, and Award of Excellent Outcomes in Chinese Health Economics Association for many times. 

Abstract:

Statement of the Problem: As a regional medical center in China, medical institutions in Shanghai take a lot of patients from out-of-Shanghai. This external-care-seeking behavior places big and increasing burden on Shanghai’s health care system, considering limited medical resource for local residents and escalating medical expenses. The purposes of this study are to evaluate the impact of external-care-seeking, explore the framework to regulate patients’ seeking doctor behavior and to promote better medical resources allocation. Methodology & Theoretical Orientation: The data was obtained from regular reports of public medical institutions in Shanghai, and patients who seek doctors from out-of-Shanghai residence and local patients were compared in terms of the quantity of service, types of diseases, medical expenses, etc. Findings: On one hand, external-care-seeking has a large quantity, especially in hospitalization. In 2012, the number of discharged population from out-of-Shanghai accounted for 22.74% of the total discharged number, the proportion was even higher than 30% in tertiary hospitals. Tertiary hospitals had a significant attraction effect, concentrating 59.42% of the outpatient and emergency visits and 71.82% of the amount of hospitalization, with corresponding cost of 75.86% and 82.56%. The top three divisions in tertiary hospitals for external-care-seeking were surgical, obstetrics and gynecology, internal medicine. On the other hand, out-of-shanghai patients are conducive to improvement of medical skills the efficiency of health resource. However, the local residents may have less accessibility of high quality of medical service. External-care-seeking will have a more far-reaching impact on the health care system in Shanghai, some interventions should be necessary, including rationally allocating medical resources based on the estimates of external-care-seeking and establishing a medical service supervision mechanism.

Recommendations are made for regulating external-care-seeking.

Biography:

Ms.Farhtheeba Rahat Khan is a development professional with experience backed up by private sector interventions and development sector working realities and challenges. As the lead of ‘Private Sector Health project’, Ms.Khan undertook studies to understand private sector healthcare market dynamics and simultaneously worked on the policy front with Ministry of Health and Family Welfare and its directorates in addressing the supply side issues of healthcare market. She provided technical assistance for formulation of policy framework, guidelines and accreditation systems in the health training, and emphasized on avenues for women employment in the health sector. Currently, Ms.Khan is the Team Leader for the ‘Working with Women’ project implemented by SNV where she is facilitating interventions in garment factories, following a  gender sensitive and gender-specific approach to ensure equity in healthcare service provision for female garment workers.

Abstract:

Statement of the Problem: Bangladesh is the world’s third largest garment producer. An estimated 3,000+ factories currently employ some 4 million workers and 85% of them are women. The industry is the single largest source of employment for 14-35 year old women, largely migrants from rural areas and from disadvantaged backgrounds. These women have limited or almost no access to healthcare. Methodology & Theoretical Orientation: Most workers do not know the importance of sexual and reproductive health. Health issues including malnutrition, communicable diseases, and pregnancy complications, incorrect use of family planning materials, reproductive infections and diseases undermine their productivity. Findings: The incidence of suffering from health issues was found higher among married (66%) workers in comparison to unmarried workers (44%). Elder workers appear to be more prone to SRHR issues than younger workers. Family Planning (31%), MR/Menstrual Hygiene/Abortion/Unwanted pregnancy (24%) and Menstrual Hygiene (19%) were the top-3 SRHR issues. Due to long working hours with little time to spare, and financial constraints a significant portion of the workers are unable to seek healthcare services and commodities from the formal providers. In addition, there is social stigma that hinder them from accessing proper healthcare.89% access pharmacies and unqualified providers.  Illness leads them to loss of paid days. Women report missing up to 4-6 days work a month because of reproductive health issues. In the absence of affordable healthcare services, and no support/subsidy from government, women end up with a huge medical expenditure, which in turn lowers their financial capacity leading to poor living conditions, poverty and affecting women empowerment. Conclusion & Significance: Sustainable healthcare solutions that ensure easily accessible and affordable services for RMG workers need to be established across the sector. And a holistic approach from information to behavioural change towards availing services needs to be in place

Biography:

 

Sung-Yuan Hu has his expertise in internal medicine, emergency & critical care medicine, occupational medicine and toxicology. Dr. Hu is the Director, Division of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan. Poisoning caused by occupational exposures is an uncommon clinical emergency situation. We have a poisoning control center in our hospital and can undertake an immediate response to manage occupational poisoned cases, including decontamination, resuscitation and the use of antidotes. We design a training program, including basic and advanced lectures, for nurses and residents to manage the poisoned cases caused by chemical exposures.

Abstract:

Introduction: Most poisoned cases caused by occupational exposures were accidently due to errors of personal or mechanical operations. Certain poisons, such as cyanide and cyanogenic compounds, caused by occupational exposures may be lethal, but only few antidotes had been used to recuse these occupational workers. Material and Methods: This was a retrospective study of poisoned cases caused by occupational exposures and the use of antidotes between 2007 and 2015 in Division of Clinical Toxicology, Department of Emergency Medicine, Taichung Veterans General Hospital, Taiwan. Results: According to the category of poisons, five index poisoned cases caused by occupational exposures were reviewed, including acrylonitrile, aniline, mercury, 2-chloroethanol and hydrogen fluoride. Routes of exposures and the use of antidotes were reported in poisoned cases. Discussion: In general, management of poisoned cases caused by occupational exposures included decontamination for respiratory tract, skin and mucosa; resuscitation to stabilize poisoned patients with airway protection, oxygen, and fluid; the use of antidotes for specific situations according to the characteristics of occupational poisons. Acute life support was an important issue for all poisoned cases, but only few specific antidotes were undertaken for detoxification through different mechanisms which were described as follows. Sodium nitrite oxidized hemoglobin to methemoglobin which binds the free cyanide and could enhance endothelial cyanide detoxification. Methylene blue converted methemoglobin (Fe³⁺) to hemoglobin (Fe²⁺). DMPS was a chelating agent for chelation of metal ions. Fomepizole was a competitive inhibitor of the alcohol dehydrogenase which is found in the liver. Calcium gluconate rapidly combines with fluoride ion in the tissue. Conclusion: Primary prevention for occupational exposures through education, personal protective equipment and the checkpoint of the environmental safety was recommended. Decontamination, resuscitation and the use of antidotes for specific situations should be undertaken immediately to reduce injury if the occupational exposures occurred.

Biography:

Hui Lin received his master’s degree from Tongji Medical College of Huazhong University of Science and Technology. He has published 6 papers in reputed journals and has been serving as an occupational diseases doctor for 8 years.

Abstract:

Occupational injuries and illness not only threaten worker’s health, but also cause a great deal of loss like sick leave in economy. In this project, we first observed 31.7% workers reported sick leave with losing 3 workdays averagly. Then, we used Logistic Analysis with Backward stepwise method to estimate odds ratios and 95% CI of factors associated with sick leave, and found the possibility for taking sick leave increased in workers with being female, more working hours per week, longer service, higher tress, and younger age. To evaluate the effectiveness of participatory training for sick leave reduction, we led a one-year Randomized Controlled Trial, with 918 and 2,561 workers receiving participatory and didactic training, respectively. Participants were asked to report workdays lost caused by sick leave during the previous 12 months before training and the next 12 months after training. We found that the propotion of workers taking sick leave in the intervention group reduced from 34.5% to 25.2%(P<0.001), and the rate reductions in the control group was not statistically significant. At one-year follow up, the workdays lost in intervention group and control group didn’t reduced significantly. Finally, we developed a method to measure the cost-benefit ratios of the programs and found that the participatory training was more effective in saving cost for sick leave reduction than the didactic training.

Biography:

Amalia Oktaviana is currently pursuing further degree in Master of Science in Occupational Health, Safety, and Environment, University of Birmingham. Her another research about fatigue among shift worker nurses.

Abstract:

Statement of the Problem: In the modern era, company tends to sacrifice their worker’s health aspect to pursue higher productivity by implementing longer work hours and shift works which may lead to fatigue. Research has identified multiple factors contributing to occupational fatigue; however, the differentiate between the acute and chronic fatigue yet is still lacking. the usual mechanism of acute fatigue developed into chronic fatigue properties that are not adaptive still difficult to understand fully. This research aims to study the factors related to acute and chronic fatigue in production and packaging workers of Manufacturing Company X. The studied variables in this research is comprised into individual factors such as age, time to sleep, commuting time, and job factors such as duration, shift work, location of work, and overtime. Methodology & Theoretical Orientation: The Occupational Fatigue Exhaustion Recovery (OFER) scale is used to measure acute and chronic fatigue among 78 workers. This research is a descriptive analytic study using cross sectional study design. Findings: The results showed that the sleep time and commuting time has a significant effect on acute fatigue in workers, while the sleep time and duration of the work has a significant impact on chronic fatigue in workers. Workers who experience high level of acute fatigue and chronic fatigue are 2.6%. Also, moderate recovery rate of 61.5% and a high recovery rate is approximately 34.6%. Conclusion & Significance: Not all job and individual factors are associated with acute and chronic fatigue. In addition, the number of high chronic fatigue is not high because recovery can be achieved well. Strategies that can be done to reduce fatigue complaints can be made through management approaches and approaches

Biography:

Gustina is currently a student of the MSc in Occupational Safety, Health, and the Environment at University of Birmingham, United Kingdom. She has graduated with a BSc in Occupational Safety and Health at Diponegoro University, Indonesia. She has working experiences in Oil and Gas Industry as Health, Safety and Environmental Engineer and Specialist. She was a Process Advisor in Repetitive Stress Injury Prevention and Based-Behavior Safety in the big company in Indonesia. Her passion in Health and Safety field leads herself to conduct the fascinating researches. She believes that her researches can contribute the new knowledge on its fields.

Abstract:

Statement of the Problem: Heat stress in the work environment affects worker’s physical condition; the blood vessel capacity increases and dilates. Also, heat stress can trigger the heart to pump more blood to the skin to release heat. This leads to an increased pulse rate. Furthermore, it affects the evaporation mechanism of the body and causes changes in body temperature and continuous sweating affects the composition of body fluids. The purpose of this study was to determine the differences in pulse, core body temperature, weight of the workers before and after work in the heat stress environment of a Tea filling process at 30.8 degrees Celsius room temperature in average. The design of this study utilized cross-sectional methods. 15 tea workers were samples of a total workforce of 20. The data was analyzed using a Paired t-Test and Wilcoxon Signed Ranked Test. Findings: The results showed that 80% of respondents experienced an increasing of pulse rate, 100% of respondents experienced an increasing of the core body temperature, and 66.7% of respondents experienced weight loss. Conclusion & significant: The results of the Paired t-Test revealed there was a significant difference in pulse rate before and after working in the hot environment (p=0.007), there was also a significant difference in body core temperature before and after work in the hot environment (p=0.001). However, there was no significant difference in weight loss before and after working in the hot environment (p=0.630). Recommendations are to improve the work environment temperature by installation of proper ventilation, to manage the schedule of the workers, to provide drinks for the workers and to provide adequate cool rest facilities for break times.

Biography:

Dr. Deborah Alperovitch-Najenson has her expertise in ergonomics. She lectures Ergonomics in Ben Gurion University of the Negev in the department of Physical Therapy, and in Tel Aviv University in the Department of Environmental and Occupational Health. She does research in the field of Ergonomics and she guides students in their thesis

Abstract:

Background: Health care providers, especially those with direct patient contact, are one of the occupational groups most injured by WRMD. A combination of lifting heavy loads with awkward postures is most hazardous, especially for low back pain. Adjusting the bed, during performance of manual tasks, creates a more erect thus safer for the therapist's lumbar spine.

 

Objectives: To compare adjusted bed height between two passive manual tasks and to find an optimal topographic location to rely on when adjusting bed height.

 

Design: Cross-sectional study.

 

Methods: Eighty physical therapy students performed two specific passive movements: shoulder flexion (SF) and straight leg raise of thigh (SLR), each task executed either on a standard bed and an adjustable one. The lumbar angle was measured at the beginning and at the end of each task using a smartphone, which served as an inclinometer. The rate of perceived exertion (RPE) was measured after each task. Distances from anatomical points on the hand and pelvis to the floor were measured.

 

Results. The mean bed height for SF was significantly higher than for the SLR. The third knuckle hand technique and the radial styloid process of the wrist (RSP) were established as the most valuable anthropometric points to rely on when adjusting the bed height. Both tasks had higher RPE rates and the subjects experienced more of a bent back bent when performing the tasks on a standard bed height compared to an adjustable one.

 

Conclusions. Each manual task requires its own bed height adjustment. Moreover, it is essential that any manual task entailing lifting appears to place the therapist at risk for lower back pain as a result of awkward postures. The third knuckle and RSP are recommended as reference points when adjusting the bed height.

Biography:

Ms.Farhtheeba Rahat Khan is a development professional with experience backed up by private sector interventions and development sector working realities and challenges. As the lead of ‘Private Sector Health project’, Ms.Khan undertook studies to understand private sector healthcare market dynamics and simultaneously worked on the policy front with Ministry of Health and Family Welfare and its directorates in addressing the supply side issues of healthcare market. She provided technical assistance for formulation of policy framework, guidelines and accreditation systems in the health training, and emphasized on avenues for women employment in the health sector. Currently, Ms.Khan is the Team Leader for the ‘Working with Women’ project implemented by SNV where she is facilitating interventions in garment factories, following a  gender sensitive and gender-specific approach to ensure equity in healthcare service provision for female garment workers.

 

Abstract:

Statement of the Problem: The normal life a Bangladeshi women garment worker starts at 4am, cooks food in a the common kitchen available for 4-5 families, goes to work at 7am, and has a longer work day till 7pm, then is back to take care of her family and goes to bed between 10-11pm. She has no time of her own, a victim of violence and abuse both in the factory and work, no one to share her pain. Methodology & Theoretical Orientation: A lot of mental distress affect their work life, productivity and end up having a poor quality life. There should be structures within the factory to address this issue. The management should start realizing that when psychosocial challenges and issues go unaddressed, they impact workers’ effectiveness in the work place. Fourteen welfare officers, who are the first contact point for workers in factory, were trained and mentored by certified trainers in counselling; and, 14 trained para-counsellors were institutionalized inside factory from December 2016 Findings: Interestingly, women workers are visiting the counselling center in the factory, on being referred by the para-counsellors. The latest record collected as of 5^th Jan 2017 reflects, 3 women came with anxiety and one of them had 4 sessions with the counsellor for mental relief; 3 women reported work stress and took 3 separate counselling sessions, others include conflict with supervisor, family conflict, financial crisis, relationship issue and the resulted anxiety. Conclusion & Significance: The incidence report within this short duration of less than a month itself is the evidence for counselling need and the vacuum in services. Still, in a factory where 600+ workers are employed this number is just minimal, and the para-professionals have an important role to play to facilitate the workers in identifying such mental health issues and referring them to the counselors.