A combined DEMATEL and grey system theory approach for analyzing occupational risks: A case study in Turkish shipbuilding industry

The shipbuilding industry is known as heavy industry because of its high-risk work activities. Therefore, in order to prevent fatal occupational accidents in the shipbuilding industry, the processes of defining hazards, evaluating risks, taking action to eliminate or reduce risks are important issues in risk assessment. This article presents a novel occupational risk-assessment approach, which can help managers of shipbuilding make proper precautions strategies for accidents, to evaluate shipyard Critical Risk Factors and risky shipyard processes/work units. Thus, DEMATEL (Decision Making Trial and Evaluation Laboratory) and Grey system theory approaches are integrated to develop a systematic risk-assessment framework for the shipbuilding industry. This approach was applied to a real case study in a Turkish shipyard. The performance evaluation results have indicated that the combined approach can provide satisfactory risk assessment for occupational risk causes and relevant improvement strategies to prevent accidents. Sensitivity analysis was also conducted on the results to ensure the reliability of solutions. Even though a novel decision support and evaluation approach on risk implementation is introduced for shipbuilding, limitations and concerns are areas for further research opportunities. Further, a sensitivity analysis of results, managerial implications, conclusions, limitations and future research opportunities are provided.     

A Multiple Case Study of Mental Health Interventions in Middle Income Countries: Considering the Science of Delivery

In the debate in global mental health about the most effective models for developing and scaling interventions, there have been calls for the development of a more robust literature regarding the "non-specific", science of delivery aspects of interventions that are locally, contextually, and culturally relevant. This study describes a rigorous, exploratory, qualitative examination of the key, non-specific intervention strategies of a diverse group of five internationally-recognized organizations addressing mental illness in middle income countries (MICs). A triangulated approach to inquiry was used with semi-structured interviews conducted with service recipients, service providers and leaders, and key community partners (N = 159). The interview focus was upon processes of implementation and operation. A grounded theory-informed analysis revealed cross cutting themes of: a holistic conceptualization of mental health problems, an intensive application of principles of leverage and creating the social, cultural, and policy “space” within which interventions could be applied and resourced. These findings aligned with key aspects of systems dynamic theory suggesting that it might be a helpful framework in future studies of mental health service implementation in MICs.     

Indonesia ergonomics roadmap: where we are going?

There are so many definitions for ergonomics terms such as human factors, human factors engineering, human engineering, human factors psychology, engineering psychology, applied ergonomics, occupational ergonomics, industrial ergonomics and industrial engineering. The most inclusive terms are ergonomics and human factors. Both represent the study of work and the interaction between people and their work environmental systems. The main objective is especially fitting with the need to design, develop, implement and evaluate human-machine and environment systems that are productive, comfortable, safe and satisfying to use. The work of the ergonomists in Indonesia--most of them are academicians--have one thing in common, i.e. with the appropriate type of ergonomic approaches to interventions; there would be improvements in productivity, quality of working conditions, occupational safety and health (OSH), costs reduction, better environment, and increase in profits. So many researches, training, seminars and socialization about ergonomics and OSH have been done concerning micro-to-macro themes; but it seems that we are practically still running at the same place up to now. In facts, workers are still working using their traditional or obsolete methods in poor working conditions. Accidents are still happening inside and outside industry with the main root-cause being human "unsafe behavior" and errors. Industrial products cannot compete in the global market, and so many manufacturing industries collapsed or relocated to foreign countries. This paper discusses such a roadmap and review what we ergonomists in Indonesia have done and where we are going to? This review will be treated in the field of ergonomics and OSH to take care the future Indonesia challenges. Some of the challenges faced are care for the workers, care for the people, care for the quality and productivity of work, care for the new advanced technologies, care for the environment, and last but not least care for the nation.     

Reuse of samples: ethical issues encountered by two institutional ethics review committees in Kenya

There is growing concern about the reuse and exploitation of biological materials (human tissues) for use in research worldwide. Most discussions about samples have taken place in developed countries, where genetic manipulation techniques have greatly advanced in recent years. There is very little discussion in developing countries, although collaborative research with institutions from developed countries is on the increase. The study sought to identify and describe ethical issues arising in the storage, reuse and exportation of samples in a developing country. Research protocols presented to two Ethics Review Committees in Kenya during a period of two years were reviewed. A record was made of the protocol title, sample collected, request for storage, reuse or exportation and whether or not subject consent was sought. The findings indicated that about 25% out of the 388 protocols sought permission for reuse and only half of those actually informed subjects of the contemplated re-use. Less than 20% requested storage and again, about half of them sought consent from subjects. There is an indication that investigators do not see the need to seek consent for storage, reuse and exportation of samples. It is proposed that these issues should be addressed through policy interventions at both the national and global levels.     

Manufacturing capacity planning and the value of multi-stage stochastic programming under Markovian demand

Capacity planning is a crucial part of global manufacturing strategies in the automotive industry, especially in the presence of volatile markets with high demand uncertainty. Capacity adjustments in machining intensive areas, e.g. body shop, paint shop, or aggregate machining face lead times exceeding a year, making an elaborated decision support indispensable. In this regard, two-stage stochastic programming is a frequently used framework to support capacity and flexibility decisions under uncertainty. However, it does not anticipate future capacity adjustment opportunities in response to market demand developments. Motivated by empirical findings from the automotive industry, we develop a multi-stage stochastic dynamic programming approach where the evolution of demand is represented by a Markov demand model. An efficient multi-stage solution algorithm is proposed and the benefits compared to a rolling horizon application of a two-stage approach are illustrated for different generic manufacturing networks. Especially network structures with limited flexibility might significantly benefit from applying a multi-stage framework.     

Integrated ergonomics approach toward designing night and shift work in developing countries based on experiences in Bali, Indonesia

Recently, the effort in carrying out an integrated ergonomics approach known as "SHIP" (systemic, holistic, interdisciplinary and participatory) approach has been intensively undertaken in Bali with the aim of sustaining improvements being done. The People's Consultative Assembly of the Republic of Indonesia issued for the 1999-2004 period a "SHIP" Act on the Macro Guidelines of Tourism Development in which ergonomics and other factors must be considered comprehensively to attain sustainable development in tourism. Therefore the night and shift work that is recently increasingly applied in the tourism industry must also be designed and organized through this approach. In fact, however, economic factors have still been the predominant reason for workers to accept any type of night and shift work decided by the management, without taking into account possible impacts and consequences. For example, rapid forward rotation schemes seem more adapted to the hotel industry instead of traditional 6-6-6 rotation. Further, inter-city bus drivers are approved to work a 24-hour shift followed by one day off. These drivers often work an additional risky night shift after two consecutive night shifts so as to meet needed expenses for the family. Cultural or religious activities still presented constraints for workers as they carried out subsequently the night work. Therefore, proactive steps should be taken in a timely manner through the integrated SHIP approach in designing night and shift work so as to achieve work schedules compatible with both social life of shiftworkers and business concerns.     

A forest habitat network for the Atlantic Oakwoods in Highland region,Scotland

Summary

The need to conserve biological diversity and ensure the future viability and integrity of Atlantic oakwoods in a fragmented landscape has led to strategies that facilitate a more holistic view of biodiversity conservation across extensive areas. The Scottish Forestry Strategy contains a major aspiration to develop forest habitat networks through the restoration and improvement of existing woodland and the expansion of new woodland. The Forest Research landscape ecology model BEETLE (Biological and Environmental Evaluation Tools for Landscape Ecology) uses a focal species approach to assess the functional connectivity of habitat within the wider landscape matrix. This model has been used to predict the current habitat network for Atlantic oakwood specialists in the Highland region of Scotland. The analysis outputs are presented with an approach to help practitioners and planners visualise the opportunities to target expansion, conversion or restoration of Atlantic oakwoods and their intrinsic biodiversity.     

An ergonomics process for the care and use of research animals

Personnel who work with laboratory animals incur potential occupational health risks that can lead to the development of musculoskeletal disorders. Demanding manual tasks may also result in increased errors, worker fatigue, poor human performance, and decreased productivity. Studies have shown that a comprehensive ergonomics program that utilizes a systematic risk management approach can reduce the likelihood of exposure to musculoskeletal disorder risk factors and remove barriers to human performance. Research has characterized the risk factors of musculoskeletal disorder exposure in terms of force, frequency, posture, and muscle exertion. Ergonomic risk factors for typical animal handling tasks and work areas are identified, and a method is suggested for prioritizing interventions using interrelated data indicators. An initial review of potential control measures is offered to improve the health, safety, and effectiveness of people involved in the care and use of research animals.     

Future directions in the study of induced plant responses to herbivory

This paper reviews current progress and makes recommendations for future studies of induced plant responses to herbivory in three research areas: the role of induction in structuring herbivore communities, costs associated with the expression of induced responses, and theory and data on the macro‐evolution of induced responses. It is argued that although mechanistic approaches will be important for progress, it is also critical to maintain a holistic approach, including a consideration of field environments, multi‐species interactions, and patterns over ecological and evolutionary time.     

Studying health-seeking behaviours: collecting reliable data, conducting comprehensive analysis

There is certainly a growing need to justify the significance of studying health-seeking behaviours for designing advocacy campaigns, lobbying for a policy shift and convincing donors to invest in priority areas. Moreover, policymakers need to be encouraged to design evidence-based policies that take into account information relating to health-promoting, -seeking and -utilization behaviour and the factors determining these behaviours. This paper primarily covers the 'methodology' used in the study of health-seeking behaviours and determinants of health services utilization in a predominantly rural district of Pakistan. The paper substantiates that this methodology is comprehensive and reliable, and there is potential for replicating this in similar settings. The approach of Kroeger in his research on the study of health-seeking behaviours, particularly in developing countries, provides the most holistic framework for examining, analysing and interpreting factors and determinants of health-seeking behaviours and health services utilization in developing countries. This study endeavoured to validate Kroeger's framework in a Pakistani setting, exploring all the factors listed through mixed method research, and qualitative supplemented by representative quantitative enquiry. This approach has also helped in understanding the inter-relationship of various factors and drivers of health-seeking behaviours from all angles.     

The changing landscape of data monitoring committees—Perspectives from regulators,members, and sponsors

Data Monitoring Committees (DMCs) are an integral part of clinical drug development. Their use has evolved along with changing study designs and regulatory expectations, which has associated statistical and ethical implications. Although there is guidance from the different regulatory agencies, there are opportunities to bring more consistency to address practical issues of establishing and operating a DMC. Challenging issues include defining the scope of DMC decisions, the regulatory requirements and expectations, the perceived independence of DMCs, the specific focus primarily on safety, etc. Wider use of adaptive clinical trial designs in recent years introduce additional challenges in terms of trial governance and the complexity of DMC activities. A panel comprised of clinical and statistical experts from across academia, industry, and regulatory agencies shared their experience and thoughts on the importance of these aspects and offered perspectives on the future of the DMCs. This paper documents the thinking from the panel session at the CEN‐ISBS conference held in Vienna, Austria, 2017.     

21st European Workshop for Rheumatology Research, Vienna, Austria, 1–4 March 2001

Major advances in technology now drive how we approach questions in immunology, particularly in analyzing complex data sets commonly encountered in genomics and proteomics studies. Active areas of investigation include development of novel technologies, identification of elusive target antigens for RA and other diseases, dissection of signaling pathways connecting the lymphocyte cell surface with the nucleus, and exploration of new avenues for therapeutic interventions. The European Workshop for Rheumatology Research (EWRR) is a forum for many European and non-European scientists to present research findings of high quality. Arthritis researchers from around the globe should be strongly encouraged to attend future meetings, the next of which is the 22^nd EWRR meeting in Leiden, the Netherlands, in 2002.     

From Nuremberg to the ethics committees in human experimentation

During the Nuremberg trials, the accusation prompted the creation of an ad hoc committee to advise on human experiments carried out on prisoners during wartime in the USA. Precisely a charge that had been brought against Karl Brandt and his colleagues. This committee was the forerunner of the Independent Committees, to which the Declaration of Helsinki assigned a role in analysing the ethics of research projects in humans. From 1980 onwards, in industrialised countries, the legislation regarding clinical trials began to incorporate similar structures, IRBs in the United States of America, Ethics Committees elsewhere, and the 'Committee for the Protection of Persons" in France. However, at that time, in spite of the misleading words, we went from ethics to law, from rules of conduct intended for researchers to legal regulations organising relations between sponsors, investigators and persons participating in biomedical research, which is not the same thing.     

Using learning networks to understand complex systems: a case study of biological,geophysical and social research in the Amazon

Developing high‐quality scientific research will be most effective if research communities with diverse skills and interests are able to share information and knowledge, are aware of the major challenges across disciplines, and can exploit economies of scale to provide robust answers and better inform policy. We evaluate opportunities and challenges facing the development of a more interactive research environment by developing an interdisciplinary synthesis of research on a single geographic region. We focus on the Amazon as it is of enormous regional and global environmental importance and faces a highly uncertain future. To take stock of existing knowledge and provide a framework for analysis we present a set of mini‐reviews from fourteen different areas of research, encompassing taxonomy, biodiversity, biogeography, vegetation dynamics, landscape ecology, earth‐atmosphere interactions, ecosystem processes, fire, deforestation dynamics, hydrology, hunting, conservation planning, livelihoods, and payments for ecosystem services. Each review highlights the current state of knowledge and identifies research priorities, including major challenges and opportunities. We show that while substantial progress is being made across many areas of scientific research, our understanding of specific issues is often dependent on knowledge from other disciplines. Accelerating the acquisition of reliable and contextualized knowledge about the fate of complex pristine and modified ecosystems is partly dependent on our ability to exploit economies of scale in shared resources and technical expertise, recognise and make explicit interconnections and feedbacks among sub‐disciplines, increase the temporal and spatial scale of existing studies, and improve the dissemination of scientific findings to policy makers and society at large. Enhancing interaction among research efforts is vital if we are to make the most of limited funds and overcome the challenges posed by addressing large‐scale interdisciplinary questions. Bringing together a diverse scientific community with a single geographic focus can help increase awareness of research questions both within and among disciplines, and reveal the opportunities that may exist for advancing acquisition of reliable knowledge. This approach could be useful for a variety of globally important scientific questions.     

Moral residue and health justice for the global south: Addressing past issues through current interventions and research

This paper introduces the concept of moral residue to global health, and shows how its presence undermines crucial interventions and research, especially in the global south. Lingering feelings of anxiety, anger, blame or frustration often exist among local populations, where previous interventions or research have left traces of harm and/or exploitation. The existence of such feelings reflects the presence of moral residue, recognizing the moral experiences of epistemic injustices, which in turn undermines critical interventions and research through outright rejection or passive non‐compliance among affected populations. While such situations have been variously interpreted and relevant strategies developed to address the issues, little to no consideration is made on the implications of moral residue experiences in global health contexts and how to address them. This paper demonstrates the presence of moral residue in global health and proffers an African ethical approach, a harmony framework, for addressing moral residue issues, as part of a holistic approach towards tackling population health crises without compromising health gains for affected populations in the global south.     

Future directions for HIV service delivery research: Research gaps identified through WHO guideline development

Nathan Ford and co-authors discuss the systematic identification of research gaps in improving HIV service delivery.

Summary points

• Improvements in HIV service delivery are key to bringing countries closer to achieving the target of ending AIDS as a public health threat and situating HIV treatment and care as part of universal healthcare coverage.
• The World Health Organization (WHO) guideline development process is recognized as one approach to identifying research gaps. Systematic reviews form the basis of recommendations formulated by an expert guideline development group, which is also tasked to identify research gaps.
• The 2021 WHO HIV Service Delivery Guideline process identified 27 research gaps grouped into 8 areas where more research is needed to support enhancement and implementation of the new recommendations across the cascade of care.
• Areas covered by the WHO Service Delivery Guideline include antiretroviral therapy (ART) initiation outside the health facility, frequency of visits/refills, tracing and reengagement in care, assessing adherence, integration of HIV and sexual and reproductive health services, integration of HIV and diabetes and hypertension care, psychosocial interventions for adolescents, and task sharing of specimen collection and point-of-care testing.
• Key areas identified by the guideline process that could benefit from future research include tools to support ART initiation outside the health facility, outcomes of spacing of clinical visits/drug refills beyond 6 months, tailored support to minimize disengagement and support reengagement along the continuum of care, and accurate, feasible measures of adherence.
• Strategies of integration of HIV and sexual and reproductive health services and hypertension and diabetes care, costs and cost-effectiveness of psychological support interventions, the performance of newer point-of-care technologies by nonlaboratory personnel, and the impact of diagnostic integration across disease types were also identified as key areas that would benefit from future research.

     

Socio-Cultural Aspects of Chagas Disease: A Systematic Review of Qualitative Research

Background

Globally, more than 10 million people are infected with Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into areas where it was previously unknown. Economic, social and cultural factors play a significant role in its presence and perpetuation. This systematic review aims to provide a comprehensive overview of qualitative research on Chagas disease, both in endemic and non-endemic countries.

Methodology/Principal Findings

Searches were carried out in ten databases, and the bibliographies of retrieved studies were examined. Data from thirty-three identified studies were extracted, and findings were analyzed and synthesized along key themes. Themes identified for endemic countries included: socio-structural determinants of Chagas disease; health practices; biomedical conceptions of Chagas disease; patient''s experience; and institutional strategies adopted. Concerning non-endemic countries, identified issues related to access to health services and health seeking.

Conclusions

The emergence and perpetuation of Chagas disease depends largely on socio-cultural aspects influencing health. As most interventions do not address the clinical, environmental, social and cultural aspects jointly, an explicitly multidimensional approach, incorporating the experiences of those affected is a potential tool for the development of long-term successful programs. Further research is needed to evaluate this approach.     

The future of Chagas disease control

In the past 15 years, there have been major advances in the control of Chagas disease in most of the countries endemic for this infection. Attention now turns to the future continuity of surveillance and control interventions - especially in regions where control has been so successful that the epidemiological significance of Chagas disease is in steep decline. The effort and expenditure of the recent past cannot continue indefinitely, but a degree of surveillance and selective intervention will be required because of the risk of new infestations and infections resulting from adventitious silvatic vectors accidentally entering houses. In this review, we summarize the progress of multinational control initiatives against Chagas disease. In addition, we suggest that the most sustainable approach to future surveillance involves both the primary healthcare system and university-based teams, with progressively greater attention given to case detection and treatment. Such an idea is not new, but we believe that it merits extensive discussion because of the different ways that research and health interventions are financed and because of the need to establish clearer reporting links between the research communities and the national health authorities.     

代谢组学技术及其在毒理学研究领域中的应用

代谢组学是近几年发展起来的对某一生物或细胞所有低分子量代谢产物进行定性和定量分析的一门新学科,其研究对象主要是生物体液,研究手段主要是核磁共振和质谱。简要综述了代谢组学的概念、代谢组学在毒理学研究领域中的应用、当前代谢组学研究中存在的问题及今后的发展趋势,并探讨了代谢组学在研究毒物作用机制、药物的临床前安全性评价、确定毒物作用靶器官及器官特异性新的生物标志物中的实际应用。     

Identifying ‘prime suspects’: symbioses and the evolution of multicellularity

The possible involvement of symbioses in the evolution of multicellularity is explored. Evidence is drawn principally from the biology of present day associations of plants and animals with prokaryotes. A particular emphasis is placed on future research opportunities in this area of biology that have been provided by the advent of specific molecular techniques and new model systems. With the application of new approaches that result from these advances, a more holistic understanding of the biology of the coevolved communities, composed of animals or plants and their associated prokaryotes, is within the reach of biologists over the next few decades.