The focus of this investigation was an analysis of the work demands being placed on South African automotive industry workers as there is a recognised problem with regard to the prevalence of musculoskeletal disorders (MSDs). Preliminary work was conducted to highlight the dominant risks and areas which elicited higher numbers of MSDs within the chosen automotive plant. An area of concern was highlighted through medical record analysis and the use of risk assessment tools, thereby prioritising the need for ergonomic intervention. In particular, the effects of varying restricted and overhead work heights on the biomechanical, physiological and psychophysical responses of an individual were investigated. Twenty-eight subjects were required to complete sixteen conditions. The conditions consisted of the adoption of restricted and upright overhead static postures, with half requiring the holding of four kilograms of weight in the hands and the remaining eight conditions having no weight. Testing was carried out using an electromyography unit, ergospirometer and a perceptual Body Discomfort Map and Scale. This involved a habituation and testing session. The results of the testing revealed the biomechanical and physiological responses were dependant on the change in height. Body discomfort was also shown to be variable over the changing height conditions. This indicates that there is a significant effect of height on an individual’s responses during overhead work. The extreme restricted (-200mm and -100mm) and upright (+300mm and +400mm) overhead conditions within this study were limiting, as they elicited the highest muscle activation, physiological responses and body discomfort ratings. Positions that are preferable to adopt, which were identified from the results in this study, indicate conditions closer to head height (0mm and +100mm) were favourable. The results therefore illustrate how awkward working postures during work are likely to elicit higher demands from an individual, which could lead to an increased risk for the development of a musculoskeletal disorder. The added factor of weight elicited significant results over all variables, excluding a respiratory The focus of this investigation was an analysis of the work demands being placed on South African automotive industry workers as there is a recognised problem with regard to the prevalence of musculoskeletal disorders (MSDs). Preliminary work was conducted to highlight the dominant risks and areas which elicited higher numbers of MSDs within the chosen automotive plant. An area of concern was highlighted through medical record analysis and the use of risk assessment tools, thereby prioritising the need for ergonomic intervention. In particular, the effects of varying restricted and overhead work heights on the biomechanical, physiological and psychophysical responses of an individual were investigated. Twenty-eight subjects were required to complete sixteen conditions. The conditions consisted of the adoption of restricted and upright overhead static postures, with half requiring the holding of four kilograms of weight in the hands and the remaining eight conditions having no weight. Testing was carried out using an electromyography unit, ergospirometer and a perceptual Body Discomfort Map and Scale. This involved a habituation and testing session. The results of the testing revealed the biomechanical and physiological responses were dependant on the change in height. Body discomfort was also shown to be variable over the changing height conditions. This indicates that there is a significant effect of height on an individual’s responses during overhead work. The extreme restricted (-200mm and -100mm) and upright (+300mm and +400mm) overhead conditions within this study were limiting, as they elicited the highest muscle activation, physiological responses and body discomfort ratings. Positions that are preferable to adopt, which were identified from the results in this study, indicate conditions closer to head height (0mm and +100mm) were favourable. The results therefore illustrate how awkward working postures during work are likely to elicit higher demands from an individual, which could lead to an increased risk for the development of a musculoskeletal disorder. The added factor of weight elicited significant results over all variables, excluding a respiratory individual.

Depuis l’apparition du CHSCT en 1982, la représentation élue du personnel a connu de profondes évolutions. Délégués du personnel, comités d’entreprise et CHSCT ont dû s’adapter à la considérable extension des notions de santé et de sécurité. L’intégration de l’impératif de protection de la santé mentale des travailleurs dans le Code du travail a bouleversé le champ de compétences du CHSCT. La prévention des risques psycho-sociaux s’est rapidement invitée au centre de ses préoccupations, élargissant d’autant l’obligation de consultation mise à la charge de l’employeur. Des projets et mesures qui initialement nécessitaient la seule consultation du comité d’entreprise doivent dorénavant être également soumis à l’avis du CHSCT. Dans cette procédure de double consultation l’employeur est guidé par le principe de spécialité qui transforme le comité d’entreprise en simple chambre d’enregistrement des avis de l’instance spécialisée. De l’expansion du CHSCT naissent redondances et lourdeurs. Une réforme doit être envisagée. Transformation de l’instance spécialisée en commission du comité d’entreprise ou redistribution des compétences de chacun : l’alternative offerte impose la discussion. / Since the emergence of the CHSCT (health, safety and working conditions committee) in 1982, the elected representation of employees has profoundly changed. Employee representatives, works councils and the CHSCT have had to adapt to the considerable extension of the concepts of health and safety. The integration of the requirement to protect the mental health of workers in the Labour Code has radically altered the scope of competence of the CHSCT. The prevention of psychosocial risks quickly invited itself as the centre of its concerns, thereby extending the consultation obligation borne by the employer. Projects and measures that initially only required the consultation of the works council are now also subject to the prior opinion of the CHSCT. In this procedure of double consultation the employer is guided by the principle of specialty that turns the works council in a mere rubber stamp of the opinion of the specialized committee. The expansion of the CHSCT has caused reiterations and cumbersomeness. A reform must be considered. Transformation of the specialized body in a committee of the works council or redistribution of powers of each : the alternative offered requires discussion.

Chemical (gaseous) emissions from wastewater treatment plants (WWTP) are perceived as odour and can generate undesirable health reactions. These could affect the quality of life to those regularly albeit intermittently exposed, although regular exposure may result in tolerance and loss of recognition of the odour. Consequently, research is necessary to establish the role of Environmental Impact Assessment (EIA) in ensuring that facilities such as WWTP do not pose a threat to local communities, particularly in relation to housing developments for poor communities. The aim of this study was to investigate if the EIA regulations were effectively implemented before building of the Residential Development Proiect (RDP) houses at KwaMathukuza, in Newcastle South Africa. Furthermore, the study intended to determine the impact the (WWTP) has on the health of people who reside close to the site and to establish if the families staying close to the WWTP have any common ailments such as handicapped babies, early deaths within families. Findings would also indicate if RDP houses should be built in close proximity to such sites. Data was collected through a survey of 85 residents living within five kilometers and ten residing beyond five kilometers from the WWTP. The participants were selected randomly. Municipality employees who worked with the WWTP were also sampled together with healthcare givers. Data included information about health of the community, their perception of the gases released from the WWTP as well as EIA meetings and processes related to the construction of the RDP houses. The outcome of this study revealed that EIA regulations were not adequately implemented and that this residential site was unsuitable for the construction of RDP houses. It emerged that the residence regularly experience unpleasant odours released from the WWTP. These could be associated with ill-health of the residents as well as v degradation the environment in general. The study also found that the effect of the WWTP affects even those communities who reside beyond five kilometers from the WWTP. The researcher argues for more stringent mechanisms to ensure that EIA regulations are properly implemented to prevent adverse effects on the communities. / Environmental Sciences / M. Sc. (Environmental Management)

A random sample of 365 students attending a university in northern Texas returned a mailed questionnaire measuring the students' knowledge of Acquired Immuno-Deficiency Syndrome (AIDS), their perceived susceptibility to AIDS, and their sexual practices during the last year. The students had high knowledge levels about AIDS in general. However, 70% did not worry about getting AIDS. Collectively, there was a display of concern until it became a personal issue. The students (59%) saw themselves as less likely than most people to get AIDS. Although 70% of this sexually active group did not use condoms, they still did not perceive themselves as susceptible to AIDS.

MPH / Department of Public Health / Background: Climate change is a universal public health problem that affects developed and developing countries including South Africa. This environmental hazard causes damage of properties, injuries and death. In most cases, survivors experience psychosocial problems such as depression, anger and isolation after flood because of climate change. Purpose: The purpose of the study was to determine health effects of climate change at Ga- Mashamothane village, Fetakgomo Tubatse Municipality, South Africa. Methodology: A quantitative approach using cross-sectional descriptive design was used in this study. A sample of 352 households has been selected from the target population by means of simple random sampling. Self-administered questionnaires with closed-ended questions were administered to respondents between the age of 18 years and above who met the inclusion criteria. Permission to conduct the study was obtained from the Ethics Committee of the University of Venda. Data were analysed using Statistical Package for Social Science (SPSS version 25) and presented in the form of tables, charts and graphs. Chi-square was used to test significant relationship between heavy rainfall and injuries, and between drought and malnutrition. Results: Three hundred and fifty-two (352) questionnaires were distributed to respondents and 258 questionnaires were satisfactorily completed and returned. The findings of the study showed that 177 (68.6%) of the respondents were male and 81 (31.4%) of the respondents were females. The results indicated that heavy rainfall and injuries statistically are significantly correlated (P-value =0.000). There was positive relationship between heavy rainfall and injuries, as majority of the respondents 242 (93.8%) sustained injuries after experiencing heavy rainfall. The results of the study indicated that drought and malnutrition statistically are significantly correlated (P-value =0.000). There was positive relationship between drought and malnutrition, as majority of respondents 225 (87.2%) suffered from malnutrition during drought. Conclusions: The study found that there is association between heavy rainfall and injuries and there is association between drought and malnutrition. Recommendations: There is a need of collaboration of several stakeholders such as local municipality, Department of Health, Department of Agriculture, Department of Labour and department of Basic Education to come up with strategies to protect people’s lives. / HWSETA

Firewood is a dominant household fuel type used in many developing countries. Even in countries where there is improved access to electricity, most households still rely on firewood for their energy needs. Harvesting of some wood is illegal, however the high poverty rate, absence of alternative fuels and lack of law enforcement means even the protected wood species will continue to be used, with consequent pressure on the forests. Furthermore, the combustion of firewood for domestic use takes place in poorly ventilated homes emitting hazardous pollutants, which causes indoor air pollution and affect human health. The use of firewood as a household fuel can be superimposed nearly perfectly on that of socioeconomic development. Additionally, the use of household firewood is invariably associated with poverty in countries, in communities within a country and in households within a community. Indoor air pollution studies on human health should then consider socio-economic factors which seem to be one of the determinants of both firewood use and ill health, a determinant which is often neglected in most indoor air pollution studies. Domestic inhalation of firewood smoke is one of the mechanisms linking socio-economic (poverty) to disease. The current study sought to determine a baseline of wood usage and health risks caused by volatile organic compounds in Senwabarwana villages. This study integrated observations, ethnobotanical meta-analysis and experimental into one comprehensive integrated environmental health risk assessment framework to assess the risks associated with exposure to volatile organic compounds from firewood combustion. Basic information about firewood usage, socio-economic dynamics and perceived health problems related to volatile organic compounds was collected using a structured questionnaire. The Vac-U-Chamber was used to sample the air. The results show that firewood is extensively used in poorly ventilated kitchens for cooking and home heating in Senwabarwana villages. Ten priority firewood plant species are frequently used in the study area, namely Mohweleri (Combretum apiculatum), Moretshe (Dichrostachys cinera), Motswiri (Combretum imberbe), Mokgwa (Acacia burkei), Mushu (Acacia tortilis), Motshe (Cussonia paniculate), Mokata (Combretum hereroense), Mphata (Lonchocarpus capassa), Mokgalo (Ziziphus mucronate) and Mogwana (Grewia monticola), in their order of preference. The results also indicated thirteen common reasons or factors that influence the hoice of firewood plant species by households, the main four being: (i) the embers formed during combustion, (ii) heat value, (iii) low ash content and (iv) availability of the firewood plant species. Further analysis revealed several uses and ranking thereof, including reviewing the national status and legal profile of each identified plant species. The study found that most of the firewood species used in Senwabarwana Village were indigenous. Major drivers of firewood use are household income, educational status of breadwinners, family sizes, and place of residence, fuel affordability and accessibility, among others. Concentrations of benzene, toluene, ethylbenzene and xylene per plant species were studied to assess the risk exposed to the Senwabarwana community. Literature indicates that these pollutants have several health effects associated with acute exposure such as eye, nose and throat irritation, headaches, dizziness, nausea and vomiting. Both hazard quotient and hazard index were found to be less than one indicating no risk exists with the use of plant species used for firewood in Senwabarwana even to sensitive individuals. The risk of developing health effects due to the presence of the studied volatile organic compounds can be assessed as negligible. Since firewood is a more convenient source of energy, it is recommended that the size of the windows be extended for ventilation. Agroforesty should also be implemented as a conservation method. The wood that emits less concentration of pollutants be used for firemaking. / Environmental Sciences

While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy Families Oregon (HS/HFO) home visitation program (treatment group) who completed a follow-up phone survey at the child’s 12 month birthday (n = 405). Families were offered HS/HFO services prenatally after meeting risk screening eligibility criteria on the New Baby Questionnaire (NBQ). Program mothers having received at least one home visit (n = 248) were included in the final analyses. Families had an average of 3.1 (SD = 1.2) NBQ risk factors at enrollment and 83% reported having trouble paying for basic needs. Families received an average of 16 home visits in the first 6 months of the program. Thirty-one percent of mothers were aged 19 or younger, 60% were White and Non-Hispanic, 31% were Hispanic, and 9% were another race/ethnicity. Hierarchical regression models with main effects (RFI, PFI, race) and an interaction term (RFI X PFI) were developed to predict eight outcomes. Interaction effects models were not significant. Five RFI main effects were significant: higher RFI scores were associated with greater likelihood of child welfare involvement, greater parenting stress, less favorable scores on child health and well-being, lower parent responsiveness and ii acceptance, and less supportive learning environments. One PFI main effect was significant: higher PFI scores predicted lower parenting stress. A trend level result showed higher PFI scores were associated with less child welfare involvement. Race was significant in two models: White/Non-Hispanic families were more likely to have a home visitor report child welfare involvement and had more frequent parent-child activities compared to other race/ethnicity families. Unpacking the results with separate single risk factor (12 items) and protective factor (10 items) regression models followed. Results showed parent’s prior family history of maltreatment and younger maternal age predicted child welfare involvement (home visitor report), while protection was seen for those with access to housing support. Social support and family functioning protectors were linked to lower parenting stress, while maternal depression showed the opposite finding. Better scores on a child health and well-being measure were seen with higher neighborhood cohesion and greater participation in HS/HFO; in contrast, neighborhood violence and frequent mobility were linked to worse scores. Developmentally supportive home environments were seen for families participating in additional parent support programs, in which the mother had greater knowledge of infant milestones and behavior, and if the family had access to housing supports. Unemployment proved to be associated with less enriched home environments. In summary, there was no support for the cumulative PFI in buffering risk for negative outcomes in this model. The RFI was also a more robust predictor of outcomes compared to the PFI in the main effects models. Overall, study findings provide some evidence for the utility of specific protective factors, as well as cumulative and specific single risk factors, for screening families for effectively targeting services and guiding the conceptual development of program and evaluation formats.

Indiana University-Purdue University Indianapolis (IUPUI) / Children's and adolescents' capacity to provide valid informed consent is one of the key ethical concerns in pediatric research, and the focus of this project. The original contribution to knowledge is the advancement of both conceptual and empirical bioethical approaches to research with vulnerable populations. First, a review of adolescent vulnerability is presented to highlight the complex interplay between capacity and other forms of vulnerability. This review is offered as an interdisciplinary analysis to better understand why the study of vulnerable populations is critical to the ethical advancement of clinical research. Results from this analysis suggest the need for enhanced screening techniques as well as the utilization of specialized staff to identify and reduce the impact of different forms of vulnerability. The primary tasks of the empirical portion of the dissertation were to: (1) Adapt a validated adult competency assessment tool for clinical research, the MacArthur Competency Assessment Tool for Clinical Research, to assess the capacity of children and adolescents to consent to clinical research; (2) Identify predictors that impact children and adolescents’ capacity to provide consent to clinical research; and (3) assess differences and similarities in capacity between healthy and chronically ill children and adolescents. Overall results suggest adolescent capacity to consent to research was similar to adults, and most strongly associated with their family's socioeconomic status as well as their level of health literacy. These findings contrast starkly with the age-based criterion for providing consent currently utilized in assent and consent determinations. These findings also provide insights into ways to ethically involve youth in complex biomedical research.

Parents make decisions on behalf of their children on a daily basis. Some parents in the United States face the unique decision of whether or not to allow football participation for their child at a very young age. Using sensemaking theory, I examined how parents assessed the risks involved in making the decision to allow their child to play tackle football. I interviewed 24 participants in the form of 12 parental couples who had children playing middle school football and coded their responses to identify themes and strategies for risk assessment. Themes that emerged were decision-agency (parent and child agency), risk assessment (downplaying risk, acknowledgement of risk with rationalizations, zero risk assessment), and decision-making concepts (cultural influence, familial identity, social influences, information sources). I expanded on the sensemaking supposition of individual identity by arguing that familial identity can also impact decision-making. A key finding to this study was the typology of parents that emerged including football families-parent agency, hesitant family- parent agency, and child focused family-child agency. The type of family reflected families' reception to community culture, impact of social influence, and openness to information sources. Family type also impacted the risk assessment process and belief of control over outcomes in football participation.

Indiana University-Purdue University Indianapolis (IUPUI) / During a 2011 summer dominated by headlines about an earthquake and a hurricane along the East Coast, extreme heat that silently killed scores of Americans largely went unnoticed by the media and public. However, despite a violent spasm of tornadic activity that claimed over 500 lives during the spring of the same year, heat-related mortality annually ranks as the top cause of death incident to weather. Two major data groups used in researching vulnerability to extreme heat events (EHE) include socioeconomic indicators of risk and factors incident to urban living environments. Socioeconomic determinants such as household income levels, age, race, and others can be analyzed in a geographic information system (GIS) when formatted as vector data, while environmental factors such as land surface temperature are often measured via raster data retrieved from satellite sensors. The current research sought to combine the insights of both types of data in a comprehensive examination of heat susceptibility using knowledge-based classification. The use of knowledge classifiers is a non-parametric approach to research involving the creation of decision trees that seek to classify units of analysis by whether they meet specific rules defining the phenomenon being studied. In this extreme heat vulnerability study, data relevant to the deadly July 1995 heat wave in Chicago’s Cook County was incorporated into decision trees for 13 different experimental conditions. Populations vulnerable to heat were identified in five of the 13 conditions, with predominantly low-income African-American communities being particularly at-risk. Implications for the results of this study are given, along with direction for future research in the area of extreme heat event vulnerability.