Improving the Performance in Occupational Health and Safety Management in the Electric Sector: An Integrated Methodology Using Fuzzy Multicriteria Approach

The electric sector is fundamental for the economic and social development of society, impacting on essential aspects such as health, education, employment generation, industrial production, and the provision of various services. In addition to the above, the growing trend in energy consumption worldwide could increase, according to expert estimates, up to 40% by 2030, which in turn increases the efforts of the public and private sector to meet increasing demands and increase access to energy services under requirements of reliability and quality. However, the electricity sector presents challenges and complexities, one of which is the reduction of health and safety risks for workers, service users, and other stakeholders. In many countries, this sector is classified as high risk in occupational safety and health, due to its complexity and the impact of accidents and occupational diseases on the health of workers, in infrastructure, in operating costs and competitiveness of the energy sector. Worldwide, there are rigorous regulations for the electricity sector, from local and national government regulations to international standards to guarantee health and safety conditions. However, it is necessary to develop objective and comprehensive methodologies for evaluating occupational safety and health performance that provides solutions for the electricity sector, not only to comply with standards and regulations also as a continuous improvement tool that supports the decision-making processes given the complexity of the industry and the multiple criteria that are taken into account when evaluating and establishing improvement strategies. In scientific literature, different studies focus on the analysis of accident statistics, the factors that affect accidents and occupational diseases, and the risk assessment of the sector. Despite these considerations, studies that focus directly on the development of hybrid methodologies for the evaluation and improvement of performance in occupational safety and health in the electrical sector, under multiple criteria and uncertainty are mostly limited. Therefore, this document presents an integrated methodology for improving the performance in occupational health and safety in the electric sector through the application of two techniques of Multi-criteria Decision Methods (MCDM) uses in environments under uncertainly. First, the fuzzy Analytic Hierarchy Process (FAHP) is applied to estimate the initial relative weights of criteria and sub-criteria. The fuzzy set theory is incorporated to represent the uncertainty of decision-makers’ preferences. Then, the Decision-making Trial and Evaluation Laboratory (DEMATEL) used for evaluating the interrelations and feedback among criteria and sub-criteria. FAHP and DEMATEL are later combined for calculating the final criteria and sub-criteria weights under vagueness and interdependence. Subsequently, we applied the proposed methodology in a company of the energy sector for diagnosis of performance in OHS to establish improvement proposals, the work path, and implementation costs. Finally, we evaluate the impact of the strategies applied in the improvement of the performance of the company

Nutritional therapies for mental disorders

According to the Diagnostic and Statistical Manual of Mental Disorders, 4 out of the 10 leading causes of disability in the US and other developed countries are mental disorders. Major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder (OCD) are among the most common mental disorders that currently plague numerous countries and have varying incidence rates from 26 percent in America to 4 percent in China. Though some of this difference may be attributable to the manner in which individual healthcare providers diagnose mental disorders, this noticeable distribution can be also explained by studies which show that a lack of certain dietary nutrients contribute to the development of mental disorders. Notably, essential vitamins, minerals, and omega-3 fatty acids are often deficient in the general population in America and other developed countries; and are exceptionally deficient in patients suffering from mental disorders. Studies have shown that daily supplements of vital nutrients often effectively reduce patients' symptoms. Supplements that contain amino acids also reduce symptoms, because they are converted to neurotransmitters that alleviate depression and other mental disorders. Based on emerging scientific evidence, this form of nutritional supplement treatment may be appropriate for controlling major depression, bipolar disorder, schizophrenia and anxiety disorders, eating disorders, attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD), addiction, and autism. The aim of this manuscript is to emphasize which dietary supplements can aid the treatment of the four most common mental disorders currently affecting America and other developed countries: major depression, bipolar disorder, schizophrenia, and obsessive compulsive disorder (OCD)

Plasma concentrations of neuroactive steroids before and after electroconvulsive therapy in major depression

There is evidence that both cerebrospinal fluid (CSF) and plasma concentrations of 3 alpha-reduced neuroactive steroids are decreased in major depressive disorder. Successful antidepressant pharmacotherapy, for example, with selective serotonin reuptake inhibitors (SSRIs), over several weeks is accompanied by an increase in CSF and plasma concentrations of these neuroactive steroids. However, no such increase has been observed during nonpharmacological treatments such as partial sleep deprivation or repetitive transcranial magnetic stimulation. In order to investigate whether concentration changes in neuroactive steroids are an important component of clinically effective antidepressant treatment, we examined plasma concentrations of the neuroactive steroids 3 alpha,5 alpha-tetrahydroprogesterone, 3 alpha, 5 beta-tetrahydroprogesterone, 3 beta, 5 alpha-tetrahydroprogesterone, and their precursors progesterone, 5 alpha-dihydroprogesterone, and 5 beta-dihydroprogesterone in 31 pharmacotherapy- resistant depressed in-patients before and after unilateral electroconvulsive therapy (ECT) as a monotherapy over 4 weeks. Samples were quantified for neuroactive steroids by means of a highly sensitive and specific combined gas chromatography/mass spectrometry analysis. In all, 51.6% of the patients were treatment responders. There was no influence of ECT on the plasma concentrations of any neuroactive steroid studied. Moreover, neuroactive steroid levels did not differ between treatment responders and nonresponders. Our study shows that changes in neuroactive steroid plasma levels are not a mandatory factor for successful antidepressant treatment by ECT. Thus, the previously observed changes in plasma concentrations of neuroactive steroids following treatment with antidepressants such as SSRIs more likely reflect distinct pharmacological properties of these compounds rather than clinical improvement

Efficacy of Antimanic Treatments: Meta-analysis of Randomized, Controlled Trials

We conducted meta-analyses of findings from randomized, placebo-controlled, short-term trials for acute mania in manic or mixed states of DSM (III–IV) bipolar I disorder in 56 drug–placebo comparisons of 17 agents from 38 studies involving 10 800 patients. Of drugs tested, 13 (76%) were more effective than placebo: aripiprazole, asenapine, carbamazepine, cariprazine, haloperidol, lithium, olanzapine, paliperdone, quetiapine, risperidone, tamoxifen, valproate, and ziprasidone. Their pooled effect size for mania improvement (Hedges' g in 48 trials) was 0.42 (confidence interval (CI): 0.36–0.48); pooled responder risk ratio (46 trials) was 1.52 (CI: 1.42–1.62); responder rate difference (RD) was 17% (drug: 48%, placebo: 31%), yielding an estimated number-needed-to-treat of 6 (all p<0.0001). In several direct comparisons, responses to various antipsychotics were somewhat greater or more rapid than lithium, valproate, or carbamazepine; lithium did not differ from valproate, nor did second generation antipsychotics differ from haloperidol. Meta-regression associated higher study site counts, as well as subject number with greater placebo (not drug) response; and higher baseline mania score with greater drug (not placebo) response. Most effective agents had moderate effect-sizes (Hedges' g=0.26–0.46); limited data indicated large effect sizes (Hedges' g=0.51–2.32) for: carbamazepine, cariprazine, haloperidol, risperidone, and tamoxifen. The findings support the efficacy of most clinically used antimanic treatments, but encourage more head-to-head studies and development of agents with even greater efficacy