Swan General Ltd (SWAN.mu) listed on the Stock Exchange of Mauritius under the Insurance sector has released it’s 2006 annual report.For more information about Swan General Ltd (SWAN.mu) reports, abridged reports, interim earnings results and earnings presentations, visit the Swan General Ltd (SWAN.mu) company page on AfricanFinancials.Document: Swan General Ltd (SWAN.mu) 2006 annual report.Company ProfileSwan General Limited offers insurance services, including personal and corporate insurance. The company provides services that include life, car, home, health, travel, boat, property and liability, financial lines, motor fleet, marine, and keyman and partnership insurance products, as well as reinsurance services. Swan General Limited also provides loans; education, retirement, and investment plans; wealth management and securities trading services; and pension and actuarial services, pension administration, and investment advisory services. Life, casualty, and property are the segments through which the company conducts its business and is based in Mauritius. Swan General Limited is listed on the Stock Exchange of Mauritius
I’m sure you’ll agree that’s quite the statement from Motley Fool Co-Founder Tom Gardner.But since our US analyst team first recommended shares in this unique tech stock back in 2016, the value has soared.What’s more, we firmly believe there’s still plenty of upside in its future. In fact, even throughout the current coronavirus crisis, its performance has been beating Wall St expectations.And right now, we’re giving you a chance to discover exactly what has got our analysts all fired up about this niche industry phenomenon, in our FREE special report, A Top US Share From The Motley Fool. “This Stock Could Be Like Buying Amazon in 1997” Simply click below to discover how you can take advantage of this. Click here to claim your copy now — and we’ll tell you the name of this Top US Share… free of charge! It’s no surprise that Bakkavor’s (LSE: BAKK) share price has plunged in recent months. The UK’s largest supplier of ready meals and food-to-go had been on a steady path pre Covid-19, maintaining its underlying profitability and successfully protecting its EBITDA margins despite difficult market conditions – notably low consumer confidence and labour inflation. Importantly, prior to Covid-19, IGD had predicted that the food-to-go market would grow by more than 26% in value between 2019 and 2024 in the UK due to changing consumer patterns that will still exist post lockdown.Bakkavor, which has also expanded into the US and Chinese markets, was forced to temporarily close two factories and put all non-essential capital investment and discretionary expenditure on hold. However, it has been able to operate with significant headroom during this extremely turbulent time. What’s more, it hasn’t had to turn to government funding.5G is here – and shares of this ‘sleeping giant’ could be a great way for you to potentially profit!According to one leading industry firm, the 5G boom could create a global industry worth US$12.3 TRILLION out of thin air…And if you click here we’ll show you something that could be key to unlocking 5G’s full potential…So why do I think Bakkavor is a cheap UK share?The FTSE 250 company’s fortunes are looking up as the lockdown restrictions are eased across the globe. In Bakkavor’s own words, “sales volumes in all three regions have stabilised and are showing early signs of recovery”.Bakkavor’s UK like-for-like sales, which were down 19% in April, were only down 13% in May and like-for-like sales for the five months ending in May were only down 5% against last year’s. This is promising given the company generates 88% of its revenue on home turf. In addition, a further recovery is anticipated as footfall will increase in the coming weeks as high streets reopen. This ought to create a greater demand for food-to-go items.Looking abroad to China and the USA, a recovery is commencing. This international segment of the company had just started to benefit from recent capital investments. It had experienced a healthy 16% revenue growth in the 2019 financial year against a modest like-for-like 0.2% in the UK.Despite Chinese operations being severely impacted towards the end of January through the beginning of April, sales volumes have stabilised since. This is thanks to restrictions on movement being lifted, while the majority of restaurants and stores are now open.With the western world being a couple months behind, Bakkavor has focused its efforts in the USA on reducing capacity to adapt to the lower demand. As a result of it doing this quickly and efficiently, it has been able to limit the financial impact. With the US releasing lockdown, Bakkavor will be expecting an increase in demand, which is why I view it as a cheap UK share right now!Worth investing in?Bakkavor’s shares are currently trading at 80p, exactly half the 12-month high of £1.60. The shares have a historic adjusted P/E ratio of just 6.2x and a historic yield of 5%. Although the company is suspending dividends at present, this does indicate the prospective yield potential once the business recovers from Covid-19.In the long term, this cheap UK share still has a very bright future. I believe it’s worth investing in while it is still at that 50% discount! Enter Your Email Address Image source: Getty Images. Anastasia Hale has no position in any of the shares mentioned. The Motley Fool UK has no position in any of the shares mentioned. Views expressed on the companies mentioned in this article are those of the writer and therefore may differ from the official recommendations we make in our subscription services such as Share Advisor, Hidden Winners and Pro. Here at The Motley Fool we believe that considering a diverse range of insights makes us better investors. This cheap UK share looks oversold to me Anastasia Hale | Wednesday, 17th June, 2020 | More on: BAKK I would like to receive emails from you about product information and offers from The Fool and its business partners. Each of these emails will provide a link to unsubscribe from future emails. More information about how The Fool collects, stores, and handles personal data is available in its Privacy Statement. Renowned stock-picker Mark Rogers and his analyst team at The Motley Fool UK have named 6 shares that they believe UK investors should consider buying NOW.So if you’re looking for more stock ideas to try and best position your portfolio today, then it might be a good day for you. Because we’re offering a full 33% off your first year of membership to our flagship share-tipping service, backed by our ‘no quibbles’ 30-day subscription fee refund guarantee. Our 6 ‘Best Buys Now’ Shares See all posts by Anastasia Hale
LATEST RUGBY WORLD MAGAZINE SUBSCRIPTION DEALS Following the pre-sale period between March 15 and April 5, general sale for the City and Follow my Team tickets open. Operating on a first come first serve basis, general sale opens at 5pm GMT on April 6.Individual match tickets aren’t available until 2022.Related: Rugby World Cup 2023 Pool DrawWorld Rugby Chairman, Sir Bill Beaumont said: “Rugby World Cup France 2023 will showcase the best of rugby and the best of France. We are delighted to launch the tournament’s ticketing programme. Our ambition is to make France 2023 the most accessible tournament to date. This ticketing programme certainly does that. Everyone is invited to join a special celebration of France and 200 years of rugby.”France 2023 Organising Committee CEO, Claude Atcher added: “With our ticketing programme, we want to make Rugby World Cup 2023 as accessible as possible for everyone. We want to provide the opportunity for fans to attend matches from the best 20 rugby nations in the world. Rugby World Cup France 2023 is also the promise of an incredible show with an unprecedented match schedule format. We look forward to celebrating and sharing moments in our nine host cities with fans from all over the world.” Rugby World Cup 2023 tickets on saleTickets for the 2023 Rugby World Cup hosted in France go on pre-sale on March 15 at 11am GMT, with 2.6 million tickets are available for the tenth edition of the tournament.The first phase of ticket sales requires fans to register for the 2023 Family by 22:59 GMT on March 13. Running until April 5, fans can buy one of two ticket packages in the pre-sale period: the Follow my Team pack, or City pack.Related: Rugby World Cup 2023 ExtendedThe Follow my Team package enables a fan to attend all four pool matches of an already qualified team, with the option of tickets to the quarter-final, should they progress to that stage.Conversely, the City package enables a fan to attend at least three pool matches in one of the nine host cities. Unfortunately, the Stade de France is excluded from the City package. Each city will include a compulsory fixture as part of the City package, with the remaining options free to choose.Tickets for the opening fixture of the 2023 Rugby World Cup between France and New Zealand, on 8 September 2023, are also exempt from both package deals.There are four different price categories for the event. For example, fans can watch three matches in Toulouse from €58 in category four, including New Zealand and Japan. Similarly, the Lille pack features three matches including England, Scotland and France for €70. 2.6 million tickets are available for the France 2023 Rugby World Cup (Getty Images) The first sale of tickets for the 2023 Rugby World Cup in France go on sale March 15. Can’t get to the shops? Download the digital edition of Rugby World straight to your tablet. Subscribe to the print edition for magazine delivery to your door.Follow Rugby World on Facebook, Instagram and Twitter.
TAGSCVS NewsVolunteering Previous articleThe Apopka news year in review: City Council votes to modify medical marijuana banNext articleWhy does using a period in a text message make you sound insincere or angry? Denise Connell RELATED ARTICLESMORE FROM AUTHOR Support conservation and fish with NEW Florida specialty license plate Free webinar for job seekers on best interview answers, hosted by Goodwill June 11 LEAVE A REPLY Cancel reply The importance of volunteering in the communityVolunteering connects you to othersOne of the better-known benefits of volunteering is the impact on the community. Unpaid volunteers are often the glue that holds a community together. Volunteering allows you to connect to your community and make it a better place. However, volunteering is a two-way street, and it can benefit you and your family as much as the cause you choose to help. Dedicating your time as a volunteer helps you make new friends, expand your network, and boost your social skills.Volunteering as a familyWhile it might be a challenge to coordinate everyone’s schedules, volunteering as a family has many worthwhile benefits. Children watch everything you do. By giving back to the community, you show them firsthand how volunteering makes a difference and how good it feels to help others and enact change. It’s also a valuable way for you to get to know organizations in the community and find resources and activities for your children and family.I have limited mobility—can I still volunteer?Whether due to a lack of transportation, time constraints, a disability or other reasons, many people prefer to volunteer via phone or computer. There are many projects where you can help. Writing and graphic design lends itself to working at home, and in today’s digital age many organizations might also need help with email and websites.If you think home-based volunteering might be right for you, contact organizations you like and ask what some of the possibilities might be. Some volunteer organizations may require you to attend an initial training or periodical meetings. You also want to make sure that you are getting enough social contact, and that the organization is available to support you should you have questions.Volunteering: The happiness effectHelping others kindles happiness, as many studies have demonstrated. When researchers at the London School of Economics examined the relationship between volunteering and measures of happiness in a large group of American adults, they found the more people volunteered, the happier they were, according to a study in Social Science and Medicine. Compared with people who never volunteered, the odds of being “very happy” rose 7% among those who volunteer monthly and 12% for people who volunteer every two to four weeks. Among weekly volunteers, 16% felt very happy—a hike in happiness comparable to having an income of $75,000–$100,000 versus $20,000, say the researchers. Giving time to religious organizations had the greatest impact.Volunteering can advance your careerIf you’re considering a new career, volunteering can help you get experience in your area of interest and meet people in the field. Even if you’re not planning on changing careers, volunteering gives you the opportunity to practice important skills used in the workplace, such as teamwork, communication, problem-solving, project planning, task management, and organization. You might feel more comfortable stretching your wings at work once you’ve honed these skills in a volunteer position first.Volunteering can provide career experienceVolunteering offers you the chance to try out a new career without making a long-term commitment. It is also a great way to gain experience in a new field. In some fields, you can volunteer directly at an organization that does the kind of work you’re interested in. For example, if you’re interested in nursing, you could volunteer at a hospital or a nursing home. Your volunteer work might also expose you to professional organizations or internships that could be of benefit to your career.Volunteering can teach you valuable job skillsJust because volunteer work is unpaid does not mean the skills you learn are basic. Many volunteering opportunities provide extensive training. For example, you could become an experienced crisis counselor while volunteering for a women’s shelter or a knowledgeable art historian while donating your time as a museum docent.Volunteering can also help you build upon skills you already have and use them to benefit the greater community. For instance, if you hold a successful sales position, you raise awareness for your favorite cause as a volunteer advocate, while further developing and improving your public speaking, communication, and marketing skills.Volunteering brings fun and fulfillment to your lifeVolunteering is a fun and easy way to explore your interests and passions. Doing volunteer work you find meaningful and interesting can be a relaxing, energizing escape from your day-to-day routine of work, school, or family commitments. Volunteering also provides you with renewed creativity, motivation, and vision that can carry over into your personal and professional life.Many people volunteer in order to make time for hobbies outside of work as well. For instance, if you have a desk job and long to spend time outdoors, you might consider volunteering to help plant a community garden, lead local hikes, or help at a children’s camp.Consider your goals and interestsYou will have a richer and more enjoyable volunteering experience if you first take some time to identify your goals and interests. Start by thinking about why you want to volunteer. Also, think about what you would enjoy doing. Volunteer opportunities that match both your goals and your interests are most likely to be fun and fulfilling for you.Source: HELPGIDE.org Please enter your name here Share on Facebook Tweet on Twitter Save my name, email, and website in this browser for the next time I comment. You have entered an incorrect email address! 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The Anatomy of Fear By Bert Cregg, Michigan State UniversityEnvironmentally conscious consumers often ask me whether a real Christmas tree or an artificial one is the more sustainable choice. As a horticulture and forestry researcher, I know this question is also a concern for the Christmas tree industry, which is wary of losing market share to artificial trees.And they have good reason: Of the 48.5 million Christmas trees Americans purchased in 2017, 45 percent were artificial, and that share is growing. Many factors can influence this choice, but the bottom line is that both real and artificial Christmas trees have negligible environmental impacts. Which option “wins” in terms of carbon footprint depends entirely on assumptions about how long consumers would keep an artificial tree versus how far they would drive each year to purchase a real tree.From seedling to wood chipperMany consumers believe real Christmas trees are harvested from wild forest stands and that this process contributes to deforestation. In fact, the vast majority of Christmas trees are grown on farms for that express purpose.To estimate the total impact of something like a Christmas tree, researchers use a method called life cycle assessment to develop a “cradle to grave” accounting of inputs and outputs required to produce, use and dispose of it. For natural Christmas trees, this covers everything from planting seedlings to harvesting the trees and disposing of them, including equipment use, fertilizer and pesticide applications, and water consumption for irrigation.Life cycle assessments often will also estimate a system’s carbon footprint. Fuel use is the biggest source of greenhouse gas emissions in Christmas tree production. Using 1 gallon of gas or diesel to power a tractor or delivery truck releases 20 to 22 pounds (9 to 10 kilograms) of carbon dioxide into the atmosphere.On the positive side, Christmas trees absorb and store carbon from the atmosphere as they grow, which helps to offset emissions from operations. Carbon represents about 50 percent of the dry weight of the wood in a tree at harvest. According to recent estimates, Christmas tree-sized conifers store roughly 20 pounds of carbon dioxide in their above-ground tissue and likely store similar amounts below ground in their roots.Christmas tree farming requires careful planning to manage a crop that takes six to seven years to mature.However, using 1 gallon of gasoline produces about the same amount of carbon dioxide, so if a family drives 10 miles each way to get their real tree, they likely have already offset the carbon sequestered by the tree. Buying a tree closer to home or at a tree lot along your daily commute can reduce or eliminate this impact.And natural trees have other impacts. In 2009, Scientific American specifically called out the Christmas tree industry for greenwashing, because growers’ press releases touted carbon uptake from Christmas tree plantations while ignoring pesticide use and carbon dioxide emissions from plantation management, harvesting and shipping.Is synthetic better?Artificial trees have a different set of impacts. Although many people think shipping trees from factories in China takes a lot of energy, ocean shipping is actually very efficient. The largest energy use in artificial trees is in manufacturing.Producing the polyvinyl chloride and metals that are used to make artificial trees generates greenhouse gas emissions and other pollutants. China is working to reduce pollution from its chemical industry, but this may drive up the prices of those materials and the goods made from them.Moreover, to consider sustainability from a broader perspective, production of real Christmas trees supports local communities and economies in the United States, whereas purchasing artificial trees principally supports manufacturers in China.Artificial trees require assembly, but no watering and little cleanup. They also can be reused year after year.Sean Locke Photography/Shutterstock.comGoing head to headRecently the American Christmas Tree Association, which represents artificial tree manufacturers, commissioned a life cycle assessment comparing real and artificial Christmas trees. The analysis considered environmental aspects of sustainability, but did not examine social or economic impacts.The report concluded that the environmental ‘break-even’ point between a real Christmas tree and an artificial tree was 4.7 years. In other words, consumers would need to keep artificial trees for five years to offset the environmental impact of purchasing a real tree each year.One major shortcoming of this analysis was that it ignored the contribution of tree roots – which farmers typically leave in the ground after harvest – to soil carbon storage. This omission could have a significant impact on the break-even analysis, given that increasing soil organic matter by just one percent can sequester 11,600 pounds of carbon per acre.Reuse or recycle your treeConsumers can’t affect how farmers grow their live trees or how manufacturers produce artificial versions, but they can control what happens after Christmas to the trees they purchase. For artificial trees, that means reusing them as many times as possible. For natural trees, it means recycling them.This is essential to optimize the carbon footprint of a real tree. Grinding used Christmas trees and using them for mulch returns organic matter to the soil, and can contribute to building soil carbon. Many public works departments across the United States routinely collect and chip used Christmas trees after the holidays. If local tree recycling is not available, trees can be chipped and added to compost piles. They also can be placed in backyards or ponds to provide bird or fish habitat.In contrast, if a used tree is tossed into a bonfire, all of its carbon content is immediately returned to the air as carbon dioxide. This also applies to culled trees on tree farms. And if used trees are placed in landfills, their carbon content will ultimately return to atmosphere as methane because of the way materials buried in landfills break down. Methane is a greenhouse gas 21 times more potent than carbon dioxide over a century, so this is the most environmentally harmful way to dispose of a used tree.All kinds of factors influence choices about Christmas trees, from fresh trees’ scent to family traditions, travel plans and the desire to support farmers or buy locally. Regardless of your choice, the key to relieving environmental angst is planning to reuse or recycle your tree. Then you can focus on gifts to put under it.This article is republished from The Conversation. You have entered an incorrect email address! Please enter your email address here Free webinar for job seekers on best interview answers, hosted by Goodwill June 11 Share on Facebook Tweet on Twitter Please enter your comment! LEAVE A REPLY Cancel reply Support conservation and fish with NEW Florida specialty license plate Save my name, email, and website in this browser for the next time I comment. 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KSA (Katherine Spitz Associates Inc.) Projects Area: 45095 m² Year Completion year of this architecture project South Korea Ananti Penthouse Seoul / Ken Min Architects Photographs ShareFacebookTwitterPinterestWhatsappMailOrhttps://www.archdaily.com/918032/ananti-penthouse-seoul-ken-min-architects Clipboard Save this picture!© Ananti+ 25Curated by Clara Ott Share Design Team:Cho Pyungjae, Han Hyunsoo, Roh Hyungyu, Moon Kyungmin, Lee Chulmin, Ryu Hyeonsu, Lee Seungjune, Yoo Seungbum, Lee Heegeun, Kim Kwangil, Ahn SehoClients:AnantiEngineering:Mac EngMechanical Consultancy:Jusung Eng.Electrical Consultancy:Nara Eng.City:Gapyeong-gunCountry:South KoreaMore SpecsLess SpecsSave this picture!© Namgoong SunRecommended ProductsDoorsLinvisibileLinvisibile Curved Hinged Door | AlbaLightsVibiaCeiling Lights – BIGDoorsRabel Aluminium SystemsMinimal Sliding Door – Rabel 62 Slim Super ThermalDoorsAir-LuxPivoting DoorText description provided by the architects. The Ananti Penthouse Seoul sits adjacent to the Ananti Club Seoul in Gapyeong, Gyeonggi-do. It is located in a region densely populated by a 100-year-old pine forest. I focused particularly on taking advantage of the elevation of the slope to suit the brief I was given while ensuring the natural environment was respected. To maximize the benefits of the sloping landscape the mass of terraced housing was created at a setback of 2.4m, syncing with the shape of the land and ensuring that each unit was formed in harmony with the scale of the complex as a whole.Save this picture!© Namgoong SunSave this picture!Site PlanSave this picture!© AnantiIn addition to presenting a new lifestyle, we also planned a number of unique spatial sequences for those visiting the Ananti Penthouse Seoul. Cracks in the mass allow the gaze to travel across the landscape, and diverse activities were arranged between these spaces. We also made bold investments to introduce eco-friendly facilities and energy systems, making environmentally friendly and positive structures that are in harmony with nature.Save this picture!© Shin KyungsubThrough a partnership with Imtech, a German facility design firm and one of the most environmentally friendly in the world, we designed machine equipment to maximize the flow of energy by quantifying and charting the operating conditions of the resorts and the physical conditions of the land, ranging from precipitation, wind direction, air volume, seasonal temperature/humidity change, sunshine, terrestrial heat, to the amount and the velocity of valley water.Save this picture!© Kim SungjinThanks to this facility, anyone staying at this resort can enjoy the fresh air by simply opening a window. We managed to minimize the use of fossil fuels by adopting four-season cycles where the remaining heat from summer is used during the winter, and the cold air in the winter can, in turn, be used during the summer as well as making use of eco-friendly resources such as geothermal heat, solar heat, air heat, and waterpower (using a minimal amount of water).Save this picture!© Kim SungjinSave this picture!SectionSave this picture!© Namgoong SunProject gallerySee allShow lessBridge House / BIO-architectsSelected ProjectsThe Peach Garden / UPASelected ProjectsProject locationAddress:1007-90 Yumyeong-ro, Seorak-myeon, Gapyeong-gun, Gyeonggi-do, South KoreaLocation to be used only as a reference. It could indicate city/country but not exact address. Share “COPY” Architects: SKM Architects Area Area of this architecture project Ananti Penthouse Seoul / Ken Min ArchitectsSave this projectSaveAnanti Penthouse Seoul / Ken Min Architects Lead Architects: Year: Landscape: ArchDaily 2016 Ken Sungjin Min Photographs: Ananti, Namgoong Sun, Shin Kyungsub, Kim Sungjin Hospitality Architecture “COPY” ShareFacebookTwitterPinterestWhatsappMailOrhttps://www.archdaily.com/918032/ananti-penthouse-seoul-ken-min-architects Clipboard CopyHospitality Architecture, Penthouse•Gapyeong-gun, South Korea CopyAbout this officeSKM ArchitectsOfficeFollowProductConcrete#TagsProjectsBuilt ProjectsSelected ProjectsHospitality ArchitectureResidential ArchitectureHousingPenthouseGapyeong-gunSouth KoreaPublished on May 31, 2019Cite: “Ananti Penthouse Seoul / Ken Min Architects” 31 May 2019. ArchDaily. Accessed 11 Jun 2021.
Michigan supporters of Workers World Party presidential candidate Monica Moorehead and vice presidential candidate Lamont Lilly recently learned that the two have achieved official write-in candidate status in the state. That means that the state is legally obligated to tally every vote for these two revolutionary socialists.Getting official status involved locating a supporter in each of 14 congressional districts who would go on record as an “elector” for Moorehead and Lilly. On Sept. 9, a delegation from Detroit Workers World Party and Fight Imperialism Stand Together accompanied Moorehead to Lansing, the state capital, to file the necessary paperwork.Speaking in Detroit on Sept. 10, Moorehead pointed out that “Detroit has a proud place in African-American history, as exemplified by the role of African-American workers — many communists and socialists — in the forming of the UAW [United Auto Workers union], particularly at Ford.”Michigan workers, especially workers of color, have a high stake in the fight against capitalism. As Moorehead further elaborated, “Capitalist hi-tech, low-pay restructuring resulted in layoffs of tens of thousands of good paying jobs for Black workers in disproportionate numbers. The entire inner city of Detroit has been made expendable by the bosses and especially the banks. … Detroit and similar cities like Flint, Benton Harbor, Muskegon, Saginaw and Pontiac are owed reparations to help rebuild their cities under control of the workers and community united, void of police terror.”FacebookTwitterWhatsAppEmailPrintMoreShare thisFacebookTwitterWhatsAppEmailPrintMoreShare this
More Cool Stuff 12 recommended0 commentsShareShareTweetSharePin it First Heatwave Expected Next Week Top of the News Name (required) Mail (required) (not be published) Website Make a comment Your email address will not be published. Required fields are marked * Herbeauty6 Lies You Should Stop Telling Yourself Right NowHerbeautyHerbeautyHerbeautyNutritional Strategies To Ease AnxietyHerbeautyHerbeautyHerbeautyYou Can’t Go Past Our Healthy Quick RecipesHerbeautyHerbeautyHerbeauty10 Instagram Girls Women Obsess OverHerbeautyHerbeautyHerbeautyStop Eating Read Meat (Before It’s Too Late)HerbeautyHerbeautyHerbeautyTiger Woods’ Ex Wife Found A New Love PartnerHerbeautyHerbeauty EVENTS & ENTERTAINMENT | FOOD & DRINK | THE ARTS | REAL ESTATE | HOME & GARDEN | WELLNESS | SOCIAL SCENE | GETAWAYS | PARENTS & KIDS Pasadena’s ‘626 Day’ Aims to Celebrate City, Boost Local Economy faithfernandez More » ShareTweetShare on Google+Pin on PinterestSend with WhatsApp,Virtual Schools PasadenaHomes Solve Community/Gov/Pub SafetyPASADENA EVENTS & ACTIVITIES CALENDARClick here for Movie Showtimes Get our daily Pasadena newspaper in your email box. Free.Get all the latest Pasadena news, more than 10 fresh stories daily, 7 days a week at 7 a.m. Pasadena Will Allow Vaccinated People to Go Without Masks in Most Settings Starting on Tuesday Community News Sermons and Lessons Video: “Taking Your Place in Love’s Kingdom” Delivered by REV. ED BACON, ALL SAINTS CHURCH, PASADENA Published on Thursday, May 9, 2013 | 12:47 pm This sermon was delivered by Rev. Ed Bacon, Rector of All Saints Church, Pasadena on Sunday, May 5, 2013. Bacon has been the rector of All Saints Church since 1995. During his tenure All Saints has continued its reputation for energetic worship, a radically inclusive spirit, and a progressive peace and justice agenda.Under Edâ€™s leadership All Saints has created New Vision Partners, a non-profit resource center to create innovative, collaborative partnerships for 21st century social action and urban ministry with interfaith colleagues, and Transformational Journeys, physical journeys of faith which transform participants through challenging encounters with other local and global communities.All Saints Church, 132 N. Euclid Avenue, Pasadena, (626) 796-1172 or visit www.allsaints-pas.org. Subscribe Business News Community News Home of the Week: Unique Pasadena Home Located on Madeline Drive, Pasadena
CPD: Occupational health’s role in managing lumbar disc prolapseA prolapsed lumbar disc can cause intense pain, numbness and tingling through the hips, buttocks, legs and feet, affecting mobility… Work-related upper limb disorders can have a significant impact on the workplace, with women over the age of 45 at higher risk. But, with early intervention and appropriate occupational health and employer support, they can be managed and, as Victoria Keenan and Anne Harriss show, an employee may make a full recovery.This article explores the management referral of a 57-year-old woman employed as a hospital administrator.Diane (a pseudonym) was referred by her line manager for an occupational health (OH) opinion as a result of experiencing pain in her right wrist and forearm which were associated with a repetitive wrist movements which forms a work-related upper limb disorder (WRULD).About the authorsVictoria Keenan is an occupational health nurse and Anne Harriss is professor in occupational healthWRULDs can have a significant impact on the workplace. In the UK in 2016/17 three million working days were lost because of WRULD. Females above the age of 45 are at higher risk of developing a work-related upper limb disorder than those under the age of 45 (HSE, 2017).The condition Diane described is sometimes referred to as repetitive strain injury (RSI), a descriptive term for an overuse injury (Clarke, 2018). For a number of years RSI has been considered to be an inappropriate term. Aw et al (2007) note a lack of evidence supporting the term injury, and static muscle loading rather than repetitive movements may cause the disorder. Although repetitive movements led to Diane’s symptoms the term WRULD will be used within this case study.WRULDs can involve joints, muscles, ligaments, tendons, nerves or other soft tissues with symptoms affecting the neck, shoulders, arms, wrists, hands and fingers. It is an umbrella term for a range of conditions, including tenosynovitis, De Quervain’s tenosynovitis, carpal tunnel syndrome, epicondylitis and peritendinitis crepitans (NHS Choices, 2016).Each of which is associated with repetitive tasks and can be caused or exacerbated by work; prolonged or excessive force; uncomfortable working positions; carrying out tasks without suitable rest breaks and poor working environment (HSE, 2013). Micro-trauma occurs with resultant tenderness, aches and pain, stiffness, weakness, cramp, numbness and swelling (HSE, 2013). All or some of these symptoms may be present and they may be chronic, acute or recurrent (Aw et al, 2007).Whenever muscles or tendons are over used, micro-tears can occur in the tissue leading to local inflammation as the body attempts to repair the damage. Thickening and scar tissue form over-damaged tissues and pain results. Normally, the body would repair the damage and the pain would resolve. However, with insufficient rest, tissues do not repair resulting in further damage (Clarke, 2018).Nerve compression causing tingling in the hands is a feature of WRULDs. Damaged nerves can heal, but it can be an extremely slow process. Most cases of WRULDs involve the nerves running from the neck, down the arms, and into the wrists and hands. These nerves pass by other structures, most notably the discs and facet joints in the neck, and if they become damaged or tight, then the nerves cannot move freely in the arm. If these tight structures are then used repetitively they become sore and inflamed (Clarke, 2018).Early intervention is key to a full recovery when recognising and treating WRULD (HSE, 2013). When acute it is relatively simple to assess and treat successfully, but not so when it develops into a chronic condition and this may lead to sufferers eventually developing a chronic pain syndrome affecting many aspects of their life. Recommended treatment options include analgesia, soft tissue massage, physiotherapy, wearing a brace or support and TENS therapy (NHS Choices, 2016).Fitness to work framework and biopsychosocial flagsThornbory (2013) highlights the role of the occupational health nurse (OHN) in case management is to assess a client’s fitness to work, so that beneficial advice and information can be given to both client and employer. A fitness to work framework can be used as a consistent, transparent method of assessing a client’s fitness to work. This case was managed using the fitness to work framework of Murugiah et al (2002) and the bio-psychosocial model of case management (Vivian, 2014).The framework of Murugiah et al (2002) focuses on four specific areas: the personal aspect, legal aspects, the characteristic of work tasks, and the characteristics of the work environment. The personal aspects focus on the client assessment, is individual to the client and based around their work role (Murugiah et al, 2002). The assessment considers past occupations, skill levels, work technique and ability viewed in the light of the medical history.Lifestyle factors impacting on the client’s work performance should also be explored. As illnesses and injuries may have psychological effects individual, their psychological state should also be addressed (Murugiah et al, 2002).The legal aspects of the Murugiah framework relate to the duties of employers to their employees as required by the Health and Safety at Work etc. Act (1974) and the Equality Act (2010) and the advice given by the OHN must be based on sound legal principles (Murugiah et al, 2002).In terms of the characteristics of work, OHNs require a thorough knowledge of the job specification and the client’s required skill-set. The employee’s symptoms and health should be viewed in the light of their job role. Factors for consideration include job demand, the specific type, intensity, duration and schedule (Murugiah et al, 2002).The workplace environment relates to environmental risks that may affect those with an illness or disability. Although able-bodied individuals may be able to undertake a task without issue, those returning to work following illness or impairment may pose a hazard to themselves or others.The holistic biopsychosocial approach to assessing clients and flag system was used in the assessment as these flags can help identify barriers to work (Vivian, 2014). Each flag represents a different element: red flags focusing on biological issues; yellow with psychological factors; blue with social factors; and black with factors outside the client’s control, such as financial issues.Schultz, et al (2012) highlight symptoms of WRULD can be persistent affecting many aspects of the individual’s life; therefore it is important to carry out a holistic assessment to provide an effective management plan.The assessmentAt the beginning of the appointment the OHN introduced herself and explained the referral process. Diane gave written consent to participate in this assessment and for a report to be sent to her manager. The Data Protection Act requires that consent is obtained before personal information is collected.Diane confirmed understanding the reason for her manager’s referral and of the referral process clarified. In line with requirements of the Nursing and Midwifery Council (NMC, 2015) the consultation was confidential and it was confirmed that the response to management would only be shared with Diane and her manager who might subsequently share it with HR. Diane confirmed her readiness to proceed.The manager’s referral confirmed Diane’s consent to the referral and included a brief outline of her job description. Her manager posed specific questions regarding how her condition affected her work role and whether any adjustments would support her in the workplace.Diane had been employed as a clinical administrator for the past five years, working 37.5 hours a week from 9am to 5pm. Her main duties involved typing reports that had been dictated by medical staff, emailing and using the telephone. Approximately five hours of her working day involved using a keyboard and mouse. She could take a 10-minute break in the morning and afternoon and a 30-minute lunch break.Diane had worked in various administrative roles involving typing and paperwork since the age of 17. Details of her past medical history and any medication she was taking were recorded. She disclosed two well-managed conditions: hypercholesterolemia treated with Simvastatin, and asthma, requiring the occasional use of Salbutamol inhalers.Diane reported no previous history of musculoskeletal conditions but described experiencing symptoms consistent with WRULD for the past three months, including pain in her wrist and arm with occasional tingling and numbness in her hand and fingers.She self-managed her symptoms using over-the-counter analgesia. Her symptoms were increasing in frequency and severity and she treatment from her GP who prescribed stronger analgesia and referred her for nerve conduction studies to exclude carpal tunnel syndrome. Test results were negative and the consultant considered her symptoms resulted from acute WRULD. Although not having taken any sickness absence she had disclosed her condition to her manager who then made the OH referral.Diane’s symptoms occurred predominantly when undertaking keyboard and mouse-focused tasks for long periods. She experienced discomfort when holding the telephone handset and lifting heavy boxes of files. Symptoms occurred at home when lifting shopping bags, her young grandson or pursuing her hobby of cross-stitch. Despite wearing a wrist support whilst at work and self-treating with analgesia, her symptoms had not improved.A social history was taken as part of the assessment. Diane lived with her husband. Her two adult children lived nearby and she occasionally cared for her three-year-old grandson. She drank two to three glasses of wine at weekends and was a non-smoker. She was fairly active, walking her dog and swimming for exercise. However, the pain she experienced had recently prevented her from swimming and precluded her continuing her hobby of needlework.Diane was asked about her daily living activities, including dressing, and domestic tasks such as cooking. She reported being independent with most of these tasks but had noticed an exacerbation of symptoms if she vacuumed or ironed for long periods and she experienced difficulties lifting heavy saucepans in her right hand whilst cooking.Her husband assisted her with some domestic tasks including carrying heavy items. Diane described the impact of her symptoms on her daily activities and highlighted that this was affecting her mood. Analgesia and the use of a wrist support had been ineffective for symptom reduction.Red flags for Diane were the impact of work tasks that might have contributed to the symptoms she was experiencing, specifically typing. She used her right hand for most of her work tasks, including the use of the telephone, keyboard and mouse and had experienced pain in her right wrist and forearm for the past six months.If left to progress this could have significant consequences on her job role. A numerical rating scale was used to determine Diane’s level of pain. She was asked to rate her pain on a scale of 0-10, with 0 meaning no pain at all and 10 being the worst pain they have ever experienced or could imagine (Swift, 2015).Diane described her pain intensity as variable, when not at work her pain level decreased significantly to around 2/10. Following a day at work it could reach 9/10. Specific tasks including typing, and the use of the computer, mouse and telephone triggered symptoms predominantly in the right hand and wrist.Sharp, stabbing painHowever, over the past six weeks it had radiated to the forearm. She described experiencing a constant dull ache developing to a sharp, stabbing pain when typing. She described weakness, numbness and tingling in her fingers. A grip assessment of her right hand performed by the OHN confirmed slightly reduced grip strength compared to her left hand.Diane had initially self-treated her pain with paracetamol although this proved ineffective. She then applied a topical anti-inflammatory gel onto the affected areas with little effect, a treatment option recommended by NHS Choices (2016).The yellow flag for Diane was her belief that her symptoms would improve over time with the correct treatment. She had been proactive in trying to self-manage her symptoms and when this was ineffective she had sought treatment by her GP. She was generally feeling positive that her condition would improve but frustrated regarding the impact it was having on her daily living activities, including cleaning and shopping and on her mood. She was also worried of the effect on her job role if her symptoms did not improve soon.Pain can be a barrier to work resulting from low mood, leading to feelings of anxiety or stress. Stress in turn can exacerbate WRULD symptoms because of constant muscle tensing (Devereux et al, 2004). Diane expressed coping well with her low mood because of support from her family and colleagues. She did not appear low in mood during the consultation, maintained good eye contact and engaged well in conversation. She did not participate in any unhealthy coping strategies such as increased alcohol intake or smokingBlue biopsychosocial flags represent social factors impacting work. No social issues impacting on work were disclosed, so there did not appear to be any barriers. Diane enjoyed her role and no conflict issues were evident in the workplace. Black biopsychosocial flags represent financial and legal issues.Diane had not taken any sickness absence from work and was receiving her full salary. She explained that her husband was medically retired making her the sole earner. She was concerned how her condition might impact her financially if her job was affected. Her manager had reassured her that if she did need to be absent then the company sick policy would cover her for a period of time. As Diane was hoping to see an improvement in her symptoms with the correct treatment and workplace adjustments, it was determined that financial issues were not a barrier to her recovery.RecommendationsFollowing the consultation, it was determined that Diane was fit to remain in work with some advice to manage her condition, subject to a display screen equipment (DSE) risk assessment followed by recommendations of workplace adjustments for her manager to consider.The aim of the DSE risk assessment was to discount or rectify poor working positions that may underpin the pain Diane had experienced. Particularly important considerations included her use of arm positions that did not maintain neutral positions and holding items, including the telephone in the same place for a period of time.The assessment took various factors into account, such as the position, height and layout of the workstation and the provision of ergonomic equipment (HSE, 2013). It was suggested Diane might benefit from the use of a wireless vertical mouse, a split keyboard and a screen raiser. Further suggestions included a hands free telephone headset and a new chair which would better support her upper spine.Diane’s job required her to occasionally lift heavy boxes of paperwork that put excessive force on her upper limbs. It was recommended that she avoid carrying out such tasks where possible by reducing the weight of the boxes or delegating such tasks to another colleague. Diane was advised to carry out task rotation where possible taking regular breaks away from her workstation breaking up prolonged work periods involving repetition as repetitive work using the same muscles over and over, is associated with the development of an upper limb disorder (HSE, 2013).An in-house physiotherapy referral was arranged. Diane was shown a series of exercises and provided with an information sheet detailing exercises she could undertake at her desk. Research suggests that regular stretching and exercise can be effective in reducing musculoskeletal discomfort in computer users (Fenety & Walker, 2002). The report that would be sent to her manager was discussed with Diane and a copy retained in her OH records.This case study has explored the OH management referral of an employee with an acute WRULD highlighting the impact on the workplace. A fitness to work framework and biopsychosocial flag system underpinned the holistic assessment of the client.A DSE assessment coupled with task rotation, regular breaks and avoidance of heavy lifting were recommended to her manager. A physiotherapy referral aimed to assist with muscle strengthening exercises. It was decided that a review appointment was unnecessary but her manager could re-refer her should her condition deteriorate or there were workplace concerns.These workplace adjustments, along with appropriate medical and physiotherapy treatment, were successful in Diane’s full recovery.ReferencesReferencesAw, T C, Gardiner, K, Harrington, J M, Whitaker, S, Jackson, C A, Ahmed, S M and Hitchins, J. (2007) Pocket consultant: occupational health. 5th ed. Oxford Blackwell Publishing Ltd.Clarke, A. (2018) Repetitive Strain Injury, Physio Works. Available from: https://physioworks.com.au/injuries-conditions-1/rsi-repetitive-strain-injury/Devereux, J. Rydstedt, L, Kelly, V, Weston, P and Buckle, P. (2004) The role of work stress and psychological factors in the development of musculoskeletal disorders. London: Health and Safety Executive.Fenety, A and Walker, J. (2002) Short-Term Effects of Workstation Exercises on Musculoskeletal Discomfort and Postural Changes in Seated Video Display Unit Workers. Physical Therapy, 82 (6), pp. 578-589.Health and Safety Executive (2013) Managing upper limb disorders in the workplace. Available from: http://www.hse.gov.uk/pubns/indg171.pdfHealth and Safety Executive (2017) Work-related Musculoskeletal Disorders (WRMSDs) Statistics in Great Britain. Available from: http://www.hse.gov.uk/statistics/causdis/musculoskeletal/msd.pdfMurugiah, S, Thornbory, G and Harriss, A. (2002) Assessment of fitness, Personnel Today. Available From: https://www.personneltoday.com/hr/assessment-of-fitness/NHS Choices (2016) Repetitive strain injury (RSI) -Treatment. Available From: http://www.nhs.uk/Conditions/Repetitive-strain-injury/Pages/Treatment.aspxNursing and Midwifery Council (2015). The Code, Professional standards of practice and behaviour for nurses and midwives. Available From: http://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/revised-new-nmc-code.pdfSchultz, G, Mostert, K and Rothmann, I. (2012) Repetitive strain injury among South African Employees: The relationship with burnout and work engagement. International Journal of Industrial Ergonomics, 42 (5), pp. 449-456.Swift, A. (2015) Pain management 3: the importance of assessing pain in adults. Nursing Times, 11 (41), pp. 12-17.Thornbory, G. (2013) Contemporary Occupational Health Nursing. Oxford: Routledge.Vivian, C. (2014) Biopsychosocial incapacity assessments: a survey of occupational physicians’ opinions. Available From: https://academic.oup.com/occmed/article/64/5/337/1437207/Biopsychosocial-incapacity-assessments-a-survey-of CPD: A pain in the wrist – supporting work-related upper limb disorderOn 7 Jun 2019 in Continuing professional development, Musculoskeletal disorders, Respiratory, Return to work and rehabilitation, Occupational Health, Personnel Today No comments yet. Leave a Reply Click here to cancel reply.Comment Name (required) Email (will not be published) (required) Website CPD: Developing a return-to-work strategy for osteoarthritisOsteoarthritis (OA) affects some 10% of men and 18% of women over the age of 60, and can make sitting,… Related posts: Previous Article Next Article