Search results for: adaptation policies

Authors: Nilam Bano, Uzma Iram

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Globally, the dilemma of undernutrition has become a notable concern for the researchers, academicians, and policymakers because of its severe consequences for many centuries. The nutritional deficiencies create hurdles for the people to achieve goals related to live a better lifestyle. Not only at micro level but also at the macro level, the consequences of undernutrition affect the economic progress of the country. The initial five years of a child’s life are considered critical for the physical growth and brain development. In this regard, children require special care and good quality food (nutrient intake) to fulfill their nutritional demand of the growing body. Having the sensitive stature and health, children specially under the age of 5 years are more vulnerable to the poor economic, housing, environmental and other social conditions. Beside confronting economic challenges and political upheavals, Pakistan is also going through from a rough patch in the context of social development. Majority of the children are facing serious health problems in the absence of required nutrition. The complexity of this issue is getting severe day by day and specially children are left behind with different type of immune problems and vitamins and mineral deficiencies. It is noted that children from the well-off background are less likely affected by the undernutrition. In order to underline this issue, the present study aims to highlight the existing nutritional inequalities among the children of under five years in Pakistan. Moreover, this study strives to decompose those factors that severely affect the existing nutritional inequality and standing in the queue to capture the consideration of concerned authorities. Pakistan Demographic and Health Survey 2012-13 was employed to assess the relevant indicators of undernutrition such as stunting, wasting, underweight and associated socioeconomic factors. The objectives were executed through the utilization of the relevant empirical techniques. Concentration indices were constructed to measure the nutritional inequalities by utilizing three measures of undernutrition; stunting, wasting and underweight. In addition to it, the decomposition analysis following the logistic regression was made to unfold the determinants that severely affect the nutritional inequalities. The negative values of concentration indices illustrate that children from the marginalized background are affected by the undernutrition more than their counterparts who belong from rich households. Furthermore, the result of decomposition analysis indicates that child age, size of a child at birth, wealth index, household size, parents’ education, mother’s health and place of residence are the most contributing factors in the prevalence of existing nutritional inequalities. Considering the result of the study, it is suggested to the policymakers to design policies in a way so that the health sector of Pakistan can stimulate in a productive manner. Increasing the number of effective health awareness programs for mothers would create a notable difference. Moreover, the education of the parents must be concerned by the policymakers as it has a significant association with the present research in terms of eradicating the nutritional inequalities among children.

Keywords: concentration index, decomposition analysis, inequalities, undernutrition, Pakistan

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Authors: Jasna Milošević Đorđević, Jelisaveta Blagojević, Jovana Timotijević, Alison Mckinley

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Young people in Serbia, have grown up in turbulent times during the Balkan wars, in a cultural and economic isolation without adequate education on (ethnic, gender, social,..) equality. They often have very strong patriarchal gender stereotypes. The perception of gender in Serbia is still heavily influenced by traditional worldview and young people have little opportunity in traditional educational system to challenge it, receiving no formal sex education. Educational policies have addressed achieving gender equality as one of the goals, supporting all young people to gain better educational opportunities, but there are obvious shortcomings of the official education system in implementation of those goals. Therefore new approaches should be implemented. We evaluate the impact of non traditional approach, such as participatory theatre performance with strong transformative potential, especially in relation to gender issues. Theatre based intervention (TBI) was created to provoke the young people to become aware of their gender constructs. Engaging young people in modern form of education such as transformative gender intervention through participatory theatre could have positive impact on their sex knowledge and understanding gender roles. The transformative process in TBI happens on two levels – the affective and the cognitive. The founding agency of the project and evaluation is IPPF. The most important aim of this survey is evaluation of the transformative TBI, as a new educational approach related to better understanding gender as social construct. To reach this goal, we have measured attitude change in three indicators: a) gender identity/ perception of feminine identity, perception of masculine identity, importance of gender for personal identity, b) gender roles on the labor market, c) Gender equality in partnership & sexual behavior. Our main hypothesis is that participatory theatre-based intervention can have a transformational potential in challenging traditional gender knowledge and attitudes among youth in Serbia. To evaluate the impact of TB intervention, we implement: online baseline and end-line survey with nonparticipants of the TBI on the representative sample in targeted towns (control group). Additionally we conducted testing the experimental group twice: pretest at the beginning of each TBI and post testing of participants after the play. A sample of 500 respondents aged 18-30 years, from 9 towns in Serbia responded to online questionnaire in September 2017, in a baseline research. Pre and post measurement of all tested variables among participants in nine towns would be performed. End-line survey with 500 respondents would be conducted at the end of the project (early year 2018). After the first TBI (60 participants) no impact was detected on measured indicators: perception of desirable characteristics of man F(1,59)= 1.291, p=.260; perception of desirable characteristics of women F(1,55)=1.386, p= .244; gender identity importance F(1,63)= .050, p=.824; sex related behavior F(1,61)=1,145, p=.289; gender equality on labor market F(1,63)=.076, p=.783; gender equality in partnership F(1,61)=.201, p=.656; However, we hope that following intervention would bring more data showing that participatory theatre intervention explaining gender as a social construct could have additional positive impact in traditional educational system.

Keywords: educational impact, gender identity, gender role, participatory theatre based intervention

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Authors: Muhammad Waqas Baqai, Noman Shahzad, Rehman Alvi

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Communication among health care givers is the essence of quality patient care and any compromise results in errors and inefficiency leading to cumbersome outcomes. The use of smartphone among health professionals has increased tremendously. Almost every health professional carries it and majority of them uses a third party communication software called whatsApp for work related communications. It gives instant access to the person responsible for any particular query and therefore helps in efficient and timely decision making. It is also an easy way of sharing medical documents, multimedia and provides platform for consensual decision making through group discussions. However clinical communication through whatsApp has some demerits too including reduction in verbal communication, worsening professional relations, unprofessional behavior, risk of confidentiality breach and threats from cyber-attacks. On the other hand the traditional pager device being used in many health care systems is a unidirectional communication that lacks the ability to convey any information other than the number to which the receiver has to respond. Our study focused on these two widely used modalities of communication among doctors of the largest tertiary care center of Pakistan i.e. The Aga Khan University Hospital. Our aim was to note which modality is considered better and has fewer threats to medical data. Approval from ethical review committee of the institute was taken prior to conduction of this study. We submitted an online survey form to all the interns and residents working at our institute and collected their response in a month’s time. 162 submissions were recorded and analyzed using descriptive statistics. Only 20% of them were comfortable with using pagers exclusively, 52% with whatsApp and 28% with both. 65% think that whatsApp is time-saving and quicker than pager. 54% of them considered whatsApp to be causing nuisance from work related notifications in their off-work hours. 60% think that they are more likely to miss information through pager system because of the unidirectional nature. Almost all (96%) of residents and interns found whatsApp to be useful in terms of saving information for future reference. For urgent issues, majority (70%) preferred pager over whatsApp and also pager was considered more valid in terms of hospital policies and legal issues. Among major advantages of whatsApp as listed by them were; easy mass communication, sharing of clinical pictures, universal access and no need of carrying additional device. However the major drawback of using whatsApp for clinical communication that everyone shared was threat to patients’ confidentiality as clinicians usually share pictures of wounds, clinical documents etc. Lastly we asked them if they think there is a need of a separate application for instant communication dedicated to clinical communication only and 90% responded positively. Therefore, we concluded that both modalities have their merits and demerits but the greatest drawback with whatsApp is the risk of breach in patients’ confidentiality and off-work disturbance. Hence, we recommend a more secure, institute-run application for all intra hospital communications where they can share documents, pictures etc. easily under a controlled environment.

Keywords: WhatsApp, pager, clinical communication, confidentiality

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Authors: Henok Biruk Alemayehu, Kalkidan Berhane Tsegaye, Fozia Seid Ali, Nebiyat Feleke Adimassu, Getasew Alemu Mersha

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Background: Strabismus is a visual disorder where the eyes are misaligned and point in different directions. Untreated strabismus can lead to amblyopia, loss of binocular vision, and social stigma due to its appearance. Since it is assumed that knowledge is pertinent for early screening and prevention of strabismus, the main objective of this study was to assess knowledge and attitudes toward strabismus in Woreta town, Northwest Ethiopia. Providing data in this area is important for planning health policies. Methods: A community-based cross-sectional study was done in Woreta town from April–May 2020. The sample size was determined using a single population proportion formula by taking a 50% proportion of good knowledge, 95% confidence level, 5% margin of errors, and 10% non- response rate. Accordingly, the final computed sample size was 424. All four kebeles were included in the study. There were 42,595 people in total, with 39,684 adults and 9229 house holds. A sample fraction ’’k’’ was obtained by dividing the number of the household by the calculated sample size of 424. Systematic random sampling with proportional allocation was used to select the participating households with a sampling fraction (K) of 21 i.e. each household was approached in every 21 households included in the study. One individual was selected ran- domly from each household with more than one adult, using the lottery method to obtain a final sample size. The data was collected through a face-to-face interview with a pretested and semi-structured questionnaire which was translated from English to Amharic and back to English to maintain its consistency. Data were entered using epi-data version 3.1, then processed and analyzed via SPSS version- 20. Descriptive and analytical statistics were employed to summarize the data. A p-value of less than 0.05 was used to declare statistical significance. Result: A total of 401 individuals aged over 18 years participated, with a response rate of 94.5%. Of those who responded, 56.6% were males. Of all the participants, 36.9% were illiterate. The proportion of people with poor knowledge of strabismus was 45.1%. It was shown that 53.9% of the respondents had a favorable attitude. Older age, higher educational level, having a history of eye examination, and a having a family history of strabismus were significantly associated with good knowledge of strabismus. A higher educational level, older age, and hearing about strabismus were significantly associated with a favorable attitude toward strabismus. Conclusion and recommendation: The proportion of good knowledge and favorable attitude towards strabismus were lower than previously reported in Gondar City, Northwest Ethiopia. There is a need to provide health education and promotion campaigns on strabismus to the community: what strabismus is, its’ possible treatments and the need to bring children to the eye care center for early diagnosis and treatment. it advocate for prospective research endeavors to employ qualitative study design.Additionally, it suggest the exploration of studies that investigate causal-effect relationship.

Keywords: strabismus, knowledge, attitude, Woreta

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Authors: Ruth Shapira

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Introduction: The rapid urbanization of the last century confronts planners, regulatory bodies, developers and most of all – the public with seemingly unsolved conflicts regarding values, capital, and wellbeing of the built and un-built urban space. This is reflected in the quality of the urban form and life which has known no significant progress in the last 2-3 decades despite the on-growing urban population. It is the objective of this paper to analyze some of these fundamental issues through the case study of a relatively small town in the center of Israel (Kiryat-Ono, 100,000 inhabitants), unfold the deep structure of qualities versus disruptors, present some cure that we have developed to bridge over and humbly suggest a practice that may be generic for similar cases. Basic Methodologies: The OBJECT, the town of Kiryat Ono, shall be experimented upon in a series of four action processes: De-composition, Re-composition, the Centering process and, finally, Controlled Structural Disintegration. Each stage will be based on facts, analysis of previous multidisciplinary interventions on various layers – and the inevitable reaction of the OBJECT, leading to the conclusion based on innovative theoretical and practical methods that we have developed and that we believe are proper for the open ended network, setting the rules for the contemporary urban society to cluster by. The Study: Kiryat Ono, was founded 70 years ago as an agricultural settlement and rapidly turned into an urban entity. In spite the massive intensification, the original DNA of the old small town was still deeply embedded, mostly in the quality of the public space and in the sense of clustered communities. In the past 20 years, the recent demand for housing has been addressed to on the national level with recent master plans and urban regeneration policies mostly encouraging individual economic initiatives. Unfortunately, due to the obsolete existing planning platform the present urban renewal is characterized by pressure of developers, a dramatic change in building scale and widespread disintegration of the existing urban and social tissue. Our office was commissioned to conceptualize two master plans for the two contradictory processes of Kiryat Ono’s future: intensification and conservation. Following a comprehensive investigation into the deep structures and qualities of the existing town, we developed a new vocabulary of conservation terms thus redefying the sense of PLACE. The main challenge was to create master plans that should offer a regulatory basis to the accelerated and sporadic development providing for the public good and preserving the characteristics of the PLACE consisting of a tool box of design guidelines that will have the ability to reorganize space along the time axis in a coherent way. In Conclusion: The system of rules that we have developed can generate endless possible patterns making sure that at each implementation fragment an event is created, and a better place is revealed. It takes time and perseverance but it seems to be the way to provide a healthy framework for the accelerated urbanization of our chaotic present.

Keywords: housing, architecture, urban qualities, urban regeneration, conservation, intensification

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Authors: Fang Bin Guo, Emma Roberts, Haibin Du, Yonggang Wang, Yu Chen, Xiuli Ge

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This paper explores the findings so far from a major externally-funded project which operates internationally in China, Germany and the UK. The research team is working in the context of the redevelopment of post-industrial sites in China and how these might be platforms for creative enterprises and thereby, the economy and welfare to flourish. Results from the project are anticipated to inform urban design policies in China and possibly farther afield. The research has utilised ethnographic studies and participatory design methods to investigate alternative strategies for sustainable urban renewal of China’s post-industrial areas. Additionally, it has undertaken comparative studies of successful examples of European and Chinese urban regeneration cases. The international cross-disciplinary team has been seeking different opportunities for developing relevant creative industries whilst retaining cultural and industrial heritage. This paper will explore the research conducted so far by the team and offer initial findings. Findings point out the development challenges of cities respecting the protection of local culture/heritages, history of the industries and transformation of the local economies. The preliminary results and pilot analysis of the current research have demonstrated that local government policyholders, business investors/developers and creative industry practitioners are the three major stakeholders that will impact city revitalisations. These groups are expected to work together with asynchronous vision in order for redevelopments to be successful. Meanwhile, local geography, history, culture, politics, economy and ethnography have been identified as important factors that impact on project design and development during urban transformations. Data is being processed from the team’s research conducted across the focal Western and Chinese cities. This has provided theoretical guidance and practical support to the development of significant experimental projects. Many were re-examined with a more international perspective, and adjustments have been based on the conclusions of the research. The observations and research are already generating design solutions in terms of ascertaining essential site components, layouts, visual design and practical facilities for regenerated sites. Two significant projects undertaken by this project team have been nominated by the central Chinese government as the most successful exemplars. They have been listed as outstanding national industry heritage projects; in particular, one of them was nominated by ArchDaily as Building of the Year 2019, and so this project outcome has made a substantial contribution to research and innovation. In summary, this paper will outline the funded project, discuss the work conducted so far, and pinpoint the initial discoveries. It will detail the future steps and indicate how these will impact on national and local governments in China, designers, local citizens and building users.

Keywords: cultural & industrial heritages, ethnographic research, participatory design, regeneration of post-industrial sites, sustainable

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Authors: Wendy De Gomez

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The University of Waterloo is situated in central Canada in the Province of Ontario- one hour from the metropolitan city of Toronto. For over 30 years, it has held Canada’s top spot as the most innovative university; and has been consistently ranked in the top 25 computer science and top 50 engineering schools in the world. Waterloo benefits from the federal government’s over 100 domestic innovation policies which have assisted in the country’s 15th place global ranking in the World Intellectual Property Organization’s (WIPO) 2022 Global Innovation Index. Yet undoubtedly, the University of Waterloo’s unique characteristics are what propels its innovative creativeness forward. This paper will provide a contextual definition of innovation in higher education and then demonstrate the five operational attributes that contribute to the University of Waterloo’s innovative reputation. The methodology is based on statistical analyses obtained from ranking bodies such as the QS World University Rankings, a secondary literature review related to higher education innovation in Canada, and case studies that exhibit the operationalization of the attributes outlined below. The first attribute is geography. Specifically, the paper investigates the network structure effect of the Toronto-Waterloo high-tech corridor and the resultant industrial relationships built there. The second attribute is University Policy 73-Intellectal Property Rights. This creator-owned policy grants all ownership to the creator/inventor regardless of the use of the University of Waterloo property or funding. Essentially, through the incentivization of IP ownership by all researchers, further commercialization and entrepreneurship are formed. Third, this IP policy works hand in hand with world-renowned business incubators such as the Accelerator Centre in the dedicated research and technology park and velocity, a 14-year-old facility that equips and guides founders to build and scale companies. Communitech, a 25-year-old provincially backed facility in the region, also works closely with the University of Waterloo to build strong teams, access capital, and commercialize products. Fourth, Waterloo’s co-operative education program contributes 31% of all co-op participants to the Canadian economy. Home to the world’s largest co-operative education program, data shows that over 7,000 from around the world recruit Waterloo students for short- and long-term placements- directly contributing to the student’s ability to learn and optimize essential employment skills when they graduate. Finally, the students themselves at Waterloo are exceptional. The entrance average ranges from the low 80s to the mid-90s depending on the program. In computer, electrical, mechanical, mechatronics, and systems design engineering, to have a 66% chance of acceptance, the applicant’s average must be 95% or above. Singularly, none of these five attributes could lead to the university’s outstanding track record of innovative creativity, but when bundled up into a 1000 acre- 100 building main campus with 6 academic faculties, 40,000+ students, and over 1300 world-class faculty, the recipe for success becomes quite evident.

Keywords: IP policy, higher education, economy, innovation

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Authors: Teresa Naves, Katy Pallas, Carme Florit, Cristina Anton, Joan Collado, Diana Millan

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Although gender-fair language is relatively novel in Spain, in Catalonia, the Department of Education, as well as LGBT Associations, have been promoting several innovative programmes aimed at implementing gender-inclusive schools. These Rainbow School communities are ideal for looking at how these programmes affect the use of gender-fair language and the balanced representation of gender. The students' and teachers' perceptions and attitudes have been compared to those analysed in schools that have never implemented such programmes in primary or secondary education. Spanish and Catalan, unlike English, are gendered languages in which masculine forms have traditionally been used as the unmarked gender and have been claimed to be inclusive of all genders. While the Royal Spanish Academy (RAE) rejects the use of inclusive language and thus deems all variables of inclusion of double gender as unnecessary, the vast majority of universities are promoting not only inclusive language but also gender-inclusive curricula. Adopting gender-fair language policies and including gender perspective in the curricula is an innovative trend at university level and in primary and secondary school education. Inclusion in education is a basic human right and the foundation for a more just and equal society. Educators can facilitate the process of welcoming by ensuring handbooks, forms, and other communications are inclusive of all family structures and gender identities. Using gendered language such as 'girls and boys' can be alienating for gender non-conforming and gender diverse students; on the other hand, non-gendered words like 'students' are regarded as inclusive of all identities. The paper discusses the results of mixed method research (survey, interviews, and experiment) conducted in Rainbow and non-Rainbow schools in Alacant and Barcelona (Spain). The experiment aimed at checking the role of gender-fair language in learners' perception of gender balance. It was conducted in Spanish, Catalan, and English. Students aged 10 to 16 (N > 600) were asked to draw pictures of people using specific prompts. The prompts in Spanish and Catalan were written using the generic masculine, 'los presidentes' 'els presidents' (presidents); using double gendered language such as 'ninos y ninas', 'nens i nenes' (boys and girls); and using non-gendered words like 'alumnado' 'alumnat' (students). The prompts were subdivided into people in school contexts participants could identify with, such as students and teachers; occupations mostly associated with men, such as pilots and firefighters; and occupations associated with women, such as ballet dancers and nurses. As could be expected, the participants only drew approximately the same percentage of female and male characters when double-gendered language or non-gendered words such as 'students' or 'teachers' were used, regardless of the language used in the experiment. When they were asked to draw people using the so-called generic masculine in Spanish or Catalan, 'los estudiantes' 'els estudiants' (students), less than 35% of the drawings contained female characters. The differences between the results for Rainbow and Non-Rainbow schools will be discussed in the light of the innovative coeducation programmes and learners' perceptions on gender-fair language gathered in the surveys and interviews.

Keywords: gender-fair language, gender-inclusive schools, learners’ and teachers’ perceptions and attitudes, rainbow coeducation programmes

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Rafat Fazeli, Reza Fazeli

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This paper focuses on the study of the welfare state and social wage in the leading liberal economy of the United States. The welfare state acquired a broad acceptance as a major socioeconomic achievement of the liberal democracy in the Western industrialized countries during the postwar boom period. The modern and modified vision of capitalist democracy offered, on the one hand, the possibility of high growth rate and, on the other hand, the possibility of continued progression of a comprehensive system of social support for a wider population. The economic crises of the 1970s, provided the ground for a great shift in economic policy and ideology in several Western countries, most notably the United States and the United Kingdom (and to a lesser extent Canada under Prime Minister Brian Mulroney). In the 1980s, the free market oriented reforms undertaken under Reagan and Thatcher greatly affected the economic outlook not only of the United States and the United Kingdom, but of the whole Western world. The movement which was behind this shift in policy is often called neo-conservatism. The neoconservatives blamed the transfer programs for the decline in economic performance during the 1970s and argued that cuts in spending were required to go back to the golden age of full employment. The agenda for both Reagan and Thatcher administrations was rolling back the welfare state, and their budgets included a wide range of cuts for social programs. The question is how successful were Reagan and Thatcher’s efforts to achieve retrenchment? The paper involves an empirical study concerning the distributive role of the welfare state in the two countries. Other studies have often concentrated on the redistributive effect of fiscal policy on different income brackets. This study examines the net benefit/ burden position of the working population with respect to state expenditures and taxes in the postwar period. This measurement will enable us to find out whether the working population has received a net gain (or net social wage). This study will discuss how the expansion of social expenditures and the trend of the ‘net social wage’ can be linked to distinct forms of economic and social organizations. This study provides an empirical foundation for analyzing the growing significance of ‘social wage’ or the collectivization of consumption and the share of social or collective consumption in total consumption of the working population in the recent decades. The paper addresses three other major questions. The first question is whether the expansion of social expenditures has posed any drag on capital accumulation and economic growth. The findings of this study provide an analytical foundation to evaluate the neoconservative claim that the welfare state is itself the source of economic stagnation that leads to the crisis of the welfare state. The second question is whether the increasing ideological challenges from the right and the competitive pressures of globalization have led to retrenchment of the American welfare states in the recent decades. The third question is how social policies have performed in the presence of the rising inequalities in the recent decades.

Keywords: the welfare state, social wage, The United States, limits to growth

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Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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Authors: B. Sudhakara Reddy

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This study provides a snapshot of the sustainability of selected Indian cities by employing 70 indicators in four dimensions to develop an overall city sustainability index. In recent years, the concept of ‘urban sustainability’ has become prominent due to its complexity. Urban areas propel growth and at the same time poses a lot of ecological, social and infrastructural problems and risks. In case of developing countries, the high population density of and the continuous in-migration run the highest risk in natural and man-made disasters. These issues combined with the inability of policy makers in providing basic services makes the cities unsustainable. To assess whether any given policy is moving towards or against urban sustainability it is necessary to consider the relationships among its various dimensions. Hence, in recent years, while preparing the sustainability index, an integral approach involving indicators of different dimensions such as ‘economic’, ‘environmental’ and 'social' is being used. It is also important for urban planners, social analysts and other related institutions to identify and understand the relationships in this complex system. The objective of the paper is to develop a city performance index (CPI) to measure and evaluate the urban regions in terms of sustainable performances. The objectives include: i) Objective assessment of a city’s performance, ii) setting achievable goals iii) prioritise relevant indicators for improvement, iv) learning from leaders, iv) assessment of the effectiveness of programmes that results in achieving high indicator values, v) Strengthening of stakeholder participation. Using the benchmark approach, a conceptual framework is developed for evaluating 25 Indian cities. We develop City Sustainability index (CSI) in order to rank cities according to their level of sustainability. The CSI is composed of four dimensions: Economic, Environment, Social, and Institutional. Each dimension is further composed of multiple indicators: (1) Economic that considers growth, access to electricity, and telephone availability; (2) environmental that includes waste water treatment, carbon emissions, (3) social that includes, equity, infant mortality, and 4) institutional that includes, voting share of population, urban regeneration policies. The CSI, consisting of four dimensions disaggregate into 12 categories and ultimately into 70 indicators. The data are obtained from public and non-governmental organizations, and also from city officials and experts. By ranking a sample of diverse cities on a set of specific dimensions the study can serve as a baseline of current conditions and a marker for referencing future results. The benchmarks and indices presented in the study provide a unique resource for the government and the city authorities to learn about the positive and negative attributes of a city and prepare plans for a sustainable urban development. As a result of our conceptual framework, the set of criteria we suggest is somewhat different to any already in the literature. The scope of our analysis is intended to be broad. Although illustrated with specific examples, it should be apparent that the principles identified are relevant to any monitoring that is used to inform decisions involving decision variables. These indicators are policy-relevant and, hence they are useful tool for decision-makers and researchers.

Keywords: benchmark, city, indicator, performance, sustainability

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Authors: Carolina Busco, Daniela Osses

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The development of digital literacy has become a fundamental element that allows for citizen inclusion, access to quality jobs, and a labor market capable of responding to the digital economy. There are no methodological instruments available in Chile to measure the workforce’s digital literacy and improve national policies on this matter. Thus, the objective of this research is to develop a survey to measure digital literacy in a sample of 200 Chilean workers. Dimensions considered in the instrument are sociodemographics, access to infrastructure, digital education, digital skills, and the ability to use e-government services. To achieve the research objective of developing a digital literacy model of indicators and a research instrument for this purpose, along with an exploratory analysis of data using factor analysis, we used an empirical, quantitative-qualitative, exploratory, non-probabilistic, and cross-sectional research design. The research instrument is a survey created to measure variables that make up the conceptual map prepared from the bibliographic review. Before applying the survey, a pilot test was implemented, resulting in several adjustments to the phrasing of some items. A validation test was also applied using six experts, including their observations on the final instrument. The survey contained 49 items that were further divided into three sets of questions: sociodemographic data; a Likert scale of four values ranked according to the level of agreement; iii) multiple choice questions complementing the dimensions. Data collection occurred between January and March 2022. For the factor analysis, we used the answers to 12 items with the Likert scale. KMO showed a value of 0.626, indicating a medium level of correlation, whereas Bartlett’s test yielded a significance value of less than 0.05 and a Cronbach’s Alpha of 0.618. Taking all factor selection criteria into account, we decided to include and analyze four factors that together explain 53.48% of the accumulated variance. We identified the following factors: i) access to infrastructure and opportunities to develop digital skills at the workplace or educational establishment (15.57%), ii) ability to solve everyday problems using digital tools (14.89%), iii) online tools used to stay connected with others (11.94%), and iv) residential Internet access and speed (11%). Quantitative results were discussed within six focus groups using heterogenic selection criteria related to the most relevant variables identified in the statistical analysis: upper-class school students; middle-class university students; Ph.D. professors; low-income working women, elderly individuals, and a group of rural workers. The digital divide and its social and economic correlations are evident in the results of this research. In Chile, the items that explain the acquisition of digital tools focus on access to infrastructure, which ultimately puts the first filter on the development of digital skills. Therefore, as expressed in the literature review, the advance of these skills is radically different when sociodemographic variables are considered. This increases socioeconomic distances and exclusion criteria, putting those who do not have these skills at a disadvantage and forcing them to seek the assistance of others.

Keywords: digital literacy, digital society, workforce digitalization, digital skills

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Authors: Michael A. Unbehauen, Gregory D. Sloan, Alberto J. Squatrito

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Missile proliferation and global stability are intrinsically linked. Missile threats continually appear at the forefront of global security issues. North Korea’s recently demonstrated nuclear and intercontinental ballistic missile (ICBM) capabilities, for the first time since the Cold War, renewed public interest in strategic missile defense capabilities. To protect from limited ICBM attacks from so-called rogue actors, the United States developed the Ground-based Midcourse Defense (GMD) system. This study examines if the GMD missile defense shield has contributed to a safer world or triggered a new arms race. Based upon increased missile-related developments and the lack of adherence to international missile treaties, it is generally perceived that the GMD system is a destabilizing factor for global security. By examining the current state of arms control treaties as well as existing missile arsenals and ongoing efforts in technologies to overcome U.S. missile defenses, this study seeks to analyze the contribution of GMD to global stability. A thorough investigation cannot ignore that, through the establishment of this limited capability, the U.S. violated longstanding, successful weapons treaties and caused concern among states that possess ICBMs. GMD capability contributes to the perception that ICBM arsenals could become ineffective, creating an imbalance in favor of the United States, leading to increased global instability and tension. While blame for the deterioration of global stability and non-adherence to arms control treaties is often placed on U.S. missile defense, the facts do not necessarily support this view. The notion of a renewed arms race due to GMD is supported neither by current missile arsenals nor by the inevitable development of new and enhanced missile technology, to include multiple independently targeted reentry vehicles (MIRVs), maneuverable reentry vehicles (MaRVs), and hypersonic glide vehicles (HGVs). The methodology in this study encapsulates a period of time, pre- and post-GMD introduction, while analyzing international treaty adherence, missile counts and types, and research in new missile technologies. The decline in international treaty adherence, coupled with a measurable increase in the number and types of missiles or research in new missile technologies during the period after the introduction of GMD, could be perceived as a clear indicator of GMD contributing to global instability. However, research into improved technology (MIRV, MaRV and HGV) prior to GMD, as well as a decline of various global missile inventories and testing of systems during this same period, would seem to invalidate this theory. U.S. adversaries have exploited the perception of the U.S. missile defense shield as a destabilizing factor as a pretext to strengthen and modernize their militaries and justify their policies. As a result, it can be concluded that global stability has not significantly decreased due to GMD; but rather, the natural progression of technological and missile development would inherently include innovative and dynamic approaches to target engagement, deterrence, and national defense.

Keywords: arms control, arms race, global security, GMD, ICBM, missile defense, proliferation

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Authors: Arushi S. Goyal, Jo Aggarwal, Ravi Jasuja

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Statement of the Problem: Vapes have always been marketed as safer alternatives to traditional cigarettes; however, research suggests that perceived safety of e-cigarettes use may be overstated. While the addictive properties of nicotine have garnered significant scientific interest, the adverse effects of ‘inert’ ingredients in vapes are being investigated only recently. Seemingly harmless components in vapes such as propylene glycol have been shown to damage astrocytes and oligodendrocytes, and certain flavorings are causatively associated with neuroinflammation. With ease of concealment and varied aromas, vape usage amongst high school students continues unabated in countries like India, which have instituted comprehensive bans on e-cigarettes. With overt government ban, there is paucity of public data on determinants of teenage vaping patterns and parental engagement in curbing this debilitating dependency. Additionally, the large body of peer reviewed studies on vaping have been primarily conducted in Western countries. Accordingly, the purpose of this study was to examine the factors affecting the causes and attitudes towards vaping among adolescents in urban India, as well as the gaps in parental awareness. We posit that this study would lay out a reusable framework for extending the studies across conservative societies where adolescents support vaping behavior even with strong governmental policies. Methodology & Theoretical Orientation: Two surveys were used to collect data. Participants from eight private schools in Bangalore completed an online survey. The first survey sampled adolescents aged 14-18, while the second surveyed the parents of children in the same age group from the same schools. Informed consent was obtained from all participants, and all data collected was anonymous. Results: We find substantial discordance in self-reported vape use by the adolescents and the parents’ knowledge of their child’s exposure to vaping. Over one fifth of respondents (22.4%) reported using e-cigarettes, while only 5% of parents reported that their children used e-cigarettes. Even though over 70% of adolescents believe that vaping is addictive, only 22.8% of respondents were aware of the components, or the extent of its impact. While peer pressure is often perceived to be the enabling factor, curiosity was reported as the primary reason for the initiation. Adolescents who vape saw regulations on sales and marketing as the most effective deterrent. In contrast, parents and other students leaned on school infrastructure to intervene. There has been a significant increase in vaping and a substantial discordance between parental perceptions and adolescent vaping. Conclusion & Significance: Despite a complete ban, vapes continue to be easily accessible. The data suggests that an open discussion about the adverse health consequences of untested, “seemingly inert” ingredients in these unregulated vape liquids would galvanize the student community by demystifying vaping. While increased regulation against the sale of vapes deters open use, increased parental involvement could enable open dialog with children and assist in reducing the prevalence of vaping. A reduction in vaping could have a considerable impact on the health and educational outcomes for the youth of India.

Keywords: adolescent, e-cigarettes, health consequences, India, parental awareness, vapes

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Authors: Shierwin Agagen Cabunilas

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The unitary form of Philippine government has built a tradition of bureaucracy that strengthened oligarch and clientele politics. Consequently, the Philippines is lagged behind development. There is so much poverty, unemployment, and inadequate social services. In addition, it seems that the rights of national ethnic minority groups like the Igorots to develop their political and economic interests, linguistic and cultural heritage are neglected. Given these circumstances, a paradigm shift is inevitable. The author advocates a transition from a unitary to a federal system of government. Contrary to the notion that a unitary system facilitates better governance, it actually stifles it. As a unitary government, the Philippines seems (a) to exhibit incompetence in delivering efficient, necessary services to the people and (b) to exclude the minority from political participation and policy making. This shows that Philippine unitary system is highly centralized and operates from a top-bottom scheme. However, a federal system encourages decentralization, plurality and political participation. In my view, federalism is beneficial to the Philippine society and congenial to the Igorot indigenous peoples insofar as participative decision-making and development goals are concerned. This research employs critical and constructive analyses. The former interprets some complex practices of Philippine politics while the latter investigates how theories of federalism can be appropriated to deal with political deficits, ethnic diversity, and indigenous peoples’ rights to self-determination. The topic is developed accordingly: First, the author briefly examines the unitary structure of the Philippines and its impact on inter-governmental affairs and processes, asserting that bureaucracy and corruption, for example, are counterproductive to a participative political life, to economic development and to the recognition of national ethnic minorities. Second, he scrutinizes why federalism might transform this. Here, he assesses various opposing philosophical contentions on federal system in managing ethnically diverse society, like the Philippines, and argue that decentralization of political power, economic and cultural developments are reasons to exit from unitary government. Third, he suggests that federalism can be instrumental to Igorots self-determination. Self-determination is neither opposed to national development nor to the ideals of democracy – liberty, justice, solidarity. For example, as others have already noted, a politics in the vernacular facilitates greater participation among the people. Hence, there is a greater chance to arrive at policies that serve the interest of the people. Some may wary that decentralization disintegrates a nation. According to the author, however, the recognition of minority rights which includes self-determination may promote filial devotion to the state. If Igorot indigenous peoples have access to suitable institutions to determine their political life, economic goals, social needs, i.e., education, culture, language, chances are it moves the country forward to development fostering national unity. Remarkably, federal system thus best responds to the Philippines’s democratic and development deficits. Federalism can also significantly rectify the practices that oppress and dislocate national ethnic minorities as it ensures the creation of localized institutions for optimum political, economic, cultural determination and maximizes representation in the public sphere.

Keywords: federalism, Igorot, indigenous peoples, self-determination

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: Emma Pope, Demos Parapanos

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Rural tourism has become more obvious and prevalent, with tourists’ increasingly seeking authentic experiences. This movement accelerated post-Covid, putting destinations in danger of reaching levels of saturation called ‘overtourism’. Whereas the phenomenon of overtourism has been frequently discussed in the urban context by academics and practitioners over recent years, it has hardly been referred to in the context of rural tourism, where perhaps it is even more difficult to manage. Rural tourism was historically considered small-scale, marked by its traditional character and by having little impact on nature and rural society. The increasing number of rural areas experiencing overtourism, however, demonstrates the need for new approaches, especially as the impacts and enablers of overtourism are context specific. Cumbria, with approximately 47 million visitors each year, and 23,000 operational enterprises, is one of these rural areas experiencing overtourism in the UK. Using the county of Cumbria as an example, this paper aims to explore better planning and management in rural destinations by clustering the area into rural and ‘urban-rural’ tourism zones. To achieve the aim, this study uses secondary data from a variety of sources to identify variables relating to visitor economy development and demand. These data include census data relating to population and employment, tourism industry-specific data including tourism revenue, visitor activities, and accommodation stock, and big data sources such as Trip Advisor and All Trails. The combination of these data sources provides a breadth of tourism-related variables. The subsequent analysis of this data draws upon various validated models. For example, tourism and hospitality employment density, territorial tourism pressure, and accommodation density. In addition to these statistical calculations, other data are utilized to further understand the context of these zones, for example, tourist services, attractions, and activities. The data was imported into ARCGIS where the density of the different variables is visualized on maps. This study aims to provide an understanding of the geographical context of visitor economy development and tourist behavior in rural areas. The findings contribute to an understanding of the spatial dynamics of tourism within the region of Cumbria through the creation of thematized maps. Different zones of tourism industry clusters are identified, which include elements relating to attractions, enterprises, infrastructure, tourism employment and economic impact. These maps visualize hot and cold spots relating to a variety of tourism contexts. It is believed that the strategy used to provide a visual overview of tourism development and demand in Cumbria could provide a strategic tool for rural areas to better plan marketing opportunities and avoid overtourism. These findings can inform future sustainability policy and destination management strategies within the areas through an understanding of the processes behind the emergence of both hot and cold spots. It may mean that attract and disperse needs to be reviewed in terms of a strategic option. In other words, to use sector or zonal policies for the individual hot or cold areas with transitional zones dependent upon local economic, social and environmental factors.

Keywords: overtourism, rural tourism, sustainable tourism, tourism planning, tourism zones

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Authors: Sohrab Donyavi

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The global construction market is experiencing significant shifts, particularly for micro, small, and medium enterprises (MSMEs), driven by the dual imperatives of technological advancement and sustainability. MSMEs play a crucial role in the construction industry, often being the backbone of economic development and fostering entrepreneurial skills. However, their dominance has also led to industry fragmentation and challenges such as technological lag and declining profit margins, which threaten their global competitiveness. This paper explores the integration of technology and sustainability in reshaping the paradigms for MSMEs in the construction sector. The adoption of advanced technologies, such as building information modeling (BIM) and AI, are pivotal for promoting sustainable construction practices. These tools enable MSMEs to design and construct environmentally responsible buildings, thereby contributing to the industry's sustainability goals. The research highlights that achieving sustainability in construction involves significant efforts in conservation, recycling, and the development of new materials and technologies. This approach aligns with the broader goal of integrating economic, environmental, and social aims into firm objectives to create long-term value while ensuring the protection of natural resources for future generations. Critical factors for implementing sustainable oriented innovation (SOI) practices in MSMEs include top management support, government initiatives, and financial resources. These factors are essential for fostering an environment conducive to innovation and sustainability. Furthermore, the empowerment of MSMEs through improved governance, market-oriented programs, sustainable productivity growth, and access to financing is vital. In developing regions like Indonesia, these strategies are crucial for enabling MSMEs to thrive in the face of globalization. The tendency of large firms to grow larger with the help of technology and globalization has led to the emergence of a high-technology oligopoly, posing a significant challenge to traditional construction practices. This shift necessitates that MSMEs adapt by leveraging technology and embracing sustainable practices to remain competitive. The research underscores the importance of integrating technology and sustainability not only as a competitive strategy but also as a means to contribute to the global effort of environmental conservation and sustainable development. This paper concludes that the successful integration of technology and sustainability in MSMEs requires a multifaceted approach. It involves the adoption of advanced technological tools, strong support from top management, proactive government policies, and access to financial resources. By addressing these factors, MSMEs can overcome the challenges of industry fragmentation, technological lag, and declining profit margins. Ultimately, this integration will enable MSMEs to play a pivotal role in driving the construction industry towards a more sustainable and technologically advanced future. The findings and recommendations are based on a comprehensive case study utilizing semi-structured interviews, observations, questionnaires, and document reviews.

Keywords: MSMEs, construction, technology, sustainability, innovation

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Authors: Marie Boost

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Despite activation policies, forced personal initiative to step out of unemployment and a general prosper economic situation, poverty and financial hardship constitute a crucial role in the daily lives of many families in Germany. In 2015, ~16 million persons (20.2%) of the German population are at risk of poverty or social exclusion. This is illustrated by an unemployment rate of 13.3% in the research area, located in East Germany. Despite this high amount of persons living in vulnerable households, we know little about how they manage to stabilize their lives or even overcome poverty – apart from solely relying on welfare state benefits or entering in a stable, well-paid job. Most of them are struggling in precarious living circumstances, switching from one or several short-term, low-paid jobs into self-employment or unemployment, sometimes accompanied by welfare state benefits. Hence, insecurity and uncertain future expectation form a crucial part of their lives. Within the EU-funded project “RESCuE”, resilient practices of vulnerable households were investigated in nine European countries. Approximately, 15 expert interviews with policy makers, representatives from welfare state agencies, NGOs and charity organizations and 25 household interviews have been conducted within each country. It aims to find out more about the chances and conditions of social resilience. The research is based on the triangulation of biographical narrative interviews, followed by participatory photo interviews, asking the household members to portray their typical everyday life. The presentation is focusing on the explanatory strength of this mixed-methods approach in order to show the potential of household practices to overcome financial hardship. The methodological combination allows an in-depth analysis of the families and households everyday living circumstances, including their poverty and employment situation, whether formal and informal. Active household budgeting practices, such as saving and consumption practices are based on subsistence or Do-It-Yourself work. Especially due to the photo-interviews, the importance of inherent cultural and tacit knowledge becomes obvious as it pictures their typical practices, like cultivation and gathering fruits and vegetables or going fishing. One of the central findings is the multiple purposes of these practices. They contribute to ease financial burden through consumption reduction and strengthen social ties, as they are mostly conducted with close friends or family members. In general, non-commodified practices are found to be re-commodified and to contribute to ease financial hardship, e.g. by the use of commons, barter trade or simple mutual exchange (gift exchange). These practices can substitute external purchases and reduce expenses or even generate a small income. Mixing different income sources are found to be the most likely way out of poverty within the context of a precarious labor market. But these resilient household practices take its toll as they are highly preconditioned, and many persons put themselves into risk of overstressing themselves. Thus, the potentials and risks of resilient household practices are reflected in the presentation.

Keywords: consumption practices, labor market, qualitative research, resilience

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Authors: Hsien-Te Lin

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The purpose of this paper is to introduce the BCFES (building carbon footprint evaluation system), which is a LCA (life cycle assessment) tool developed by the Low Carbon Building Alliance (LCBA) in Taiwan. A qualified BCFES for the building industry should fulfill the function of evaluating carbon footprint throughout all stages in the life cycle of building projects, including the production, transportation and manufacturing of materials, construction, daily energy usage, renovation and demolition. However, many existing BCFESs are too complicated and not very designer-friendly, creating obstacles in the implementation of carbon reduction policies. One of the greatest obstacle is the misapplication of the carbon footprint inventory standards of PAS2050 or ISO14067, which are designed for mass-produced goods rather than building projects. When these product-oriented rules are applied to building projects, one must compute a tremendous amount of data for raw materials and the transportation of construction equipment throughout the construction period based on purchasing lists and construction logs. This verification method is very cumbersome by nature and unhelpful to the promotion of low carbon design. With a view to provide an engineer-oriented BCFE with pre-diagnosis functions, a component input/output (I/O) database system and a scenario simulation method for building energy are proposed herein. Most existing BCFESs base their calculations on a product-oriented carbon database for raw materials like cement, steel, glass, and wood. However, data on raw materials is meaningless for the purpose of encouraging carbon reduction design without a feedback mechanism, because an engineering project is not designed based on raw materials but rather on building components, such as flooring, walls, roofs, ceilings, roads or cabinets. The LCBA Database has been composited from existing carbon footprint databases for raw materials and architectural graphic standards. Project designers can now use the LCBA Database to conduct low carbon design in a much more simple and efficient way. Daily energy usage throughout a building's life cycle, including air conditioning, lighting, and electric equipment, is very difficult for the building designer to predict. A good BCFES should provide a simplified and designer-friendly method to overcome this obstacle in predicting energy consumption. In this paper, the author has developed a simplified tool, the dynamic Energy Use Intensity (EUI) method, to accurately predict energy usage with simple multiplications and additions using EUI data and the designed efficiency levels for the building envelope, AC, lighting and electrical equipment. Remarkably simple to use, it can help designers pre-diagnose hotspots in building carbon footprint and further enhance low carbon designs. The BCFES-LCBA offers the advantages of an engineer-friendly component I/O database, simplified energy prediction methods, pre-diagnosis of carbon hotspots and sensitivity to good low carbon designs, making it an increasingly popular carbon management tool in Taiwan. To date, about thirty projects have been awarded BCFES-LCBA certification and the assessment has become mandatory in some cities.

Keywords: building carbon footprint, life cycle assessment, energy use intensity, building energy

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Authors: Shewit Kidane, Abebe Getahun, Wassie Anteneh, Admassu Demeke, Peter Goethals

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We have reviewed major findings of scientific studies on Lake Tana fish resources and their threats. The aim was to provide summarized information for all concerned bodies and international readers to get full and comprehensive picture about the lake’s fish resource and conservation problems. The Lake Tana watershed comprise 28 fish species, of which 21 are endemic. Moreover, Lake Tana is the one among the top 250 lake regions of global importance for biodiversity and it is world recognized migratory birds wintering site. Lake Tana together with its adjacent wetlands provide directly and indirectly a livelihood for more than 500,000 people. However, owing to anthropogenic activities, the lake ecosystem as well as fish and attributes of the fisheries sector are severely degraded. Fish species in Lake Tana are suffering due to illegal fishing, damming, habitat/breeding ground degradation, wastewater disposal, introduction of exotic species, and lack of implementing fisheries regulations. Currently, more than 98% of fishers in Lake Tana are using the most destructive monofilament. Indeed, dams, irrigation schemes and hydropower are constructed in response to the emerging development need only. Mitigation techniques such as construction of fish ladders for the migratory fishes are the most forgotten. In addition, water resource developers are likely unaware of both the importance of the fisheries and the impact of dam construction on fish. As a result, the biodiversity issue is often missed. Besides, Lake Tana wetlands, which play vital role to sustain biodiversity, are not wisely utilised in the sense of the Ramsar Convention’s definition. Wetlands are considered as unhealthy and hence wetland conversion for the purpose of recession agriculture is still seen as advanced mode of development. As a result, many wetlands in the lake watershed are shrinking drastically over time and Cyprus papyrus, one of the characteristic features of Lake Tana, has dramatically declined in its distribution with some local extinction. Furthermore, the recently introduced water hyacinth (Eichhornia crassipes) is creating immense problems on the lake ecosystem. Moreover, currently, 1.56 million tons of sediment have deposited into the lake each year and wastes from the industries and residents are directly discharged into the lake without treatment. Recently, sign of eutrophication is revealed in Lake Tana and most coarsely, the incidence of cyanobacteria genus Microcystis was reported from the Bahir Dar Gulf of Lake Tana. Thus, the direct dependency of the communities on the lake water for drinking as well as to wash their body and clothes and its fisheries make the problem worst. Indeed, since it is home to many endemic migratory fish, such kind of unregulated developmental activities could be detrimental to their stocks. This can be best illustrated by the drastic stock reduction (>75% in biomass) of the world unique Labeobarbus species. So, unless proper management is put in place, the anthropogenic impacts can jeopardize the aquatic ecosystems. Therefore, in order to sustainably use the aquatic resources and fulfil the needs of the local people, every developmental activity and resource utilization should be carried out adhering to the available policies.

Keywords: anthropogenic impacts, dams, endemic fish, wetland degradation

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Authors: Jonathan Kissi, Baozhen Dai, Wisdom W. K. Pomegbe, Abdul-Basit Kassim

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Protecting patient’s digital information is a growing concern for healthcare institutions as people nowadays perpetually live their lives through telemedicine services. These telemedicine services have been confronted with several determinants that hinder their successful implementations, especially in developing countries. Identifying such determinants that influence the acceptance of telemedicine services is also a problem for healthcare professionals. Despite the tremendous increase in telemedicine services, its adoption, and use has been quite slow in some healthcare settings. Generally, it is accepted in today’s globalizing world that the success of telemedicine services relies on users’ satisfaction. Satisfying health professionals and patients are one of the crucial objectives of telemedicine success. This study seeks to investigate the determinants that influence health professionals’ intention to utilize telemedicine services in clinical activities in a sub-Saharan African country in West Africa (Ghana). A hybridized model comprising of health adoption models, including technology acceptance theory, diffusion of innovation theory, and protection of motivation theory, were used to investigate these quandaries. The study was carried out in four government health institutions that apply and regulate telemedicine services in their clinical activities. A structured questionnaire was developed and used for data collection. Purposive and convenience sampling methods were used in the selection of healthcare professionals from different medical fields for the study. The collected data were analyzed based on structural equation modeling (SEM) approach. All selected constructs showed a significant relationship with health professional’s behavioral intention in the direction expected from prior literature including perceived usefulness, perceived ease of use, management strategies, financial sustainability, communication channels, patients security threat, patients privacy risk, self efficacy, actual service use, user satisfaction, and telemedicine services systems securities threat. Surprisingly, user characteristics and response efficacy of health professionals were not significant in the hybridized model. The findings and insights from this research show that health professionals are pragmatic when making choices for technology applications and also their willingness to use telemedicine services. They are, however, anxious about its threats and coping appraisals. The identified significant constructs in the study may help to increase efficiency, quality of services, quality patient care delivery, and satisfactory user satisfaction among healthcare professionals. The implantation and effective utilization of telemedicine services in the selected hospitals will aid as a strategy to eradicate hardships in healthcare services delivery. The service will help attain universal health access coverage to all populace. This study contributes to empirical knowledge by identifying the vital factors influencing health professionals’ behavioral intentions to adopt telemedicine services. The study will also help stakeholders of healthcare to formulate better policies towards telemedicine service usage.

Keywords: telemedicine service, perceived usefulness, perceived ease of use, management strategies, security threats

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Authors: Hanee Ryu

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The former president Lee Myung-bak's administration of Korea presented “green growth” as a catchphrase from 2008. He declared “low-carbon, green growth” the nation's vision for the next decade according to United Nation Framework on Climate Change. The government designed omnidirectional policy for low-carbon and green growth with concentrating all effort of departments. The structural change was expected because this slogan is the identity of the government, which is strongly driven with the whole department. After his administration ends, the purpose of this paper is to quantify the policy effect and to compare with the value of the other OECD countries. The major target values under direct policy objectives were suggested, but it could not capture the entire landscape on which the policy makes changes. This paper figures out the policy impacts through comparing the value of ex-ante between the one of ex-post. Furthermore, each index level of Korea’s low-carbon and green growth comparing with the value of the other OECD countries. To measure the policy effect, indicators international organizations have developed are considered. Environmental Sustainable Index (ESI) and Environmental Performance Index (EPI) have been developed by Yale University’s Center for Environmental Law and Policy and Columbia University’s Center for International Earth Science Information Network in collaboration with the World Economic Forum and Joint Research Center of European Commission. It has been widely used to assess the level of natural resource endowments, pollution level, environmental management efforts and society’s capacity to improve its environmental performance over time. Recently OCED publish the Green Growth Indicator for monitoring progress towards green growth based on internationally comparable data. They build up the conceptual framework and select indicators according to well specified criteria: economic activities, natural asset base, environmental dimension of quality of life and economic opportunities and policy response. It considers the socio-economic context and reflects the characteristic of growth. Some selected indicators are used for measuring the level of changes the green growth policies have induced in this paper. As results, the CO2 productivity and energy productivity show trends of declination. It means that policy intended industry structure shift for achieving carbon emission target affects weakly in the short-term. Increasing green technologies patents might result from the investment of previous period. The increasing of official development aids which can be immediately embarked by political decision with no time lag present only in 2008-2009. It means international collaboration and investment to developing countries via ODA has not succeeded since the initial stage of his administration. The green growth framework makes the public expect structural change, but it shows sporadic effect. It needs organization to manage it in terms of the long-range perspectives. Energy, climate change and green growth are not the issue to be handled in the one period of the administration. The policy mechanism to transfer cost problem to value creation should be developed consistently.

Keywords: comparing ex-ante between ex-post indicator, green growth indicator, implication for green growth policy, measuring policy effect

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Authors: Amir Shouri, Fereshteh Tabe

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Master planning and urban infrastructure’s thoughtful and sequential design strategies will play the major role in reducing the damages of natural disasters, war and or social/population related conflicts for cities. Defensive strategies have been revised during the history of mankind after having damages from natural depressions, war experiences and terrorist attacks on cities. Lessons learnt from Earthquakes, from 2 world war casualties in 20th century and terrorist activities of all times. Particularly, after Hurricane Sandy of New York in 2012 and September 11th attack on New York’s World Trade Centre (WTC) in 21st century, there have been series of serious collaborations between law making authorities, urban planners and architects and defence related organizations to firstly, getting prepared and/or prevent such activities and secondly, reduce the human loss and economic damages to minimum. This study will work on developing a model of planning for New York City, where its citizens will get minimum impacts in threat-full time with minimum economic damages to the city after the stress is passed. The main discussion in this proposal will focus on pre-hazard, hazard-time and post-hazard transformative policies and strategies that will reduce the “Life casualties” and will ease “Economic Recovery” in post-hazard conditions. This proposal is going to scrutinize that one of the key solutions in this path might be focusing on all overlaying possibilities on architectural platforms of three fundamental infrastructures, the transportation, the power related sources and defensive abilities on a dynamic-transformative framework that will provide maximum safety, high level of flexibility and fastest action-reaction opportunities in stressful periods of time. “Planning Fore Stress” is going to be done in an analytical, qualitative and quantitative work frame, where it will study cases from all over the world. Technology, Organic Design, Materiality, Urban forms, city politics and sustainability will be discussed in deferent cases in international scale. From the modern strategies of Copenhagen for living friendly with nature to traditional approaches of Indonesian old urban planning patterns, the “Iron Dome” of Israel to “Tunnels” in Gaza, from “Ultra-high-performance quartz-infused concrete” of Iran to peaceful and nature-friendly strategies of Switzerland, from “Urban Geopolitics” in cities, war and terrorism to “Design of Sustainable Cities” in the world, will all be studied with references and detailed look to analysis of each case in order to propose the most resourceful, practical and realistic solutions to questions on “New City Divisions”, “New City Planning and social activities” and “New Strategic Architecture for Safe Cities”. This study is a developed version of a proposal that was announced as winner at MoMA in 2013 in call for ideas for Rockaway after Sandy Hurricane took place.

Keywords: urban scale, city safety, natural disaster, war and terrorism, city divisions, architecture for safe cities

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Authors: Rachel Buchanan, Rebecca LaRiviere

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Context: The ongoing effects of colonialism continue to be experienced through paternalistic policies and funding processes that cause disjuncture between and across Indigenous early childhood programming on-reserve and in urban and Northern settings in Canada. While various educational organizations and social service providers have risen to address these challenges in the short, medium and long term, there continues to be a lack in nation-wide cohesive, culturally grounded, and meaningful early learning programming for Indigenous children in Canada. Indigenous-centered early learning programs tend to face one of two scaling dilemmas: their program goals are too prescriptive to enable the program to be meaningfully replicated in different cultural/ community settings, or their program goals are too broad to be meaningfully adapted to the unique cultural and contextual needs and desires of Indigenous communities (the “franchise approach”). There are over 600 First Nations communities in Canada representing more than 50 Nations and languages. Consequently, Indigenous early learning programming cannot be applied with a universal or “one size fits all” approach. Sustainable and comprehensive programming must be responsive to each community context, building upon existing strengths and assets to avoid program duplication and irrelevance. Thesis: Community-driven and culturally adapted early childhood programming is critical but cannot be achieved on a large scale within traditional program models that are constrained by prescriptive overarching program goals. Principles, rather than goals, are an effective way to navigate and evaluate complex and dynamic systems. Principles guide an intervention to be adaptable, flexible and scalable. The Martin Family Initiative (MFI) ’s Early Years program engages a principles-based approach to programming. As will be discussed in this paper, this approach enables the program to catalyze existing community-based strengths and organizational assets toward bridging gaps across and disjuncture between Indigenous early learning programs, as well as to scale programming in sustainable, context-responsive and dynamic ways. This paper argues that using a principles-driven and adaptive scaling approach, the Early Years model establishes important learnings for culturally adapted Indigenous early learning programming in Canada. Methodology: The Early Years has leveraged this approach to develop an array of programming with partner organizations and communities across the country. The Early Years began as a singular pilot project in one First Nation. In just three years, it has expanded to five different regions and community organizations. In each context, the program supports the partner organization through different means and to different ends, the extent to which is determined in partnership with each community-based organization: in some cases, this means supporting the organization to build home visiting programming from the ground-up; in others, it means offering organization-specific culturally adapted early learning resources to support the programming that already exists in communities. Principles underpin but do not define the practices of the program in each of these relationships. This paper will explore numerous examples of principles-based adaptability with the context of the Early Years, concluding that the program model offers theadaptability and dynamism necessary to respond to unique and ever-evolving community contexts and needs of Indigenous children today.

Keywords: culturally adapted programming, indigenous early learning, principles-based approach, program scaling

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Authors: Raptis Sotirios

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Health and social care (HSc) services planning and scheduling are facing unprecedented challenges due to the pandemic pressure and also suffer from unplanned spending that is negatively impacted by the global financial crisis. Data-driven can help to improve policies, plan and design services provision schedules using algorithms assist healthcare managers’ to face unexpected demands using fewer resources. The paper discusses services packing using statistical significance tests and machine learning (ML) to evaluate demands similarity and coupling. This is achieved by predicting the range of the demand (class) using ML methods such as CART, random forests (RF), and logistic regression (LGR). The significance tests Chi-Squared test and Student test are used on data over a 39 years span for which HSc services data exist for services delivered in Scotland. The demands are probabilistically associated through statistical hypotheses that assume that the target service’s demands are statistically dependent on other demands as a NULL hypothesis. This linkage can be confirmed or not by the data. Complementarily, ML methods are used to linearly predict the above target demands from the statistically found associations and extend the linear dependence of the target’s demand to independent demands forming, thus groups of services. Statistical tests confirm ML couplings making the prediction also statistically meaningful and prove that a target service can be matched reliably to other services, and ML shows these indicated relationships can also be linear ones. Zero paddings were used for missing years records and illustrated better such relationships both for limited years and in the entire span offering long term data visualizations while limited years groups explained how well patients numbers can be related in short periods or can change over time as opposed to behaviors across more years. The prediction performance of the associations is measured using Receiver Operating Characteristic(ROC) AUC and ACC metrics as well as the statistical tests, Chi-Squared and Student. Co-plots and comparison tables for RF, CART, and LGR as well as p-values and Information Exchange(IE), are provided showing the specific behavior of the ML and of the statistical tests and the behavior using different learning ratios. The impact of k-NN and cross-correlation and C-Means first groupings is also studied over limited years and the entire span. It was found that CART was generally behind RF and LGR, but in some interesting cases, LGR reached an AUC=0 falling below CART, while the ACC was as high as 0.912, showing that ML methods can be confused padding or by data irregularities or outliers. On average, 3 linear predictors were sufficient, LGR was found competing RF well, and CART followed with the same performance at higher learning ratios. Services were packed only if when significance level(p-value) of their association coefficient was more than 0.05. Social factors relationships were observed between home care services and treatment of old people, birth weights, alcoholism, drug abuse, and emergency admissions. The work found that different HSc services can be well packed as plans of limited years, across various services sectors, learning configurations, as confirmed using statistical hypotheses.

Keywords: class, cohorts, data frames, grouping, prediction, prob-ability, services

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Authors: Savita Tangwongkit, Chittur S Srinivasan, Philip J. Jones

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Thailand has become the world’s fourth largest sugarcane producer and second largest sugar exporter. While there have been a number of drivers of this growth, the primary driver has been wide-ranging government support measures. Recently, the Thai government has emphasized the need for policy reform as part of a broader industry restructuring to bring the sector up-to-date with the current and future developments in the international sugar market. Because of the sectors historical dependence on government support, any such reform is likely to have a very significant impact on the fortunes of Thai cane farmers. This study explores the impact of three policy scenarios, representing a spectrum of policy approaches, on Thai cane producers. These reform scenarios were designed in consultation with policy makers and academics working in the cane sector. Scenario 1 captures the current ‘government proposal’ for policy reform. This scenario removes certain domestic production subsidies but seeks to maintain as much support as is permissible under current WTO rules. The second scenario, ‘protectionism’, maintains the current internal market producer supports, but otherwise complies with international (WTO) commitments. Third, the ‘libertarian scenario’ removes all production support and market interventions, trade and domestic consumption distortions. Most important driver of producer behaviour in all of the scenarios is the producer price of cane. Cane price is obviously highest under the protectionism scenario, followed by government proposal and libertarian scenarios, respectively. Likely producer responses to these three policy scenarios was determined by means of a large-scale survey of cane farmers. The sample was stratified by size group and quotas filled by size group and region. One scenario was presented to each of three sub-samples, consisting of approx.150 farmers. Total sample size was 462 farms. Data was collected by face-to-face interview between June and August 2019. There was a marked difference in farmer response to the three scenarios. Farmers in the ‘Protectionism’ scenario, which maintains the highest cane price and those who farm larger cane areas are more likely to continue cane farming. The libertarian scenario is likely to result in the greatest losses in terms of cane production volume broadly double that of the ‘protectionism’ scenario, primarily due to farmers quitting cane production altogether. Over half of loss cane production volume comes from medium-size farm, i.e. the largest and smallest producers are the most resilient. This result is likely due to the fact that the medium size group are large enough to require hired labour but lack the economies of scale of the largest farms. Over all size groups the farms most heavily specialized in cane production, i.e. those devoting 26-50% of arable land to cane, are also the most vulnerable, with 70% of all farmers quitting cane production coming from this group. This investigation suggests that cane price is the most significant determinant of farmer behaviour. Also, that where scenarios drive significantly lower cane price, policy makers should target support towards mid-sized producers, with policies that encourage efficiency gains and diversification into alternative agricultural crops.

Keywords: farmer intentions, farm survey, policy reform, Thai cane production

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Authors: O. O. Oku, K. S. Jerry-Alagbaoso

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It is universally acknowledged that the primary function of universities is the generation and dissemination of knowledge. This mission is pursued through the research component of the university programme especially at the post-graduate level. The senior academic staff teach, supervise and provide general academic leadership to post-graduate students who are expected to carry out research leading to the presentation of dissertation as requirement for the award of doctoral degree in their various disciplines. Carrying out the research enterprises involves a lot of corroboration among individuals and communities. The need to safeguard the interest of everyone involved in the enterprise makes the development of ethical standard in research imperative. Ensuring the development and effective application of such ethical standard falls within the leadership role of the vice –chancellors, Deans of post-graduate schools/ faculties, Heads of Departments and supervisors. It is the relevance and application of such ethical standard in Nigerian university research efforts that this study discussed. The study adopted the descriptive research design. A researcher-made 4 point rating scale was used to elicit information from the post-graduate dissertation supervisors sampled from one university each from the six geo-political zones in Nigeria using the purposive sampling technique. The data collected was analysed using the mean score and standard deviation. The findings of the study include among others that there are several cases of unethical practices by Ph.D dissertation students in Nigerian universities. Prominent among these include duplicating research topics, making unauthorized copies of data paper or computer programme, failing to acknowledge contributions of relevant people and authors, rigging an experiment to prempt the result among others. Some of the causes of the unethical practices according to the respondents include inadequate funding of universities resulting in inadequate remuneration for university teachers, inadequacy of equipment and infrastructures, poor supervision of Ph.D students,’ poverty on the side of the student researchers and non-application of sanctions on violators. Improved funding of the Nigerian universities system with emphasis on both staff and student research efforts, admitting academic oriented students into the Ph.D programme and ensuring the application of appropriate sanctions in cases of unethical conduct in research featured prominently in the needed leadership imperatives. Based on the findings of the study, the researchers recommend the development of university research policies that is closely tied to each university’s strategic plan. Such plan should explain the research focus that will attract more funding and direct students interest towards it without violating the principle of academic freedom. The plan should also incorporate the establishment of a research administration office to provide the necessary link between the students and funding agencies and also organise training for supervisors on leadership activities expected of them while educating students on the processes involved in carrying out a qualitative and acceptable research study. Such exercise should include the ethical principles and guidelines that comprise all parts of research from research topic through the literature review to the design and the truthful reporting of results.

Keywords: academic leadership, ethical standards, research stakeholders, research enterprise

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Authors: Julia Baker

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Development plays a major role in stopping biodiversity loss. But the ‘silo species’ protection of legislation (where certain species are protected while many are not) means that development can be ‘legally compliant’ and result in biodiversity loss. ‘Net Gain’ (NG) policies can help overcome this by making it an absolute requirement that development causes no overall loss of biodiversity and brings a benefit. However, offsetting biodiversity losses in one location with gains elsewhere is controversial because people suspect ‘offsetting’ to be an easy way for developers to buy their way out of conservation requirements. Yet the good practice principles (GPP) of offsetting provide several advantages over existing legislation for protecting biodiversity from development. This presentation describes the learning from implementing NG approaches based on GPP. It regards major upgrades of the UK’s transport networks, which involved removing vegetation in order to construct and safely operate new infrastructure. While low-lying habitats were retained, trees and other habitats disrupting the running or safety of transport networks could not. Consequently, achieving NG within the transport corridor was not possible and offsetting was required. The first ‘lessons learnt’ were on obtaining a commitment from business leaders to go beyond legislative requirements and deliver NG, and on the institutional change necessary to embed GPP within daily operations. These issues can only be addressed when the challenges that biodiversity poses for business are overcome. These challenges included: biodiversity cannot be measured easily unlike other sustainability factors like carbon and water that have metrics for target-setting and measuring progress; and, the mindset that biodiversity costs money and does not generate cash in return, which is the opposite of carbon or waste for example, where people can see how ‘sustainability’ actions save money. The challenges were overcome by presenting the GPP of NG as a cost-efficient solution to specific, critical risks facing the business that also boost industry recognition, and by using government-issued NG metrics to develop business-specific toolkits charting their NG progress whilst ensuring that NG decision-making was based on rich ecological data. An institutional change was best achieved by supporting, mentoring and training sustainability/environmental managers for these ‘frontline’ staff to embed GPP within the business. The second learning was from implementing the GPP where business partnered with local governments, wildlife groups and land owners to support their priorities for nature conservation, and where these partners had a say in decisions about where and how best to achieve NG. From this inclusive approach, offsetting contributed towards conservation priorities when all collaborated to manage trade-offs between: -Delivering ecologically equivalent offsets or compensating for losses of one type of biodiversity by providing another. -Achieving NG locally to the development whilst contributing towards national conservation priorities through landscape-level planning. -Not just protecting the extent and condition of existing biodiversity but ‘doing more’. -The multi-sector collaborations identified practical, workable solutions to ‘in perpetuity’. But key was strengthening linkages between biodiversity measures implemented for development and conservation work undertaken by local organizations so that developers support NG initiatives that really count.

Keywords: biodiversity offsetting, development, nature conservation planning, net gain

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