Search results for: South African foreign policy
4883 Mergers and Acquisitions in the Banking Sector: The West African Experience
Authors: Sunday Odunaiya
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The statistics of banks in operation in this current dispensation compared to some decades ago has brought about a lot of changes on the face of the financial system. The demand of customers, technological advancement, and government policies among others has therefore generated a lot of heat for financial sector’s growth, sustenance and survival. This paper discusses mergers and acquisitions (M&A) in banking sector using West Africa as a yardstick of evaluation. It explains rigorously the conditions that warrant mergers and acquisitions in the banking sector, its effect, and how to ensure mergers and acquisitions effectiveness in the banking sector. The conceptual and empirical review of the relevant literature were done systematically while value-increasing and value-decreasing theories were used to substantiate the discourse. Findings of this paper show that mergers and acquisitions is a practical and conscious activity in Nigeria, Ghana and Ivory Coast from earliest time till date with tremendous turnaround in the financial sector. It was found out that M&A is consensually arrived at by the targets and the acquirer on a value-based account. In other words, merger and acquisition is a deliberate decision reached by the management of such bank for a ‘just cause’.Keywords: acquisitions, merger, management, financial sector
Procedia PDF Downloads 2834882 The Content-Based Classroom: Perspectives on Integrating Language and Content
Authors: Mourad Ben Bennani
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Views of language and language learning have undergone a tremendous change over the last decades. Language is no longer seen as a set of structured rules. It is rather viewed as a tool of interaction and communication. This shift in views has resulted in change in viewing language learning, which gave birth to various approaches and methodologies of language teaching. Two of these approaches are content-based instruction and content and language integrated learning (CLIL). These are similar approaches which integrate content and foreign/second language learning through various methodologies and models as a result of different implementations around the world. This presentation deals with sociocultural view of CBI and CLIL. It also defines language and content as vital components of CBI and CLIL. Next it reviews the origins of CBI and the continuum perspectives and CLIL definitions and models featured in the literature. Finally it summarizes current aspects around research in program evaluation with a focus on the benefits and challenges of these innovative approaches for second language teaching.Keywords: CBI, CLIL, CBI continuum, CLIL models
Procedia PDF Downloads 4424881 Effective Service Provision and Multi-Agency Working in Service Providers for Children and Young People with Special Educational Needs and Disabilities: A Mixed Methods Systematic Review
Authors: Natalie Tyldesley-Marshall, Janette Parr, Anna Brown, Yen-Fu Chen, Amy Grove
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It is widely recognised in policy and research that the provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) is enhanced when health and social care, and education services collaborate and interact effectively. In the UK, there have been significant changes to policy and provisions which support and improve collaboration. However, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance or framework to illustrate how effective multi-agency working could or should work. This systematic review will identify the key components of effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. The review highlights interventions that lead to service improvements; and the conditions in the local area that support and encourage success. A protocol was written and registered with PROSPERO registration: CRD42022352194. Searches were conducted on several health, care, education, and applied social science databases from the year 2012 onwards. Citation chaining has been undertaken, as well as broader grey literature searching to enrich the findings. Qualitative, quantitative, mixed methods studies and systematic reviews were included, assessed independently, and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data were extracted in NVivo software and checked by a more experienced researcher. A convergent segregated approach to synthesis and integration was used in which the quantitative and qualitative data were synthesised independently and then integrated using a joint display integration matrix. Findings demonstrate the key ingredients for effective partnership working for services delivering SEND. Interventions deemed effective are described, and lessons learned across interventions are summarised. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0-25 can most effectively collaborate and achieve service improvement. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.Keywords: collaboration, joint commissioning, service delivery, service improvement
Procedia PDF Downloads 1144880 Developing EFL Research Skills of Pre-Master Students through a Suggested Quest Based Learning Strategy
Authors: Heba Mustafa Abdullah
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The research aimed at examining the effect of a using a quest based learning strategy on developing EFL Pre-Master Students. The study adopted the quasi-experimental design. The sample of the research consists of a group of 30 students enrolled in Pre-Master program, Curriculum and EFL Instruction Department, Faculty of Graduate Studies in Education Tools of the study included a EFL research skills checklist and EFL research skills test. Results revealed that there were statistically significant differences at 0.01 levels with regard to some research skills. Results were discussed in relation to several factors that affected the language learning process. Finally, the research provided beneficial contributions in relation to manipulating e-learning technologies in general and Quest based learning strategy in particular with respect to EFL research skills.Keywords: English as foreign language, e-Learning, research skills, quest based learning
Procedia PDF Downloads 4464879 Aggregate Supply Response of Some Livestock Commodities in Algeria: Cointegration- Vector Error Correction Model Approach
Authors: Amine M. Benmehaia, Amine Oulmane
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The supply response of agricultural commodities to changes in price incentives is an important issue for the success of any policy reform in the agricultural sector. This study aims to quantify the responsiveness of producers of some livestock commodities to price incentives in Algerian context. Time series analysis is used on annual data for a period of 52 years (1966-2018). Both co-integration and vector error correction model (VECM) are used through the Nerlove model of partial adjustment. The study attempts to determine the long-run and short-run relationships along with the magnitudes of disequilibria in the selected commodities. Results show that the short-run price elasticities are low in cow and sheep meat sectors (8.7 and 8% respectively), while their respective long-run elasticities are 16.5 and 10.5, whereas eggs and milk have very high short-run price elasticities (82 and 90% respectively) with long-run elasticities of 40 and 46 respectively. The error correction coefficient, reflecting the speed of adjustment towards the long-run equilibrium, is statistically significant and have the expected negative sign. Its estimates are 12.7 for cow meat, 33.5 for sheep meat, 46.7 for eggs and 8.4 for milk. It seems that cow meat and milk producers have a weak feedback of about 12.7% and 8.4% respectively of the previous year's disequilibrium from the long-run price elasticity, whereas sheep meat and eggs producers adjust to correct long run disequilibrium with a high speed of adjustment (33.5% and 46.7 % respectively). The implication of this is that much more in-depth research is needed to identify those factors that affect agricultural supply and to describe the effect of factors that shift supply in response to price incentives. This could provide valuable information for government in the use of appropriate policy measures.Keywords: Algeria, cointegration, livestock, supply response, vector error correction model
Procedia PDF Downloads 1454878 Conjugal Relationship and Reproductive Decision-Making among Couples in Southwest Nigeria
Authors: Peter Olasupo Ogunjuyigbe, Sarafa Shittu
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This paper emphasizes the relevance of conjugal relationship and spousal communication towards enhancing men’s involvement in contraceptive use among the Yorubas of South Western Nigeria. An understanding of males influence and the role they play in reproductive decision making can throw better light on mechanisms through which egalitarianness of husband/wife decision making influences contraceptive use. The objective of this study was to investigate how close conjugal relationships can be a good indicator of joint decision making among couples using data derived from a survey conducted in three states of South Western Nigeria. The study sample consisted of five hundred and twenty one (521) male respondents aged 15-59 years and five hundred and forty seven (547) female respondents aged 15-49 years. The study used both quantitative and qualitative approached to elicit information from the respondents. In order that the study would be truly representative of the towns, each of the study locations in the capital cities was divided into four strata: The traditional area, the migrant area, the mixed area (i.e. traditional and migrant), and the elite area. In the rural areas, selection of the respondents was by simple random sampling technique. However, the random selection was made in such a way that all the different parts of the locations were represented. Generally, the data collected were analysed at univariate, bivariate, and multivariate levels. Logistic regression models were employed to examine the interrelationships between male reproductive behaviour, conjugal relationship and contraceptive use. The study indicates that current use of contraceptive is high among this major ethnic group in Nigeria because of the improved level of communication among couples. The problem, however, is that men still have lower exposure rate when it comes to question of family planning information, education and counseling. This has serious implications on fertility regulation in Nigeria.Keywords: behavior, conjugal, communication, counseling, spouse
Procedia PDF Downloads 1404877 The Role of the University Campus in Shaping the Built Environment of Its Local Communities
Authors: Lawrence Babatunde Ogunsanya
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The university has been in existence, in one form or another, for over a thousand years and has contributed in multiple ways to modern society. It is considered a center of culture, aesthetic direction, and moral forces shaping the civilized society. Universities also contribute in important ways to the economic health and physical landscape of neighborhoods and cities, serving as permanent fixtures of the urban economy and the built environment. Due to the size and location of university campuses, they put demands on the urban character, systems, and infrastructure of the neighboring communities. These demands or impacts have substantial implications for the built environment. It is important to understand the impacts university campuses have on their surrounding communities and urban environments because the destiny of the university is inextricably linked to the destiny of the adjacent neighborhoods. This paper identifies the diverse factors generated by universities in shaping the built environments of their local communities within different spatial contexts such as urban, rural, and township regions situated in South Africa.By applying a mixed methods approach in four university campuses within the province of KwaZulu-Natal in South Africa. Several data collection instruments were used, such as in-depth interviews, a survey, remote sensing, and onsite observations. The thematic findings revealed numerous factors which influence the morphology of neighbourhood built environments and the myriad of relationships the university has with its local community. This paper also reveals that the university campus is more than a precinct which accommodates buildings and academic endeavours, the role of the university in this century has changed dramatically from its traditional roots of being an elite enclave of academics to a more inclusive and engaged entity that is concerned about providing relevant holistic solutions to society’s current challenges in the built environment.Keywords: university campus, built environment, architecture, neighborhood planning
Procedia PDF Downloads 1334876 DNA Barcoding of Selected Fin Fishes from New Calabar River in Rivers State, South-South Nigeria Using Cytochrome C Oxidase Subunit 1 Gene
Authors: Anukwu J. U., Nwamba H. O., Njom V. S., Achikanu C. E., Edoga C. O. Chiaha I. E.
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The major environmental crisis is the loss of biodiversity and the decline is predominant in the fish population. Although taxonomic history began 250 years ago, there are still undiscovered members of species and new species are waiting to be uncovered. The failure of the traditional taxonomic method to address this issue has resulted to the adoption of a molecular approach-DNA barcoding. It was proposed that DNA barcoding using the mitochondrion cytochrome oxidase subunit I (COI) gene has the capability to serve as a barcode for fish. The aim of this study was to use DNA barcoding in the identification of fish species in the New Calabar River, Rivers State. BLAST result showed the correlation between the sequence queried and the biological sequences with the NCBI database. The names of the samples, percentage ID, predicted organisms, and GenBank Accession numbers were clearly identified. A total of 18 sequences (all > 600bp) belonging to 8 species, 7 genera, 7 families, and 5 orders were validated and submitted to the NCBI database. Each nucleotide peak was represented by a single colour with various percentage occurrences. Two (22%) out of the 9 original samples analyzed corresponded with the predicted organisms from the BLAST result.) There were a total of 712 positions in the final dataset. Evolutionary analyses were conducted in MEGA11. Pairwise sequence alignment showed different consensus positions and a total of 30 mutations. There was one insertion from Polynemus dubius and 29 substitutions (transition-15 and transversion-14) mutations. No deletion and nonsense codons were detected in all the amplified sequences. This work will facilitate more research in other keys areas such as the identification of mislabeled fish products, illegal trading of endangered species, and effective tracking of fish biodiversity.Keywords: DNA barcoding, Imo river, phylogenetic tree, mutation.
Procedia PDF Downloads 154875 Tectonostratigraphic, Paleogeography and Amalgamation of Sumatra Terranes, Indonesia
Authors: Syahrir Andi Mangga, Ipranta
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The geological, paleomagnetic, geochemical and geophysical Investigation in The Sumatra Region has yielded some new data, has stimulated a reassessment of stratigraphy, structure, tectonic evolution and which can show a Sumatra geodynamic model. Sumatra island has in the margin of southwest part of the Eurasia plate in the Sundaland cratonic block and occurred as the amalgamation of allochtonous microplates, continental fragments, Island arc and accrctionary by foreland complex which assembled prior to Tertiary. The allochtonous rocks (terranes), can be divided into 4 (four) Terranes with Paleozoic to Mesosoic in age, had different origin, lithology and are separated by a Suture as main fault with trending NW-SE. The terranes are: the Tigapuluh-Bohorok (East Sumatra block / Sibumasu block), Permo-Carboniferous in age and is characterized by the rock types formed in glacio-marine and was intruded by Late Triassic to Early Jurrasic granitics, occupied in the Eastern part of Sumatra, the paleomagnetic data shown 41° South. Tanjung Karang - Gunung Kasih Terrane, is composed of higher metamorphic rocks and supposed to be pre-Carboniferous in age, covered by Mesozoic sedimentary rocks and were intruded by granitic-dioritic rocks, occupied in the Southern part of Sumatra, the paleomagnetic data shown 19° North. The Kuantan-Duabelas Mountain (West Sumatra block) is occupied by metamorphic, sedimentary and volcanic rocks of Paleozoic - Mesozoic (Carboniferous - Triassic) in age, contains a Cathaysion fauna and flora and are intruded by the Mesozoic granitoid rocks. The terrane occurred in the western part of Sumatra. Meanwhile, the Gumai-Garba (Waloya Terrane) which is occupied by the tectonite/melange, metasediment, carbonate and volcanic rocks of Mesozoic (Jurassic - Cretaceous) in age, are intruted by the Late Cretaceous granitoid rocks, the paleomagnetic data shown 30° - 31° South.Keywords: tectonostratigraphy, amalgamation, allochtonous, terranes, sumatra
Procedia PDF Downloads 3464874 Accessibility of Social Justice through Social Security in Indian Organisations: Analysis Based on Workforce
Authors: Neelima Rashmi Lakra
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India was among one of the highly developed economy up to 1850 due to its cottage industries. During the end of the 18th century, modern industrial enterprises began with the first cotton mill in Bombay, the jute mill near Calcutta and the coal mine in Raniganj. This was counted as the real beginning of industry in 1854 in India. Prior to this period people concentrated only to agriculture, menial service or handicraft, and the introduction of industries exposed them to the disciplines of factory which was very tedious for them. With increasing number of factories been setup adding on to mining and introduction of railway, World War Period (1914-19), Second World War Period (1939-45) and the Great Depression (1929-33) there were visible change in the nature of work for the people, which resulted in outburst of strike for various reasons in these factories. Here, with India’s independence there was emergence of public sector industries and labour legislations were introduced. Meanwhile, trade unions came to notice to the rescue of the oppressed but failed to continue till long. Soon after, with the New Economic Policy organisations came across to face challenges to perform their best, where social justice for the workmen was in question. On these backdrops, studies were found discussing the central human capabilities which could be addressed through Social Security schemes. Therefore, this study was taken up to look at the reforms and legislations mainly meant for the welfare of the labour. This paper will contribute to the large number of Indian population who are serving in public sectors in India since the introduction of industries and will complement the issue of social justice through social security measures among this huge crowd serving the nation. The objectives of the study include; to find out what labour Legislations have already been existing in India, the role of Trade Union Movement, to look at the effects of New Economic Policy on these reforms and its effects and measures taken for the workforce employed in the public sectors and finally, if these measures fulfil the social justice aspects for the larger society on whole. The methodology followed collection of data from books, journal articles, reports, company reports and manuals focusing mainly on Indian studies and the data was analysed following content analysis method. The findings showed the measures taken for Social Security, but there were also reflections of very few particular additions or amendments to these Acts and provisions with the onset of New Liberalisation Policy. Therefore, the study concluded examining the social justice aspects in the context of a developing economy and discussing the recommendations.Keywords: public sectors, social justice, social security schemes, trade union movement
Procedia PDF Downloads 4544873 Reaching Students Who “Don’t Like Writing” through Scenario Based Learning
Authors: Shahira Mahmoud Yacout
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Writing is an essential skill in many vocational, academic environments, and notably workplaces, yet many students perceive writing as being something tiring and boring or maybe a “waste of time”. Studies in the field of foreign languages related this fact might be due to the lack of connection between what is learned in the university and what students come to encounter in real life situations”. Arabic learners felt they needed more language exposure to the context of their future professions. With this idea in mind, Scenario based learning (SBL) is reported to be an educational approach to motivate, engage and stimulate students’ interest and to achieve the desired writing learning outcomes. In addition, researchers suggested Scenario based learning (SBL)as an instructional approach that develops and enhances students skills through developing higher order thinking skills and active learning. It is a subset of problem-based learning and case-based learning. The approach focuses on authentic rhetorical framing reflecting writing tasks in real life situations. It works successfully when used to simulate real-world practices, providing context that reflects the types of situations professionals respond to in writing. It was claimed that using realistic scenarios customized to the course’s learning objectives as it bridged the gap for students between theory and application. Within this context, it is thought that scenario-based learning is an important approach to enhance the learners’ writing skills and to reflect meaningful learning within authentic contexts. As an Arabicforeign language instructor, it was noticed that students find difficulties in adapting writing styles to authentic writing contexts and addressing different audiences and purposes. This idea is supported by studieswho claimed that AFL students faced difficulties with transferring writing skills to situations outside of the classroom context. In addition, it was observed that some of the Arabic textbooks for teaching Arabic as a foreign language lacked topics that initiated higher order thinking skills and stimulated the learners to understand the setting, and created messages appropriate to different audiences, context, and purposes. The goals of this study are to 1)provide a rational for using scenario-based learning approach to improveAFL learners in writing skills, 2) demonstrate how to design/ implement a scenario-based learning technique aligned with the writing course objectives,3) demonstrate samples of scenario-based approach implemented in AFL writing class, and 4)emphasis the role of peer-review along with the instructor’s feedback, in the process of developing the writing skill. Finally, this presentation highlighted and emphasized the importance of using the scenario-based learning approach in writing as a means to mirror students’ real-life situations and engage them in planning, monitoring, and problem solving. This approach helped in making writing an enjoyable experience and clearly useful to students’ future professional careers.Keywords: meaningful learning, real life contexts, scenario based learning, writing skill
Procedia PDF Downloads 1054872 The Role of Accounting in the Run-Added Tax in Iran
Authors: Zahra Karimi
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Money is not the only medium of economic exchanges, but also affects the national identity of citizens and national sovereignty of the government. Hence, money can be used as a tool to strengthen the national and political identity of nations. In other words, the value of the national currency can be affecting citizen’s view to the economic situation of their country and national identity. Government with the maintenance of the value of the national currency must increase the confidence of its citizens into national currency and prevents that "currency substitution phenomenon" occurred and people turn to foreign currencies. Hence, this article intends to explain the zeros elimination from the national currency and study of experience of other countries and discussion history analyzed benefits and harms of zeroes elimination from the national currency, And then to evaluate the effect or lack of effect of removing of zeros from the national currency on inflation answer the question whether it is appropriate and on time to delete three zeros from the Riyal of Iran is or not?Keywords: zeros elimination from the national currency, value of the national currency, Riyal, inflation, Iran, money, government
Procedia PDF Downloads 5444871 Ethnopharmacology of Urinary Deseases in Algerian Sahara
Authors: Khaled Sekkoum
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The traditional pharmacopoeia of Algerian Sahara is very rich on vegetable drugs. The great resources and biodiversity of Algerian Sahara flora seem responsible. A survey of medicinal plants used by the local population of the south west of Algeria for the urinary disorders is reported. Sixty-three plant species belonging to thirty-three families were identified. Their botanical and local names, plant part used, mode of use and ailment treated are given.Keywords: medicinal plants, urinary diseases, Sahara, Algeria
Procedia PDF Downloads 3354870 Revisiting Classic Triad of Japanese Spotted Fever: A Case Series of Forty-Three Patients
Authors: Y. Kunitani, Y. Nakashima, S. Yamauchi, Y. Ishigami, K. Naito, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi
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Background: Japanese Spotted Fever (JSF) is one of the Rickettsial infections, caused by Rickettsia japonica, which is transmitted by ticks. JSF is seen in limited area, such as Japan and South Korea. Its clinical triad is rash, eschar and fever. It often shows leukocytopenia, thrombopenia, elevated transaminase and high C-reactive protein (CRP). Sometimes it can be life-threatening due to disseminated intravascular coagulation or multiple organ failure. Study Aim: The aim of this study is to describe the features of JSF, as this unique infection is rapidly growing in Japan. Methods: This is a case series of JSF from 2009 to 2016, in Mie Prefectural Hospital in Japan. We collected JSF cases, which were diagnosed by polymerase chain reaction (PCR) of the skin or blood serum, or the elevation of the antibody titer of paired blood samples. Results: There were 43 JSF patients (19 male, 24 female) with a median age of 71 years [IQR:65-80]. The median body temperature was 38.1°C[IQR: 37.5-39.0]. 95% had a rash, 67% had eschar and 50% had fever. The median WBC count was 6,700 [IQR: 5,750-8,200] and leukocytopenia was observed in only 7%. The median platelet count was 14x104 [IQR10x104-17x104], thrombopenia was observed in 65%. The median aspartate transaminase (AST) was 53 IU/L [IQR: 41-93]; the median alanine aminotransferase (ALT) was 34 IU/L [IQR: 24-54]; the median CRP was 10.4 mg/dL [IQR:7.2-13.9]; the median lactate dehydrogenase (LDH) was 352IU/L [IQR:282-451]. CRP and LDH were elevated in almost all of the patients. Median length of stay in hospital was 8 days [IQR: 6-11]. All patients were treated with tetracycline and quinolone on the day of the presentation. There was no fatality from JSF. Conclusion: The patients with JSF classically presents with eschar, rash and fever. However, in this study, the half of the patients were afebrile. Although JSF is not a common infectious disease worldwide, if the patient had previously visited Japan or South Korea and presented with rash and eschar with or without fever, we should consider JSF as a potential diagnosis.Keywords: infectious disease, Japanese spotted fever, Rickettsial disease, Rickettsia japonica
Procedia PDF Downloads 2314869 Students’ Awareness of the Use of Poster, Power Point and Animated Video Presentations: A Case Study of Third Year Students of the Department of English of Batna University
Authors: Bahloul Amel
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The present study debates students’ perceptions of the use of technology in learning English as a Foreign Language. Its aim is to explore and understand students’ preparation and presentation of Posters, PowerPoint and Animated Videos by drawing attention to visual and oral elements. The data is collected through observations and semi-structured interviews and analyzed through phenomenological data analysis steps. The themes emerged from the data, visual learning satisfaction in using information and communication technology, providing structure to oral presentation, learning from peers’ presentations, draw attention to using Posters, PowerPoint and Animated Videos as each supports visual learning and organization of thoughts in oral presentations.Keywords: EFL, posters, PowerPoint presentations, Animated Videos, visual learning
Procedia PDF Downloads 4494868 Top-Down, Middle-Out, Bottom-Up: A Design Approach to Transforming Prison
Authors: Roland F. Karthaus, Rachel S. O'Brien
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Over the past decade, the authors have undertaken applied research aimed at enabling transformation within the prison service to improve conditions and outcomes for those living, working and visiting in prisons in the UK and the communities they serve. The research has taken place against a context of reducing resources and public discontent at increasing levels of violence, deteriorating conditions and persistently high levels of re-offending. Top-down governmental policies have mainly been ineffectual and in some cases counter-productive. The prison service is characterised by hierarchical organisation, and the research has applied design thinking at multiple levels to challenge and precipitate change: top-down, middle-out and bottom-up. The research employs three distinct but related approaches, system design (top-down): working at the national policy level to analyse the changing policy context, identifying opportunities and challenges; engaging with the Ministry of Justice commissioners and sector organisations to facilitate debate, introducing new evidence and provoking creative thinking, place-based design (middle-out): working with individual prison establishments as pilots to illustrate and test the potential for local empowerment, creative change, and improved architecture within place-specific contexts and organisational hierarchies, everyday design (bottom-up): working with individuals in the system to explore the potential for localised, significant, demonstrator changes; including collaborative design, capacity building and empowerment in skills, employment, communication, training, and other activities. The research spans a series of projects, through which the methodological approach has developed responsively. The projects include a place-based model for the re-purposing of Ministry of Justice land assets for the purposes of rehabilitation; an evidence-based guide to improve prison design for health and well-being; capacity-based employment, skills and self-build project as a template for future open prisons. The overarching research has enabled knowledge to be developed and disseminated through policy and academic networks. Whilst the research remains live and continuing; key findings are emerging as a basis for a new methodological approach to effecting change in the UK prison service. An interdisciplinary approach is necessary to overcome the barriers between distinct areas of the prison service. Sometimes referred to as total environments, prisons encompass entire social and physical environments which themselves are orchestrated by institutional arms of government, resulting in complex systems that cannot be meaningfully engaged through narrow disciplinary lenses. A scalar approach is necessary to connect strategic policies with individual experiences and potential, through the medium of individual prison establishments, operating as discrete entities within the system. A reflexive process is necessary to connect research with action in a responsive mode, learning to adapt as the system itself is changing. The role of individuals in the system, their latent knowledge and experience and their ability to engage and become agents of change are essential. Whilst the specific characteristics of the UK prison system are unique, the approach is internationally applicable.Keywords: architecture, design, policy, prison, system, transformation
Procedia PDF Downloads 1394867 EMS Providers' Ability and Willingness to Respond to Bioterrorism
Authors: Ryan Houser
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Introduction: Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services, even in the accelerating environment of biothreats. Methods: This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS (Emergency Medical Services ) providers. The survey was available for one month in 2021, during which 190 EMS providers responded to the survey. Results: Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a CBRN agent. The provider Clinical Competency levels range from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution and community). Only 10% of the respondents are both willing and able to effectively function in a bioterror environment. Discussion: In order to effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.Keywords: bioterrorism, prehospital, EMS, disaster, emergency, medicine, preparedness, policy
Procedia PDF Downloads 1614866 Effect of Ease of Doing Business to Economic Growth among Selected Countries in Asia
Authors: Teodorica G. Ani
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Economic activity requires an encouraging regulatory environment and effective rules that are transparent and accessible to all. The World Bank has been publishing the annual Doing Business reports since 2004 to investigate the scope and manner of regulations that enhance business activity and those that constrain it. A streamlined business environment supporting the development of competitive small and medium enterprises (SMEs) may expand employment opportunities and improve the living conditions of low income households. Asia has emerged as one of the most attractive markets in the world. Economies in East Asia and the Pacific were among the most active in making it easier for local firms to do business. The study aimed to describe the ease of doing business and its effect to economic growth among selected economies in Asia for the year 2014. The study covered 29 economies in East Asia, Southeast Asia, South Asia and Middle Asia. Ease of doing business is measured by the Doing Business indicators (DBI) of the World Bank. The indicators cover ten aspects of the ease of doing business such as starting a business, dealing with construction permits, getting electricity, registering property, getting credit, protecting investors, paying taxes, trading across borders, enforcing contracts and resolving insolvency. In the study, Gross Domestic Product (GDP) was used as the proxy variable for economic growth. Descriptive research was the research design used. Graphical analysis was used to describe the income and doing business among selected economies. In addition, multiple regression was used to determine the effect of doing business to economic growth. The study presented the income among selected economies. The graph showed China has the highest income while Maldives produces the lowest and that observation were supported by gathered literatures. The study also presented the status of the ten indicators of doing business among selected economies. The graphs showed varying trends on how easy to start a business, deal with construction permits and to register property. Starting a business is easiest in Singapore followed by Hong Kong. The study found out that the variations in ease of doing business is explained by starting a business, dealing with construction permits and registering property. Moreover, an explanation of the regression result implies that a day increase in the average number of days it takes to complete a procedure will decrease the value of GDP in general. The research proposed inputs to policy which may increase the awareness of local government units of different economies on the simplification of the policies of the different components used in measuring doing business.Keywords: doing business, economic growth, gross domestic product, Asia
Procedia PDF Downloads 3864865 Linking Adaptation to Climate Change and Sustainable Development: The Case of ClimAdaPT.Local in Portugal
Authors: A. F. Alves, L. Schmidt, J. Ferrao
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Portugal is one of the more vulnerable European countries to the impacts of climate change. These include: temperature increase; coastal sea level rise; desertification and drought in the countryside; and frequent and intense extreme weather events. Hence, adaptation strategies to climate change are of great importance. This is what was addressed by ClimAdaPT.Local. This policy-oriented project had the main goal of developing 26 Municipal Adaptation Strategies for Climate Change, through the identification of local specific present and future vulnerabilities, the training of municipal officials, and the engagement of local communities. It is intended to be replicated throughout the whole territory and to stimulate the creation of a national network of local adaptation in Portugal. Supported by methodologies and tools specifically developed for this project, our paper is based on the surveys, training and stakeholder engagement workshops implemented at municipal level. In an 'adaptation-as-learning' process, these tools functioned as a social-learning platform and an exercise in knowledge and policy co-production. The results allowed us to explore the nature of local vulnerabilities and the exposure of gaps in the context of reappraisal of both future climate change adaptation opportunities and possible dysfunctionalities in the governance arrangements of municipal Portugal. Development issues are highlighted when we address the sectors and social groups that are both more sensitive and more vulnerable to the impacts of climate change. We argue that a pluralistic dialogue and a common framing can be established between them, with great potential for transformational adaptation. Observed climate change, present-day climate variability and future expectations of change are great societal challenges which should be understood in the context of the sustainable development agenda.Keywords: adaptation, ClimAdaPT.Local, climate change, Portugal, sustainable development
Procedia PDF Downloads 2014864 Assessment of the Relationship between Energy Price Dynamics and Green Growth in the Sub-Sharan Africa
Authors: Christopher I. Ifeacho, Adeleke Omolade
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The paper examines the relationship between energy price dynamics and green growth in Sub Sahara African Countries. The quest for adopting green energy in order to improve green growth that can engender sustainability and stability has received more attention from researchers in recent times. This study uses a panel autoregressive distributed lag approach to investigate this relationship. Findings from the result showed that energy price dynamics and exchange rates have more short-run significant impacts on green growth in individual countries rather than the pooled result. Furthermore, the long-run result confirmed that inflation and capital have a significant long-run relationship with green growth. The causality test result revealed the existence of a bi-directional relationship between green growth and energy price dynamics. The study recommends caution in a currency devaluation and improvement in renewable energy production in the Sub Sahara Africa in order to achieve sustainable green growth.Keywords: green growth, energy price dynamics, Sub Saharan Africa, relationship
Procedia PDF Downloads 1054863 Unfolding the Affective Atmospheres during the COVID-19 Pandemic Crisis: The Constitution and Performance of Affective Governance in Taiwan
Authors: Sang-Ju Yu
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This paper examines the changing essences and effects of ‘affective atmosphere’ during the COVID-19 pandemic crisis, which have been facilitated and shaped the ‘affective governance’ in Taiwan. Due to long-term uncertainty and unpredictability, the COVID-19 pandemic not only caused unprecedented global crisis but triggered the public’s negative emotional responses. This paper unravels how the shortage of Personal Protective Equipment and the proliferating fake news heightened people’s fear and anxiety and how specific affective atmospheres can be provoked and manipulated to harness emotional appeals of citizens strategically in Taiwan. Through the in-depth interviews with diverse stakeholders involved, it unfolds the dynamics and strategies of affective governance, wherein public emotions and concerns are now given significant consideration in both policy measures and the affective expression of leadership, spatial arrangement, service delivery, and the interaction with citizens. Addressing psychosocial and emotional needs has become the core of crisis response mechanisms suited to dynamic affective atmospheres and pandemic situation. This paper also demonstrates that epidemic prevention and control is not merely the production of neutral or rational policy-making processes, as it is dominated by multiple emotions resulted from unexpected and salient events at different moments. It provides explicit insight into how different prevention scenarios operated effectively through political and affective mobilisation to strengthen emotional bonding and collective identity which energises collective action. Basically, successful affective governance calls for both negative and positive emotions, for both scientific and political decision-making, for both community and bureaucracy, and both quality and efficiency of private–public collaboration.Keywords: affective atmospheres, affective governance, COVID-19 pandemic, private-public collaboration
Procedia PDF Downloads 1034862 Effects of Web-Enabled Sculpture Package on Colleges of Education Students’ Psychomotor Ability in Fine Arts in South-West, Nigeria
Authors: Ibrahim A. Kareem, Sina O. Ayelaagbe
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This study investigated the effects of web-enabled Sculpture package on Colleges of Education students’ psychomotor level in Fine Arts in South-west, Nigeria. The objectives of this study were to: (i) determine the effect of web-enabled Sculpture package on Fine Arts Students’ performance; (ii) find out the effect of ability levels on Fine Arts Students’ performance and (iii) ascertain the interaction effect of treatment and ability levels on Fine Arts Students’ performance. The study was quasi-experimental design. A total of 48 Fine Arts Students participated in the study. There were 26 students in experimental and 22 for the control. The respondents were purposively sampled from Adeyemi College of Education, Ondo and Federal College of Education (Special) Oyo. Sculpture Achievement Test, Sculpture Skill Test and Sculpture ‘on the Spot’ Skill Assessment Instrument were validated by experts while Pearson’s Product Moment Correlation (PPMC) statistics was used to analyse the instrument while the remaining two instruments were subjected to Cronbach alpha statistics. Data were analysed using t-test and ANCOVA were used to test the hypotheses at 0.05 level of significance. The findings of the study revealed that: (i) Fine Arts Students’ in the experimental group performed significantly better than the control group; (ii) there was a significant difference among high, medium and low ability levels mean scores of Fine Arts Students’ performance in Colleges of Education; (iii) there was no significant interaction effect of treatment and ability levels on the mean scores of Fine Arts Students’ performance in Colleges of Education and. The study concluded that Fine Arts Students exposed to web-enabled Sculpture package performed better than those taught using the conventional method. Based on the study it was recommended that lecturers in Colleges of Education should endeavour to adapt and utilise web-enabled Sculpture package for teaching sculpture.Keywords: fine art, psychomotor, sculpture, web-enabled
Procedia PDF Downloads 1554861 De-Securitizing Identity: Narrative (In)Consistency in Periods of Transition
Authors: Katerina Antoniou
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When examining conflicts around the world, it is evident that the majority of intractable conflicts are steeped in identity. Identity seems to be not only a causal variable for conflict, but also a catalytic parameter for the process of reconciliation that follows ceasefire. This paper focuses on the process of identity securitization that occurs between rival groups of heterogeneous collective identities – ethnic, national or religious – as well as on the relationship between identity securitization and the ability of the groups involved to reconcile. Are securitized identities obstacles to the process of reconciliation, able to hinder any prospects of peace? If the level to which an identity is securitized is catalytic to a conflict’s discourse and settlement, then which factors act as indicators of identity de-securitization? The level of an in-group’s identity securitization can be estimated through a number of indicators, one of which is narrative. The stories, views and stances each in-group adopts in relation to its history of conflict and relation with their rival out-group can clarify whether that specific in-group feels victimized and threatened or safe and ready to reconcile. Accordingly, this study discusses identity securitization through narrative in relation to intractable conflicts. Are there conflicts around the world that, despite having been identified as intractable, stagnated or insoluble, show signs of identity de-securitization through narrative? This inquiry uses the case of the Cyprus conflict and its partitioned societies to present official narratives from the two communities and assess whether these narratives have transformed, indicating a less securitized in-group identity for the Greek and Turkish Cypriots. Specifically, the study compares the official historical overviews presented by each community’s Ministry of Foreign Affairs website and discusses the extent to which the two official narratives present a securitized collective identity. In addition, the study will observe whether official stances by the two communities – as adopted by community leaders – have transformed to depict less securitization over time. Additionally, the leaders’ reflection of popular opinion is evaluated through recent opinion polls from each community. Cyprus is currently experiencing renewed optimism for reunification, with the leaders of its two communities engaging in rigorous negotiations, and with rumors calling for a potential referendum for reunification to be taking place even as early as within 2016. Although leaders’ have shown a shift in their rhetoric and have moved away from narratives of victimization, this is not the case for the official narratives used by their respective ministries of foreign affairs. The study’s findings explore whether this narrative inconsistency proves that Cyprus is transitioning towards reunification, or whether the leaders are risking sending a securitized population to the polls to reject a potential reunification. More broadly, this study suggests that in the event that intractable conflicts might be moving towards viable peace, in-group narratives--official narratives in particular--can act as indicators of the extent to which rival entities have managed to reconcile.Keywords: conflict, identity, narrative, reconciliation
Procedia PDF Downloads 3274860 Analyzing the Changing Pattern of Nigerian Vegetation Zones and Its Ecological and Socio-Economic Implications Using Spot-Vegetation Sensor
Authors: B. L. Gadiga
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This study assesses the major ecological zones in Nigeria with the view to understanding the spatial pattern of vegetation zones and the implications on conservation within the period of sixteen (16) years. Satellite images used for this study were acquired from the SPOT-VEGETATION between 1998 and 2013. The annual NDVI images selected for this study were derived from SPOT-4 sensor and were acquired within the same season (November) in order to reduce differences in spectral reflectance due to seasonal variations. The images were sliced into five classes based on literatures and knowledge of the area (i.e. <0.16 Non-Vegetated areas; 0.16-0.22 Sahel Savannah; 0.22-0.40 Sudan Savannah, 0.40-0.47 Guinea Savannah and >0.47 Forest Zone). Classification of the 1998 and 2013 images into forested and non forested areas showed that forested area decrease from 511,691 km2 in 1998 to 478,360 km2 in 2013. Differencing change detection method was performed on 1998 and 2013 NDVI images to identify areas of ecological concern. The result shows that areas undergoing vegetation degradation covers an area of 73,062 km2 while areas witnessing some form restoration cover an area of 86,315 km2. The result also shows that there is a weak correlation between rainfall and the vegetation zones. The non-vegetated areas have a correlation coefficient (r) of 0.0088, Sahel Savannah belt 0.1988, Sudan Savannah belt -0.3343, Guinea Savannah belt 0.0328 and Forest belt 0.2635. The low correlation can be associated with the encroachment of the Sudan Savannah belt into the forest belt of South-eastern part of the country as revealed by the image analysis. The degradation of the forest vegetation is therefore responsible for the serious erosion problems witnessed in the South-east. The study recommends constant monitoring of vegetation and strict enforcement of environmental laws in the country.Keywords: vegetation, NDVI, SPOT-vegetation, ecology, degradation
Procedia PDF Downloads 2244859 Assessment of Groundwater Chemistry and Quality Characteristics in an Alluvial Aquifer and a Single Plane Fractured-Rock Aquifer in Bloemfontein, South Africa
Authors: Modreck Gomo
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The evolution of groundwater chemistry and its quality is largely controlled by hydrogeochemical processes and their understanding is therefore important for groundwater quality assessments and protection of the water resources. A study was conducted in Bloemfontein town of South Africa to assess and compare the groundwater chemistry and quality characteristics in an alluvial aquifer and single-plane fractured-rock aquifers. 9 groundwater samples were collected from monitoring boreholes drilled into the two aquifer systems during a once-off sampling exercise. Samples were collected through low-flow purging technique and analysed for major ions and trace elements. In order to describe the hydrochemical facies and identify dominant hydrogeochemical processes, the groundwater chemistry data are interpreted using stiff diagrams and principal component analysis (PCA), as complimentary tools. The fitness of the groundwater quality for domestic and irrigation uses is also assessed. Results show that the alluvial aquifer is characterised by a Na-HCO3 hydrochemical facie while fractured-rock aquifer has a Ca-HCO3 facie. The groundwater in both aquifers originally evolved from the dissolution of calcite rocks that are common on land surface environments. However the groundwater in the alluvial aquifer further goes through another evolution as driven by cation exchange process in which Na in the sediments exchanges with Ca2+ in the Ca-HCO3 hydrochemical type to result in the Na-HCO3 hydrochemical type. Despite the difference in the hydrogeochemical processes between the alluvial aquifer and single-plane fractured-rock aquifer, this did not influence the groundwater quality. The groundwater in the two aquifers is very hard as influenced by the elevated magnesium and calcium ions that evolve from dissolution of carbonate minerals which typically occurs in surface environments. Based on total dissolved levels (600-900 mg/L), groundwater quality of the two aquifer systems is classified to be of fair quality. The negative potential impacts of the groundwater quality for domestic uses are highlighted.Keywords: alluvial aquifer, fractured-rock aquifer, groundwater quality, hydrogeochemical processes
Procedia PDF Downloads 2084858 Water Management of Polish Agriculture and Adaptation to Climate Change
Authors: Dorota M. Michalak
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The agricultural sector, due to the growing demand for food and over-exploitation of the natural environment, contributes to the deepening of climate change, on the one hand, and on the other hand, shrinking freshwater resources, as a negative effect of climate change, threaten the food security of each country. Therefore, adaptation measures to climate change should take into account effective water management and seek solutions ensuring food production at an unchanged or higher level, while not burdening the environment and not contributing to the worsening of the negative consequences of climate change. The problems of Poland's water management result not only from relatively small, natural water resources but to a large extent on the low efficiency of their use. Appropriate agricultural practices and state solutions in this field can contribute to achieving significant benefits in terms of economical water management in agriculture, providing a greater amount of water that could also be used for other purposes, including for purposes related to environmental protection. The aim of the article is to determine the level of use of water resources in Polish agriculture and the advancement of measures aimed at adapting Polish agriculture in the field of water management to climate change. The study provides knowledge about Polish legal regulations and water management tools, the shaping of water policy of Polish agriculture against the background of EU countries and other sources of energy, and measures supporting Polish agricultural holdings in the effective management of water resources run by state budget institutions. In order to achieve the above-mentioned goals, the author used research tools such as the analysis of existing sources and a survey conducted among five groups of entities, i.e. agricultural advisory centers and departments, agricultural, rural and environmental protection departments, regional water management boards, provincial agricultural chambers and restructuring and modernization of agriculture. The main conclusion of the analyses carried out is the low use of water in Polish agriculture in relation to other EU countries, other sources of intake in Poland, as well as irrigation. The analysis allows us to observe another problem, which is the lack of reporting and data collection, which is extremely important from the point of view of the effectiveness of adaptation measures to climate change. The results obtained from the survey indicate a very low level of support for government institutions in the implementation of adaptation measures to climate change and the water management of Polish farms. Some of the basic problems of the adaptation policy to change climate with regard to water management in Polish agriculture include a lack of knowledge regarding climate change, the possibilities of adapting, the available tools or ways to rationalize the use of water resources. It also refers to the lack of ordering procedures and the separation of responsibility with a proper territorial unit, non-functioning channels of information flow and practically low effects.Keywords: water management, adaptation policy, agriculture, climate change
Procedia PDF Downloads 1464857 Harnessing Renewable Energy as a Strategy to Combating Climate Change in Sub Saharan Africa
Authors: Gideon Nyuimbe Gasu
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Sub Saharan Africa is at a critical point, experiencing rapid population growth, particularly in urban areas and young growing force. At the same time, the growing risk of catastrophic global climate change threatens to weaken food production system, increase intensity and frequency of drought, flood, and fires and undermine gains on development and poverty reduction. Although the region has the lowest per capital greenhouse gas emission level in the world, it will need to join global efforts to address climate change, including action to avoid significant increases and to encourage a green economy. Thus, there is a need for the concept of 'greening the economy' as was prescribed at Rio Summit of 1992. Renewable energy is one of the criterions to achieve this laudable goal of maintaining a green economy. There is need to address climate change while facilitating continued economic growth and social progress as energy today is critical to economic growth. Fossil fuels remain the major contributor of greenhouse gas emission. Thus, cleaner technologies such as carbon capture storage, renewable energy have emerged to be commercially competitive. This paper sets out to examine how to achieve a low carbon economy with minimal emission of carbon dioxide and other greenhouse gases which is one of the outcomes of implementing a green economy. Also, the paper examines the different renewable energy sources such as nuclear, wind, hydro, biofuel, and solar voltaic as a panacea to the looming climate change menace. Finally, the paper assesses the different renewable energy and energy efficiency as a propeller to generating new sources of income and jobs and in turn reduces carbon emission. The research shall engage qualitative, evaluative and comparative methods. The research will employ both primary and secondary sources of information. The primary sources of information shall be drawn from the sub Saharan African region and the global environmental organizations, energy legislation, policies and related industries and the judicial processes. The secondary sources will be made up of some books, journal articles, commentaries, discussions, observations, explanations, expositions, suggestions, prescriptions and other material sourced from the internet on renewable energy as a panacea to climate change. All information obtained from these sources will be subject to content analysis. The research result will show that the entire planet is warming as a result of the activities of mankind which is clear evidence that the current development is fundamentally unsustainable. Equally, the study will reveal that a low carbon development pathway in the sub Saharan African region should be embraced to minimize emission of greenhouse gases such as using renewable energy rather than coal, oil, and gas. The study concludes that until adequate strategies are devised towards the use of renewable energy the region will continue to add and worsen the current climate change menace and other adverse environmental conditions.Keywords: carbon dioxide, climate change, legislation/law, renewable energy
Procedia PDF Downloads 2344856 Intertextuality in Tourism Advertising: Sources of Knowledge Asymmetries in Translating Vocative Texts
Authors: Maria Ilyushkina
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The article addresses the problem of translating vocative texts with intertextual references and describes the influence of language on how knowledge and meaning are developed in the field of advertising. The starting point of the article takes advertisements from the sphere of tourism and the way we choose, translate, and interpret intertexts. The article focuses on the perception and understanding of the information in printed texts advertising recreational facilities and services for tourists as the target audience by representatives of other cultures and the knowledge intertexts convey. The authors argue that intertextuality complicates translation leading to knowledge asymmetries. Studying typical communicative failures is considered to be of great importance, allowing for improvement in the practice of translation in the sphere of advertising as well as preventing the fallacious transfer of knowledge when translating foreign intertexts.Keywords: advertising, translation, intertext, Russian culture, knowledge asymmetries, tourism, vocative texts
Procedia PDF Downloads 1404855 Speech Acts and Politeness Strategies in an EFL Classroom in Georgia
Authors: Tinatin Kurdghelashvili
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The paper deals with the usage of speech acts and politeness strategies in an EFL classroom in Georgia (Rep of). It explores the students’ and the teachers’ practice of the politeness strategies and the speech acts of apology, thanking, request, compliment/encouragement, command, agreeing/disagreeing, addressing and code switching. The research method includes observation as well as a questionnaire. The target group involves the students from Georgian public schools and two certified, experienced local English teachers. The analysis is based on Searle’s Speech Act Theory and Brown and Levinson’s politeness strategies. The findings show that the students have certain knowledge regarding politeness yet they fail to apply them in English communication. In addition, most of the speech acts from the classroom interaction are used by the teachers and not the students. Thereby, it is suggested that teachers should cultivate the students’ communicative competence and attempt to give them opportunities to practice more English speech acts than they do today.Keywords: english as a foreign language, Georgia, politeness principles, speech acts
Procedia PDF Downloads 6414854 Pricing and Economic Benefits of Commercial Insurance Incorporated into Home-based Hospice Care
Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin
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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays
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