Search results for: business practices
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7173

Search results for: business practices

1653 Impact of Treatment of Fragility Fractures Due to Osteoporosis as an Economic Burden Worldwide: A Systematic Review

Authors: Fabiha Tanzeem

Abstract:

BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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1652 Vocational Education and Gender Equality in Nigeria: Challenges and Opportunities

Authors: Josephine Emebiziogo Anene-Okeakwa

Abstract:

This study investigates the challenges and opportunities for gender equality in vocational education in Awka South, Anambra State, Nigeria. Recognizing the critical role of vocational education in economic development, the research aims to evaluate the current state of gender equality, identify key barriers faced by female students, assess the impact of government policies, and explore opportunities for enhancing gender equality in this sector. Ten vocational schools within Awka South were randomly selected, and a total of 1,000 questionnaires were distributed among students, with 991 completed and returned, yielding a high response rate of 99.1%, and the retrieved data were analyzed using SPSS. The findings indicate significant gender disparities in vocational education enrollment and participation, with male students overwhelmingly outnumbering female students in most technical and engineering-related programs. Key barriers identified include cultural norms discouraging females from pursuing technical fields, economic constraints, lack of female role models, and social stereotypes regarding gender roles. Despite various government policies aimed at promoting gender equality, their implementation and effectiveness remain inadequate, as reflected in persistent gender disparities. However, opportunities for improving gender equality were identified, such as implementing gender-sensitive curricula, expanding mentorship programs for female students, and adopting best practices from other countries. The study recommends enhancing access to vocational training resources, implementing gender-sensitive curricula, expanding mentorship programs, and strengthening the implementation and monitoring of government policies. Addressing these challenges through targeted interventions is essential for achieving gender parity in vocational education, thereby empowering female students and contributing to Nigeria's socio-economic development.

Keywords: vocational education, gender equality, barriers, government policies

Procedia PDF Downloads 33
1651 Methane versus Carbon Dioxide Mitigation Prospects

Authors: Alexander J. Severinsky, Allen L. Sessoms

Abstract:

Atmospheric carbon dioxide (CO₂) has dominated the discussion about the causes of climate change. This is a reflection of the time horizon that has become the norm adopted by the IPCC as the planning horizon. Recently, it has become clear that a 100-year time horizon is much too long, and yet almost all mitigation efforts, including those in the near-term horizon of 30 years, are geared toward it. In this paper, we show that, for a 30-year time horizon, methane (CH₄) is the greenhouse gas whose radiative forcing exceeds that of CO₂. In our analysis, we used radiative forcing of greenhouse gases in the atmosphere since they directly affect the temperature rise on Earth. In 2019, the radiative forcing of methane was ~2.5 W/m² and that of carbon dioxide ~2.1 W/m². Under a business-as-usual (BAU) scenario until 2050, such forcing would be ~2.8 W/m² and ~3.1 W/m², respectively. There is a substantial spread in the data for anthropogenic and natural methane emissions as well as CH₄ leakages from production to consumption. We estimated the minimum and maximum effects of the reduction of these leakages. Such action may reduce the annual radiative forcing of all CH₄ emissions by between ~15% and ~30%. This translates into a reduction of the RF by 2050 from ~2.8 W/m² to ~2.5 W/m² in the case of the minimum effect and to ~2.15 W/m² in the case of the maximum. Under the BAU, we found that the RF of CO₂ would increase from ~2.1 W/m² nowadays to ~3.1 W/m² by 2050. We assumed a reduction of 50% of anthropogenic emission linearly over the next 30 years. That would reduce radiative forcing from ~3.1 W/m² to ~2.9 W/m². In the case of ‘net zero,’ the other 50% of reduction of only anthropogenic emissions would be limited to either from sources of emissions or directly from the atmosphere. The total reduction would be from ~3.1 to ~2.7, or ~0.4 W/m². To achieve the same radiative forcing as in the scenario of maximum reduction of methane leakages of ~2.15 W/m², then an additional reduction of radiative forcing of CO₂ would be approximately 2.7 -2.15=0.55 W/m². This is a much larger value than in expectations from ‘net zero’. In total, one needs to remove from the atmosphere ~660 GT to match the maximum reduction of current methane leakages and ~270 GT to achieve ‘net zero.’ This amounts to over 900 GT in total.

Keywords: methane leakages, methane radiative forcing, methane mitigation, methane net zero

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1650 Building Up a Sustainable, Future-Proof, Export-Orientated Chili Value Chain in Bugesera District, Rwanda

Authors: Akingeneye Liliane

Abstract:

The value chain concept in recent times is being used by businesses and organizations to develop and implement their businesses. Chili farming has been identified as a significant contributor to the economic growth of Bugesera district. However, numerous challenges have led to a decrease in production. The primary objective of this research was to assess the current Bugesera chili value chain, identify the bottlenecks in the value chain, and come up with interventions that can help increase the output of the Bugesera chili value chain, in a climate-smart way and enhance Long-term sustainability of the value chain. The research used a case study approach to fulfill its objectives, utilizing primary and secondary data sources. Data, both qualitative and quantitative, were gathered through semi-structured interviews conducted with 22 individual farmers, five exporters, and five supporters within the Bugesera district. A focus group discussion (FGD) with seven stakeholders was also conducted to validate the research findings. The study's results underscore the challenges faced by chili farmers and other actors in the chain, the perceptions of different stakeholders to contribute to chili production, and the importance of promoting strong collaboration among stakeholders in the chili value chain to establish a sustainable framework. Based on these findings, the study puts forward recommendations that aim to address the identified challenges and improve the chili farming sector in Bugesera. The business canvas model, as a proposed recommendation, once implemented, is believed to represent the most effective approach to enhancing chili productivity in Bugesera and securing the long-term sustainability of an export-oriented chili value chain in the district.

Keywords: building, sustainable, chili, value chain

Procedia PDF Downloads 57
1649 Using Variation Theory in a Design-based Approach to Improve Learning Outcomes of Teachers Use of Video and Live Experiments in Swedish Upper Secondary School

Authors: Andreas Johansson

Abstract:

Conceptual understanding needs to be grounded on observation of physical phenomena, experiences or metaphors. Observation of physical phenomena using demonstration experiments has a long tradition within physics education and students need to develop mental models to relate the observations to concepts from scientific theories. This study investigates how live and video experiments involving an acoustic trap to visualize particle-field interaction, field properties and particle properties can help develop students' mental models and how they can be used differently to realize their potential as teaching tools. Initially, they were treated as analogs and the lesson designs were kept identical. With a design-based approach, the experimental and video designs, as well as best practices for a respective teaching tool, were then developed in iterations. Variation theory was used as a theoretical framework to analyze the planned respective realized pattern of variation and invariance in order to explain learning outcomes as measured by a pre-posttest consisting of conceptual multiple-choice questions inspired by the Force Concept Inventory and the Force and Motion Conceptual Evaluation. Interviews with students and teachers were used to inform the design of experiments and videos in each iteration. The lesson designs and the live and video experiments has been developed to help teachers improve student learning and make school physics more interesting by involving experimental setups that usually are out of reach and to bridge the gap between what happens in classrooms and in science research. As students’ conceptual knowledge also rises their interest in physics the aim is to increase their chances of pursuing careers within science, technology, engineering or mathematics.

Keywords: acoustic trap, design-based research, experiments, variation theory

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1648 Videoconference Technology: An Attractive Vehicle for Challenging and Changing Tutors Practice in Open and Distance Learning Environment

Authors: Ramorola Mmankoko Ziphorah

Abstract:

Videoconference technology represents a recent experiment of technology integration into teaching and learning in South Africa. Increasingly, videoconference technology is commonly used as a substitute for the traditional face-to-face approaches to teaching and learning in helping tutors to reshape and change their teaching practices. Interestingly, though, some studies point out that videoconference technology is commonly used for knowledge dissemination by tutors and not so much for the actual teaching of course content in Open and Distance Learning context. Though videoconference technology has become one of the dominating technologies available among Open and Distance Learning institutions, it is not clear that it has been used as effectively to bridge the learning distance in time, geography, and economy. While tutors are prepared theoretically, in most tutor preparation programs, on the use of videoconference technology, there are still no practical guidelines on how they should go about integrating this technology into their course teaching. Therefore, there is an urgent need to focus on tutor development, specifically on their capacities and skills to use videoconference technology. The assumption is that if tutors become competent in the use of the videoconference technology for course teaching, then their use in Open and Distance Learning environment will become more commonplace. This is the imperative of the 4th Industrial Revolution (4IR) on education generally. Against the current vacuum in the practice of using videoconference technology for course teaching, the current study proposes a qualitative phenomenological approach to investigate the efficacy of videoconferencing as an approach to student learning. Using interviews and observation data from ten participants in Open and Distance Learning institution, the author discusses how dialogue and structure interacted to provide the participating tutors with a rich set of opportunities to deliver course content. The findings to this study highlight various challenges experienced by tutors when using videoconference technology. The study suggests tutor development programs on their capacity and skills and on how to integrate this technology with various teaching strategies in order to enhance student learning. The author argues that it is not merely the existence of the structure, namely the videoconference technology, that provides the opportunity for effective teaching, but that is the interactions, namely, the dialogue amongst tutors and learners that make videoconference technology an attractive vehicle for challenging and changing tutors practice.

Keywords: open distance learning, transactional distance, tutor, videoconference

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1647 Housing First, Not Housing Only: The Life Skills Project

Authors: Sara Cumming, Julianne DiSanto, Leah Burton

Abstract:

Homelessness in Canada is a persistent problem. It has been widely argued that the best tactic for eradicating homelessness is to approach social issues from a Housing First perspective—an approach that centers on quickly moving people into permanent and independent housing and then providing them additional support and services as needed. It is recognized that life skills training is both necessary and an effective way to reduce cyclical homelessness; however, there is a scarcity of research on effective ways to teach life skills; this problem was exacerbated in a pandemic context, where in-person delivery was severely restricted or no longer possible. Very little attention has been paid to the diverse cultural needs of clients in a multicultural context and the need to foster cultural knowledge/awareness in individuals to successfully contribute to the cultural safety of communities. This research attempts to fill these gaps in the literature and in practice by employing a community-engaged research (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, equity, diversity, and inclusion (EDI) informed life skill learning management system. We employed a triangulation methodology for this research. An environmental scan was conducted for best practices. Two separate Creative Problem Solving Sessions were held with over 100 front-line workers, managers, and executive directors who work with homeless populations. Quantitative and open-ended surveys were completed by over 200 individuals with experience with homelessness. All sections of this research aimed to discover the areas of skills that individuals need to maintain housing and to ascertain what a more client-driven EDI approach to life skills training should include. This research will showcase which life skills are deemed essential for homeless and precariously housed individuals.

Keywords: homelessness, Housing First, life skills, community engaged research

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1646 Acute Hepatitis A Outbreak in Men Who Has Sex with Men in a Medical Center in Northern Taiwan

Authors: Yu-Tzu Hsu, Alice Wu, Hsiang-Kuang Tseng

Abstract:

Introduction: Hepatitis A virus causes acute hepatitis and is usually transmitted by a fecal-oral route of food contamination, which is more prevalent in areas with poor hygienic practices. However, we described a hepatitis A outbreak associated with a fecal-oral route of sexual behavior in men who has sex with men (MSM) in Northern Taiwan. Methods: We retrospectively collected patients with acute HAV infection in MacKay Memorial Hospital, Taipei, Taiwan between July 2015 and November 2016. Demographic data (age, gender, onset time and infection risk), laboratory data (GOT, GPT, bilirubin, HIV status, HBsAg, HCV antibody and syphilis), clinical symptoms and travel history with a foreign tour were analyzed. We compared variables between HIV and non-HIV group. Unless otherwise stated, continuous variables were expressed as mean ± SD, and categorical variables were expressed as number (percentage) for each item. The t test for continuous variables was applied for the comparison between two groups and chi-square for categorical variables were applied for measures of association. Results: We collected 80 cases during the study period. Among them, 54 (67.5%) cases were MSM and 43 (53.8%) cases were HIV positive. The average age was 32.6±7.59 years-old. The average value of initial liver function was 1324 IU/L for AST (GOT), 2100 IU/L for ALT (GPT), and 5.82 mg/dL for bilirubin. We found seven (8.6%) cases were in the status of HBV carrier, five (6.3%) cases were positive for HCV antibody, and 15 (18.6%) cases were co-infected with syphilis. With regards to associated symptoms, 32 (40%) had fever, 46 (57.5%) had nausea, 34 (42.5%) had abdominal discomfort and 46 (57.5%) had general malaise. To compare the non-HIV patients with HIV patients, HIV patients were more likely to be male (p=0.008), MSM (p=0.000), co-infected syphilis (p=0.000) and slowly improving liver function of transaminases (p=0.033, 0.027). Conclusion: The HAV outbreak in Northern Taiwan was mainly occurred in MSM population. Hereafter, our cohort data support a policy in Taiwan to provide one dose of free HAV vaccine shot in this population. Hopefully, the outbreak could be stop by the free vaccine policy and public education.

Keywords: acute hepatitis A, men who has sex with men, human immunodeficiency virus, vaccine

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1645 Remote Sensing and GIS Based Methodology for Identification of Low Crop Productivity in Gautam Buddha Nagar District

Authors: Shivangi Somvanshi

Abstract:

Poor crop productivity in salt-affected environment in the country is due to insufficient and untimely canal supply to agricultural land and inefficient field water management practices. This could further degrade due to inadequate maintenance of canal network, ongoing secondary soil salinization and waterlogging, worsening of groundwater quality. Large patches of low productivity in irrigation commands are occurring due to waterlogging and salt-affected soil, particularly in the scarcity rainfall year. Satellite remote sensing has been used for mapping of areas of low crop productivity, waterlogging and salt in irrigation commands. The spatial results obtained for these problems so far are less reliable for further use due to rapid change in soil quality parameters over the years. The existing spatial databases of canal network and flow data, groundwater quality and salt-affected soil were obtained from the central and state line departments/agencies and were integrated with GIS. Therefore, an integrated methodology based on remote sensing and GIS has been developed in ArcGIS environment on the basis of canal supply status, groundwater quality, salt-affected soils, and satellite-derived vegetation index (NDVI), salinity index (NDSI) and waterlogging index (NSWI). This methodology was tested for identification and delineation of area of low productivity in the Gautam Buddha Nagar district (Uttar Pradesh). It was found that the area affected by this problem lies mainly in Dankaur and Jewar blocks of the district. The problem area was verified with ground data and was found to be approximately 78% accurate. The methodology has potential to be used in other irrigation commands in the country to obtain reliable spatial data on low crop productivity.

Keywords: remote sensing, GIS, salt affected soil, crop productivity, Gautam Buddha Nagar

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1644 Fitness Apparel and Body Cathexis of Women Consumers When and after Using Virtual Fitting Room

Authors: Almas Athif Fathin Wiyantoro, Fransiskus Xaverius Ivan Budiman, Fithra Faisal Hastiadi

Abstract:

The growth of clothing and technology as a marketing tool has a great influence on online business owners to know how much the characteristics and psychology of consumers in influencing purchasing decisions made by Indonesian women consumers. One of the most important issues faced by Indonesian women consumers is the suitability of clothing. The suitability of clothing can affect the body cathexis, identity, and confidence. So the thematic analysis of clothing fitness and body cathexis of women consumers when and after using virtual fitting room technology to purchase decision is important to do. This research using group method of pre-post treatment and considers how the recruitment technique of snowball sampling, which uses interpersonal relations and connections between people, both includes and excludes individuals into 39 participants' social networks to access specific populations. The results obtained from the study that the results of body scans and photos of virtual fitting room results can be made an intervention in women consumers in assessing their body cathexis objectively in the process of making purchasing decisions. The study also obtained a regression equation Y = 0.830 + 0.290X1 + 0.292X2, showing a positive relationship between suitability of clothing and body cathexis which influenced purchasing decisions on women consumers and after (personal and psychological factors) using virtual fitting room, meaning that all independent variables influence Positive towards the purchasing decision of the women consumers.

Keywords: body cathexis, clothing fitness, purchasing decision making and virtual fitting room

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1643 Extended Intuitionistic Fuzzy VIKOR Method in Group Decision Making: The Case of Vendor Selection Decision

Authors: Nastaran Hajiheydari, Mohammad Soltani Delgosha

Abstract:

Vendor (supplier) selection is a group decision-making (GDM) process, in which, based on some predetermined criteria, the experts’ preferences are provided in order to rank and choose the most desirable suppliers. In the real business environment, our attitudes or our choices would be made in an uncertain and indecisive situation could not be expressed in a crisp framework. Intuitionistic fuzzy sets (IFSs) could handle such situations in the best way. VIKOR method was developed to solve multi-criteria decision-making (MCDM) problems. This method, which is used to determine the compromised feasible solution with respect to the conflicting criteria, introduces a multi-criteria ranking index based on the particular measure of 'closeness' to the 'ideal solution'. Until now, there has been a little investigation of VIKOR with IFS, therefore we extended the intuitionistic fuzzy (IF) VIKOR to solve vendor selection problem under IF GDM environment. The present study intends to develop an IF VIKOR method in a GDM situation. Therefore, a model is presented to calculate the criterion weights based on entropy measure. Then, the interval-valued intuitionistic fuzzy weighted geometric (IFWG) operator utilized to obtain the total decision matrix. In the next stage, an approach based on the positive idle intuitionistic fuzzy number (PIIFN) and negative idle intuitionistic fuzzy number (NIIFN) was developed. Finally, the application of the proposed method to solve a vendor selection problem illustrated.

Keywords: group decision making, intuitionistic fuzzy set, intuitionistic fuzzy entropy measure, vendor selection, VIKOR

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1642 Climate Change Results in Increased Accessibility of Offshore Wind Farms for Installation and Maintenance

Authors: Victoria Bessonova, Robert Dorrell, Nina Dethlefs, Evdokia Tapoglou, Katharine York

Abstract:

As the global pursuit of renewable energy intensifies, offshore wind farms have emerged as a promising solution to combat climate change. The global offshore wind installed capacity is projected to increase 56-fold by 2055. However, the impacts of climate change, particularly changes in wave climate, are not widely understood. Offshore wind installation and maintenance activities often require specific weather windows, characterized by calm seas and low wave heights, to ensure safe and efficient operations. However, climate change-induced alterations in wave characteristics can reduce the availability of suitable weather windows, leading to delays and disruptions in project timelines. it applied the operational limits of installation and maintenance vessels to past and future climate wave projections. This revealed changes in the annual and monthly accessibility of offshore wind farms at key global development locations. When accessibility is only defined by significant wave height, spatial patterns in the annual accessibility roughly follow changes in significant wave height, with increased availability where significant wave height is decreasing. This resulted in a 1-6% increase in Europe and North America and a similar decrease in South America, Australia and Asia. Monthly changes suggest unchanged or slightly decreased (1-2%) accessibility in summer months and increased (2-6%) in winter. Further assessment includes assessing the sensitivity of accessibility to operational limits defined by wave height combined with wave period and wave height combined with wind speed. Results of this assessment will be included in the presentation. These findings will help stakeholders inform climate change adaptations in installation and maintenance planning practices.

Keywords: climate change, offshore wind, offshore wind installation, operations and maintenance, wave climate, wind farm accessibility

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1641 The Role of Chennai NGOs in Combatting Human Trafficking

Authors: Nisha James, Shubha Ranganathan

Abstract:

Sex trafficking is a type of human trafficking involving prostitution of individuals for sexual exploitation. The stigma and social isolation they face in the society often makes it difficult for them to become rehabilitated from trafficking, due to which many of them continue in prostitution for years after being sex trafficked. Victims are subjected to violations of their fundamental human rights, deprived of basic medical facilities and undergo long-term abuse. This paper focuses on the role of Non-Governmental Organizations (NGOs) in the rescue and rehabilitation of victims of sex trafficking. Semi-structured interviews were conducted with 26 survivors of sex trafficking, five sex workers and 14 non-community staff members of a project running NGO in the city of Chennai in South India. Chennai has a number of NGOs that are involved in HIV/AIDS awareness and prevention programs. In many cases, rehabilitation of sex trafficking victims is also a mandate of these NGOs. This particular NGO was also involved in development activities towards the eradication of HIV/AIDS. For instance, they were engaged in inculcating safe sex practices among high-risk groups such as sex workers or in fighting for sex worker rights. The study found that the NGO’s role in combatting sex trafficking is overrun by the way it approaches these issue related to HIV/AIDS. Further, their activities are dependent solely on funding. Given that gradually, international funding for HIV/AIDS has slowly been withdrawn, there have been problems such as reduction in the salary of the project staff, the outreach workers and peer educators, many of whom were survivors of sex trafficking who have been able to survive on their wages instead of continuing in prostitution. Therefore, till date, the project funding has helped in making them aware of the health and social consequences of continuing in prostitution, and in supporting them socioeconomically, but the lack of funding may also lead the NGO workers into a state of unemployment, poverty and eventually into being re-trafficked. The study concludes by pointing to the need for disengaging anti-trafficking efforts from the HIV/AIDS related programs.

Keywords: non-governmental organization role, non-governmental organization staff, sex trafficking survivors, sex workers

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1640 Building Up a Sustainable, Future-Proof, Export-Orientated Chili Value Chain in Bugesera District, Rwanda

Authors: Akingeneye Liliane

Abstract:

The value chain concept in recent times is being used by businesses and organizations to develop and implement their businesses. Chili farming has been identified as a significant contributor to the economic growth of Bugesera district. However, numerous challenges have led to a decrease in production. The primary objective of this research was to assess the current Bugesera chili value chain, identify the bottlenecks in the value chain, and come up with interventions that can help increase the output of the Bugesera chili value chain, in a climate-smart way and enhance Long-term sustainability of the value chain. The research used a case study approach to fulfill its objectives, utilizing primary and secondary data sources. Qualitative and quantitative data were gathered through semi-structured interviews with 22 individual farmers, five exporters, and five supporters within the Bugesera district. A focus group discussion (FGD) with seven stakeholders was also conducted to validate the research findings. The study's results underscore the challenges faced by chili farmers and other actors in the chain, the perceptions of different stakeholders to contribute to chili production, and the importance of promoting strong collaboration among stakeholders in the chili value chain to establish a sustainable framework. Based on these findings, the study puts forward recommendations to address the identified challenges and improve the chili farming sector in Bugesera. The business canvas model, as a proposed recommendation, once implemented, is believed to represent the most effective approach to enhancing chili productivity in Bugesera and securing the long-term sustainability of an export-oriented chili value chain in the district.

Keywords: build, sustainability, chili value chain, export-oriented

Procedia PDF Downloads 43
1639 Alcohol Rituals and Active Ageing: A Thematic Analysis of Semi-Structured Interviews with Retirees in the West of Scotland

Authors: Deborah Nicholson, Fiona McCormack, Pete Seaman, Karen Bell

Abstract:

This paper explores alcohol consumption amongst retirees in the West of Scotland in the context of active and healthy ageing discourses. The public health consequences of alcohol use are well documented and of growing concern to policy makers in Scotland and elsewhere. However, alcohol occupies a prominent position in a range of cultural and social practices and has associated meanings for users related to conviviality, leisure, sociability, and inclusion- features closely tied to active and healthy ageing. These perceived positive and negative meanings place alcohol in an ambiguous and contradictory position in relation to the Scottish Government’s key health policy initiatives aimed at healthy ageing and the reduction of alcohol-related ill-health. This paper explores these positive and negative associations through an examination of the meanings which retirees attach to alcohol and the routines and rituals they develop to navigate wider health concerns. Methods: participants were recruited from the West of Scotland area using a quota sampling design based around gender, age, and socioeconomic position. Forty participants were interviewed using a semi-structured interview schedule and qualitative techniques. The interviews were transcribed and thematic analysis of the data was conducted. Results: Alcohol use amongst retirees in Scotland was widely varied with marked differences noted in terms of gender and age group, but with less clear variance by socioeconomic position. A range of strategies was employed to limit alcohol use by time, context, location and/or volume and these strategies clearly drew on a perception of alcohol use in retirement as potentially more problematic than at earlier stage of life. Thus, the retirees in the sample used these limiting strategies to navigate the positive and negative meanings they attached to alcohol use.

Keywords: alcohol, health, retirement, routines

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1638 International Comparative Study of International Financial Reporting Standards Adoption and Earnings Quality: Effects of Differences in Accounting Standards, Industry Category, and Country Characteristics

Authors: Ichiro Mukai

Abstract:

The purpose of this study is to investigate whether firms applying International Financial Reporting Standards (IFRS), provide high-quality and comparable earnings information that is useful for decision making of information users relative to firms applying local Generally Accepted Accounting Principles (GAAP). Focus is placed on the earnings quality of listed firms in several developed countries: Australia, Canada, France, Germany, Japan, the United Kingdom (UK), and the United States (US). Except for Japan and the US, the adoption of IFRS is mandatory for listed firms in these countries. In Japan, the application of IFRS is allowed for specific listed firms. In the US, the foreign firms listed on the US securities market are permitted to apply IFRS but the listed domestic firms are prohibited from doing so. In this paper, the differences in earnings quality are compared between firms applying local GAAP and those applying IFRS in each country and industry category, and the reasons of differences in earnings quality are analyzed using various factors. The results show that, although the earnings quality of firms applying IFRS is higher than that of firms applying local GAAP, this varies with country and industry category. Thus, even if a single set of global accounting standards is used for all listed firms worldwide, it is difficult to establish comparability of financial information among global firms. These findings imply that various circumstances surrounding firms, industries, and countries etc. influence business operations and affect the differences in earnings quality.

Keywords: accruals, earnings quality, IFRS, information comparability

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1637 Media-Based Interventions to Influence English Language Learning: A Case of Bangladesh

Authors: Md. Mizanoor Rahman, Md. Zakir Hossain Talukder, M. Mahruf C. Shohel, Prithvi Shrestha

Abstract:

In Bangladesh, classroom practice and English Learning (EL) competencies acquired both by the teacher and learner in primary and secondary schools are still very weak. Therefore, English is the most commonly failed examination subject at the school level; in addition, there are severe problems in communicative English by the Bangladeshi nationals– this has been characterized as a constraint to economic development. Job applicants and employees often lack English language skills necessary to work effectively. As a result; both government and its international development partners such as DFID, UNESCO, and CIDA have been very active to uplift the quality of the English language learning and implementing projects with innovative approaches. Recently; the economy has been increasing and in line with this, the technology has been deployed in English learning to improve reading, writing, speaking and listening skills. Young Bangladeshi creative, from a variety of backgrounds including film, animation, photography, and digital media are being trained to develop ideas for English Language Teaching (ELT) media. They are being motivated to develop a wide range of ideas for low cost English learning media products. English Language education policy in Bangladesh supports communicative language teaching practices and accordingly, actors have been influencing curriculum, textbook, deployment of technology and assessment changes supporting communicative ELT. The various projects are also being implemented to reform the curriculum, revise the textbook and adjust the assessment mechanism so that the country can increase in proficiency in communicative English among the population. At present; the numbers of teachers, students and adult learners classified at higher levels of proficiency because of deployment of technology and motivation for learning and using English among school population of Bangladesh. The current paper discusses the various interventions in Bangladesh with appropriate media to improve the competencies of the ELT among population.

Keywords: English learning, technology, education, psychological sciences

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1636 A Geogpraphic Overview about Offshore Energy Cleantech in Portugal

Authors: Ana Pego

Abstract:

Environmental technologies were developed for decades. Clean technologies emerged a few years ago. In these perspectives, the use of cleantech technologies has become very important due the fact of new era of environmental feats. As such, the market itself has become more competitive, more collaborative towards a better use of clean technologies. This paper shows the importance of clean technologies in offshore energy sector in Portuguese market, its localization and its impact on economy. Clean technologies are directly related with renewable cluster and concomitant with economic and social resource optimization criteria, geographic aspects, climate change and soil features. Cleantech is related with regional development, socio-technical transitions in organisations. There are an economical and social combinations which allow specialisation of regions in activities, higher employment, reduce of energy costs, local knowledge spillover and, business collaboration and competitiveness. The methodology used will be quantitative (IO matrix for Portugal 2013) and qualitative (questionnaires to stakeholders). The mix of both methodologies will confirm whether the use of technologies will allow a positive impact on economic and social variables used on this model. It is expected a positive impact on Portuguese economy both in investment and employment taking in account the localization of offshore renewable activities. This means that the importance of offshore renewable investment in Portugal has a few points which should be pointed out: the increase of specialised employment, localization of specific activities in territory, and increase of value added in certain regions. The conclusion will allow researchers and organisation to compare the Portuguese model to other European regions in order to a better use of natural and human resources.

Keywords: cleantech, economic impact, localisation, territory dynamics

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1635 Disaster Victim Identification: A Social Science Perspective

Authors: Victor Toom

Abstract:

Albeit it is never possible to anticipate the full range of difficulties after a catastrophe, efforts to identify victims of mass casualty events have become institutionalized and standardized with the aim of effectively and efficiently addressing the many challenges and contingencies. Such ‘disaster victim identification’ (DVI) practices are dependent on the forensic sciences, are subject of national legislation, and are reliant on technical and organizational protocols to mitigate the many complexities in the wake of catastrophe. Apart from such technological, legal and bureaucratic elements constituting a DVI operation, victims’ families and their emotions are also part and parcel of any effort to identify casualties of mass human fatality incidents. Take for example the fact that forensic experts require (antemortem) information from the group of relatives to make identification possible. An identified body or body part is also repatriated to kin. Relatives are thus main stakeholders in DVI operations. Much has been achieved in years past regarding facilitating victims’ families’ issues and their emotions. Yet, how families are dealt with by experts and authorities is still considered a difficult topic. Due to sensitivities and required emphatic interaction with families on the one hand, and the rationalized DVI efforts, on the other hand, there is still scope for improving communication, providing information and meaningful inclusion of relatives in the DVI effort. This paper aims to bridge the standardized world of DVI efforts and families’ experienced realities and makes suggestions to further improve DVI efforts through inclusion of victims’ families. Based on qualitative interviews, the paper narrates involvement and experiences of inter alia DVI practitioners, victims’ families, advocates and clergy in the wake of the 1995 Srebrenica genocide which killed approximately 8,000 men, and the 9/11 in New York City with 2,750 victims. The paper shows that there are several models of including victims’ families into a DVI operation, and it argues for a model of where victims’ families become a partner in DVI operations.

Keywords: disaster victim identification (DVI), victims’ families, social science (qualitative), 9/11 attacks, Srebrenica genocide

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1634 Black Masculinity, Media Stereotyping And Its Influence on Policing in the United States: A Functionalist Perspective

Authors: Jack Santiago Monell

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In America, misrepresentations of black males have been perpetuated throughout the history of popular culture. Because of these narratives, varying communities have developed biases and stereotypes about what black male masculinity represents and more importantly, how they respond to them. The researcher explored the perspectives of police officers in the following states, Maryland, Pennsylvania, and North Carolina. Because of the nature of police and community relations, and national attention to high profile cases, having officers provide context into how black males are viewed from their lens, was critical while expanding on the theoretical explanations to describe attitudes towards police confrontations. As one of the objectives was to identify specific themes relevant to why police officers may view African American males differently, hence, responding more aggressively, this proved to be the most beneficial method of initial analysis to identify themes. The following nodes (appearance, acting suspicious/ troublesome behavior, upbringing about black males, excessive force) were identified to analyze the transcripts to discern associations. The data was analyzed through NVivo 11, and several themes resulted to elaborate on the data received. In analyzing the data, four themes were identified: appearance, acting suspicious/ troublesome behavior, upbringing about black males, and excessive force. The data conveyed that continuous stereotypes about African American men will ultimately result in excessive use of force or pervasive shootings, albeit the men are armed or unarmed. African American males are consistently targeted because of their racial makeup and appearance over any other probable circumstances. As long as racial bias and stereotypical practices continue in policing, African American males will endlessly be unjustly targeted and at times, the victims of violent encounters with police officers in the United States.

Keywords: African American males, police perceptions, masculinity, popular culture

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1633 Accessing Livestock Depredation by the Himalayan Wolf in Neshyang Valley, Manag, Nepal

Authors: Tenzing Lama, Ganga Ram Regmi, Thakur Silwal, Rinzin Punjok Lama

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Livestock depredation by a wolf and associated financial loss suffered by herders is perhaps the most important issue leading to human-wolf conflict. As a result, recolonized wolves remained one of the most persecuted large carnivores in Nepal Himalaya suffering high mortality due to retaliatory killings by herdsmen. Reducing such depredation are crucial in gaining herder’s support in conservation program to ensure the long-term survival of such carnivores. In February 2018, a study was conducted through questionnaire survey with 33 herders from different settlements in Neshyang valley of Manang district to assess the status of human-wolf conflict in terms of livestock loss and herder’s attitude. A total of 36 livestock were lost to the wolf with an average loss of 1.09 ± 0.48 (SE) livestock heads per herder between March 2017 to February 2018 which represents 1.5% of the total holdings. The estimated financial value of livestock loss was equivalent to US$ 25,428 with an average of US$ 770 per herder. Majority of the herders (80%) expressed a negative attitude towards the wolf, but only a few herders (6.06%) suggested removal of the wolf from the valley. The incidences of livestock loss differed significantly with highest in day time and seasonally highest in winter, when herders freely leaves their livestock (except goat/sheep) in the pastures. Wolf showed positive selectivity to the horse (EI=0.59), yak (EI=0.24) and cattle (EI=0.14) but strong avoidance to goat/sheep (EI=-1). This study suggests that livestock depredation by wolf could be minimized through improved livestock husbandry practices and implication of mitigation measures (e.g. coral improvement) and immediate relief to the victims. Conservation education and awareness programs to enhance herders knowledge about the ecological importance of wolf, provision of relief scheme and law enforcement.

Keywords: canis lupus canco, conservation education, human wildlife conflict, compensation schemes

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1632 Improving the Global Competitiveness of SMEs by Logistics Transportation Management: Case Study Chicken Meat Supply Chain

Authors: P. Vanichkobchinda

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The Logistics Transportation techniques, Open Vehicle Routing (OVR) is an approach toward transportation cost reduction, especially for long distance pickup and delivery nodes. The outstanding characteristic of OVR is that the route starting node and ending node are not necessary the same as in typical vehicle routing problems. This advantage enables the routing to flow continuously and the vehicle does not always return to its home base. This research aims to develop a heuristic for the open vehicle routing problem with pickup and delivery under time window and loading capacity constraints to minimize the total distance. The proposed heuristic is developed based on the Insertion method, which is a simple method and suitable for the rapid calculation that allows insertion of the new additional transportation requirements along the original paths. According to the heuristic analysis, cost comparisons between the proposed heuristic and companies are using method, nearest neighbor method show that the insertion heuristic. Moreover, the proposed heuristic gave superior solutions in all types of test problems. In conclusion, the proposed heuristic can effectively and efficiently solve the open vehicle routing. The research indicates that the improvement of new transport's calculation and the open vehicle routing with "Insertion Heuristic" represent a better outcome with 34.3 percent in average. in cost savings. Moreover, the proposed heuristic gave superior solutions in all types of test problems. In conclusion, the proposed heuristic can effectively and efficiently solve the open vehicle routing.

Keywords: business competitiveness, cost reduction, SMEs, logistics transportation, VRP

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1631 Comparative Study of Analgesic Efficacy of Ultrasound Guided Femoral Nerve Block Versus Intravenous Fentanyl Injection in Fracture Femur Patients at Emergency Department

Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly

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Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.

Keywords: femur fracture, nerve block, fentanyl, ultrasound guided

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1630 Korean Smart Cities: Strategic Foci, Characteristics and Effects

Authors: Sang Ho Lee, Yountaik Leem

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This paper reviews Korean cases of smart cities through the analysis framework of strategic foci, characteristics and effects. Firstly, national strategies including c(cyber), e(electronic), u(ubiquitous) and s(smart) Korea strategies were considered from strategic angles. Secondly, the characteristics of smart cities in Korea were looked through the smart cities examples such as Seoul, Busan, Songdo and Sejong cities etc. from the views on the by STIM (Service, Technology, Infrastructure and Management) analysis. Finally, the effects of smart cities on socio-economies were investigated from industrial perspective using the input-output model and structural path analysis. Korean smart city strategies revealed that there were different kinds of strategic foci. c-Korea strategy focused on information and communications network building and user IT literacy. e-Korea strategy encouraged e-government and e-business through utilizing high-speed information and communications network. u-Korea strategy made ubiquitous service as well as integrated information and communication operations center. s-Korea strategy is propelling 4th industrial platform. Smart cities in Korea showed their own features and trends such as eco-intelligence, high efficiency and low cost oriented IoT, citizen sensored city, big data city. Smart city progress made new production chains fostering ICTs (Information Communication Technologies) and knowledge intermediate inputs to industries.

Keywords: Korean smart cities, Korean smart city strategies, STIM, smart service, infrastructure, technologies, management, effect of smart city

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1629 Botswana and Nation-Building Theory

Authors: Rowland Brucken

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This paper argues that nation-building theories that prioritize democratic governance best explain the successful post-independence development of Botswana. Three main competing schools of thought exist regarding the sequencing of policies that should occur to re-build weakened or failed states. The first posits that economic development should receive foremost attention, while democratization and a binding sense of nationalism can wait. A second group of experts identified constructing a sense of nationalism among a populace is necessary first, so that the state receives popular legitimacy and obedience that are prerequisites for development. Botswana, though, transitioned into a multi-party democracy and prosperous open economy due to the utilization of traditional democratic structures, enlightened and accountable leadership, and an educated technocratic civil service. With these political foundations already in place when the discovery of diamonds occurred, the resulting revenues were spent wisely on projects that grew the economy, improved basic living standards, and attracted foreign investment. Thus democratization preceded, and therefore provided an accountable basis for, economic development that might otherwise have been squandered by greedy and isolated elites to the detriment of the greater population. Botswana was one of the poorest nations in the world at the time of its independence in 1966, with little infrastructure, a dependence on apartheid South Africa for trade, and a largely subsistence economy. Over the next thirty years, though, its economy grew the fastest of any nation in the world. The transparent and judicious use of diamond returns is only a partial explanation, as the government also pursued economic diversification, mass education, and rural development in response to public needs. As nation-building has become a project undertaken by nations and multilateral agencies such as the United Nations and the North Atlantic Treaty Organization, Botswana may provide best practices that others should follow in attempting to reconstruct economically and politically unstable states.

Keywords: Botswana, democratization, economic development, nation-building

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1628 Correlates of Multiplicity of Risk Behavior among Injecting Drug Users in Three High HIV Prevalence States of India

Authors: Santosh Sharma

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Background: Drug abuse, needle sharing, and risky sexual behaviour are often compounded to increase the risk of HIV transmission. Injecting Drug Users are at the duel risk of needle sharing and risky sexual Behaviour, becoming more vulnerable to STI and HIV. Thus, studying the interface of injecting drug use and risky sexual behaviour is important to curb the pace of HIV epidemic among IDUs. The aim of this study is to determine the factor associated with HIV among injecting drug users in three states of India. Materials and methods: This paper analyzes covariates of multiplicity of risk behavior among injecting drug users. Findings are based on data from Integrated Behavioral and Biological Assessment (IBBA) round 2, 2010. IBBA collects the information of IDUs from the six districts. IDUs were selected on the criteria of those who were 18 years or older, who injected addictive substances/drugs for non-medical purposes at least once in past six month. A total of 1,979 in round 2 were interviewed in the IBBA. The study employs quantitative techniques using standard statistical tools to achieve the above objectives. All results presented in this paper are unweighted univariate measures. Results: Among IDUs, average duration of injecting drugs is 5.2 years. Mean duration between first drug use to first injecting drugs among younger IDUs, belongs to 18-24 years is 2.6 years Needle cleaning practices is common with above two-fifths reporting its every time cleaning. Needle sharing is quite prevalent especially among younger IDUs. Further, IDUs practicing needle sharing exhibit pervasive multi-partner behavior. Condom use with commercial partners is almost 81 %, whereas with intimate partner it is 39 %. Coexistence of needle sharing and unprotected sex enhances STI prevalence (6.8 %), which is further pronounced among divorced/separated/widowed (9.4 %). Conclusion: Working towards risk reduction for IDUs must deal with multiplicity of risk. Interventions should deal with covariates of risk, addressing youth, and risky sexual behavior.

Keywords: IDUs, HIV, STI, behaviour

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1627 Quantity, Quality and Water Productivity of Mulberry Leaf Influenced by Different Methods, Levels of Irrigation and Mulching in Eastern Dry Zone of Karnataka, India

Authors: Chengalappa Seenappa, Narayanappa Devkumar, Narayanappa Nagaraja

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Mulberry leaf is the major economic component in sericulture and quality of leaf produced per unit area has a direct effect on quality of cocoon. Among all the agronomical inputs, irrigation water has highest impact on mulberry leaf quantity and quality. The water productivity in sericulture in the country is inadequate and inefficient though India has the largest irrigated area. There is a need of proper irrigation methods and conservation practices to ensure efficiency and economy in water use. Hence, this field experiment was conducted at College of Sericulture, Chintamani, Chickaballapur district, Karnataka, India during 2013 and 2014 to know the quantity, quality and water productivity of mulberry influenced by different methods, levels of irrigation and mulching in Eastern Dry Zone (EDZ) of Karnataka, India. The results revealed that the mulberry leaf quantity, quality and water productivity were significantly influenced by different methods, levels of irrigation and mulching. Subsurface drip irrigation at 0.8 CPE (Cumulative Pan Evaporation) recorded higher leaf yield, chlorophyll, relative water, protein content and water productivity (42857 kg ha-1 yr-1, 8.54, 65.80%, 22.27% and 364.41 kg hacm-1, respectively) than surface drip at 1.0 CPE (38809 kg ha-1 yr-1, 7.34, 62.76%, 17.75% and 264 10 kg hacm-1, respectively) and micro spray jet at 1.0 CPE (39931 kg ha-1 yr-1, 7.96, 63.50%, 19.00%, 35617 kg ha-1 yr-1 and 271.83 kg hacm-1, respectively). Mulching treatment recorded maximum leaf yield, chlorophyll, relative water, protein content and water productivity (38035 kg ha-1 yr-1, 7.12, 62.11%, 16.14% and 330 kg hacm-1, respectively) compared to without mulching. These results clearly indicated that subsurface drip irrigation at lower level of irrigation (0.8 CPE) and mulching increased the quantity, quality and water productivity of mulberry leaf than surface drip and micro spray jet irrigation at higher level of irrigation (1.0 CPE) by saving 20 per cent of water. Therefore, in the coming days subsurface drip irrigation in mulberry cultivation may be more appropriate to realise higher yield, quality and water productivity in EDZ of Karnataka, India.

Keywords: subsurface drip irrigation, mulching, water productivity, mulberry

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1626 The Impact of Training on Commitment, Retention, Job Satisfaction and Performance of Private Sector Banks in Bangladesh

Authors: Md. Arifur Rahman, Ummya Salma, Nazrul Islam

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Private sector banking business is one of the leading businesses of Bangladesh as it is profitable and directly attached with the economic development of the country. Training has got very high importance in this sector for increasing the performance of the banks. It has a long term impact on a number of aspects of the bank employees and their performances. It is an investment of the organization that is permanent in nature. Study shows that there are positive relationships between training and the employee commitment, job retention, job satisfaction and company performance. Training is also concerned with promotion, compensation, work-life policies, career development, task and contextual performance of the employees. As such, this paper aims at identifying the impact of training on employee commitment, job retention, job satisfaction and the performance of the private sector banks in Bangladesh. Both primary and secondary data were used to conduct the study. Data were collected from the bank officers who were trained in their banks. Both descriptive and inferential statistics were used to analyze the data. Descriptive statistics were used to describe the present situation of the banks and their employees. Inferential statistics were used to identify the factors and their significance concerned with training. Results show that there is a significant relationship between the performance and the training of the employees. It also shows that the training can motivate employees and encourage them to work hard. However, this study did not find any relationship between the commitment of the employees and the training. This study suggests that for increasing the performance of the banks, training is a must which is to be given deliberately for improving the specific skills of the bank employees.

Keywords: training, promotion, compensation, work-life policies

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1625 From Bureaucracy to Organizational Learning Model: An Organizational Change Process Study

Authors: Vania Helena Tonussi Vidal, Ester Eliane Jeunon

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This article aims to analyze the change processes of management related bureaucracy and learning organization model. The theoretical framework was based on Beer and Nohria (2001) model, identified as E and O Theory. Based on this theory the empirical research was conducted in connection with six key dimensions: goal, leadership, focus, process, reward systems and consulting. We used a case study of an educational Institution located in Barbacena, Minas Gerais. This traditional center of technical knowledge for long time adopted the bureaucratic way of management. After many changes in a business model, as the creation of graduate and undergraduate courses they decided to make a deep change in management model that is our research focus. The data were collected through semi-structured interviews with director, managers and courses supervisors. The analysis were processed by the procedures of Collective Subject Discourse (CSD) method, develop by Lefèvre & Lefèvre (2000), Results showed the incremental growing of management model toward a learning organization. Many impacts could be seeing. As negative factors we have: people resistance; poor information about the planning and implementation process; old politics inside the new model and so on. Positive impacts are: new procedures in human resources, mainly related to manager skills and empowerment; structure downsizing, open discussions channel; integrated information system. The process is still under construction and now great stimulus is done to managers and employee commitment in the process.

Keywords: bureaucracy, organizational learning, organizational change, E and O theory

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1624 A Proposal to Tackle Security Challenges of Distributed Systems in the Healthcare Sector

Authors: Ang Chia Hong, Julian Khoo Xubin, Burra Venkata Durga Kumar

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Distributed systems offer many benefits to the healthcare industry. From big data analysis to business intelligence, the increased computational power and efficiency from distributed systems serve as an invaluable resource in the healthcare sector to utilize. However, as the usage of these distributed systems increases, many issues arise. The main focus of this paper will be on security issues. Many security issues stem from distributed systems in the healthcare industry, particularly information security. The data of people is especially sensitive in the healthcare industry. If important information gets leaked (Eg. IC, credit card number, address, etc.), a person’s identity, financial status, and safety might get compromised. This results in the responsible organization losing a lot of money in compensating these people and even more resources expended trying to fix the fault. Therefore, a framework for a blockchain-based healthcare data management system for healthcare was proposed. In this framework, the usage of a blockchain network is explored to store the encryption key of the patient’s data. As for the actual data, it is encrypted and its encrypted data, called ciphertext, is stored in a cloud storage platform. Furthermore, there are some issues that have to be emphasized and tackled for future improvements, such as a multi-user scheme that could be proposed, authentication issues that have to be tackled or migrating the backend processes into the blockchain network. Due to the nature of blockchain technology, the data will be tamper-proof, and its read-only function can only be accessed by authorized users such as doctors and nurses. This guarantees the confidentiality and immutability of the patient’s data.

Keywords: distributed, healthcare, efficiency, security, blockchain, confidentiality and immutability

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