Search results for: economic policy of tourism
4379 Policy to Improve in vitro Fertilization Outcome in Women with Poor Ovarian Response: Frozen Embryo Transfer (ET) of Accumulated Vitrified Embryos vs. Frozen ET of Accumulated Vitrified Embryos plus Fresh ET
Authors: Hwang Kwon
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Objective: To assess the efficacy of embryo transfer (ET) of accumulated vitrified embryos and compare pregnancy outcomes between ET of thawed embryos following accumulation of vitrified embryos (frozen ET) and ET of fresh and thawed frozen embryos following accumulation of vitrified embryos (fresh ET + frozen ET). Study design: Patients were poor ovarian responders defined according to the Bologna criteria as well as a subgroup of women whose previous IVF-ET cycle through controlled ovarian stimulation (COS) yielded one or no embryos. Sixty-four frozen ETs were performed following accumulation of vitrified embryos (ACCE )(ACCE Frozen) and 51 fresh + frozen ETs were performed following accumulation of vitrified embryos (ACCE Fresh + Frozen). Positive βhCG rate, clinical pregnancy rate, ongoing pregnancy rate, and good quality embryos (%, ±SD) were compared between two groups. Results: There were more good quality embryos in the ACCE Fresh + Frozen group than in the ACCE Frozen group: 60±34.7 versus 42.9±28.9, respectively (p=0.03). Positive βhCG rate [18/64(28.2%) vs. 13/51(25.5%); p=0.75] and clinical pregnancy rate [12/64 (18.8%) vs. 11/51 (10.9%); p=0.71] were comparable between the two groups. Conclusion: Accumulation of vitrified embryos is an effective method in patients with poor ovarian response who fulfill the Bologna criteria. Pregnancy outcomes were comparable between the two groups.Keywords: accumulation of embryos, frozen embryo transfer, poor responder, Bologna criteria
Procedia PDF Downloads 2294378 An Approach to Electricity Production Utilizing Waste Heat of a Triple-Pressure Cogeneration Combined Cycle Power Plant
Authors: Soheil Mohtaram, Wu Weidong, Yashar Aryanfar
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This research investigates the points with heat recovery potential in a triple-pressure cogeneration combined cycle power plant and determines the amount of waste heat that can be recovered. A modified cycle arrangement is then adopted for accessing thermal potentials. Modeling the energy system is followed by thermodynamic and energetic evaluation, and then the price of the manufactured products is also determined using the Total Revenue Requirement (TRR) method and term economic analysis. The results of optimization are then presented in a Pareto chart diagram by implementing a new model with dual objective functions, which include power cost and produce heat. This model can be utilized to identify the optimal operating point for such power plants based on electricity and heat prices in different regions.Keywords: heat loss, recycling, unused energy, efficient production, optimization, triple-pressure cogeneration
Procedia PDF Downloads 824377 An Analysis of Critical Success Factors of Six Sigma Implementation in Pakistani SMEs
Authors: Zanjbeel Tabassum
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The main purpose of any economic investment is to get profit at the end. As the investment in large organizations bears complexities, investors are influenced to invest in small or medium enterprises. With the increase of global competition in terms of quality and productivity, these small and medium-sized enterprises (SMEs) are trying to convert to modern production practices using Six Sigma. But this concept is still lacking in Pakistani SMEs. There are some critical success factors which influence the successful implementation of Six Sigma. Through this paper, an attempt has been made to identify various CSF for successful implementation of Six Sigma in Pakistani SMEs with the help of a structured survey. On the basis of responses to the questionnaire, factor analysis is performed on the selected critical success factors (from literature) to prioritize the critical factors and those are rated by calculating descriptive statistics. This paper will provide a base for Pakistani SMEs and future researchers working in six sigma implementation and help them to prepare a road map to eradicate the hurdles in six sigma implementation.Keywords: critical success factors, SMEs, Six Sigma, CSF
Procedia PDF Downloads 2784376 Sustainable Affordable Housing Development in Indonesia
Authors: Gina Cynthia Raphita Hasibuan
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The housing sector in Indonesia is in critical condition where majority of low-income citizens live in substandard dwellings, and the number housing backlog is increasing every year. The housing problem becomes more urgent when the term 'sustainability' is considered, and sustainable affordable housing is yet to gain its successful implementation. Global urbanization develops fastest in developing countries like Indonesia where informal settlements are rapidly escalating, hence, making sustainable affordable housing strategies very critical in this context. The problem in developing countries like Indonesia lies on the institutional capacity of newly-established local governments having greater power to determine a development policy but apparently still lacking institutional capability and coordination with the central government and collaborative governance are still not established yet. The concept of upgrading informal settlements are seen changed over time and inconsistent. Despite much research on theme such as sustainable housing concept within Indonesian context, there has been a dearth of research examining the role of collaborative governance, as the current approach still shows fragmented approach between the stakeholders and the lack of community participation as the end user, and thus this research attempts to fill the gap on the aforementioned problems. By using case study with multi-methods conducted in Jakarta, this research has an overall aim to critically assess the role of collaborative governance in addressing sustainable affordable housing in Indonesia and to understand informal settlements and interventions in Indonesia rather than imposing a framework from western perspectives.Keywords: affordable housing, collaborative governance, sustainability, urban planning
Procedia PDF Downloads 4104375 A Comparison of Income and Fuzzy Index of Multidimensional Poverty in Fourteen Sub-Saharan African Countries
Authors: Joseph Siani
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Over the last decades, dissatisfaction with global indicators of economic performance, such as GDP (Gross Domestic Product) per capita, has shifted the attention to what is now referred to as multidimensional poverty. In this framework, poverty goes beyond income to incorporate aspects of well-being not captured by income measures alone. This paper applies the totally fuzzy approach to estimate the fuzzy index of poverty (FIP) in fourteen Sub-Saharan African (SSA) countries using Demographic and Health Survey (DHS) data and explores whether pictures created by the standard headcount ratio at $1.90 a day and the fuzzy index of poverty tell a similar story. The results suggest that there is indeed considerable mismatch between poverty headcount and the fuzzy index of multidimensional poverty, meaning that the majority of the most deprived people (as identified by the fuzzy index of multidimensional poverty) would not be identified by the poverty headcount ratio. Moreover, we find that poverty is distributed differently by colonial heritage (language). In particular, the most deprived countries in SSA are French-speaking.Keywords: fuzzy set approach, multidimensional poverty, poverty headcount, overlap, Sub-Saharan Africa
Procedia PDF Downloads 2054374 Supply Side Readiness for Universal Health Coverage: Assessing the Availability and Depth of Essential Health Package in Rural, Remote and Conflict Prone District
Authors: Veenapani Rajeev Verma
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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.Keywords: effective coverage, principal component analysis, readiness index, universal health coverage
Procedia PDF Downloads 1214373 Sociodemographic Predictors of Flourishing among Older Adults in Rural and Urban Mongolia
Authors: Saranchuluun Otgon, Sugarmaa Myagmarjav, Khorolsuren Lkhagvasuren, Fabio Casati
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Background: Flourishing is a eudaimonic dimension of psychological well-being that has been associated with positive social and health-related outcomes. Determining the factors associated with health and well-being is important to the development of evidence-based intervention programs, policies, and action plans targeting the older adult population, especially in low- and middle-income countries, such as Mongolia, where evidence-based research on aging, health, and well-being is still scarce. This study makes important contributions to the study of well-being in later age and also to policy activities for the older population in Mongolia. Methods: We employed multiple regression models to predict the factors of flourishing using data from 304 older adults living in urban and rural Mongolia. Data is collected by the standardized and validated questionnaire adopted by Ed Diener. Results: The median score of the flourishing of urban and rural older adults in Mongolia was significantly different, 53 and 50, respectively. The sex (β = 2.52,p = 0.034), level of education(β = 0.94, p = 0.026), receive help for the activity of daily living (β = 2.16, p = 0.022) determine the flourishing of older adults living in a rural area, while self-reported health (β = 0.94, p = 0.026), the number of social activities, friends network determine to flourish of older adults living urban area. Conclusion: Older adults who live in urban areas have more psychological resources and strengths than those in rural areas. Determinants of flourishing are different in different settings. For instance, individual and family factors determine flourishing in rural areas, and social ties determine flourishing in urban areas.Keywords: flourishing, predictors, older adults, Mongolia, psychological well-being
Procedia PDF Downloads 1304372 Assessment of the Adoption and Distribution Pattern of Agroforestry in Faisalabad District Using GIS
Authors: Irfan Ahmad, Raza Ghafoor, Hammad Raza Ahmad, Muhammad Asif, Farrakh Nawaz, M. Tahir Siddiqui
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Due to the exploding population of Pakistan the pressure on natural forests is increasing to meet the demands of wood and wood based products. Agroforestry is being practiced throughout the world on scientific basis but unfortunately the farmers of Pakistan are reluctant in its adoption. The presents study was designed to assess the adoption of agroforestry practices in Faisalabad with respect to land holdings of farmers and future suitability by using Geographic information system (GIS). Faisalabad is the third largest city of the country and is famous due to the textile industry. A comprehensive survey from target villages of the Lyallpur town of Faisalabad district was carried out. Out of total 65 villages, 40 were selected for study. From each selected village, one farmer who was actively engaged in farming activities was selected. It was observed that medium sized farmers having 10-20 acre were more in number as compared to small and large farmers. Number of trees was found maximum in large farm lands, ratio of diseased trees was almost similar in all categories with maximum in small farmlands (24.1%). Regarding the future prospects 35% farmer were interested in agroforestry practices 65% were not interested in the promotion of trees due to the non-availability of technical guidance and proper markets. Geographic images of the study site can further help the researchers and policy makers in the promotion of agroforestry.Keywords: agroforestry trends, adoption, Faisalabad, geographic information system (GIS)
Procedia PDF Downloads 5044371 A Method of Drilling a Ground Using a Robotic Arm
Authors: Lotfi Beji, Laredj Benchikh
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Underground tunnel face bolting and pipe umbrella reinforcement are one of the most challenging tasks in construction whether industrial or not, and infrastructures such as roads or pipelines. It is one of the first sectors of economic activity in the world. Through a variety of soil and rock, a cyclic Conventional Tunneling Method (CTM) remains the best one for projects with highly variable ground conditions or shapes. CTM is the only alternative for the renovation of existing tunnels and creating emergency exit. During the drilling process, a wide variety of non-desired vibrations may arise, and a method using a robot arm is proposed. The main kinds of drilling through vibration here is the bit-bouncing phenomenon (resonant axial vibration). Hence, assisting the task by a robot arm may play an important role on drilling performances and security. We propose to control the axial-vibration phenomenon along the drillstring at a practical resonant frequency, and embed a Resonant Sonic Drilling Head (RSDH) as a robot end effector for drilling. Many questionable industry drilling criteria and stability are discussed in this paper.Keywords: drilling, resonant vibration, robot arm, control
Procedia PDF Downloads 2904370 Assessment of hospital Infection Control at Intensive Care Units and Pediatric Wards
Authors: Hana A. Jameel Alsaeed, Rayyan Ibrahim Khaleel, Hanaa Hussein Mukhlif
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Background: Contamination in Iraq's hospitals is a localized problem with high rates of disease And deaths that mainly affect poor areas. Thus, this study aims to evaluate hospital infections in the city of Mosul and to identify the etiology. So to assess environmental infection prevention in pediatric wards and newborn critical care units in Mosul city. Methods: The present study is a cross-sectional hospital based in Mosul-Iraq between (10th February to 1st April 2022). Purposive sample of 60 nurses from neonatal intensive care units and pediatric wards in three pediatric teaching hospitals in Mosul city; Data was gathered using a questionnaire created by the researchers after reviewing previous studies. Results: The study showed that the majority of the study infection prevention and control policy isn't available in 46.7% of departments, and 45% of hospital workers in Iraq don't know if there is an Iraqi version of it. 70% of the study group had participated in an infection control training program. Conclusions: In the majority of samples 55% of respondents to the study claimed not to be aware of these rules. 60% of the study's participants had never attended a course on infection prevention and control, according to the study's findings on education and training programs. In the neonatal and critical care unit, nurses' skill levels, years of experience, and actual duties varied by wide statistically significant differences.Keywords: pediatric, infection control, assessment, mosul city
Procedia PDF Downloads 824369 Human Security through Human Rights in the Contemporary World
Authors: Shilpa Bagade Poharkar
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The basis for traditional notion of security was the use of force to preserve vital interest which based on either realism or power politics. The modern approach to security extends beyond the traditional notions of security which focus on issues as development and respect for human rights. In global politics, the issue of human security plays a vital role in most of the policy matter. In modern era, the protection of human rights is now recognized as one of the main functions of any legitimate modern state. The research paper will explore the relationship between human rights and security. United Nations is facing major challenges like rampant poverty, refugee outflows, human trafficking, displacement, conflicts, terrorism, intra-inter ethnic conflicts, proliferation of small arms, genocide, piracy, climate change, health issues and so on. The methodology is observed in this paper is doctrinaire which includes analytical and descriptive comparative method. The hypothesis of the paper is the relationship between human rights and a goal of United Nations to attain peace and security. Although previous research has been done in this field but this research paper will try to find out the challenges in the human security through human rights in the contemporary world and will provide measures for it. The study will focus on the following research questions: What are the issues and challenges United Nations facing while advancing human security through human rights? What measures the international community would take for ensuring the protection of human rights while protecting state security and contribute in the attainment of goals of United Nations?Keywords: human rights, human security, peace, security, United Nations
Procedia PDF Downloads 2484368 Descriptive Analysis: New Media Influence on Decision Makers
Authors: Bashaiar Alsanaa
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The process of decision making requires environment surveillance and public opinion monitoring, both of which can be attained through effective use of social media. This study aims to investigate the extent to which new media influence the decision making process by the Kuwaiti government. The research explores how unprecedented access to information as well as dynamic user-interaction made possible by new technologies play a significant role in all aspects of decision making whether on the end of the public or decision makers themselves. The research analyzes two case studies where public opinion was forceful on social media in order to explore how such media create interactive and liberal environments for individuals to participate in the process of taking action with regards to political, economic and social issues. The findings of this descriptive study indicate the overwhelming extent to which social media are being used in Kuwait to create new social reform by the government based on citizen interaction with current topics.Keywords: communication, descriptive, new media technologies, social media.
Procedia PDF Downloads 1184367 Effect of Three Sand Types on Potato Vegetative Growth and Yield
Authors: Shatha A. Yousif, Qasim M. Zamil, Hasan Y. Al Muhi, Jamal A. Al Shammari
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Potato (Solanum tuberosum L.) is one of the major vegetable crops that are grown world wide because of its economic importance. This experiment investigated the effect of local sands (River Base, Al-Ekader and Karbala) on number and total weight of mini tubers. Statistical analysis revealed that there were no significant differences among sand cultures in number of stem/plant, chlorophyll index and tubers dry weight. River Base sand had the highest plant height (74.9 cm), leaf number/plant number (39.3), leaf area (84.4 dcm2⁄plant), dry weight/plant (26.31), tubers number/plant (8.5), tubers weight/plant (635.53 gm) and potato tuber yields/trove (28.60 kg), whereas the Karbala sand had lower performance. All the characters had positive and significant correlation with yields except the traits number of stem and tuber dry weight.Keywords: correlation, potato, sand culture, yield
Procedia PDF Downloads 4764366 Differential in Dynamics of Contraceptive Practices with Women's Sexual Empowerment in Selected South Asian Countries: Evidence from Two Decades DHS Surveys, 1990 and 2012
Authors: Brajesh
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Introduction: It is generally believed that women's lack power to making decision may restrict their use of modern contraceptives practices. However, few studies have examined the different dimensions of women's empowerment and contraceptive use in Asian content. Pervasive gendered inequities and norms regarding the subordination of women give Asian men disproportionately more power than women, particularly in relation to the sex. We hypothesize that lack of sexual empowerment may pose an important barrier to reproductive health and adoption of family planning methods. Using the Demographic Health Survey, we examine the association between women’s sexual empowerment and contraceptive use in Nepal, Bangladesh and Pakistan. Objectives: To understand the trend and pattern of contraceptive choices and use among women due to sexual empowerment in selected south Asian countries. To examine the association between women’s sexual empowerment and contraceptive practices among non-pregnant married and partnered women in Nepal, Bangladesh and Pakistan. Methods: Data came from the latest round of Demographic and Health Surveys conducted between 2010-12 in and during deacde1990 -92 in Nepal, Bangladesh and Pakistan. Responses from married or cohabiting women aged 15-49 years were analyzed for six dimensions of empowerment and the current use of female-only methods or couple of methods. Bi-variate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use. Results: Positive associations were found between the overall empowerment score and method use in all countries (relative risk ratios, 1.1-1.3). In multivariate analysis, household economic decision-making was associated with the use of either female-only or couple methods (relative risk ratios -1. 1 for all), as was agreement on fertility preferences (RRR-1.3-1.6) and the ability to negotiate sexual activity (RRR -1. 1-1.2). In Bangladesh, women's negative attitudes toward domestic violence were correlated with the use of couple of methods (RRR -1. 1). Increasing levels of sexual empowerment were found to be associated with use of contraceptives, even after adjusting for demographic predictors of contraceptive use. This association is moderated by the wealth. Formal education, increasing wealth, and being in an unmarried partnership are associated with contraceptive use, whereas women who identify as being Muslim are less likely to use contraceptives than those who identify as being Hindus or other. These findings suggest that to achieve universal access to reproductive health services, gendered disparities in sexual empowerment, particularly among economically disadvantaged women, need to be better addressed. Conclusions: Intervention programs aimed at increasing contraceptive use may need to involve different approaches, including promoting couples' discussion of fertility preferences and family planning, improving women's self-efficacy in negotiating sexual activity and increasing their economic independence. Policies are needed to encourage the rural families to give their girls a chance of attending higher level education and professional course so that can get a better job opportunity and can economically support their family as son are expected to do.Keywords: reproductive and child health (RCH), relative risk ratios (RRR), demographic and health survey (DHS), women’s sexual empowerment (WSE)
Procedia PDF Downloads 2514365 The Possibility to Assess the Industrial Enterprise Sustainability
Authors: G. Khasaev, S. Ashmarina , A. Zotova
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The priority of Russian enterprises development has been given to the optimization process of industrial enterprise activity for their sustainable development in a long-term period. The assessment of sustainable development level as one of the most efficient instruments of sustainable development management at the industrial enterprise gives a complex view of its state. In order to perform accurate analysis of the current state of the industrial enterprise, it is necessary to perform the assessment of its sustainable development and using its results to elaborate the further tactic of enterprise functioning. The assessment of sustainable development level of the enterprise may help the effective management of strategy development only if the corresponding indicators system is created. The elaboration and usage the sustainable development indicators allows the enterprise to implement analysis of its activity results and monitoring of sustainable enterprise functioning. The authors’ methods are based on general aspects of the industrial enterprise functioning such as finance, customers, inner economic process, and staff system.Keywords: assessment methods, indicators system, industrial enterprise, sustainable development
Procedia PDF Downloads 3664364 Different Tillage Possibilities for Second Crop in Green Bean Farming
Authors: Yilmaz Bayhan, Emin Güzel, Ömer Barış Özlüoymak, Ahmet İnce, Abdullah Sessiz
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In this study, determining of reduced tillage techniques in green bean farming as a second crop after harvesting wheat was targeted. To this aim, four different soil tillage methods namely, heavy-duty disc harrow (HD), rotary tiller (ROT), heavy-duty disc harrow plus rotary tiller (HD+ROT) and no-tillage (NT) (seeding by direct drill) were examined. Experiments were arranged in a randomized block design with three replications. The highest green beans yields were obtained in HD+ROT and NT as 5,862.1 and 5,829.3 Mg/ha, respectively. The lowest green bean yield was found in HD as 3,076.7 Mg/ha. The highest fuel consumption was measured 30.60 L ha-1 for HD+ROT whereas the lowest value was found 7.50 L ha-1 for NT. No tillage method gave the best results for fuel consumption and effective power requirement. It is concluded that no-tillage method can be used in second crop green bean in the Thrace Region due to economic and erosion conditions.Keywords: green bean, soil tillage, yield, vegetative
Procedia PDF Downloads 3734363 The Impact of Maternity Leave Reforms: Evidence from Finland
Authors: Claudia Troccoli
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Childbearing constitutes one of the key factors affecting labour market differences between men and women, accounting for almost a quarter of the gender wage gap. Family leave policies, such as maternity, paternity, and parental leave, represent potential key policy tools to address these inequalities, as they can promote mothers' job continuity and career progression. This paper analyses four major reforms implemented in Finland between the 1960s and the early 1980s. It studies the effects of these maternity and parental leave extensions on mothers' short- and long-run labour market outcomes. Eligibility to longer leave was determined on the basis of the child's date of birth. Therefore, estimation of the causal effects of the reforms is possible by exploiting random variation in children's birthdates and comparing the outcomes of mothers giving birth just before and just after the reform cutoff date. Overall, the three maternity leave reforms did not significantly improve mothers' earnings or employment rates. On the contrary, the estimates, although imprecise, seem to indicate negative effects on women's labour market outcomes. The extension of parental leave is, on the other hand, the only reform that improved mothers' short- and long-term labour market outcomes, both in terms of earnings and employment rate. At the same time, fathers appeared to be negatively affected by the reform. These results provide suggestive evidence that shareable parental leave might have more beneficial effects on mothers' job continuity, as it weakens the connotation of childcare as a task reserved for mothers.Keywords: family policies, Finland, maternal labour market outcomes, maternity leave
Procedia PDF Downloads 1374362 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care
Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky
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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive
Procedia PDF Downloads 1404361 Revitalizing Coastal Ecosystems: Evaluating the Costs and Benefits of Restoring Clam Gardens for Indigenous Communities in British Columbia
Authors: Daniel Chen, Chengyi Li, Naifu Xu, Shangxuan Yang
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Climate change has led to substantial changes in coastal ecosystems, including elevated ocean temperatures, increased acidity, and disrupted marine habitats. These environmental impacts have also resulted in the decline of traditional Indigenous food sources on the coast of British Columbia, including clams and salmon, which have been essential to the diet and cultural practices of the coastal Indigenous communities. This research evaluates and analyzes the costs and benefits of restoring and building clam gardens, an ancestral Indigenous mariculture technique in the Pacific Northwest. Clam gardens, which involve the construction of intertidal rock walls to enhance clam production, have been shown to more than triple clam yields compared to non-walled beaches. This research analyzes the costs and benefits to Indigenous individuals, including factors such as travel, equipment, time, food supply, and cultural engagement; then it discusses the potential of clam gardens as a significant food resource with additional environmental co-benefits, given the prevalence of clam gardens and coastlines in British Columbia. Moreover, the study concludes with policy recommendations to support the restoration and preservation of clam gardens, highlighting their potential to provide sustainable seafood production, environmental co-benefits, and social-environmental educational opportunities for Indigenous communities and the wider public.Keywords: British Columbia coastline, clam garden, coastal resource management, Indigenous communities
Procedia PDF Downloads 224360 Construction of a Low Carbon Eco-City Index System Based on CAS Theory: A Case of Hexi Newtown in Nanjing, China
Authors: Xu Tao, Yilun Xu, Dingwei Xiang, Yaofei Sun
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The practice of urban planning and construction based on the concept of the “low carbon eco-city” has been universally accepted by the academic community in response to urban issues such as population, resources, environment, and social development. Based on this, the current article first analyzes the concepts of low carbon eco-city, then builds a complex adaptive system (CAS) theory based on Chinese traditional philosophical thinking, and analyzes the adaptive relationship between material and non-material elements. A three-dimensional evaluation model of natural ecology, economic low carbon, and social harmony was constructed. Finally, the construction of a low carbon eco-city index system in Hexi Newtown of Nanjing was used as an example to verify the effectiveness of the research results; this paradigm provides a new way to achieve a low carbon eco-city system.Keywords: complex adaptive system, low carbon ecology, index system, model
Procedia PDF Downloads 1524359 Evaluation of Feasibility of Ecological Sanitation in Central Nepal
Authors: K. C. Sharda
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Introduction: In the world, almost half of the population are lacking proper access to improved sanitation services. In Nepal, large number of people are living without access to any sanitation facility. Ecological sanitation toilet which is defined as water conserving and nutrient recycling system for use of human urine and excreta in agriculture would count a lot to utilize locally available resources, to regenerate soil fertility, to save national currency and to achieve the goal of elimination open defecation in country like Nepal. The objectives of the research were to test the efficacy of human urine for improving crop performance and to evaluate the feasibility of ecological sanitation in rural area of Central Nepal. Materials and Methods: The field investigation was carried out at Palung Village Development Committee (VDC) of Makawanpur District, Nepal from March – August, 2016. Five eco-san toilets in two villages (Angare and Bhot Khoriya) were constructed and questionnaire survey was carried out. During the questionnaire survey, respondents were asked about socio-economic parameters, farming practices, awareness of ecological sanitation and fertilizer value of human urine and excreta in agriculture. In prior to a field experiment, soil was sampled for analysis of basic characteristics. In the field experiment, cauliflower was cultivated for a month in the two sites to compare the fertilizer value of urine with chemical fertilizer and no fertilizer with three replications. The harvested plant samples were analyzed to understand the nutrient content in plant with different treatments. Results and Discussion: Eighty three percent respondents were engaged in agriculture growing mainly vegetables, which may raise the feasibility of ecological sanitation. In the study area, water deficiencies in dry season, high demand of chemical fertilizer, lack of sanitation awareness were found to be solved. The soil at Angare has sandier texture and lower nitrogen content compared to that in Bhot Khoriya. While the field experiment in Angare showed that the aboveground biomass of cauliflower in the urine fertilized plot were similar with that in the chemically fertilized plot and higher than those in the non-fertilized plots, no significant difference among the treatments were found in Bhot Khoriya. The more distinctive response of crop growth to the three treatments in the former might be attributed to the poorer soil productivity, which in turn could be caused by the poorer inherent soil fertility and the poorer past management by the farmer in Angare. Thus, use of urine as fertilizer could help poor farmers with low quality soil. The significantly different content of nitrogen and potassium in the plant samples among three treatments in Bhot Khoriya would require further investigation. When urine is utilized as a fertilizer, the productivity could be increased and the money to buy chemical fertilizer would be utilized in other livelihood activities. Ecological sanitation is feasible in the area with similar socio-economic parameter.Keywords: cauliflower, chemical fertilizer, ecological sanitation, Nepal, urine
Procedia PDF Downloads 3584358 Higher Education Internationalisation: The Case of Indonesia
Authors: Agustinus Bandur, Dyah Budiastuti
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With the rapid development of information and communication technology (ICT) in globalisation era, higher education (HE) internationalisation has become a worldwide phenomenon. However, even though various studies have been widely published in existing literature, the settings of these studies were taken places in developed countries. Accordingly, the major purpose of this article is to explore the current trends of higher education internationalisation programs with particular reference to identify the benefits and challenges confronted by participating staff and students. For these purposes, ethnographic qualitative study with the usage of NVivo 11 software was applied in coding, analyzing, and visualization of non-numeric data gathered from interviews, videos, web contents, social media, and relevant documents. Purposive sampling technique was applied in this study with a total of ten high-ranked accredited government and private universities in Indonesia. On the basis of thematic and cross-case analyses, this study indicates that while Australia has led other countries in dual-degree programs, partner universities from Japan and Korea have the most frequent collaboration on student exchange programs. Meanwhile, most visiting scholars who have collaborated with the universities in this study came from the US, the UK, Japan, Australia, Netherlands, and China. Other European countries such as Germany, French, and Norway have also conducted joint research with Indonesian universities involved in this study. This study suggests that further supports of government policy and grants are required to overcome the challenges as well as strategic leadership and management roles to achieve high impacts of such programs on higher education quality.Keywords: higher education, internationalisation, challenges, Indonesia
Procedia PDF Downloads 2704357 Contracting Strategies to Foster Industrial Symbiosis Implementation
Authors: Robin Molinier
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Industrial symbiosis (I.S) deals with the exchange of waste materials, fatal energy and utilities as resources for production. While it brings environmental benefits from resource conservation its economic profitability is one of the main barriers to its implementation. I.S involves several actors with their own objectives and resources so that each actor must be satisfied by ex-ante arrangements to commit toward investments and transactions. Regarding I.S Transaction cost economics helps to identify hybrid forms of governance for transactions governance due to I.S projects specificities induced by the need for customization (asset specificity, non-homogeneity). Thus we propose a framework to analyze the best contractual practices tailored to address I.S specific risks that we identified as threefold (load profiles and quality mismatch, value fluctuations). Schemes from cooperative game theory and contracting management are integrated to analyze value flows between actors. Contractual guidelines are then proposed to address the identified risks and to split the value for a set of I.S archetypes drawn from actual experiences.Keywords: contracts, economics, industrial symbiosis, risks
Procedia PDF Downloads 2094356 Intellectual Property Rights on Plant Materials in Colombia: Legal Harmonization for Food Sovereignty
Authors: Medina Muñoz Lina Rocio
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The purpose of this paper is to examine the debates related to the harmonization of intellectual property rights on plant material, the corporate governance of the seed market in Colombia and the political economy of seeds defended by indigenous communities. In recent years, the commodification of seeds through genetic engineering and political intellectual property, codified as a result of the implementation of the Free Trade Agreement with the United States, has come into conflict with the traditional production of seeds carried out by small farmers and indigenous populations. Agricultural and food practices. In order to understand the ontological dimension of conflicts over seeds, it is necessary to analyze the conceptions that indigenous communities have about good, which they consider a common element of their social organization and define them as sentient beings. Therefore, through a multiple approach, in which the intellectual property policy, the ecological aspects of seed production and the political ontology of indigenous communities are interwoven, I intend to present the discussions held by the actors involved and present the strategies of small producers to protect their interests. It demonstrates that communities have begun to organize social movements to protect such interests and have questioned the philosophy of GM corporate agriculture as a pro-life movement. Finally, it is argued that the conservation of 'traditional' seeds of the communities is an effective strategy to support their struggles for territory, identity, food sovereignty and self-determination.Keywords: intellectual property rights, intellectual property, traditional knowledge, food safety
Procedia PDF Downloads 764355 Old Houses for Tomorrow: Deliberating a Societal Need for Conserving Unprotected Heritage Houses in India
Authors: Protyoy Sen
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Heritage conservation often holds different meanings and values for different people. To a cultural or architectural body it might be about protecting relics of the past, while for an government body or corporate it might be the value of the real estate which generates profits in terms of hospitality, tourism or some form of trade. But often, a significant proportion of the built fabric in our cities comprises of what usually does not come under the common lenses of collective heritage or conservation i.e. private houses. Standing ode to a bygone era of different communities, trades and practices that once inhabited the city, old private houses of certain architectural or historic character face the gravest challenges of heritage conservation. These – despite being significant to the heritage fabric of a city – neither get the social attention nor the financial aid for repair and periodic maintenance, that many monuments and public buildings do. The situation in India is no different. Private residences belonging to affluent families of an earlier time, today lie in varying degrees of neglect and dilapidation. With the growth of nuclear families, drastic change in people’s and expensive repairs of historic material fabric (amongst other reasons), houses of heritage value often become liabilities, and metaphorical to a white elephant in a poor man’s backyard. In a capitalistic setup that values time and money over everything, it is not reasonable that one justifies the conservation of individual / family assets solely through architectural, historical or cultural values. It is quite logical them, that the houseowner – in most cases, a layperson – must be made to understand of both tangible and intangible values in order to (1) take the trouble of the effort, resources and aid (if possible) to repair and maintain a house of heritage character and, (2) choose to invest into a building that today might’ve lost its practical relevance, over demolishing and building new. The question that still remains is – Why? If heritage conservation is to be seen as an economically viable and realistic building activity, it must shed its image of being an ‘elitist, cultural pursuit’ in the eyes of the common person. Through contextual studies of historic areas in Ahmedabad and Calcutta, reading of theoretical pieces on the subject and conversations with multiple stakeholders, this study intended to justify the act of heritage conservation to the common person – one who is assumed to have no particular sensitivity towards architectural or cultural value, and rather questions what these buildings tangibly bring to the table. The theoretical frameworks (taken from literature) are then tested through actual case studies in Indian cities, followed by an elaborate inference on the subject.Keywords: heritage values, heritage houses, private ownership, unprotected heritage
Procedia PDF Downloads 554354 On the Principles of Self-determination, Remedial Secession, and Responsibility to Protect: The Case of Nagorno Karabakh
Authors: Sara Melkonyan
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Over the past decades, the political (and partly legal) doctrine of remedial secession has emerged on the basis of the development of internationally recognized human rights and rights of peoples stemming from various multilateral treaties, which stipulates that aggrieved and persecuted nations have the right to secede from the parent state as a remedy for their continuous and unstoppable grievances. The 44-day war in Nagorno-Karabakh and the following events posed severe challenges for Nagorno-Karabakh and its people. Constant aggression and threat, the humanitarian crisis caused by the closure of the Lachin Corridor, the persistent threat of ethnic cleansing of Artsakhi Armenians, and the state policy that has been executed towards Artsakhi people by the Azerbaijani authorities come to prove that the Artsakhi people cannot survive under Azerbaijani control and secession may be the last resort for ending oppression. The paper tries to make parallels with similar cases and discuss the doctrine of remedial secession applied selectively among different cases. This paper aims to figure out why in some cases the secessionist movements succeeded to gain independence based on the doctrine of remedial secession, in other cases, they refused to gain recognition from the international community. Through analyzing the domestic-level and then international-level factors, the study concluded that the doctrine of remedial secession is inherently in the political realm and almost impossible to draw substantial “recipes” for warranting secession, and the latter is not applied similarly among the cases, so its success mainly depends on the geopolitical interests of the great powers involved.Keywords: R2P, remedial secession, self-determination, conflicts
Procedia PDF Downloads 794353 A Practice of Zero Trust Architecture in Financial Transactions
Authors: Liwen Wang, Yuting Chen, Tong Wu, Shaolei Hu
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In order to enhance the security of critical financial infrastructure, this study carries out a transformation of the architecture of a financial trading terminal to a zero trust architecture (ZTA), constructs an active defense system for cybersecurity, improves the security level of trading services in the Internet environment, enhances the ability to prevent network attacks and unknown risks, and reduces the industry and security risks brought about by cybersecurity risks. This study introduces the SDP technology of ZTA, adapts and applies it to a financial trading terminal to achieve security optimization and fine-grained business grading control. The upgraded architecture of the trading terminal moves security protection forward to the user access layer, replaces VPN to optimize remote access, and significantly improves the security protection capability of Internet transactions. The study achieves 1. deep integration with the access control architecture of the transaction system; 2. no impact on the performance of terminals and gateways, and no perception of application system upgrades; 3. customized checklist and policy configuration; 4. introduction of industry-leading security technology such as single-packet authorization (SPA) and secondary authentication. This study carries out a successful application of ZTA in the field of financial trading and provides transformation ideas for other similar systems while improving the security level of financial transaction services in the Internet environment.Keywords: zero trust, trading terminal, architecture, network security, cybersecurity
Procedia PDF Downloads 1674352 Medical Waste Management in Nigeria: A Case Study
Authors: Y. Y. Babanyara, D. B. Ibrahim, T. Garba
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Proper management of medical waste is a crucial issue for maintaining human health and the environment. The waste generated in the hospitals has the potential for spreading infections and causing diseases. The study is aimed at assessing the medical waste management practices in Nigeria. Three instruments, questionnaire administration, in-depth interview and observation method for data collection were adopted in the study. The results revealed that the hospital does not quantify medical waste. Segregation of medical wastes is not conducted according to definite rules and standards. Wheeled trolleys are used for on-site transportation of waste from the points of production to the temporary storage area. Offsite transportation of the hospital waste is undertaken by a private waste management company. Small pickups are mainly used to transport waste daily to an off-site area for treatment and disposal. The main treatment method used in the final disposal of infectious waste is incineration. Non-infectious waste is disposed off using land disposal method. The study showed that the hospital does not have a policy and plan in place for managing medical waste. The study revealed number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collections and disposal of waste, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting the bags to only one colour for all waste, the absence of a dedicated waste manager, and no committee responsible for monitoring the management of medical waste. Recommendations are given with the aim of improving medical waste management in the hospital.Keywords: medical waste, treatment, disposal, public health
Procedia PDF Downloads 3184351 Economical Dependency Evolution and Complexity
Authors: Allé Dieng, Mamadou Bousso, Latif Dramani
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The purpose of this work is to show the complexity behind economical interrelations in a country and provide a linear dynamic model of economical dependency evolution in a country. The model is based on National Transfer Account which is one of the most robust methodology developed in order to measure a level of demographic dividend captured in a country. It is built upon three major factors: demography, economical dependency and migration. The established mathematical model has been simulated using Netlogo software. The innovation of this study is in describing economical dependency as a complex system and simulating using mathematical equation the evolution of the two populations: the economical dependent and the non-economical dependent as defined in the National Transfer Account methodology. It also allows us to see the interactions and behaviors of both populations. The model can track individual characteristics and look at the effect of birth and death rates on the evolution of these two populations. The developed model is useful to understand how demographic and economic phenomenon are relatedKeywords: ABM, demographic dividend, National Transfer Accounts (NTA), ODE
Procedia PDF Downloads 2054350 A Flagship Framework with Feet of Clay: Operational and Structural Challenges of the African Peace and Security Architecture
Authors: Wiriranai Brilliant Masara
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The African Peace and Security Architecture is widely celebrated and revered as a paragon of the will to address peace and security challenges in Africa. However, like any other institution, it is embedded with operational and institutional challenges that prevent it from effectively carrying out its mandate and turning goals into achieved results. The article examines the fundamental flaws and weaknesses of the African Peace and Security Architecture by focusing on its institutions, norms, instruments, and its relationship to Africa’s Regional Economic Communities. Therefore, the article reviews the flaws of the five elements of the African Peace and Security Architecture which are the Peace and Security Council, Panel of the Wise, Continental Early Warning System, African Standby Force, and Peace Fund.Keywords: African Union, African Peace and Security Architecture, peace and security council, continental early warning system, African Standby Force, Panel of the Wise, Peace Fund
Procedia PDF Downloads 140