Search results for: medical and social costs

Authors: Norm Josephy, Lucy Kimball, Victoria Steblovskaya

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Hedging of a portfolio of European options under proportional transaction costs is considered. Our discrete time financial market model extends the binomial market model with transaction costs to the case where the underlying stock price ratios are distributed over a bounded interval rather than over a two-point set. An optimal hedging strategy is chosen from a set of admissible non-self-financing hedging strategies. Our approach to optimal hedging of a portfolio of options is based on theoretical foundation that includes determination of a no-arbitrage option price interval as well as on properties of the non-self-financing strategies and their residuals. A computational algorithm for optimizing an investor relevant criterion over the set of admissible non-self-financing hedging strategies is developed. Applicability of our approach is demonstrated using both simulated data and real market data.

Keywords: extended binomial model, non-self-financing hedging, optimization, proportional transaction costs

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Authors: Xinrong Li, Jiawei Dai

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Food production, food safety, and the food supply chain are causing a great challenge to human health and the environment. Different kinds of food have different environmental costs. Therefore, a healthy diet can alleviate this problem to a certain extent. In this project, an online questionnaire was conducted to understand the purchase behaviour of consumers and their attitudes towards basic food information. However, the data shows that the public's current consumption habits and ideology do not meet the long-term development of sustainable social needs. In order to solve the environmental problems caused by the unbalanced diet of the public and the social problems of unequal food distribution, the purpose of this paper is to explore how to use the emerging media of VR to visualize food supply chain information so as to attract users' attention to the environmental cost of food. In this project, the food supply chain of imported and local cheese was compared side-by-side in the virtual reality environment, including the origin, transportation, sales, and other processes, which can effectively help users understand the difference between the two processes and environmental costs. Besides, the experimental data demonstrated that the participant would like to choose low environmental cost food after experiencing the whole process.

Keywords: virtual reality, information design, food supply chain, environmental cost

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Authors: Abdullah Alotaiq

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The transition to low-carbon power generation is essential for mitigating climate change and achieving sustainability. This process, however, entails considerable costs, and understanding the factors influencing these costs is critical. This is necessary to cater to the increasing demand for low-carbon electricity across the heating, industry, and transportation sectors. A crucial aspect of this transition is identifying cost-effective and feasible paths for decarbonization, which is integral to global climate mitigation efforts. It is concluded that hybrid solutions, combining different low-carbon technologies, are optimal for minimizing costs and enhancing flexibility. These solutions also address the challenges associated with phasing out existing fossil fuel-based power plants and broadening the spectrum of low-carbon power generation options.

Keywords: review, power generation, energy transition, decarbonisation

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Authors: Irene Carter, Roy Hanes, Judy MacDonald

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Considering that disability is universal and people with disabilities are part of all societies; that there is a connection between the disabled individual and the societal; and that it is society and social arrangements that disable people with impairments, contemporary disability discourse emphasizes the social model of disability to counter medical and rehabilitative models of disability. However, the social model does not go far enough in addressing the issues of oppression and inclusion. The authors indicate that the social model does not specifically or adequately denote the oppression of persons with disabilities, which is a central component of progressive social work practice with people with disabilities. The social model of disability does not go far enough in deconstructing disability and offering social workers, as well as people with disabilities a way of moving forward in terms of practice anchored in individual, familial and societal change. The social model of disability is expanded by incorporating principles of anti-oppression social work practice. Although the contextual analysis of the social model of disability is an important component there remains a need for social workers to provide service to individuals and their families, which will be illustrated through anti-oppressive practice (AOP). By applying an anti-oppressive model of practice to the above definitions, the authors not only deconstruct disability paradigms but illustrate how AOP offers a framework for social workers to engage with people with disabilities at the individual, familial and community levels of practice, promoting an emancipatory focus in working with people with disabilities. An anti- social- oppression social work model of disability connects the day-to-day hardships of people with disabilities to the direct consequence of oppression in the form of ableism. AOP theory finds many of its basic concepts within social-oppression theory and the social model of disability. It is often the case that practitioners, including social workers and psychologists, define people with disabilities’ as having or being a problem with the focus placed upon adjustment and coping. A case example will be used to illustrate how an AOP paradigm offers social work a more comprehensive and critical analysis and practice model for social work practice with and for people with disabilities than the traditional medical model, rehabilitative and social model approaches.

Keywords: anti-oppressive practice, disability, people with disabilities, social model of disability

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Authors: M. G. Cattaneo

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The non-effectiveness of certain codified human rights is particularly apparent with reference to the lack of access to essential drugs in developing countries, which represents a breach of the human right to receive adequate health assistance. This paper underlines the conflict and the legal contradictions between human rights, namely health rights, international Intellectual Property Rights, in particular patent law, as well as international trade law. The paper discusses the crucial links between R&D costs for innovation, patents and new medical drugs, with the goal of reformulating the hierarchies of priorities and of interests at stake in the international intellectual property (IP) law system. Different from what happens today, International patent law should be a legal instrument apt at rebalancing an axiological asymmetry between the (conflicting) needs at stake The core argument in the paper is the proposal of an alternative pathway, namely a feasible proposal for a patent law reform. IP laws tend to balance the benefits deriving from innovation with the costs of the provided monopoly, but since developing countries and industrialized countries are in completely different political and economic situations, it is necessary to (re)modulate such exchange according to the different needs. Based on this critical analysis, the paper puts forward a proposal, called Trading Time for Space (TTS), whereby a longer time for patent exclusive life in western countries (Time) is offered to the patent holder company, in exchange for the latter selling the medical drug at cost price in developing countries (Space). Accordingly, pharmaceutical companies should sell drugs in developing countries at the cost price, or alternatively grant a free license for the sale in such countries, without any royalties or fees. However, such social service shall be duly compensated. Therefore, the consideration for such a service shall be an extension of the temporal duration of the patent’s exclusive in the country of origin that will compensate the reduced profits caused by the supply at the price cost in developing countries.

Keywords: global health, global justice, patent law reform, access to drugs

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Authors: Chizzoniti Domenico, Beggiora Klizia, Cattani Letizia, Moscatelli Monica

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This paper concerns the study of sustainable construction materials applied on the "Health Post", a prototype for the primary health care situated in alienated areas of the world. It's suitable for social and climatic Sub-Saharan context; however, it could be moved in other countries of the world with similar urgent needs. The idea is to create a Health Post with local construction materials that have a low environmental impact and promote the local workforce allowing reuse of traditional building techniques lowering production costs and transport. The aim of Primary Health Care Centre is to be a flexible and expandable structure identifying a modular form that can be repeated several times to expand its existing functions. In this way it could be not only a health care centre but also a socio-cultural facility.

Keywords: low costs building, sustainable construction materials, green construction system, prototype, health care, emergency

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Authors: Ritu Shitak

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Humans are social mammals, of the primate order. Our biology, behaviour, and pathologies are unique to us. In our desire to understand, reduce solitary confinement one source of information is the many reports of social isolation of other social mammals, especially primates. A behavioural study was conducted in the department of pharmacology at Indira Gandhi Medical College, Shimla in Himachal Pradesh province in India using white albino mice. Different behavioural parameters were observed by using open field, tail suspension, tests for aggressive behaviour and social interactions and the effect of isolation was studied. The results were evaluated and the standard statistics were applied. The said study was done to establish facts that isolation itself impairs social behaviour and can lead to alcohol dependence as well as related drug dependence.

Keywords: social isolation, albino mice, drug dependence, isolation on social behaviour

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Authors: Aparajita Bhattacharya, Mousumi Dutta, Zakir Husain, Dionne Sequeira, Asima Mukhopadhyay

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Background: Tata Medical Centre (TMC), Kolkata is a major cancer referral centre in Eastern India and neighbouring countries providing state of the art facilities; however, it is a non-profit organisation with patients requiring to pay at subsidised rates. Although a system for social assessment and applying for governmental/ non-governmental (NGO) funds is in place, access is challenging. Amongst gynaecological cancers (GC), ovarian cancer (OC) is associated with the highest treatment cost; majority of which is required at the beginning when complex surgery is performed and funding arrangements cannot be made in time. We therefore appointed a dedicated Medical Social Worker (MSW) in 2016, supported by NGO for GC patients in order to assist patients/family members to access/avail these funds more readily and assist in economic evaluation for both direct and opportunity costs. Objectives: To reflect on our experience and challenges in collecting data on economic evaluation of cancer patients and compare success rates in achieving fund mobilization after introduction of MSW. Methods: A Retrospective survey. Patients with OC and their relatives were seen by the MSW during the initial outpatients department visit and followed though till discharge from the hospital and during follow-up visits. Assistance was provided in preparing the essential documents/paperwork/contacts for the funding agencies including both governmental (Chief-Minister/Prime-Minister/President) and NGO sources. In addition, a detailed questionnaire was filled up for economic assessment of direct/opportunity costs during the entire treatment and 12 months follow up period which forms a part of the study called HEPTROC (Health economic evaluation of primary treatment for ovarian cancer) developed in collaboration with economics departments of Universities. Results: In 2015, 102 patients were operated for OC; only 16 patients (15.68 %) had availed funding of a total sum of INR 1640000 through the hospital system for social assessment. Following challenges were faced by majority of the relatives: 1. Gathering important documents/proper contact details for governmental funding bodies and difficulty in following up the current status 3. Late arrival of funds. In contrast in 2016, 104 OC patients underwent surgery; the direct cost of treatment was significantly higher (median, INR 300000- 400000) compared to other GCs (n=274). 98/104 (94.23%) OC patients could be helped to apply for funds and 90/104(86.56%) patients received funding amounting to a total of INR 10897000. There has been a tenfold increase in funds mobilized in 2016 after the introduction of dedicated MSW in GC. So far, in 2017 (till June), 46/54(85.18%) OC patients applied for funds and 37/54(68.51%) patients have received funding. In a qualitative survey, all patients appreciated the role of the MSW who subsequently became the key worker for patient follow up and the chief portal for patient reported outcome monitoring. Data collection quality for the HEPTROC study was improved when questionnaires were administered by the MSW compared to researchers. Conclusion: Introduction of cancer specific MSW can expedite the availability of funds required for cancer patients and it can positively impact on patient satisfaction and outcome reporting. The economic assessment will influence fund allocation and decision for policymaking in ovarian cancer. Acknowledgement: Jivdaya Foundation Dallas, Texas.

Keywords: economic evaluation, funding, medical social worker, ovarian cancer

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: Hanen Khanchel, Karim Ben Kahla

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Pharmaceutical companies are facing competition. Indeed, the price differences between competing products can be such that it becomes difficult to compensate them by differences in value added. The conditions of competition are no longer homogeneous for the players involved. The price of a product is a given that puts a company and its customer face to face. However, price fixing obliges the company to consider internal factors relating to production costs and external factors such as customer attitudes, the existence of regulations and the structure of the market on which the firm evolved. In setting the selling price, the company must first take into account internal factors relating to its costs: costs of production fall into two categories, fixed costs and variable costs that depend on the quantities produced. The company cannot consider selling below what it costs the product. It, therefore, calculates the unit cost of production to which it adds the unit cost of distribution, enabling it to know the unit cost of production of the product. The company adds its margin and thus determines its selling price. The margin is used to remunerate the capital providers and to finance the activity of the company and its investments. Production costs are related to the quantities produced: large-scale production generally reduces the unit cost of production, which is an asset for companies with mass production markets. This shows that small and medium-sized companies with limited market segments need to make greater efforts to ensure their profit margins. As a result, and faced with high and low market prices for raw materials and increasing staff costs, the company must seek to optimize its production time in order to reduce loads and eliminate waste. Then, the customer pays only value added. Thus, and based on this principle we decided to create a project that deals with the problem of waste in our company, and having as objectives the reduction of production costs and improvement of performance indicators. This paper presents the implementation of the Value Stream Mapping (VSM) project in a pharmaceutical company. It is structured as follows: 1) determination of the family of products, 2) drawing of the current state, 3) drawing of the future state, 4) action plan and implementation.

Keywords: VSM, waste, production time, kaizen, cartography, improvement

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Authors: Havisha Banda

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Recent advancements in technology have facilitated commerce around the globe. The online medium of commerce has provided and will continue to provide great opportunities for consumers and businesses. Advancements in technology enable apparel stores, for instance, to improve their online services by using personalized virtual models allowing consumers to visualize the product on the model to determine correct sizing and fit. In addition to many advantages in online shopping the consumers will also have to undergo many types of switching costs in this process of buying apparel online. This study is to identify such switching costs and switching benefits from traditional shopping to online shopping and to understand what the consumers value the most. The scope of this study is to understand the types of switching costs and the factors that actually allow the consumers to shift from brick and mortar to online shopping and also to understand why a certain set of customers consider to purchase offline. Hence this study helps to understand the perceived cost and perceived benefit relation that the consumer draws in purchasing the garments online. This will help the upcoming e-commerce sites and brick and mortar store to understand the various factors and formulate new policies and implement strategies in their own ways to attract the customers and to retain them. A sample of 35 is considered for the process of laddered interviews. In the era of e-commerce there are people who feel comfortable to shop in a retail store rather than online purchase. Few respondents who shop online do not prefer to shop apparel online. Few respondents said that they shop online only for apparels. Most of the variables match in terms of switching costs and also in regard to benefits.

Keywords: e-commerce, switching costs, switching benefits, apparel shopping

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Authors: C. M. Cebola, V. H. Ferreira

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In the past decade mediation has been legally implemented in European legal systems, especially after the publication by the European Union of the Directive 2008/52/EC on certain aspects of mediation in civil and mercantile matters. Developments in international trade and globalization in this new century have led to an increase of the number of litigations, often cross-border, and the courts have failed to respond adequately. We do not advocate that mediation should be promoted as the solution for all justice problems, but as a means with its own specificities that the parties may choose to consider as the best way to resolve their disputes. Thus, the implementation of mediation should be based on the advantages of its application. From the economic point of view, competitive negotiation can generate negative external effects in social terms. A solution reached in a court of law is not always the most efficient one considering all elements of society (economic social benefit). On the other hand, the administration of justice adds in economic terms transaction costs that can be mitigated by the application of other forms of conflict resolution, such as mediation. In this paper, the economic benefits of mediation will be analysed in the light of various studies on the functioning of justice. Several theoretical arguments will be confronted with empirical studies to demonstrate that mediation has significant positive economic effects. The objective is to contribute to the dissemination of mediation between companies and citizens, but also to demonstrate the cost to governments and states of still limited use of mediation, particularly in the current economic crisis and propose actions to develop the application of mediation.

Keywords: economic impact, litigation costs, mediation, solutions

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Authors: Hiba Mezaache

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The study aims to assess the financial and social efficiency of microfinance institutions in india for the period 2015-2019 by using two models of economies of scale and choosing the output direction of the data envelope analysis (DEA) method and using the MIX MARKET database. The study concluded that microfinance institutions focus on achieving financial efficiency beyond their focus on achieving social efficiency to ensure their continuity in the market. Convergence in the efficiency ratios that have been achieved, but the optimum ratios have been achieved under the changing economies of scale; Efficiency is affected by the depth of reaching low-income groups, as serving this group raises costs and risks. The importance of lending to women in rural areas and raising their awareness to ensure their financial and social empowerment; Make improvements in operating expenses, asset management, and loan personnel control in order to maximize output.

Keywords: microfinance, financial efficiency, social efficiency, mix market, microfinance institutions

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Authors: Michael Dimmer, Holger Flederer

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The basis of realizing a construction project is a technically flawless concept which satisfies conditions regarding environment and costs, as well as static-constructional terms. The presented software system actively supports civil engineers during the setup of optimal designs, by giving advice regarding durability, life-cycle costs, sustainability and much more. A major part of the surrounding conditions of a design process is gathered and assimilated by experienced engineers subconsciously. It is a question about eligible building techniques and their practicability by considering emerging costs. Planning engineers have acquired many of this experience during their professional life and use them for their daily work. Occasionally, the planning engineer should disassociate himself from his experience to be open for new and better solutions which meet the functional demands, as well. The developed expert system gives planning engineers recommendations for preferred design options of new constructions as well as for existing bridge constructions. It is possible to analyze construction elements and techniques regarding sustainability and life-cycle costs. This way the software provides recommendations for future constructions. Furthermore, there is an option to design existing road bridges especially for heavy duty transport. This implies a route planning tool to get quick and reliable information as to whether the bridge support structures of a transport route have been measured sufficiently for a certain heavy duty transport. The use of this expert system in bridge planning companies and building authorities will save costs massively for new and existent bridge constructions. This is achieved by consequently considering parameters like life-cycle costs and sustainability for its planning recommendations.

Keywords: expert system, planning process, road bridges, software system

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Authors: Olena Kovalchuk

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How to define the understanding of social responsibility issues by Ukrainian companies is a contravention question. Thus, one of the practical uses of social responsibility is a diagnostic tool development for educational, business or scientific purposes. So the purpose of this research is to develop a tool for measurement of social responsibility in organization. Methodology: A 21-item questionnaire “Organization Social Responsibility Scale” was developed. This tool was adapted for the Ukrainian sample and based on the questionnaire “Perceived Role of Ethics and Social Responsibility” which connects ethical and socially responsible behavior to different aspects of the organizational effectiveness. After surveying the respondents, the factor analysis was made by the method of main compounds with orthogonal rotation VARIMAX. On the basis of the obtained results the 21-item questionnaire was developed (Cronbach’s alpha – 0,768; Inter-Item Correlations – 0,34). Participants: 121 managers at all levels of Ukrainian organizations (57 males; 65 females) took part in the research. Results: Factor analysis showed five ethical dilemmas concerning the social responsibility and profit compatibility in Ukrainian organizations. Below we made an attempt to interpret them: — Social responsibility vs profit. Corporate social responsibility can be a way to reduce operational costs. A firm’s first priority is employees’ morale. Being ethical and socially responsible is the priority of the organization. The most loaded question is "Corporate social responsibility can reduce operational costs". Significant effect of this factor is 0.768. — Profit vs social responsibility. Efficiency is much more important to a firm than ethics or social responsibility. Making the profit is the most important concern for a firm. The dominant question is "Efficiency is much more important to a firm than whether or not the firm is seen as ethical or socially responsible". Significant effect of this factor is 0.793. — A balanced combination of social responsibility and profit. Organization with social responsibility policy is more attractive for its stakeholders. The most loaded question is "Social responsibility and profitability can be compatible". Significant effect of this factor is 0.802. — Role of Social Responsibility in the successful organizational performance. Understanding the value of social responsibility and business ethics. Well-being and welfare of the society. The dominant question is "Good ethics is often good business". Significant effect of this factor is 0.727. — Global vision of social responsibility. Issues related to global social responsibility and sustainability. Innovative approaches to poverty reduction. Awareness of climate change problems. Global vision for successful business. The dominant question is "The overall effectiveness of a business can be determined to a great extent by the degree to which it is ethical and socially responsible". Significant effect of this factor is 0.842. The theoretical contribution. The perspective of the study is to develop a tool for measurement social responsibility in organizations and to test questionnaire’s adequacy for social and cultural context. Practical implications. The research results can be applied for designing a training programme for business school students to form their global vision for successful business as well as the ability to solve ethical dilemmas in managerial practice. Researchers interested in social responsibility issues are welcome to join the project.

Keywords: corporate social responsibility, Cronbach’s alpha, ethical behaviour, psychodiagnostic tool

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Authors: Sreejith Gopinath, Aspen Olmsted

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This paper is based on our previous work that proposed a risk-transference-based architecture for healthcare systems to store sensitive data outside the system boundary, rendering the system unattractive to would-be bad actors. This architecture also allows a compromised system to be abandoned and a new system instance spun up in place to ensure business continuity without paying a ransom or engaging with a bad actor. This paper delves into the details of various attacks we simulated against the prototype system. In the paper, we discuss at length the time and computational costs associated with storing and retrieving data in the prototype system, abandoning a compromised system, and setting up a new instance with existing data. Lastly, we simulate some analytical workloads over the data stored in our specialized data storage system and discuss the time and computational costs associated with running analytics over data in a specialized storage system outside the system boundary. In summary, this paper discusses the total costs of data storage, access, and analytics incurred with the proposed architecture.

Keywords: cybersecurity, healthcare, ransomware, resilience, risk transference

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Authors: Ons Sassi, Wahiba Ramdane Cherif-Khettaf, Ammar Oulamara

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In this paper, we consider a new real-life Heterogenous Electric Vehicle Routing Problem with Time Dependant Charging Costs and a Mixed Fleet (HEVRP-TDMF), in which a set of geographically scattered customers have to be served by a mixed fleet of vehicles composed of a heterogenous fleet of Electric Vehicles (EVs), having different battery capacities and operating costs, and Conventional Vehicles (CVs). We include the possibility of charging EVs in the available charging stations during the routes in order to serve all customers. Each charging station offers charging service with a known technology of chargers and time-dependent charging costs. Charging stations are also subject to operating time windows constraints. EVs are not necessarily compatible with all available charging technologies and a partial charging is allowed. Intermittent charging at the depot is also allowed provided that constraints related to the electricity grid are satisfied. The objective is to minimize the number of employed vehicles and then minimize the total travel and charging costs. In this study, we present a Mixed Integer Programming Model and develop a Charging Routing Heuristic and a Local Search Heuristic based on the Inject-Eject routine with three different insertion strategies. All heuristics are tested on real data instances.

Keywords: charging problem, electric vehicle, heuristics, local search, optimization, routing problem

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Authors: Wen Chiat Lee, K. Kuperan Viswanathan

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Illegal, Unreported and unregulated (IUU) fishing brings great losses to the economies of the fishing nations. Understanding the reasons contributing to IUU fishing is crucial in reducing it. Economic, institutional and social factors are key drivers of IIU fishing. The economic factor is the main contributor to IUU fishing. The two possible ways to curb the IUU fishing is highlighted. One way is to reduce the revenue from IUU fishing and another way is to increase the cost of IUU fishing. There are three costs of IUU fishing that can be increased namely the operating, capital and risk costs. Approaches for reducing the economic rent or profit from IUU fishing are developed and directions for reducing IUU fishing are also suggested. Improved registration of fishing vessels, preventing entry of illegal fish products and most importantly, developing co-management of fisheries are the ways forward for reducing IUU fishing. All governments in ASEAN must work in tandem with the stakeholders involved such as fishers, fishermen agencies or associations to exchange information for reducing the transaction cost of IUU fishing.

Keywords: Illegal, unreported and unregulated (IUU) fishing, co-management, fisheries management, economic rent framework

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Authors: Antonio Lopez-Villegas, Rafael Bautista-Mesa, Emilio Robles-Musso, Daniel Catalan-Matamoros, Cesar Leal-Costa

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Objectives: The purpose of this trial was to evaluate the burden borne by and the costs to informal caregivers of users with telemonitoring of pacemakers. Methods: This is a controlled, non-randomised clinical trial, with data collected from informal caregivers, five years after implantation of pacemakers. The Spanish version of the Survey on Disabilities, Personal Autonomy, and Dependency Situations was used to get information on clinical and social characteristics, levels of professionalism, duration and types of care, difficulties in providing care, health status, economic and job aspects, impact on the family or leisure due to informal caregiving for patients with pacemakers. Results: After five years of follow-up, 55 users with pacemakers finished the study. Of which, 50 were helped by a caregiver, 18 were included in the telemonitoring group (TM) and 32 in the conventional follow-up group (HM). Overall, females represented 96.0% of the informal caregivers (88.89% in TM and 100.0% in HM group). The mean ages were 63.17 ± 15.92 and 63.13 ± 14.56 years, respectively (p = 0.83) in the groups. The majority (88.0%) of the caregivers declared that they had to provide their services between 6 and 7 days per week (83.33% in TM group versus 90.63% in HM group), without significant differences between both groups. The costs related to care provided by the informal caregivers were 47.04% higher in the conventional follow-up group than in the TM group. Conclusions: The results of this trial confirm that there were no significant differences between the informal caregivers regarding to baseline characteristics, workload and time worked in both groups of follow-up. The costs incurred by the informal caregivers providing care for users with pacemakers included in telemonitoring group are significantly lower than those in the conventional follow-up group. Trial registration: ClinicalTrials.gov NCT02234245. Funding: The PONIENTE study, has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: costs, disease burden, informal caregiving, pacemaker follow-up, remote monitoring, telemedicine

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Authors: Dana Al-Qattan, Faiza Goodarzi, Heba Al-Resheedan, Kawther Shehab, Shoug Al-Ansari

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This project involves working with different types of forecasting methods and facility planning tools to help the company we have chosen to improve and reduce its inventory, increase its sales, and decrease its wastes and losses. The methods that have been used by the company have shown no improvement in decreasing the annual losses. The research made in the company has shown that no interest has been made in exploring different techniques to help the company. In this report, we introduce several methods and techniques that will help the company make more accurate forecasts and use of the available space efficiently. We expect our approach to reduce costs without affecting the quality of the product, and hence making production more viable.

Keywords: production planning, inventory management, inventory control, simulation, facility planning and design, engineering economy and costs

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Authors: Hatim Laalej, Jon Stammers

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In machining, monitoring of tool wear is essential for achieving the desired dimensional accuracy and surface finish of a machined workpiece. Currently, the task of monitoring the wear on the cutting tool is carried out by the operator who performs manual inspections of the cutting tool, causing undesirable stoppages of machine tools and consequently resulting in costs incurred from loss of productivity. The cutting tool consumable costs may also be higher than necessary when tools are changed before the end of their useful life. Furthermore, damage can be caused to the workpiece when tools are not changed soon enough leading to a significant increase in the costs of manufacturing. The present study is concerned with the development of break sensor printed on the flank surface of poly-crystalline diamond (PCD) cutting to perform on-line condition monitoring of the cutting tool used to machine Titanium Ti-6al-4v bar. The results clearly show that there is a strong correlation between the break sensor measurements and the amount of wear in the cutting tool. These findings are significant in that they help the user/operator of the machine tool to determine the condition of the cutting tool without the need of performing manual inspection, thereby reducing the manufacturing costs such as the machine down time.

Keywords: machining, manufacturing, tool wear, signal processing

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Authors: Fabiha Tanzeem

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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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Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

Procedia PDF Downloads 292

Authors: Mayada Attia Ibrahim

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Evaluating and developing the electroplating production process is a key challenge in this type of process. The process is influenced by several factors such as process parameters, process costs, and production environments. Analyzing and optimizing all these factors together requires extensive analytical techniques that are not available in real-case industrial entities. This paper presents a practice-based framework for the evaluation and optimization of some of the crucial factors that affect the costs and production times associated with this type of process, energy costs, material costs, and product flow times. The proposed approach uses Design of Experiments, Discrete-Event Simulation, and Theory of Constraints were respectively used to identify the most significant factors affecting the production process and simulate a real production line to recognize the effect of these factors and assign possible bottlenecks. Several scenarios are generated as corrective strategies for improving the production line. Following that, data envelopment analysis CCR input-oriented DEA model is used to evaluate and optimize the suggested scenarios.

Keywords: electroplating process, simulation, design of experiment, performance optimization, theory of constraints, data envelopment analysis

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Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

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Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

Procedia PDF Downloads 148

Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

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Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

Procedia PDF Downloads 100

Authors: Jalal Soleimannejad, Mohammad Asadizeidabadi, Mahmoud Koorki, Mojtaba Azarpira

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A significant percentage of production costs is the maintenance costs, and analysis of maintenance costs could to achieve greater productivity and competitiveness. With this is mind, the maintenance of machines and installations is considered as an essential part of organizational functions and applying effective strategies causes significant added value in manufacturing activities. Organizations are trying to achieve performance levels on a global scale with emphasis on creating competitive advantage by different methods consist of RCM (Reliability-Center-Maintenance), TPM (Total Productivity Maintenance) etc. In this study, increasing the capacity of Concentration Plant of Golgohar Iron Ore Mining & Industrial Company (GEG) was examined by using of reliability and maintainability analyses. The results of this research showed that instead of increasing the number of machines (in order to solve the bottleneck problems), the improving of reliability and maintainability would solve bottleneck problems in the best way. It should be mention that in the abovementioned study, the data set of Concentration Plant of GEG as a case study, was applied and analyzed.

Keywords: bottleneck, golgohar iron ore mining & industrial company, maintainability, maintenance costs, reliability

Procedia PDF Downloads 331

Authors: Rusne Kregzdaite

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The value of the cultural sector stems from the symbolic exploration that differentiates cultural organisations from other product or service organisations. As a result, the cultural sector has a dual impact on the socio-economic system: the economic value (expressed in terms of market relations) created influences the dynamics of the country's financial indicators, while the cultural (non-market) value indirectly contributes to the welfare of the state through changes in societal values, creativity transformations and cultural needs of the country. Measurement of indirect (cultural value) impacts is difficult, but in the case of the cultural sector (especially when it comes to economically inefficient state-funded culture), it helps to reveal the essential characteristics of the sector. The study aims to analyze the value of cultural organisations that are invisible in market processes and to base it on quantified calculations. This was be done by analyzing the usefulness of the consumer, incorporating not only the price paid but also the social and cultural decision-making factors that determine the spectator's choice (time dedicated for a visit, additional costs, content, previous experiences, corporate image). This may reflect the consumer's real choice to consume (all the costs he incurs may be considered the financial equivalent of his experience with the cultural establishment). The research methodology was tested by analyzing the performing arts sector and applying methods to the Lithuanian national drama theatre case. The empirical research consisted of a survey (more than 800 participants) of Lithuanian national drama theatre visitors to different performances. The willingness to pay and travel costs methods were used. Analysis of different performances lets identifies the factor that increases willingness to pay for the performance and affects theatre attendance. The research stresses the importance of cultural value and social perspective of the cultural sector and relates it to the discussions of public funding of culture.

Keywords: cultural economics, performing arts, willingness to pay, travel cost analysis, performing arts management

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

Procedia PDF Downloads 460

Authors: Barbara Ballan

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Environmental Justice (EJ) and Environmental Social Governance (ESG) are trending terms used to address the impacts of corporate actions and environmental and social regulations on the people and the planet. ESG is a private governance invention (though increasingly required by public law) that aims to disclose environmental and social criteria while fostering value for businesses. On the other hand, EJ was borne as a social movement that evolved into a regulatory tool employed by EJ advocates and governmental agencies to assess inequalities in environmental impacts and regulations. However, EJ usage is expanding, and private environmental governance in the form of ESG disclosure frameworks is incorporating EJ criteria, indexes, and tools as part of its metric-driven approach. There is an existing tension between (1) the notion of social justice at the heart of the environmental justice movement and (2) the nature of for-profit corporations which generate value by externalizing costs, translated to environmental injustices. This study aims to explore the paradoxical relation of ESG, including EJ criteria, despite their opposing notions, in response to the need for innovative mechanisms to address today’s pressing social and environmental challenges. To that end, this study will evaluate and critically assess the inclusion of EJ in ESG reporting. Furthermore, it identifies gaps in ESG frameworks and proposes the integration of EJ tools to address these deficiencies. This work is intended to help both businesses looking to expand their ESG frameworks and include EJ criteria to inform corporate decisions and assure long-term corporate viability, as well as EJ supporters in understanding the complex dynamic of ESG disclosure for the pursuit of EJ objectives.

Keywords: environmental justice, ESG, sustainability reporting, corporate law, environmental law, social justice

Procedia PDF Downloads 23