Search results for: moral issues
4420 Higher Education and the Economy in Western Canada: Is Institutional Autonomy at Risk?
Authors: James Barmby
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Canada’s westernmost provinces of British Columbia and Alberta are similar in many respects as they are both reliant on volatile natural resources for major portions of their economies. The two provinces have banded together to develop mutually beneficial trade, investment and labour market mobility rules, but in terms of developing systems of higher education, the two provinces are attempting to align higher education programs to economic development objectives by means that are quite different. In British Columbia, the recently announced initiative, B.C’s Skills for Jobs Blueprint will “make sure education and training programs are aligned with the demands of the labor market.” Meanwhile in Alberta, the province’s institutions of higher education are enjoying the tenth year of their membership in the Campus Alberta Quality Council, which makes recommendations to government on issues related to post-secondary education, including the approval of new programs. In B.C., public institutions of higher education are encouraged to comply with government objectives, and are rewarded with targeted funds for their efforts. In Alberta, the institutions as a system tell the government what programs they want to offer and government can agree or not agree to fund these programs through a ministerial approval process. In comparing the two higher education systems, the question emerges as to which one is more beneficial to the province: the one where change is directed primarily by financial incentives to achieve economic objectives or the one that makes recommendations to the government for changes in programs to achieve institutional objectives? How is institutional autonomy affected in each strategy? Does institutional autonomy matter anymore? In recent years, much has been written in regard to academic freedom, but less about institutional autonomy, which is seen by many as essential to protecting academic freedom. However, while institutional autonomy means freedom from government control, it does not necessarily mean self-government. In this study, a comparison of the two higher education systems is made using recent government policy initiatives in both provinces, and responses to those actions by the higher education institutions. The findings indicate that the economic needs in both provinces take precedence over issues of institutional autonomy.Keywords: alberta, British Columbia, institutional autonomy, funding
Procedia PDF Downloads 7014419 The Implications of Instrumental Animal Protection for the Legal and Moral Status of Animals
Authors: Ankita Shanker, Angus Nurse
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The notion of animal rights is an emerging trend in various spaces, including judicial and societal discourse. But one of the key purposes of recognizing the fundamental rights of anyone is their de-objectification. Animals are a prime example of a group that has rights that are neither recognized nor protected in any meaningful way, and anything that purports differently fails to ameliorate this because it still objectifies animals. Animals are currently treated by law and society as commodities with primarily (though not exclusively) instrumental value to some other rights-holder, such as humans or nature. So most protections that are afforded to them are done so in furtherance of the interests that they allegedly further, be it social morality or environmental protection. Animal rights are thus often seen as an application or extension of the rights of humans or, more commonly, the rights of nature. What this means is that animal rights are not always protected or even recognized in their own regard, but as stemming from some other reason, or worse, instrumentally as means to some other ends. This has two identifiable effects from a legal perspective: animal rights are not seen as inherently justified and are not seen as inherently valuable. Which in turn means that there can be no fundamental protection of animal rights. In other words, judicial protection does not always entail protection of animal ‘rights’ qua animal rights, which is needed for any meaningful protections to be afforded to animals. But the effects of this legal paradigm do not end at the legal status of animals. Because this status, in turn, affects how persons and the societies of which they form part see animals as a part of the rights of others, such as humans or nature, or as valuable only insofar as they further these rights, as opposed to as individuals with inherent worth and value deserving of protection regardless of their instrumental usefulness to these other objectives. This does nothing to truly de-objectify animals. Because even though most people would agree that animals are not objects, they continue to treat them as such wherever it serves them. For individuals and society to resolve, this inconsistency between stance and actions is for them to believe that animals are more than objects on a psychological and societal level. In this paper, we examine the implications of this perception of animals and their rights on the legal protections afforded to them and on the minds of individuals and civil society. We also argue that a change in the legal and societal status of animals can be brought about only through judicial, psychological, and sociological acknowledgment that animals have inherent value and deserve protection on this basis. Animal rights derived in such a way would not need to place reliance on other justifications and would not be subject to subjugation to other rights should a conflict arise.Keywords: animal rights law, animal protection laws, psycho-socio-legal studies, animal rights, human rights, rights of nature
Procedia PDF Downloads 1084418 Using Eye-Tracking Technology to Understand Consumers’ Comprehension of Multimedia Health Information
Authors: Samiullah Paracha, Sania Jehanzeb, M. H. Gharanai, A. R. Ahmadi, H.Sokout, Toshiro Takahara
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The purpose of this study is to examine how health consumers utilize pictures when developing an understanding of multimedia health documents, and whether attentional processes, measured by eye-tracking, relate to differences in health-related cognitive resources and passage comprehension. To investigate these issues, we will present health-related text-picture passages to elders and collect eye movement data to measure readers’ looking behaviors.Keywords: multimedia, eye-tracking, consumer health informatics, human-computer interaction
Procedia PDF Downloads 3394417 A Descriptive Study of the Mineral Content of Conserved Forage Fed to Horses in the United Kingdom, Ireland, and France
Authors: Louise Jones, Rafael De Andrade Moral, John C. Stephens
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Background: Minerals are an essential component of correct nutrition. Conserved hay/haylage is an important component of many horse's diets. Variations in the mineral content of conserved forage should be considered when assessing dietary intake. Objectives: This study describes the levels and differences in 15 commonly analysed minerals in conserved forage fed to horses in the United Kingdom (UK), Ireland (IRL), and France (FRA). Methods: Hay (FRA n=92, IRL n=168, UK n=152) and haylage samples (UK n=287, IRL n=49) were collected during 2017-2020. Mineral analysis was undertaken using inductively coupled plasma-mass spectrometry (ICP-MS). Statistical analysis was performed using beta regression, Gaussian, or gamma models, depending on the nature of the response variable. Results: There are significant differences in the mineral content of the UK, IRL, and FRA conserved forage samples. FRA hay samples had a significantly higher (p < 0.05) levels of Sulphur (0.16 ± 0.0051 %), Calcium (0.56 ± 0.0342%), Magnesium (0.16 ± 0.0069 mg/ kg DM), Iron (194 ± 23.0 mg/kg DM), Cobalt (0.21 ± 0.0244 mg/kg DM) and Copper (4.94 ± 0.196 mg/kg DM) content compared to hay from the other two countries. UK hay samples had significantly less (p < 0.05) Selenium (0.07 ± 0.0084 mg/kg DM), whilst IRL hay samples were significantly (p < 0.05) higher in Chloride (0.9 ± 0.026mg/kg DM) compared to hay from the other two countries. IRL haylage samples were significantly (p < 0.05) higher in Phosphorus (0.26 ± 0.0102 %), Sulphur (0.17 ± 0.0052 %), Chloride (1.01 ± 0.0519 %), Calcium (0.54 ± 0.0257 %), Selenium (0.17 ± 0.0322 mg/kg DM) and Molybdenum (1.47 ± 0.137 mg/kg DM) compared to haylage from the UK. Main Limitations: Forage samples were obtained from professional yards and may not be reflective of forages fed by most horse owners. Information regarding soil type, species of grass, fertiliser treatment, harvest, or storage conditions were not included in this study. Conclusions: At a DM intake of 2% body weight, conserved forage as sampled in this study will be insufficient to meet Zinc, Iodine, and Copper NRC maintenance requirements, and Se intake will also be insufficient for horses fed the UK conserved forage. Many horses receive hay/haylage as the main component of their diet; this study highlights the need to consider forage analysis when making dietary recommendations.Keywords: conserved forage, hay, haylage, minerals
Procedia PDF Downloads 2274416 The Risks of 'Techtopia': Reviewing the Negative Lessons of Smart City Development
Authors: Amanda Grace Ahl, Matthew Brummer
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‘Smart cities’ are not always as ‘smart’ as the term suggests, which is not often covered in the associated academic and public policy literatures. In what has become known as the smart city approach to urban planning, governments around the world are seeking to harness the power of information and communications technology with increasingly advanced data analytics to address major social, economic, and environmental issues reshaping the ways people live. The definitional and theoretical boundaries of the smart city framework are broad and at times ambiguous, as is empirical treatment of the topic. However, and for all the disparity, in investigating any number of institutional and policy prescriptions to the challenges faced by current and emerging metropoles, scholarly thought has hinged overwhelmingly on value-positive conceptions of informatics-centered design. From enhanced quality of services, to increased efficiency of resources, to improved communication between societal stakeholders, the smart city design is championed as a technological wellspring capable of providing answers to the systemic issues stymying a utopian image of the city. However, it is argued that this ‘techtopia’, has resulted in myopia within the discipline as to value-negative implications of such planning, such as weaknesses in practicality, scalability, social equity and affordability of solutions. In order to more carefully examine this observation - that ‘stupid’ represents an omitted variable bias in the study of ‘smart’ - this paper reviews critical cases of unsuccessful smart city developments. It is argued that also understanding the negative factors affiliated with the development processes is imperative for the advancement of theoretical foundations, policies, and strategies to further the smart city as an equitable, holistic urban innovation. What emerges from the process-tracing carried out in this study are distinctly negative lessons of smart city projects, the significance of which are vital for understanding how best to conceive smart urban planning in the 21st century.Keywords: case study, city management, innovation system, negative lessons, smart city development
Procedia PDF Downloads 4154415 Some Issues of Measurement of Impairment of Non-Financial Assets in the Public Sector
Authors: Mariam Vardiashvili
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The economic value of the asset impairment process is quite large. Impairment reflects the reduction of future economic benefits or service potentials itemized in the asset. The assets owned by public sector entities bring economic benefits or are used for delivery of the free-of-charge services. Consequently, they are classified as cash-generating and non-cash-generating assets. IPSAS 21 - Impairment of non-cash-generating assets, and IPSAS 26 - Impairment of cash-generating assets, have been designed considering this specificity. When measuring impairment of assets, it is important to select the relevant methods. For measurement of the impaired Non-Cash-Generating Assets, IPSAS 21 recommends three methods: Depreciated Replacement Cost Approach, Restoration Cost Approach, and Service Units Approach. Impairment of Value in Use of Cash-Generating Assets (according to IPSAS 26) is measured by discounted value of the money sources to be received in future. Value in use of the cash-generating asserts (as per IPSAS 26) is measured by the discounted value of the money sources to be received in the future. The article provides classification of the assets in the public sector as non-cash-generating assets and cash-generating assets and, deals also with the factors which should be considered when evaluating impairment of assets. An essence of impairment of the non-financial assets and the methods of measurement thereof evaluation are formulated according to IPSAS 21 and IPSAS 26. The main emphasis is put on different methods of measurement of the value in use of the impaired Cash-Generating Assets and Non-Cash-Generation Assets and the methods of their selection. The traditional and the expected cash flow approaches for calculation of the discounted value are reviewed. The article also discusses the issues of recognition of impairment loss and its reflection in the financial reporting. The article concludes that despite a functional purpose of the impaired asset, whichever method is used for measuring the asset, presentation of realistic information regarding the value of the assets should be ensured in the financial reporting. In the theoretical development of the issue, the methods of scientific abstraction, analysis and synthesis were used. The research was carried out with a systemic approach. The research process uses international standards of accounting, theoretical researches and publications of Georgian and foreign scientists.Keywords: cash-generating assets, non-cash-generating assets, recoverable (usable restorative) value, value of use
Procedia PDF Downloads 1434414 Quality Assessment of SSRU Program in Education
Authors: Rossukhon Makaramani, Supanan Sittilerd, Wipada Prasarnsaph
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The study aimed to 1) examine management status of a Program in Education at the Faculty of Education, Suan Sunandha Rajabhat University (SSRU); 2) determine main components, indicators and criteria for constructing quality assessment framework; 3) assess quality of a SSRU Program in Education; and 4) provide recommendations to promote academic excellence. The program to be assessed was Bachelor of Education Program in Education (5 years), Revised Version 2009. Population and samples were stakeholders involving implementation of this program during an academic year 2012. Results were: 1) Management status of the Program in Education showed that the Faculty of Education depicted good level (4.20) in the third cycle of external quality assessment by the Office for National Education Standards and Quality Assessment (ONESQA). There were 1,192 students enrolling in the program, divided into 5 major fields of study. There were 50 faculty members, 37 holding master’s degrees and 13 holding doctorate degrees. Their academic position consisted of 35 lecturers, 10 assistant professors, and 5 associate professors. For program management, there was a committee of 5 members for the program and also a committee of 4 or 5 members for each major field of study. Among the faculty members, 41 persons taught in this program. The ratio between faculty and student was 1:26. The result of 2013 internal quality assessment indicated that system and mechanism of the program development and management was at fair level. However, the overall result yielded good level either by criteria of the Office of Higher Education Commission (4.29) or the NESQA (4.37); 2) Framework for assessing the quality of the program consisted of 4 dimensions and 15 indicators; 3) Assessment of the program yielded Good level of quality (4.04); 4) Recommendations to promote academic excellence included management and development of the program focusing on teacher reform toward highly recognized profession; cultivation of values, moral, ethics, and spirits of being a teacher; construction of specialized programs; development of faculty potentials; enhancement of the demonstration school’s readiness level; and provision of dormitories for learning.Keywords: quality assessment, education program, Suan Sunandha Rajabhat University, academic excellence
Procedia PDF Downloads 2944413 “It’s All in Your Head”: Epistemic Injustice, Prejudice, and Power in the Modern Healthcare System
Authors: David Tennison
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Epistemic injustice, an injustice done to a person specifically in their capacity as a “knower”, is a subtle form of discrimination, yet its effects can be as dehumanizing and damaging as more overt forms of discrimination. The lens of epistemic injustice has, in recent years, been fruitfully applied to the field of healthcare, examining questions of agency, power, credibility and belief in doctor-patient interactions. Contested illness patients (e.g., those with illnesses lacking scientific consensuses such as fibromyalgia (FM), Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) and Long Covid) face higher levels of scrutiny than other patient groups and are often disbelieved or dismissed when their ailments cannot be easily imaged or tested for- often encapsulated by the expression “it’s all in your head”. Using the case study of FM, the trials of contested illness patients in healthcare can be conceptualized in terms of epistemic injustice, and what is going wrong in these doctor-patient relationships can be effectively diagnosed. This case study also helps reveal epistemic dysfunction (structural epistemic issues embedded in the healthcare system), how this relates to stigma identity-based prejudice, and how the healthcare system upholds existing societal hierarchies and disenfranchises the most vulnerable. In the modern landscape, where cases of these chronic illnesses are not only on the rise but future pandemics threaten to add to their number, this conversation is crucial for the well-being of patients and providers. This presentation will cover what epistemic injustice is and how it can be applied to the politics of the doctor-patient interaction on a micro level and the politics of the healthcare system more broadly. Contested illnesses will be explored in terms of how the “contested” label causes the patient to experience disease stigma and lowers their credibility in healthcare and across other aspects of life. This will be explored in tandem with a discussion of existing identity-based prejudice in the healthcare system and how social identities (such as those of gender, race, and socioeconomic status) intersect with the contested illness label. The effects of epistemic injustice, which include worsening patients’ symptoms of mental health and potentially disenfranchising them from the healthcare system altogether, will be presented alongside the potential ethical quandaries this poses for providers. Finally, issues with the way healthcare appointments and the modern NHS function will be explored in terms of epistemic injustice and solutions to improve doctor-patient communication and patient care will be discussed. The relationship between contested illness patients and healthcare providers is notoriously poor, and while this can mean frustration or feelings of unfulfillment in providers, the negative effects for patients are much more severe. The purpose of this research, then, is to highlight these issues and suggest ways in which to improve the healthcare experience for these patients, along with improving doctor-patient communication and mending the doctor-patient relationship in a tangible and realistic way. This research also aims to provoke important conversations about belief and hierarchy in medical settings and how these aspects intersect with identity prejudices.Keywords: epistemic injustice, fibromyalgia, contested illnesses, chronic illnesses, doctor-patient relationships, philosophy of medicine
Procedia PDF Downloads 604412 Threat Modeling Methodology for Supporting Industrial Control Systems Device Manufacturers and System Integrators
Authors: Raluca Ana Maria Viziteu, Anna Prudnikova
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Industrial control systems (ICS) have received much attention in recent years due to the convergence of information technology (IT) and operational technology (OT) that has increased the interdependence of safety and security issues to be considered. These issues require ICS-tailored solutions. That led to the need to creation of a methodology for supporting ICS device manufacturers and system integrators in carrying out threat modeling of embedded ICS devices in a way that guarantees the quality of the identified threats and minimizes subjectivity in the threat identification process. To research, the possibility of creating such a methodology, a set of existing standards, regulations, papers, and publications related to threat modeling in the ICS sector and other sectors was reviewed to identify various existing methodologies and methods used in threat modeling. Furthermore, the most popular ones were tested in an exploratory phase on a specific PLC device. The outcome of this exploratory phase has been used as a basis for defining specific characteristics of ICS embedded devices and their deployment scenarios, identifying the factors that introduce subjectivity in the threat modeling process of such devices, and defining metrics for evaluating the minimum quality requirements of identified threats associated to the deployment of the devices in existing infrastructures. Furthermore, the threat modeling methodology was created based on the previous steps' results. The usability of the methodology was evaluated through a set of standardized threat modeling requirements and a standardized comparison method for threat modeling methodologies. The outcomes of these verification methods confirm that the methodology is effective. The full paper includes the outcome of research on different threat modeling methodologies that can be used in OT, their comparison, and the results of implementing each of them in practice on a PLC device. This research is further used to build a threat modeling methodology tailored to OT environments; a detailed description is included. Moreover, the paper includes results of the evaluation of created methodology based on a set of parameters specifically created to rate threat modeling methodologies.Keywords: device manufacturers, embedded devices, industrial control systems, threat modeling
Procedia PDF Downloads 804411 Exploring Well-Being: Lived Experiences and Assertions From a Marginalized Perspective
Authors: Ritwik Saha, Anindita Chaudhuri
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The psychological dimension of work-based mobility of the contemporary time in the context of the ever-changing socio-economic process mounting the interest to address the consequential issues of quality of life and well-being of the migrant section of society. The negotiation with the fluidity of the job market and the changing psychosocial dimensions within and between psychosocial relations may disentangle the resilience as well as the mechanism of diligence toward migrant (marginal) life. The work-based mobility and its associated phenomena have highly impacted the migrant’s quality of life especially the marginalized (socioeconomically weak) ones along with their family members staying away from them. The subjective experiences of the journey of their migrant life and reconstruction of the psychosocial being in terms of existence and well-being at the host place are the minimal addressed issues in migrant literature. Hence this gap instigates to bring forth the issue with the present study exploring the phenomenal aspects of lived experiences, resilience, and sense-making of the well-being of migrant living by the marginalized migrant people engaging in unorganized space. In doing so qualitative research method was followed, and semi-structured interviews were used for data collection from the four selected migrant groups (Fuchkawala, Bhunjawala, Bhari - drinking water supplier, Construction worker) as they migrated to Kolkata and its metropolis area from different states of India, Five participants from each group (20 participants in total) age range between 20 to 45 were interviewed physically and participants’ observatory notes were taken to capture their lived experiences, audio recordings were transcribed and analyzed systematically following Charmaz’s three-layer coding of grounded theory. Being truthful to daily industry, the strong desire to build children’s future, the mastering mechanism to dual existence, use of traditional social network these four themes emerges after analysis of the data. However, incorporating fate as their usual way of life and making sense of well-being through their assertion is another evolving aspect of migrant life.Keywords: lived experiences, marginal living, resilience, sense-making process, well-being
Procedia PDF Downloads 614410 Human Values and Morality of Adolescents Who Have Broken the Law: A Multi-Method Study in a Socioeducational Institutional Environment
Authors: Luiz Nolasco Jr. Rezende, Antonio Villar M. Sá, Claudia Marcia L. Pato
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The increasing urban violence in Brazil involves more and more infractions committed by children and youths. The challenges faced by the institutional environments responsible for the education and resocialization of adolescents in conflict with the law are enormous, especially of those deprived of their liberty. These institutions have an inadequate educational structure. They are characterized by a dirty and unhealthy environment without the minimum basic conditions for their activities, by frequent practices of degradation, humiliation, and the physical and psychological punishment of inmates. This mixed-method study investigated the personal values of adolescents with restriction of freedom in a socio-educational institutional environment aiming to contribute to the development of their morality through an educational process. For that, we used a survey and transdisciplinary play workshops involving thirty-two boys aged between 15 and 19 years old and at least two years out of school. To evaluate the survey the reduced version of the Portrait Questionnaire—PQ21—was used. The workshops happened once a week, lasting 80 minutes each, totaling twelve meetings. By using the game of chess and its metaphors, participants produced texts and engaged in critical brainstorming about their lives. The survey results pointed out that these young people showed a predominance of values of openness to change and self-transcendence, dissatisfaction with one's own reality and surroundings, not considering the consequences of their actions on themselves and others, difficulties in speaking and writing, and desire for changes in their lives. After the pedagogical interventions, these adolescents demonstrated an understanding of the implications of their actions for themselves, for their families, especially for the mothers, with whom they demonstrated stronger bonds. It was possible to observe evidence of improvement in the capacity of linguistic expression, more autonomy and critical vision, including about themselves and their respective contexts. These results demonstrated the educational potential of lively, symbolic, dynamic and playful activities that favor the mediation and identification of these adolescents with their lives, and contribute to the projection of dreams.Keywords: adolescents arrested, human values, moral development, playful workshops
Procedia PDF Downloads 2654409 Initiating the Provision of Adolescent Reproductive Health Information and Services (ARHIS) to Communities in Quezon City, Beginning with District 2
Authors: Erickson Bernardo, Caridad Pineda
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The project Adolescent Reproductive Health Information and Services (ARHIS) is a nine-month pilot project which intends to bridge the existing gap between reproductive health information and services, particularly with regard to family planning and HIV, among adolescent boys and girls aged 10-19 years in the 2nd Congressional District of Quezon City, in the Philippines. It aims to increase adolescents' and young people's awareness about their reproductive health concerns and at the same time make a wide range of reproductive health (RH) services accessible and available to them. A number of methodologies were utilized in the implementation of the project. At the onset, a baseline survey was conducted by community mobilizers to gather a situational analysis of adolescents' and young people's issues and concerns. The results of this survey were then presented in a multi-stakeholders' meeting to gather community support and foster their involvement. Further, interactive learning sessions (ILS) on a variety of reproductive health topics, among young people, parents and community leaders based on the results of the baseline survey was conducted. With regard to reproductive health service provision, both facility-based delivery and conduct of outreach activities were employed. In the span of nine months, the project was able to yield the following results: • A total of 521 adolescents and youth (AY) were reached by ILS on puberty, responsible relationships, teenage pregnancy, family planning, as well as HIV & AIDS. • A total of 218 parents and community leaders were informed of AY RH-related issues and concerns. • More than 350 AYs availed of a wide range of FP services including pills – both combined oral and progestin-only, and progestin-only injectables and implants. • More than 380 AYs availed of condoms as means of STI and HIV prevention. A noble initiative of the project is the utilization of a "condom distributor", a youth leader who has been educated about STI and HIV prevention as well as correct condom use, as the focal point for condom access in the community. • A total of 25 young people, parents, and community leaders were identified as ARHIS champions who have been instrumental in the achievement of project deliverables through their dedication and commitment to support the project. The concept of adolescent sexual and reproductive health (ASRH) remains to be a major challenge in the Philippine context. This is due to the fact that majority of Filipinos are still not keen on discussing issues and concerns related to ASRH, albeit the alarming number of teenage pregnancies and the rapid increase of HIV cases among 15- 24 year olds. In addition, Republic Act 10354 or the Responsible Parenthood and Reproductive Health Act of 2012, requires minor adolescents to present a written parental consent prior to accessing RH services. However, with the involvement and support of parents and key community stakeholders, these barriers may be addressed. The project has demonstrated how adolescents and young people yearn for reproductive health information and services.Keywords: adolescent sexual reproductive health, barriers to access, reproductive health information and services, teenage pregnancies
Procedia PDF Downloads 1774408 A Feminist/Queer Global Bioethics’Perspective on Reproduction: Abortion, MAR and Surrogacy
Authors: Tamara Roma, Emma Capulli
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Pregnancy and fertility, in other words, reproduction, has become, in the last half of the century, increasingly and globally controlled, medicalized, and regulated. The reflection proposed starts from the consequences of the inscription of reproduction into the neoliberal economic paradigm. The new biotechnologies developments have raised a new patriarchal justification for State’s control of uterus bodies and a new construction of knowledge about reproductive health. Moral discussion and juridification remove reproduction and non-reproduction from their personal and intimate context and frame them under words like “duties”, “rights”, “family planning”, “demography”, and “population policy”, reinvent them as “States business” and ultimately help to re/confirm a specific construct of fertility, motherhood, and family. Moreover, the interaction between the neoliberal economy and medical biotechnologies brought about a new formulation of the connection between feminine generative potential and value production. The widespread and contemporary debates on Medically Assisted Reproduction (MAR), surrogacy and abortion suggest the need for a “feminist/queer global bioethical discourse” capable of inserting itself into the official bioethical debate characterized by the traditional dichotomy of laic bioethics/Catholic bioethics. The contribution moves from a feminist bioethics perspective on reproductive technologies to introduce a feminist/queer global bioethics point of view on reproductive health. The comparison between reproduction and non-reproduction debates is useful to analyze and demonstrate how restrictive legislations, dichotomic bioethical discussion and medical control confirm and strengthens gender injustice in reproductive life. In fact, MAR, surrogacy, and abortion restrictions stem from a shared social and legal paradigm that depends on traditional gender roles revealing how the stratification of reproduction is based on multiple discrimination along the lines of gender, race, and class. In conclusion, the perspective of feminist/queer global bioethics tries to read the concept of universal reproductive justice, introducing an original point of view on reproductive health access.Keywords: queer bioethics, reproductive health, reproductive justice, reproductive technologies
Procedia PDF Downloads 1254407 The New Approach to Airport Emergency Plans
Authors: Jakub Kraus, Vladimír Plos, Peter Vittek
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This article deals with a new approach to the airport emergency plans, which are the basic documents and manuals for dealing with events with impact on safety or security. The article describes the identified parts in which the current airport emergency plans do not fulfill their role and which should therefore be considered in the creation of corrective measures. All these issues have been identified at airports in the Czech Republic and confirmed at airports in neighboring countries.Keywords: airport emergency plan, aviation safety, aviation security, comprehensive management system
Procedia PDF Downloads 5114406 Pediatric Health Nursing Research in Jordan: Evaluating the State of Knowledge and Determining Future Research Direction
Authors: Inaam Khalaf, Nadin M. Abdel Razeq, Hamza Alduraidi, Suhaila Halasa, Omayyah S. Nassar, Eman Al-Horani, Jumana Shehadeh, Anna Talal
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Background: Nursing researchers are responsible for generating knowledge that corresponds to national and global research priorities in order to promote, restore, and maintain the health of individuals and societies. The objectives of this scoping review of Jordanian literature are to assess the existing research on pediatric nursing in terms of evolution, authorship and collaborations, funding sources, methodologies, topics of research, and pediatric subjects' age groups so as to identify gaps in research. Methodology: A search was conducted using related keywords obtained from national and international databases. The reviewed literature included pediatric health articles published through December 2019 in English and Arabic, authored by nursing researchers. The investigators assessed the retrieved studies and extracted data using a data-mining checklist. Results: The review included 265 articles authored by Jordanian nursing researchers concerning children's health, published between 1987 and 2019; 95% were published between 2009 and 2019. The most commonly applied research methodology was the descriptive non-experimental method (76%). The main generic topics were health promotion and disease prevention (23%), chronic physical conditions (19%), mental health, behavioral disorders, and forensic issues (16%). Conclusion: The review findings identified a grave shortage of evidence concerning nursing care issues for children below five years of age, especially those between ages two and five years. The research priorities identified in this review resonate with those identified in international reports. Implications: Nursing researchers are encouraged to conduct more research targeting topics of national-level importance in collaboration with clinically involved nurses and international scholars.Keywords: Jordan, scoping review, children health nursing, pediatric, adolescents
Procedia PDF Downloads 864405 Poverty and Illiteracy as a Key Factor for Crime and Unrest in Nigeria
Authors: Lawrence Emah
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Nigeria, Africa’s most populous nation is undoubtedly, currently going through one of the most difficult phases in her 55 years of existence as an independent nation. At no other time in her history is she under so much pressure of social unrest and unacceptable rate of crime and criminality than it is today. From the North where there is an insurgency to contend with, then to the South where kidnapping and armed robbery hold sway. These issues did not just sprout from nowhere; they have a root somewhere. This is why this paper seeks to bring to the fore poverty and illiteracy as leading causes of these twin social ills– crime and social restiveness as well as suggest practical solutions to the problems.Keywords: crime, illiteracy, poverty, unrest
Procedia PDF Downloads 2344404 Role of Imaging in Alzheimer's Disease Trials: Impact on Trial Planning, Patient Recruitment and Retention
Authors: Kohkan Shamsi
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Background: MRI and PET are now extensively utilized in Alzheimer's disease (AD) trials for patient eligibility, efficacy assessment, and safety evaluations but including imaging in AD trials impacts site selection process, patient recruitment, and patient retention. Methods: PET/MRI are performed at baseline and at multiple follow-up timepoints. This requires prospective site imaging qualification, evaluation of phantom data, training and continuous monitoring of machines for acquisition of standardized and consistent data. This also requires prospective patient/caregiver training as patients must go to multiple facilities for imaging examinations. We will share our experience form one of the largest AD programs. Lesson learned: Many neurological diseases have a similar presentation as AD or could confound the assessment of drug therapy. The inclusion of wrong patients has ethical and legal issues, and data could be excluded from the analysis. Centralized eligibility evaluation read process will be discussed. Amyloid related imaging abnormalities (ARIA) were observed in amyloid-β trials. FDA recommended regular monitoring of ARIA. Our experience in ARIA evaluations in large phase III study at > 350 sites will be presented. Efficacy evaluation: MRI is utilized to evaluate various volumes of the brain. FDG PET or amyloid PET agents has been used in AD trials. We will share our experience about site and central independent reads. Imaging logistic issues that need to be handled in the planning phase will also be discussed as it can impact patient compliance thereby increasing missing data and affecting study results. Conclusion: imaging must be prospectively planned to include standardizing imaging methodologies, site selection process and selecting assessment criteria. Training should be transparently conducted and documented. Prospective patient/caregiver awareness of imaging requirement is essential for patient compliance and reduction in missing imaging data.Keywords: Alzheimer's disease, ARIA, MRI, PET, patient recruitment, retention
Procedia PDF Downloads 1154403 Women and Terrorism in Nigeria: Policy Templates for Addressing Complex Challenges in a Changing Democratic State
Authors: Godiya Pius Atsiya
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One of the most devastating impacts of terrorism on the Nigerian state is the danger it has posed on women, children and other vulnerable groups. The complexity of terrorism in Nigeria, especially in most parts of Northern Nigeria has entrenched unprecedented security challenges such as refugee crisis, kidnapping, food shortages, increase in death tolls, malnutrition, fear, rape and several other psychological factors. Of particular interest in this paper as it relates to terrorism is the high rate of Internally Displaced Persons(IDPs), with women, children and the aged being the most affected. Empirical evidence arising from recent development in Nigeria’s North-East geo-political zone shows that large numbers of refugees fleeing the Boko Haram attacks have doubled. The attendant consequences of this mass exodus of people in the affected areas are that the victims now suffer untold and unwarranted economic hardship. In another dimension, recent findings have it that most powerless women and young teenage girls have been forcefully conscripted into the Islamic extremist groups and used as shields. In some respect, these groups of people have been used as available tools for suicide bombing and other criminal tendencies, the result of which can be detrimental to social cohesion and integration. This work is a theoretical insight into terrorism discourses; hence, the paper relies on existing works of scholars in carrying out the research. The paper argues that the implications of terrorism on women gender have grounding effects on the moral psyche of women who are supposed to be home managers and custodians of morality in society. The burden of terrorism and all it tends to propagate has literally upturned social lives and hence, Nigeria is gradually being plunged into the Hobesian state of nature. As a panacea to resolving this social malaise, the paper submits that government and indeed, all stakeholders in the nation’s democratic project must expedite action to nip this trend in the bud. The paper sums up with conclusion and other alternative policy measures to mitigate the challenges of terrorism in Nigeria.Keywords: changing democratic state, policy measures, terrorism, women
Procedia PDF Downloads 2324402 Investigating Software Engineering Challenges in Game Development
Authors: Fawad Zaidi
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This paper discusses a variety of challenges and solutions involved with creating computer games and the issues faced by the software engineers working in this field. This review further investigates the articles coverage of project scope and the problem of feature creep that appears to be inherent with game development. The paper tries to answer the following question: Is this a problem caused by a shortage, or bad software engineering practices, or is this outside the control of the software engineering component of the game production process?Keywords: software engineering, computer games, software applications, development
Procedia PDF Downloads 4754401 Dream Work: Examining the Effectiveness of Dream Interpretation in Gaining Psychological Insight into Young Adults in Korea
Authors: Ahn Christine Myunghee, Sim Wonjin, Cho Kristina, Ahn Mira, Hong Yeju, Kwok Jihae, Lim Sooyeon, Park Hansol
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With a sharp increase in the prevalence rate for mental health issues in Korea, there is a need for specific and effective intervention strategies in counseling and psychotherapy for use with Korean clients. With the cultural emphasis on restraining emotional expression and not disclosing personal and familial problems to outsiders, clients often find it difficult to discuss their emotional issues even to therapists. Exploring a client’s internal psychological processes bypassing this culture-specific mode of therapeutic communication often becomes a challenge in the therapeutic setting. Given this socio-cultural context, the purpose of the current study was to investigate the effectiveness of using dream work to individuals in Korea. The current study conducted one 60-90 minute dream session and analyzed the dream content of 39 Korean young adults to evaluate the effectiveness of the Hill dream model in accessing the intra-psychic materials, determining essential emotional themes, and learning how the individuals interpreted the contents of their dreams. The transcribed data, which included a total of 39 sessions from 39 volunteer university students, were analyzed by the Consensus Qualitative Research (CQR) approach in terms of domains and core ideas. Self-report measures on Dream Salience, Gains from Dream Interpretations and the Session Evaluation Scale were administered before and after each of their dream sessions. The results indicated that dream work appears to be an effective way to understand unconscious motivations, thoughts, and feelings related to a person’s sense of self, and also how these people relate to other people. Current findings need to be replicated with clients referred for counseling and psychotherapy to determine if the dream work is an appropriate and useful intervention in counseling settings. Limitations of the current study and suggestions for future follow-ups are included in the discussion.Keywords: dream work, dream interpretation, Korean, young adults, CQR
Procedia PDF Downloads 4464400 Connotation Reform and Problem Response of Rural Social Relations under the Influence of the Earthquake: With a Review of Wenchuan Decade
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The occurrence of Wenchuan earthquake in 2008 has led to severe damage to the rural areas of Chengdu city, such as the rupture of the social network, the stagnation of economic production and the rupture of living space. The post-disaster reconstruction has become a sustainable issue. As an important link to maintain the order of rural social development, social network should be an important content of post-disaster reconstruction. Therefore, this paper takes rural reconstruction communities in earthquake-stricken areas of Chengdu as the research object and adopts sociological research methods such as field survey, observation and interview to try to understand the transformation of rural social relations network under the influence of earthquake and its impact on rural space. It has found that rural societies under the earthquake generally experienced three phases: the break of stable social relations, the transition of temporary non-normal state, and the reorganization of social networks. The connotation of phased rural social relations also changed accordingly: turn to a new division of labor on the social orientation, turn to a capital flow and redistribution in new production mode on the capital orientation, and turn to relative decentralization after concentration on the spatial dimension. Along with such changes, rural areas have emerged some social issues such as the alienation of competition in the new industry division, the low social connection, the significant redistribution of capital, and the lack of public space. Based on a comprehensive review of these issues, this paper proposes the corresponding response mechanism. First of all, a reasonable division of labor should be established within the villages to realize diversified commodity supply. Secondly, the villages should adjust the industrial type to promote the equitable participation of capital allocation groups. Finally, external public spaces should be added to strengthen the field of social interaction within the communities.Keywords: social relations, social support networks, industrial division, capital allocation, public space
Procedia PDF Downloads 1564399 Experimental Study of the Efficacy and Emission Properties of a Compression Ignition Engine Running on Fuel Additives with Varying Engine Loads
Authors: Faisal Mahroogi, Mahmoud Bady, Yaser H. Alahmadi, Ahmed Alsisi, Sunny Narayan, Muhammad Usman Kaisan
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The Kingdom of Saudi Arabia established Saudi Vision 2030, an initiative of the government with the goal of promoting more socioeconomic as well as cultural diversity. The kingdom, which is dedicated to sustainable development and clean energy, uses cutting-edge approaches to address energy-related issues, including the circular carbon economy (CCE) and a more varied energy mix. In order for Saudi Arabia to achieve its Vision 2030 goal of having a net zero future by 2060, sustainability is essential. By addressing the energy and climate issues of the modern world with responsibility and innovation, Vision 2030 is turning into a global role model for the transition to a sustainable future. As per the Ambitions of the National Environment Strategy of the Saudi Ministry of Environment, Agriculture, and Water (MEWA), raising environmental compliance across all sectors and reducing pollution and adverse environmental impacts are critical focus areas. As a result, the current study presents an experimental analysis of the performance and exhaust emissions of a diesel engine running mostly on waste cooking oil (WCO). A one-cylinder direct-injection diesel engine with constant speed and natural aspiration is the engine type utilized. Research was done on how the engine performed and emission parameters when fueled with a mixture of 10% butanol, 10% diesel, 10% WCO, and 10% diethyl ether (D70B10W10DD10). The study's findings demonstrated that engine emissions of nitrogen oxides (NOX) and carbon monoxide (CO) varied significantly depending on the load being applied. The brake thermal efficiency, cylinder pressure, and the brake power of the engine were all impacted by load change.Keywords: ICE, waste cooking oil, fuel additives, butanol, combustion, emission characteristics
Procedia PDF Downloads 624398 The Gender Equality within the European Union Reconciliation of Work and Family Life Policies: Tackling Gender Inequality or Tackling Unemployment
Authors: Nazli Kazanoglu
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Reconciliation of work and family life has been an area of interest within the academic as well as in the political debate for more than three decades. With the dramatic changes in the extent to which women and men contribute to unpaid domestic work and paid employment, the reconciliation of work and family life issues have become more prominent than ever before. And they have begun to enjoy an increased attention of policy makers both at the EU and national levels. Over the last three decades the EU has initiated numerous equality programs and strategies and roadmaps regarding reconciliation of work and family life, though particularly because of the crisis and increasing willingness of achieving the EUs target of seventy five per cent of men and women in employment by 2020, those programs, strategies and roadmaps emphasized on eradicating womens familial burdens while entering labor market and providing them as equal opportunities as their male counterparts have. Reconciliation of work and family life policies thus bit by bit moved away from the objectives with a strong commitment to ensuring gender equality towards employment objectives. This paper is thus an endeavor to look at the nature of EU reconciliation of work and family life policies from the angle of gender equality. More precisely relying on the feminist literature, this paper rests on the assumption that reconciliation of work and family policies should provide the sufficient measures indeed with a more emphasis on endorsing gender equality rather than economic concerns and prioritizes two inter-related aspects while evaluating the gender equality of reconciliation of work and family life policies. First providing free choice to women in terms of their family and work lives and second challenge the unequal division of labor at home. In that sense, it investigates the nature of the changing uses and meanings of gender equality in reconciliation of work and family life policies in different stages of the EU social policy development particularly after the introduction of European Employment Strategy which gave a tremendous importance to reconciliation of work and family life during their collaborations with other issues on the EU agenda as well as the major rationale behind their development and implementation and locates them in terms of two inter-related parameters mentioned above.Keywords: European Union, division of unpaid work, gender equality, rhetoric of free choice
Procedia PDF Downloads 3004397 Building Climate Resilience in the Health Sector in Developing Countries: Experience from Tanzania
Authors: Hussein Lujuo Mohamed
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Introduction: Public health has always been influenced by climate and weather. Changes in climate and climate variability, particularly changes in weather extremes affect the environment that provides people with clean air, food, water, shelter, and security. Tanzania is not an exception to the threats of climate change. The health sector is mostly affected due to emergence and proliferation of infectious diseases, thereby affecting health of the population and thus impacting achievement of sustainable development goals. Methodology: A desk review on documented issues pertaining to climate change and health in Tanzania was done using Google search engine. Keywords included climate change, link, health, climate initiatives. In cases where information was not available, documents from Ministry of Health, Vice Presidents Office-Environment, Local Government Authority, Ministry of Water, WHO, research, and training institutions were reviewed. Some of the reviewed documents from these institutions include policy brief papers, fieldwork activity reports, training manuals, and guidelines. Results: Six main climate resilience activities were identified in Tanzania. These were development and implementation of climate resilient water safety plans guidelines both for rural and urban water authorities, capacity building of rural and urban water authorities on implementation of climate-resilient water safety plans, and capacity strengthening of local environmental health practitioners on mainstreaming climate change and health into comprehensive council health plans. Others were vulnerability and adaptation assessment for the health sector, mainstreaming climate change in the National Health Policy, and development of risk communication strategy on climate. In addition information, education, and communication materials on climate change and to create awareness were developed aiming to sensitize and create awareness among communities on climate change issues and its effect on public health. Conclusion: Proper implementation of these interventions will help the country become resilient to many impacts of climate change in the health sector and become a good example for other least developed countries.Keywords: climate, change, Tanzania, health
Procedia PDF Downloads 1194396 Performance Evaluation of Packet Scheduling with Channel Conditioning Aware Based on Wimax Networks
Authors: Elmabruk Laias, Abdalla M. Hanashi, Mohammed Alnas
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Worldwide Interoperability for Microwave Access (WiMAX) became one of the most challenging issues, since it was responsible for distributing available resources of the network among all users this leaded to the demand of constructing and designing high efficient scheduling algorithms in order to improve the network utilization, to increase the network throughput, and to minimize the end-to-end delay. In this study, the proposed algorithm focuses on an efficient mechanism to serve non-real time traffic in congested networks by considering channel status.Keywords: WiMAX, Quality of Services (QoS), OPNE, Diff-Serv (DS).
Procedia PDF Downloads 2864395 Emerging Issues of Non-Communicable Diseases among Older Persons in India
Authors: Dhananjay W. Bansod, Santosh Phad
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Non-Communicable Diseases (NCD) are major contributing factors to the disease burden in the world as well as in India. With a growing proportion of older persons in India gives rise to several challenges. With the advancement of age, elderly is exposed to various kinds of health problems more specifically NCDs. Therefore, an effort has been made to examine the prevalence of NCDs among older persons and its treatment-seeking behaviour, also it is tried to explore the association between the NCDs and its effect on the overall wellbeing of older persons. Data used from “Building Knowledge Base of Population Ageing Survey” conducted in 2011 in seven states of India. Six chronic diseases used (non-communicable diseases) namely Arthritis, Hypertension, Cataract, Diabetes, Asthma and Heart diseases to understand the issues related to NCDs. Also seen the effect of NCDs on the wellbeing of the elderly, the subjective well-being consists of nine questions from which SUBI score generated for mental health status, which ranges from 9 to 27. This Index indicates that lower the score better is the mental health status. Further, this index modified and generated three categories of Better (9-15), Average (16-20) and Worse (21-27). The reliability analysis is carried out with the coefficient (Cronbach’s alpha) of the scale was 0.8884. The result shows that Orthopedic / musculoskeletal ailments involving arthritis, rheumatism and osteoarthritis are the most common type of ailment followed by hypertension. Two-thirds of the elderly reported suffering from at least one chronic ailment. Most chronic illness conditions received some form of treatment and mainly depend on public health facilities. Financial insecurity is the primary obstruction in seeking treatment for most of the chronic ailments which typically require a longer duration of medication and repeated medical consultations, both having significant economic implications. According to SUBI index, only 15 per cent of the elderly are in Better mental health status, and one-third of the elderly are with the worse score. Elderly with the ailments like Cataract, Asthma and Arthritis have worse mental health. It depicts that the burden of disease is more among the elderly and it is directly affecting the overall wellbeing of older persons.Keywords: NCD, well-being, older person, India
Procedia PDF Downloads 1484394 The Evolution of Domestic Terrorism: Global Contemporary Models
Authors: Bret Brooks
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As the international community has focused their attention in recent times on international and transnational terrorism, many nations have ignored their own domestic terrorist groups. Domestic terrorism has significantly evolved over the last 15 years and as such nation states must adequately understand their own individual issues as well as the broader worldwide perspective. Contemporary models show that obtaining peace with domestic groups is not only the end goal, but also very obtainable. By evaluating modern examples and incorporating successful strategies, countries around the world have the ability to bring about a diplomatic resolution to domestic extremism and domestic terrorism.Keywords: domestic, evolution, peace, terrorism
Procedia PDF Downloads 5204393 Development of a Framework for Family Therapy for Adolescent Substance Abuse: A Perspective from India
Authors: Tanya Anand, Arun Kandasamy, L. N. Suman
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Family based therapy for adolescent substance abuse has been studied to be effective in the West. Whereas, based on literature review, family therapy and interventions for adolescent substance abuse is still in its nascent stages in India. A multidimensional perspective to treatment has been indicated consistently in the Indian literature, but standardized therapy which addresses early substance abuse, from a social-ecological perspective has not been developed and studied for Indian population. While numerous researches have been conducted in India on the need of engaging the family in therapy for the purpose of symptom reduction, long-term maintenance of gains, and reducing family burnout, distress and dysfunction; a family based model in the Indian context has not been developed and tried, to the best of our knowledge. Hence, from the aim of building a model to treat adolescent substance abuse within the family context, experts in the area of mental health and deaddiction were interviewed to inform upon the clinical difficulties, challenges, uniqueness that Indian families present with. The integration of indigenous techniques that would be helpful in engaging families of young individuals with difficulties were also explored. Eight experts' who were interviewed, have 10-30 years of experience in working with families and substance users. An open-ended interview was conducted with the experts individually and audio-recorded. The interviews were then transcribed and subjected to qualitative analysis for building a framework and treatment guideline. Additionally, interviews with patients and their parents were conducted to elicit ‘felt needs’. The results of the analysis revealed culture-specific issues widely experienced within Indian families by adolescents and young adults, centering around the theme of Individuation versus collective identity and living. Substance abuse, in this framework, was found to be perceived as one of the maladaptive ways of the youth to disengage from the family and attempt at individuation and the responsibilities that are considered entitlements in the culture. On the other hand, interviews with family members revealed them to be engaging in inconsistent patterns of care and parenting. This was experienced and observed in terms of fostering interdependence within the family, sometimes within adverse socio-economic and societal conditions, where enacted and perceived stigma kept the individual and family members in a vicious loop of maladaptive coping patterns, dysfunctional family arrangements, and often leading to burnout with poor help seeking. The paper inform upon a framework that lays down the foundation for assessments, planning, case management and therapist competencies, required to address alcohol and drug issues in an Indian family context with such etiological factors at its heart. This paper will cover qualitative results of the interviews and present a model that may guide mental health professionals for treatment of adolescent substance use and family therapy.Keywords: Indian families, family therapy, de-addiction, adolescent, youth, substance abuse, behavioral issues, felt needs, culture, etiology, model building, framework development, interviews
Procedia PDF Downloads 1344392 Artificial Intelligence and Liability within Healthcare: A South African Analysis
Authors: M. Naidoo
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AI in healthcare can have a massive positive effect in low-resource states like South Africa, where patients outnumber personnel greatly. However, the complexity and ‘black box’ aspects of these technologies pose challenges for the liability regimes of states. This is currently being discussed at the international level. This research finds that within the South African medical negligence context, the current common law fault-based inquiry proves to be wholly inadequate for patient redress. As a solution to this, this research paper culminates in legal reform recommendations designed to solve these issues.Keywords: artificial intelligence, law, liability, policy
Procedia PDF Downloads 1214391 Economic Evaluation of Cataract Eye Surgery by Health Attendant of Doctor and Nurse through the Social Insurance Board Cadr at General Hospital Anutapura Palu Central Sulawesi Indonesia
Authors: Sitti Rahmawati
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Payment system of cataract surgery implemented by professional attendant of doctor and nurse has been increasing, through health insurance program and this has become one of the factors that affects a lot of government in the budget establishment. This system has been implemented in purpose of quality and expenditure control, i.e., controlling health overpayment to obtain benefit (moral hazard) by the user of insurance or health service provider. The increasing health cost becomes the main issue that hampers the society to receive required health service in cash payment-system. One of the efforts that should be taken by the government in health payment is by securing health insurance through society's health insurance. The objective of the study is to learn the capability of a patient to pay cataract eye operation for the elders. Method of study sample population in this study was patients who obtain health insurance board card for the society that was started in the first of tri-semester (January-March) 2015 and claimed in Indonesian software-Case Based Group as a purposive sampling of 40 patients. Results of the study show that total unit cost analysis of surgery service unit was obtained $75 for unit cost without AFC and salary of nurse and doctor. The operation tariff that has been implemented today at Anutapura hospitals in eye department is tariff without AFC and the salary of the employee is $80. The operation tariff of the unit cost calculation with double distribution model at $65. Conclusion, the calculation result of actual unit cost that is much greater causes incentive distribution system provided to an ophthalmologist at $37 and nurse at $20 for one operation. The surgery service tariff is still low; consequently, the hospital receives low revenue and the quality of health insurance in eye operation department is relatively low. In purpose of increasing the service quality, it requires adequately high cost to equip medical equipment and increase the number of professional health attendant in serving patients in cataract eye operation at hospital.Keywords: economic evaluation, cataract operation, health attendant, health insurance system
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