scholarly journals A Hybrid Tool for Visual Pollution Assessment in Urban Environments

2019 ◽  
Vol 11 (8) ◽  
pp. 2211 ◽  
Author(s):  
Khydija Wakil ◽  
Malik Asghar Naeem ◽  
Ghulam Abbas Anjum ◽  
Abdul Waheed ◽  
Muhammad Jamaluddin Thaheem ◽  
...  
Keyword(s):  
Pollution Assessment ◽  
Observation Point ◽  
Urban Environments ◽  
Policy Makers ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Developed World ◽  
The Impact ◽  
Reliable Methods

With increasing focus on more nuanced aspects of quality of life, the phenomenon of urban visual pollution has been progressively gaining attention from researchers and policy makers, especially in the developed world. However, the subjectivity and complexity of assessing visual pollution in urban settings remain a challenge, especially given the lack of robust and reliable methods for quantification of visual pollution. This paper presents a novel systematic approach for the development of a robust Visual Pollution Assessment (VPA) tool. A key feature of our methodology is explicit and systematic incorporation of expert and public opinion for listing and ranking Visual Pollution Objects (VPOs). Moreover, our methodology deploys established empirical complex decision-making techniques to address the challenge of subjectivity in weighting the impact of individual VPOs. The resultant VPA tool uses close-ended options to capture the presence and characteristics of various VPOs on a given node. Based on these inputs, it calculates a point based visual pollution scorecard for the observation point. The performance of the VPA tool has been extensively tested and verified at various locations in Pakistan. To the best of our knowledge, this is the first such tool, both in terms of quantitative robustness and broad coverage of VPOs. Our VPA tool will help regulators in assessing and charting visual pollution in a consistent and objective manner. It will also help policy makers by providing an empirical basis for gathering evidence; hence facilitating evidence-based and evidence-driven policy strategies, which are likely to have significant impact, especially in the developing countries.

scholarly journals Comprehensive Overview of Sleep Disorders in Patients with Chronic Liver Disease

2021 ◽  
Vol 11 (2) ◽  
pp. 142
Author(s):  
Oana-Mihaela Plotogea ◽  
Madalina Ilie ◽  
Simona Bungau ◽  
Alexandru Laurentiu Chiotoroiu ◽  
Ana Maria Alexandra Stanescu ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Daily Practice ◽  
Chronic Liver ◽  
Asian Countries ◽  
Chronic Liver Diseases ◽  
Comprehensive Overview ◽  
The Usa ◽  
The Impact ◽  
Reliable Methods

The impact of sleep disorders (SDs) on patients with chronic liver diseases (CLD) is tremendous. SDs are frequently encountered among these patients and interfere with their quality of life. This review aims to present the data available so far about the prevalence, phenotypes, and proposed pathophysiological mechanisms of SDs in CLD. Moreover, we proposed to search the literature regarding the most reliable methods to assess SDs and the possible therapeutic options in patients with CLD. The main results of this review show that when it comes to prevalence, the percentages reported vary widely between studies performed among populations from the USA or Europe and those coming from Asian countries. Furthermore, it has been proven that SDs may also be present in the absence of neurocognitive disorders attributable to hepatic encephalopathy (HE), which contradicts traditional suppositions where SDs were considered part of the clinical scenario of HE. Currently, there are no specific recommendations or protocols to assess SDs in CLD patients and data about the therapeutic management are limited. Taking into consideration their impact, a protocol for diagnosing and managing SDs should be developed and included in the daily practice of hepatologists.

scholarly journals Quantity and quality of childcare and children’s educational outcomes

2021 ◽  
Author(s):  
Jo Blanden ◽  
Emilia Del Bono ◽  
Kirstine Hansen ◽  
Birgitta Rabe
Keyword(s):  
School Achievement ◽  
Additional Term ◽  
Publicly Funded ◽  
Highly Qualified ◽  
Policy Makers ◽  
Quality Rating ◽  
Quality Of Childcare ◽  
The Impact ◽  
School Records

AbstractPolicy-makers wanting to support child development can choose to adjust the quantity or quality of publicly funded universal pre-school. To assess the impact of such changes, we estimate the effects of an increase in free pre-school education in England of about 3.5 months at age 3 on children’s school achievement at age 5. We exploit date-of-birth discontinuities that create variation in the length and starting age of free pre-school using administrative school records linked to nursery characteristics. Estimated effects are small overall, but the impact of the additional term is substantially larger in settings with the highest inspection quality rating but not in settings with highly qualified staff. Estimated effects fade out by age 7.

Understanding Affordability

2020 ◽  
Author(s):  
Geoffrey Meen ◽  
Christine Whitehead
Keyword(s):  
Low Income ◽  
Structural Changes ◽  
Home Ownership ◽  
House Prices ◽  
Household Formation ◽  
Policy Makers ◽  
Political Forces ◽  
The Uk ◽  
Developed World ◽  
The Impact

Affordability is, perhaps, the greatest housing problem facing households today, both in the UK and internationally. Even though most households are now well housed, hardship is disproportionately concentrated among low-income and younger households. Our failure to deal with their problems is what makes housing so frustrating. But, to improve outcomes, we have to understand the complex economic and political forces which underlie their continued prevalence. There are no costless solutions, but there are new policy directions that can be explored in addition to those that have dominated in recent years. The first, analytic, part of the book considers the factors that determine house prices and rents, household formation and tenure, housing construction and the roles played by housing finance and taxation. The second part turns to examine the impact of past policy and the possibilities for improvement - discussing supply and the impact of planning regulation, supply subsidies, subsidies to low-income tenants and attempts to increase home ownership. Rather than advocating a particular set of policies, the aim is to consider the balance of policies; the constraints under which housing policy operates; what can realistically be achieved; the structural changes that would need to occur; and the significant sacrifices that would have to be made by some groups if there are to be improvements for others. Our emphasis is on the UK but throughout the book we also draw on international experience and our conclusions have relevance to analysts and policy makers across the developed world.

scholarly journals Towards Managing Visual Pollution: A 3D Isovist and Voxel Approach to Advertisement Billboard Visual Impact Assessment

2021 ◽  
Vol 10 (10) ◽  
pp. 656
Author(s):  
Szymon Chmielewski
Keyword(s):  
Cultural Context ◽  
Policy Makers ◽  
Quality Issue ◽  
Geometrical Quality ◽  
Visual Landscape ◽  
Landscape Quality ◽  
Visual Impact ◽  
The Impact ◽  
Visible Volume

Visual pollution (VP) is a visual landscape quality issue, and its most consistently recognized symptom is an excess of out of home advertising billboards (OOHb). However, the VP related research concerns landscape aesthetic and advertisement cultural context, leaving the impact of outdoor billboard infrastructure on landscape openness unanswered to date. This research aims to assess the visual impact of outdoor billboard infrastructure on landscape openness, precisely the visual volume—a key geometrical quality of a landscape. The method uses 3D isovists and voxels to calculate the visible and obstructed subsets of visible volume. Using two case studies (Lublin City, Poland) and 26 measurement points, it was found that OOHb decreased landscape openness by at least 4% of visible volume; however, the severe impact may concern up to 35% of visual volume. GIS scientists develop the proposed method for policy-makers, and urban planners end users. It is also the very first example of compiling 3D isovists and voxels in ArcGIS Pro software in an easy-to-replicate framework. The research results, accompanied by statistically significant proofs, explain the visual landscape’s fragility and contribute to understanding the VP phenomenon.

Abstract TP310: Effect of an Extended Treatment Window on Transfer Times in Patients With Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Dawn K Beland ◽  
Ilene Staff ◽  
Jenna Beckwith ◽  
Amre Nouh
Keyword(s):  
Decision Making ◽  
Process Of Care ◽  
Patient Demographics ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Stroke Type ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
The Impact ◽  
Transfer Times

STK-OP-1 examines transfer times for patients going to a higher level of care. Known as door in, door out or DIDO, certified stroke centers are required to report times for both ischemic and hemorrhagic stroke patients transferred to a Primary or Comprehensive Stroke Center (CSC). Purpose: Barriers to time-sensitive transfer and complex decision making are common. As a result, Hartford Healthcare (HHC) began a QI initiative to measure DIDO times while introducing advanced CTP imaging and treatment in the extended window, April 2018. This project evaluates the impact on DIDO. Methods: This multi-center QI project evaluated data pre and post implementation for stroke transfers to the CSC. Pre-implementation was May 2017 to April 2018, post-implementation May 2018 to March 2019. Patient and process of care data abstracted from Epic was entered into Excel. The main analysis compared median DIDO times using Wilcoxon Ranked Sum. Results: Data were collected on hospital, stroke type/severity and treatments administered; patient demographics, and key timing variables of door in/door out, EMS and CT. While there is no universal criterion for DIDO, 60 minutes is often the ultimate goal with 90 or 120 minutes as intermediate goals. Pre and post implementation median DIDO times for all hospitals were 117 and 139 minutes (p = 0.02), for HHC hospitals 115 and 137 minutes (p = 0.027) and for non-HHC hospitals 118 and 140.5 minutes (p = 0.423). Of the pre-implementation group, 7.8% had CTP imaging prior to transfer compared with 9.3% post. Extended times post-implementation include factors such as complex decision making, patient eligibility or hospital capacity issues. A new transfer algorithm was implemented April 2019. Future analyses will correlate DIDO with patient, stroke and treatment categories to better define delays and barriers. Relevance: A JC directive to CSCs are to develop supportive relationships with referring hospitals to facilitate efficient care. As decision making becomes more complex, the process for transfer needs to improve. DIDO goals need to be realistic to prevent secondary imaging at the CSC, i.e. the tradeoff for an extra 15 or 20 minutes should translate into shorter door to puncture times. Reducing the time to treatment may help improve patient outcomes.

scholarly journals Supporting surgeons in patient-centred complex decision-making: a qualitative analysis of the impact of a perioperative physician clinic

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033277
Author(s):  
Clarabelle T Pham ◽  
Catherine L Gibb ◽  
Robert A Fitridge ◽  
Jon Karnon ◽  
Elizabeth Hoon
Keyword(s):  
Decision Making ◽  
High Risk ◽  
Elective Surgery ◽  
Structured Interviews ◽  
Complex Patients ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Additional Value ◽  
The Impact ◽  
High Risk Clinic

ObjectivePatients with comorbidities can be referred to a physician-led high-risk clinic for medical optimisation prior to elective surgery at the discretion of the surgical consultant, but the factors that influence this referral are not well understood. The aims of this study were to understand the factors that influence a surgeon’s decision to refer a patient to the clinic, and how the clinic impacts on the management of complex patients.DesignQualitative study using theoretical thematic analysis to analyse transcribed semi-structured interviews.SettingInterviews were held in either the surgical consultant’s private office or a quiet office/room in the hospital ward.ParticipantsSeven surgical consultants who were eligible to refer patients to the clinic.ResultsWhen discussing the factors that influence a referral to the clinic, all participants initially described the optimisation of comorbidities and would then discuss with examples the challenges with managing complex patients and communicating the risks involved with having surgery. When discussing the role of the clinic, two related subthemes were dominant and focused on the management of risk in complex patients. The participants valued the involvement of the clinic in the decision-making and communication of risks to the patient.ConclusionsThe integration of the high-risk clinic in this study appears to offer additional value in supporting the decision-making process for the surgical team and patient beyond the clinical outcomes. The factors that influence a surgeon’s decision to refer a patient to the clinic appear to be driven by the aim to manage the uncertainty and risk to the patient regarding surgery and it was seen as a strategy for managing difficult and complex cases.

Requested withdrawal of gastrostomy feeding in motor neurone disease

2020 ◽  
pp. bmjspcare-2020-002428
Author(s):  
Donna Wakefield ◽  
Sarah Rhiannon Hanson
Keyword(s):  
Healthcare Professionals ◽  
Consensus Guidelines ◽  
Early Referral ◽  
Prognostic Group ◽  
Complex Decision Making ◽  
Life Sustaining Treatment ◽  
Advance Care ◽  
Complex Decision ◽  
Additional Support

NICE (National Institute for Health & Care Excellence) guidance recommends that healthcare professionals with expertise in palliative care should be an integral part of the multidisciplinary team in managing patients with motor neuron disease (MND). Those in the poorest prognostic group may benefit from early referral to help manage rapidly progressive symptoms, psychological distress and offer additional support with complex decision-making and early robust advance care planning. Patients frequently develop dysphagia and gastrostomy feeding can be used to prolong survival and improve quality of life. As the disease progresses patients may request withdrawal of life-sustaining treatment such as gastrostomy feeding; however, a literature search found no evidence or guidance on how best to facilitate this. We present the case of a patient with MND admitted to the hospice inpatient unit requesting withdrawal of gastrostomy feeding, outline the challenges and need for further consensus guidelines to inform practice.

scholarly journals Do mergers and acquisitions affect information asymmetry in the banking sector?

2020 ◽  
Vol 46 (12) ◽  
pp. 1521-1547
Author(s):  
John S. Howe ◽  
Thibaut G. Morillon
Keyword(s):  
Mergers And Acquisitions ◽  
Information Asymmetry ◽  
Design Methodology ◽  
Banking Sector ◽  
Policy Makers ◽  
Content Type ◽  
Deal Completion ◽  
Asymmetry Measures ◽  
The Impact

PurposeThis paper aims to investigate the consequences of mergers and acquisitions (M&As) on information asymmetry in the banking sector. Specifically, the authors look at whether specific firm or deal characteristic influence information asymmetry levels between insiders and investors, as well as the impact of recent regulation such as the Dodd–Frank Act.Design/methodology/approachThe authors decompose the M&A process into three periods (pre-announcement, negotiation and post-completion period) and document changes in the information asymmetry levels between insiders and investors through the M&A process. The authors capture changes in information asymmetry using six different spread-based information asymmetry measures.FindingsThe authors find evidence that information asymmetry increases following M&A announcement and decreases following deal completion. These findings are more pronounced for acquisitions involving a private target, all-cash deals and for mergers, as opposed to acquisition of assets. We find that overall, successful mergers improve the quality of the information environment, while failed deals degrade it. Additionally, the enactment of Dodd–Frank reduced the magnitude of the changes in information asymmetry during the M&A process. The results are important to regulators, policy makers and investors.Originality/valueTo authors’ knowledge, this is the first study that looks at the effect of bank M&As on information asymmetry as well as the effect of regulations on information asymmetry.

scholarly journals Upside down solutions: palliative care and COVID-19

2020 ◽  
pp. bmjspcare-2020-002385 ◽  
Author(s):  
Daniel Knights ◽  
Felicity Knights ◽  
Iain Lawrie
Keyword(s):  
Palliative Care ◽  
Symptom Control ◽  
Well Being ◽  
Models Of Care ◽  
Resource Limited ◽  
Relief Of Suffering ◽  
Complex Decision Making ◽  
Complex Decision ◽  
Effective Use

The current COVID-19 pandemic is unprecedented and requires innovation beyond existing approaches to contribute to global health and well-being. This is essential to support the care of people at the end of their lives or who are critically ill from COVID-19 or other life-limiting illnesses. Palliative care (PC) is centred on effective symptom control, promotion of quality of life, complex decision-making, and holistic care of physical, psychological, social and spiritual health. It is ideally placed to both provide and contribute to care for patients, families, communities and colleagues during the pandemic. Where recovery is uncertain, emphasis should be on care and relief of suffering, as well as survival. Where healthcare resources and facilities come under intense pressure, lessons can be learnt from models of care in other settings around the world. This article explores how the field can contribute by ensuring that PC principles and practices are woven into everyday healthcare practice. We explore alternative ways of providing care under such pressure and discuss three areas of learning from resource-limited settings: (1) integration of palliative medicine into everyday practice, (2) simplification of biomedical management plus multidisciplinary teamwork and (3) effective use of volunteers.

scholarly journals CORPORATE GOVERNANCE AND BUSINESS PERFORMANCE: EVIDENCE FOR THE ROMANIAN ECONOMY

2015 ◽  
Vol 17 (3) ◽  
pp. 458-474 ◽  
Author(s):  
Monica-Violeta ACHIM ◽  
Sorin-Nicolae BORLEA ◽  
Codruţa MARE
Keyword(s):  
Corporate Governance ◽  
Business Performance ◽  
Stock Exchange ◽  
Policy Makers ◽  
Governance Practices ◽  
Corporate Governance Practice ◽  
Corporate Governance Quality ◽  
The Impact ◽  
A Company

Our finding contributes towards the understanding of movements regarding the adoption of corporate governance practice in emerging countries such as Romania and its impact on business performances of a company. We have developed two econometric models to assess the business performances of the companies listed on Bucharest Stock Exchange, in order to point out the impact of corporate governance on business performances. Our results are inconsistent for the period 2001–2011, but if we consider only 2011, the results document a positive correlation between corporate governance quality and market value of companies, such it is reflected by Tobin’s Q. Therefore, our results contribute to the studies relating corporate governance and business performances, as it confirms a positive relationship between the two variables which appears once the Romanian emerging economy has began to adopt the best corporate governance practices. Firstly, our research has important implications for managers in order to know that the adoption of the best corporate governance practices could contribute to the financial success of the firm. Secondly, the results are useful for any investor who needs to consider the quality of corporate governance as a good predictor for the best rate of return of theirs investments. Moreover, our findings have also implications on policy-makers and regulatory authorities in European developing countries and offer them a barometer of adopting the best corporate governance practices in European space.

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