The carbon footprint of an Australian satellite haemodialysis unit

2013 ◽  
Vol 37 (3) ◽  
pp. 369 ◽  
Author(s):  
Allan E. K. Lim ◽  
Anthony Perkins ◽  
John W. M. Agar
Keyword(s):  
Water Use ◽  
Carbon Footprint ◽  
Water Consumption ◽  
National Level ◽  
Healthcare Providers ◽  
The State ◽  
Measurement Unit ◽  
Target Setting ◽  
Local Factors ◽  
The Impact

Objectives. This study aimed to better understand the carbon emission impact of haemodialysis (HD) throughout Australia by determining its carbon footprint, the relative contributions of various sectors to this footprint, and how contributions from electricity and water consumption are affected by local factors. Methods. Activity data associated with HD provision at a 6-chair suburban satellite HD unit in Victoria in 2011 was collected and converted to a common measurement unit of tonnes of CO2 equivalents (t CO2-eq) via established emissions factors. For electricity and water consumption, emissions factors for other Australian locations were applied to assess the impact of local factors on these footprint contributors. Results. In Victoria, the annual per-patient carbon footprint of satellite HD was calculated to be 10.2 t CO2-eq. The largest contributors were pharmaceuticals (35.7%) and medical equipment (23.4%). Throughout Australia, the emissions percentage attributable to electricity consumption ranged from 5.2% to 18.6%, while the emissions percentage attributable to water use ranged from 4.0% to 11.6%. Conclusions. State-by-state contributions of energy and water use to the carbon footprint of satellite HD appear to vary significantly. Performing emissions planning and target setting at the state level may be more appropriate in the Australian context. What is known about the topic? Healthcare provision carries a significant environmental footprint. In particular, conventional HD uses substantial amounts of electricity and water. In the UK, provision of HD and peritoneal dialysis was found to have an annual per-patient carbon footprint of 7.1 t CO2-eq. What does this paper add? This is the first carbon-footprinting study of HD in Australia. In Victoria, the annual per-patient carbon footprint of satellite conventional HD is 10.2 t CO2-eq. Notably, the contributions of electricity and water consumption to the carbon footprint varies significantly throughout Australia when local factors are taken into account. What are the implications for practitioners? We recommend that healthcare providers consider local factors when planning emissions reduction strategies, and target setting should be performed at the state, as opposed to national, level. There is a need for more comprehensive and current emissions data to enable healthcare providers to do so.

scholarly journals The Impact of a Massachusetts State-Sponsored Educational Program on Antimicrobial Stewardship in Acute Care Hospitals

2013 ◽  
Vol 34 (4) ◽  
pp. 437-439 ◽  
Author(s):  
Adam Weston ◽  
Lauren Epstein ◽  
Lisa E. Davidson ◽  
Alfred DeMaria ◽  
Shira Doron
Keyword(s):  
Acute Care ◽  
Antimicrobial Stewardship ◽  
Educational Program ◽  
Business Models ◽  
National Level ◽  
State Level ◽  
Acute Care Hospitals ◽  
The State ◽  
Team Approach ◽  
The Impact

Antimicrobial stewardship programs (ASPs) are critically important for combating the emergence of antimicrobial resistance. Despite this, there are no regulatory requirements at a national level, which makes initiatives at the state level critical. The objectives of this study were to identify existing antimicrobial stewardship practices, characterize barriers to antimicrobial stewardship implementation in acute care hospitals throughout Massachusetts, and evaluate the impact on these hospitals of a state-sponsored educational conference on antimicrobial stewardship.In September 2011, a state-sponsored educational program entitled “Building Stewardship: A Team Approach Enhancing Antibiotic Stewardship in Acute Care Hospitals” was offered to interested practitioners from throughout the state. The program consisted of 2 audio conferences, reading materials, and a 1-day conference consisting of lectures focusing on the importance of ASPs, strategies for implementation, improvement strategies for existing programs, and panel discussions highlighting successful practices. Smaller breakout sessions focused on operational issues, including understanding of pharmacodynamics, business models, and electronic surveillance.

scholarly journals Digital Archiving for Archaeology: the state of the art in Argentina

2021 ◽  
Author(s):  
Andrés D. Izeta ◽  
Roxana Cattáneo
Keyword(s):  
State Of The Art ◽  
National Level ◽  
Legal Framework ◽  
The State ◽  
Digital Data ◽  
Archaeological Research ◽  
General Evaluation ◽  
Research Infrastructures ◽  
The Status ◽  
The Impact

This article discusses the state-of-the art of digital archives for archaeological research in Argentina. It also presents and characterises the national and international legal framework and the role played by funding agencies and professional bodies in archaeological practice. In addition, it reports how legal corpora regulate the impact on the management of archaeological digital data. Research infrastructures available at the national level are described, such as the Suquía, an institutional digital archive devoted to archaeology since 2016. Finally, we make a general evaluation of the status quo of research infrastructures mostly concerned with preserving and disseminating data from archaeological research at the national level.

scholarly journals Analysis of regional features of water use structure in the North Caucasus. Part 1. Water availability and water consumption

2021 ◽  
pp. 96-105
Author(s):  
Е.А. Rybak ◽  
◽  
О.О. Rybak ◽  
◽  
◽  
...  
Keyword(s):  
Water Resources ◽  
Water Supply ◽  
Water Use ◽  
Water Consumption ◽  
Water Withdrawal ◽  
Negative Consequences ◽  
North Caucasus ◽  
The North ◽  
Access To Water ◽  
The Impact

The key task of the societal development is to ensure effective management of water resources. As a consequence of aggravation of water problems in the world, the issues of sustainable and guaranteed access to water are considered as one of the components of ensuring food security, conservation and restoration recovery of natural resources, which are the basis of life support for the population. To date, the regulation of water resources in the North Caucasus experiences difficulties resulting from fragmented water use, unequal access to water, and contradictory legislation in the field of water use regulation. These problems are compounded by two factors: climate change and demographic situation. The main problem of water consumption in Russia is the irrational and ineffective use of water resources and, as a result, high specific water consumption. In the North Caucasus, water consumption is currently one of the highest in Russia. The characteristics of the impact on water resources are directly related to the use of water, the main elements of which are the water withdrawal from natural sources, the use of water and the discharge of wastewater. Based on open statistical sources, we analyzed the current situation in the use of water resources in the North Caucasus. The North Caucasus is characterized by problems similar to those of many regions of the country, in particular, large losses during transportation due to the emergency state of water supply networks and treatment facilities. Water supply problems in the North Caucasus are expected to worsen in the future. If urgent measures are not taken, the complex of problems will only accumulate. To overcome their negative consequences, it is necessary to revise the water use strategy and change the water consumption structure.

IMPACTS OF INCREASING FREIGHT RAILWAY TARIFFS ON STATE ECONOMY

2021 ◽  
Vol 2021 (12) ◽  
pp. 44-56
Author(s):  
Olha STASIUK ◽  
◽  
Larysa CHMYROVA ◽  
Natalia FEDIAI ◽  
◽  
...  
Keyword(s):  
National Economy ◽  
National Level ◽  
State Regulation ◽  
The State ◽  
Rail Transport ◽  
Positive Effects ◽  
Freight Traffic ◽  
State Economy ◽  
Regulatory Impact ◽  
The Impact

Based on global experience, the article proves the necessity of improving the analysis of regulatory impact of legislative acts, which is the main instrument of state regulation quality assurance. Recent years display the trend of temporal inland traffic freight railway tariffs increase. The last increase was approved by the corresponding Order of the Ministry of Infrastructure of Ukraine dd. August 11, 2021 qualified as a regulatory act, which is subject to compulsory regulatory impact analysis according to the Methodology approved at the national level. The national methodology does not provide for assessment of impacts on state economy. In view of this, the assessment was completed for the possible impact of regulatory act work on the state economy according to the methodological approach developed by the State Organization “Institute of the Economy and Forecasting of the National Academy of Sciences of Ukraine”, which main point is a more comprehensive and sophisticated quantitative assessment of the direct regulatory impact on the field of economic interest of both citizens, economic entities, state, and the society in general (national economy). The impact assessment of the freight railway tariffs’ increase on national economy followed two perspectives: the possible impact on GDP and the competition within the traffic infrastructure of Ukraine. The contribution of JSC “Ukrzaliznytsia” into GDP of Ukraine is computed based on freight railway tariffs increase. The article proves that the Order of the Ministry of Infrastructure of Ukraine will have the effects on intermodal competition within the transport system of Ukraine through the redistribution of the freight traffic as, on the one hand, certain off-grade freights will be handled by the river and motor transport and, on the other hand, specific 3rd rate class freights will be handled by the rail transport. Such redistribution will have positive effects for the competitive position of rail transport on the inner freight traffic market because the loss of some off-grade freights, which transport is unprofitable, will not have a negative impact on rail facilities.

scholarly journals Evaluating the impact of expanding the number of diagnosis codes reported in inpatient discharge databases on the counts and rates of birth defects

2018 ◽  
Vol 25 (11) ◽  
pp. 1524-1533 ◽  
Author(s):  
Jason L Salemi ◽  
Rachel E Rutkowski ◽  
Jean Paul Tanner ◽  
Jennifer Matas ◽  
Russell S Kirby
Keyword(s):  
Birth Defects ◽  
Birth Defect ◽  
National Level ◽  
Healthcare Providers ◽  
Case Finding ◽  
Diagnosis Code ◽  
Diagnostic Codes ◽  
Clinical Databases ◽  
The Impact

Abstract Objective Public health surveillance programs worldwide implement a variety of case-finding strategies, and many rely at least in part on International Classification of Diseases (ICD)-based diagnostic codes in administrative and clinical databases. Over time, state- and national-level hospital discharge databases have been expanding the number of reported diagnosis code fields. This study aimed to evaluate the impact of these expansions on frequencies and rates of major birth defects, and the classification of birth defects as isolated vs multiple. Methods We used state-level 2006-2013 Florida Birth Defects Registry data and 2009-2012 data from a nationally representative database (Kids’ Inpatient Database). We generated data under different scenarios by varying the number of diagnosis code fields available, and comparing counts and rates of major birth defects generated under each scenario. Results The expansion from 10 to 31 diagnosis code fields improved ascertainment by preventing the loss of 1 in every 40 birth defect cases with defect-related diagnoses appearing only in code positions 11 to 31. Although there was variation by birth defect, the largest impact of the expansion tended to occur for less severe birth defects diagnosed in sicker infants. When restricting to fewer codes, not only were fewer cases diagnosed, but more were classified as being isolated due to the inability to capture co-occurring defects. Conclusion Our findings encourage additional research for other health outcomes in patients of all ages. Other disease registries rely at least in part on diagnostic codes documented by healthcare providers in their case-finding activities, irrespective of ascertainment protocols, making routine investigation of these databases essential.

scholarly journals The impact of budget transparency on tax compliance

2021 ◽  
Vol 284 ◽  
pp. 07029
Author(s):  
Tatyana Zvereva ◽  
Pavel Taranov ◽  
Angelika Musaelyan ◽  
Marina Krasnoplakhtich ◽  
Antonina Pavlyukova
Keyword(s):  
Tax Evasion ◽  
Economic Status ◽  
National Level ◽  
Tax Compliance ◽  
Preventive Measure ◽  
The State ◽  
Tax Burden ◽  
Public Finances ◽  
Per Capita ◽  
The Impact

The article analyzes the factors influencing tax evasion: the value of gross domestic product per capita, tax burden, corruption and openness of information on the use of budgetary funds. The correlation model includes the analysis of two groups of indicators. The first group is indicators of the individual level: education, socio-economic status, attitude to religion, gender, etc. The second group is indicators of the global or national level: GDP per capita, tax burden, the level of corruption in the country, the degree of financial transparency of public finances. The results of the study confirmed the hypothesis that law-abiding tax behavior is largely determined by the openness of information about the use of tax revenues by governments. Disclosure of information on the use of budget funds can become a powerful tool for strengthening the understanding of the legitimacy of the state tax policy, as well as act as a preventive measure to overcome existing facts of tax evasion. Increasing the transparency of public finances will make it possible to reproduce a new level of tax culture, to form an internal agreement of citizens with the fiscal policy of the state.

scholarly journals What roles do smart sensors play in citizens' water use? From the perspective of household water-saving

2021 ◽  
Author(s):  
Kang Tian ◽  
Zhuo Chen
Keyword(s):  
Water Use ◽  
Water Consumption ◽  
Water Conservation ◽  
New Technologies ◽  
Water Saving ◽  
Smart Sensors ◽  
Future Research ◽  
Behavioural Intervention ◽  
Household Water ◽  
The Impact

Abstract The rapid population growth has led to increasing demand for water resources. Studies have shown that the application of new technologies can effectively influence and promote citizens to save water. The application of smart water sensors can effectively monitor household water consumption and feedback the recorded data to citizens promptly, thereby influencing family members' water-saving attitudes and behaviours. For the widespread use of future water sensors in households, it can demonstrate its essential role in three aspects: water use information feedback to reduce water consumption, water information measurement helps to cultivate water conservation awareness, and water use information release as an effective means of behavioural intervention. This research provides some suggestions for the promotion and use of smart sensors in the home and points out the future research directions for the impact of water sensing on household water-saving behaviour.

scholarly journals Evaluation of patient satisfaction in hospitals in China 2003–2013: A national longitudinal analysis of population-based survey data

2019 ◽  
Author(s):  
Daisheng Tang ◽  
Ying Lian ◽  
Xuefan Dong
Keyword(s):  
Patient Satisfaction ◽  
Rural Areas ◽  
Policy Development ◽  
National Level ◽  
Healthcare Providers ◽  
Medical Expense ◽  
Medical Quality ◽  
Temporal Variance ◽  
Urban And Rural Areas ◽  
The Impact

Abstract Understanding the perception of patients towards the quality of hospitals is critical to policy development and improvement. However, there remains a dearth of literature examining the impact of the new health reform launched by China's government in 2009 on the changes of the patient satisfaction. Thus, the aim of this paper was to evaluate long-term trends in patient satisfaction to healthcare providers in China from 2003 to 2013. The data from three rounds (2003, 2008, and 2013) of the National Health Service Survey. The unsatisfactory rate, hospital satisfaction assessment and the most dissatisfied items for outpatients and inpatients in urban and rural areas in China were considered Percentages changes from 2003 to 2008, 2008 to 2013, and 2003 to 2013 were calculated to descriptively show the trends of patient satisfaction between these 10 years. Chi-square tests regarding the changes of each item between any two years were carried out to evaluate temporal variance. The results reveal a significant overall improvement in the patient satisfaction of both inpatients and outpatients in urban and rural areas in China from 2003 to 2013, especially for the period between 2008 and 2013. However, the percentage of outpatients who dissatisfied with the waiting time for treatment largely increased between 2008 and 2013. In addition, both inpatients and outpatients tended to pay more attention to the service quality and medical expense. With respect to the patient-physician trust relationship, an overall marked improvement could be identified. The findings of this study are unique in presenting the patient satisfaction at the national level in China, which highlight a need to carry out more national actions focusing on the optimization of visiting mechanism, the deduction of medical costs and the improvement of doctors' service and medical quality.

scholarly journals Adaptive Crop Management under Climate Uncertainty: Changing the Game for Sustainable Water Use

Atmosphere ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1080
Author(s):  
Soe W. Myint ◽  
Rimjhim Aggarwal ◽  
Baojuan Zheng ◽  
Elizabeth A. Wentz ◽  
Jim Holway ◽  
...  
Keyword(s):  
Water Use ◽  
Water Consumption ◽  
Active Management ◽  
Agricultural Water ◽  
Multiple Cropping ◽  
Water Savings ◽  
Drought Tolerant ◽  
Crop Types ◽  
Research Questions ◽  
The Impact

Water supplies are projected to become increasingly scarce, driving farmers, energy producers, and urban dwellers towards an urgent and emerging need to improve the effectiveness and the efficiency of water use. Given that agricultural water use is the largest water consumer throughout the U.S. Southwest, this study sought to answer two specific research questions: (1) How does water consumption vary by crop type on a metropolitan spatial scale? (2) What is the impact of drought on agricultural water consumption? To answer the above research questions, 92 Landsat images were acquired to generate fine-resolution daily evapotranspiration (ET) maps at 30 m spatial resolution for both dry and wet years (a total of 1095 ET maps), and major crop types were identified for the Phoenix Active Management Area. The study area has a subtropical desert climate and relies almost completely on irrigation for farming. Results suggest that there are some factors that farmers and water managers can control. During dry years, crops of all types use more water. Practices that can offset this higher water use include double or multiple cropping practice, drought tolerant crop selection, and optimizing the total farmed area. Double and multiple cropping practices result in water savings because soil moisture is retained from one planting to another. Further water savings occur when drought tolerant crop types are selected, especially in dry years. Finally, disproportionately large area coverage of high water consuming crops can be balanced and/or reduced or replaced with more water efficient crops. This study provides strong evidence that water savings can be achieved through policies that create incentives for adopting smart cropping strategies, thus providing important guidelines for sustainable agriculture management and climate adaptation to improve future food security.

scholarly journals Concentration of water use permit and volume-based fees in Ceará, Brazil

Water Policy ◽  
2021 ◽  
Author(s):  
Francisco Wellington Ribeiro ◽  
Jackeline Lucas Souza ◽  
Raimundo Eduardo Silveira Fontenele ◽  
Francisco Adelmo Medeiros Damasceno
Keyword(s):  
Water Use ◽  
Gini Index ◽  
High Impact ◽  
The State ◽  
Supply Industry ◽  
The Impact

Abstract This research aims to identify the level of concentration of the volume granted (the so-called permit) by grantee sectors in the State of Ceará, Brazil, as well as to simulate both the impact of the permit fees, and to conjecture about the permit concentration trend due to fee increase. The Gini index is calculated for all users with granted volume; next, fees are applied to the volume granted, observing the impact of charging to users; and lastly, the migration of irrigation users are conjectured based on the volume granted. The results indicate high Gini index for the supply, industry and irrigation; high impact on irrigation charge and low impacts on supply and industry; and concentration trend in irrigation due to elevated charges when the permit fee is applied. The authors conclude that the joint charging (consumption and permit) is relevant, as long as an effort is made by the basin committee to increase acceptance of a substantial fee increase.

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