Sustainable Model Research Articles

Advancing Correctional Health Care: The Imperative of LPN Advancement to RN.

This opinion consolidates regulatory frameworks, legal cases, workforce data, and research studies to advocate for the advancement of licensed practical nurses to registered nurses within correctional health care. By emphasizing adherence to nursing scope of practice and proposing a sustainable workforce development model, this article aims to enhance patient care and elevate standards in correctional facilities.

A Sustainable urban renovation assessment model (SURAM) for enhancing elderly-friendly environments

The rapid increase in the aging population has raised significant concerns about the living conditions and well-being of elderly residents in old communities. This study addresses these concerns by proposing a Sustainable Urban Renovation Assessment Model (SURAM) specifically designed to enhance elderly-friendly environments in Chongqing City. The model encompasses multiple dimensions, including the comfort of public facilities, service safety and convenience, medical travel services, infrastructure security, life service convenience, neighbor relations, ambulance aid accessibility, commercial service facilities, privacy protection, elderly care facilities and service supply, and medical and health facilities. By employing factor analysis, the study reduces the dimensionality of the 49 indicator factors, allowing for a more focused and comprehensive evaluation of the effectiveness of aging-friendly renovation efforts. The main factors identified in the proposed model include community infrastructure security, elderly comfort of community public facilities, completeness and convenience of surrounding living services, and security and convenience of elderly care services. The results reveal that the age-appropriate comfort of public facilities plays a significant role in achieving successful aging-appropriate renovation outcomes. The findings demonstrate that by addressing specific needs such as safety, accessibility, and convenience, communities can significantly improve the quality of life for elderly residents. Moreover, the application of SURAM provides actionable insights for policymakers, urban planners, and community stakeholders, guiding them in implementing targeted initiatives for sustainable and inclusive urban development.

Strategy of Development of Sustainable Red Chili Agribusiness Areas in North Sumatra Province

The development of sustainable red chili agribusiness areas in North Sumatra Province is a challenge that involves various aspects, including cultivation technology, farmer institutions, supply chain efficiency, government policy support, and environmental sustainability. This study aims to identify and formulate a sustainable red chili agribusiness development strategy that can increase farmers' productivity and welfare without sacrificing the environment. Through a qualitative approach, data were collected from in-depth interviews with farmers, agribusiness stakeholders, as well as a review of government policies related to sustainable agriculture. The results show that the application of precision agriculture technology, such as drip irrigation systems and integrated pest management, can significantly increase productivity while preserving natural resources. Strengthening farmer institutions, such as cooperatives, is also very important in coordinating production, improving market access, and stabilizing farmers' income. In addition, supply chain efficiency through the construction of storage and distribution centers will reduce post-harvest losses and price fluctuations, while government policy support is needed in the provision of agricultural infrastructure and stable price regulation. In conclusion, the sustainable development model of red chili agribusiness areas must include synergies between environmentally friendly technologies, strong institutions, efficient supply chains, and proactive policy support. With this model, red chili agribusiness areas in North Sumatra can develop sustainably, contribute to food security, and improve farmers' welfare.

Developing a circular economy framework for e‐commerce packaging materials: A study on behavioural intentions of online consumers

AbstractThe exponential growth of e‐commerce brings the need for sustainable business models to address the negative environmental impacts of packaging. This study used a bibliometric analysis, the theory of planned behaviour and stakeholder theory to explore the behavioural intentions of consumers in adopting a circular economy model for e‐commerce packaging materials. Surveying 362 respondents in the Indian market, our findings revealed e‐commerce users were likely to participate in a closed‐loop system, with environmental concern and attitude emerging as pivotal factors. The study's novelty lies in examining consumers' willingness to engage in circular economy practices, using an extended model of the theory of planned behaviour. We propose leveraging existing reverse logistics networks for e‐commerce packaging that incorporate circular economy principles for packaging sustainability. The study contributes to the theory by emphasising the primacy of environmental concerns over financial incentives in motivating consumer participation in the emerging economies context. We advance the prioritisation of environmental considerations by e‐commerce consumers, which necessitates a focus on education and knowledge development on the circular economy. Building upon our findings from the Indian market context, we propose key recommendations for practice and policy, which could be applicable to other emerging markets and contribute to their CE adoption.

Optimizing public investments: A Sustainable Economic, Environmental, and Social Investment Multi-criteria Decision Model (SEESIM)

One of the most important aspects for the economic and social growth of a country is high efficiency of public investments. This imperative has never been more critical, especially in the context of Europe and Italy, where the integration of environmental, economic, and social goals is essential to address the multifaceted challenges of the 21st century. This research introduces the Sustainable Economic, Environmental, and Social Investment Model (SEESIM), a novel multi-criteria decision-making framework designed to ensure the sustainability of projects as their validity over time, especially from a National Recovery and Resilience Plan perspective. Utilizing the Analytic Hierarchy Process (AHP), SEESIM integrates environmental, economic, and social criteria as useful tool to evaluate a project in the post-funding phase, ensuring a balanced approach to efficiency and sustainability. The model is adaptable to various regional contexts, providing a transparent and replicable methodology for assessing the impacts and costs of public investments. An experimental scenario demonstrates SEESIM’s utility in guiding investment decisions, highlighting its potential to significantly enhance the effectiveness of public resources in achieving long-term sustainability goals. SEESIM represents a pivotal advancement in sustainable development strategies, offering a comprehensive tool for integrating multi-dimensional sustainability criteria into public investment decisions.

The Role of Health Systems in Cross-Sector Collaboration in Addressing Social Determinants of Health and Promoting Health and Well-Being.

The articles featured underscore the critical role of trust, strategic planning, and cross-sector partnerships in addressing health inequities, while emphasizing the need for further research on sustainable and cost-effective collaboration models. Tocco and colleagues from Northwell Health describe the formation of the Health Equity Taskforce (HET), initially aimed at equitable COVID-19 vaccine distribution on Long Island. The HET has since expanded to address broader health disparities, focusing on community involvement, strategic partnerships, and sustainability. Nemiroff and colleagues discuss collaborations with community partners and payors to address social determinants of health in underserved populations, highlighting opportunities that can facilitate collaborations such as the New York State's Medicaid 1115 Demonstration Waiver.

Effectiveness and sustainability of a multidisciplinary care model for patients with hemodialysis access dysfunction.

A multidisciplinary care model involving the interventional radiologist, vascular surgeon, interventional nephrologist, renal advanced nurse practitioner, and renal coordinators was implemented to improve the care for the patient admitted with dysfunctional hemodialysis access. This study aims to evaluate the effectiveness and sustainability of this multidisciplinary care model. A dedicated interventional nephrology suite was established to perform endovascular procedures for patients admitted with hemodialysis access dysfunction via the emergency department of the hospital. We retrospectively collected data from electronic medical records 1-year before and after the implementation (April 2015). Outcome measures include waiting time for intervention, length of stays (LOS), number of dialysis catheter insertions before the intervention, number of inpatient dialysis required, and success rates of the interventions. The waiting time for intervention and LOS was tracked over the next 3 years to determine the sustainability of the care model. Eight hundred eighty-one endovascular interventions (314 angioplasties, 567 thrombolysis) were performed on 554 patients. Post-implementation, a greater proportion of intervention was performed within 24 h (238 (50.2%) vs 70 (17.2%), p < 0.001) with lesser proportion of patients requiring bridging hemodialysis via temporary catheter, 156 (32.9%) versus 215 (52.8%), p < 0.001. A shorter median LOS and days-to-intervention were reported, 3 (IQR 2-6) versus 5 days (IQR 3-8), p < 0.001 and 1 (IQR 1-2) versus 3 days (IQR 2-4), p < 0.001 respectively. Less hemodialysis session/patient required, 2 (IQR 1-3) versus 3 (IQR 2-4), p < 0.001. The procedural success rate was greater, 440 (92.8%) versus 355 (87.2%), p = 0.020. Three years following implementation, the proportion of patients who received intervention within 24 h and were discharged within 48 h was reported to be persistently greater, 43% versus 13%, p < 0.001, and 27% versus 6%, p < 0.001 respectively. This multi-disciplinary collaboration demonstrated a sustainable care model in improving the delivery of healthcare services for patients with dysfunctional hemodialysis access.

The Role of Health Systems in Cross-Sector Collaboration in Addressing Social Determinants of Health and Promoting Health and Well-Being.

The articles featured underscore the critical role of trust, strategic planning, and cross-sector partnerships in addressing health inequities, while emphasizing the need for further research on sustainable and cost-effective collaboration models. Tocco and colleagues from Northwell Health describe the formation of the Health Equity Taskforce (HET), initially aimed at equitable COVID-19 vaccine distribution on Long Island. The HET has since expanded to address broader health disparities, focusing on community involvement, strategic partnerships, and sustainability. Nemiroff and colleagues discuss collaborations with community partners and payors to address social determinants of health in underserved populations, highlighting opportunities that can facilitate collaborations such as the New York State's Medicaid 1115 Demonstration Waiver.

Improving Patient Care Through Collaborative Re-envisioning of the Model of Critical Care.

Advanced medical therapies enable people to live longer with multiple comorbidities, increasing the acuity and complexity of care required upon admission into the intensive care unit. This, coupled with the shift toward a less experienced nursing workforce as skilled nurses retire or leave the critical care environment, prompted the need to re-envision how critical care is delivered. The purpose of this quality improvement project was to embed the values of staff and patient partners in a re-envisioned critical care model, which aligns the provision of high-quality care with staff skill mix and patient needs. Through a series of clinical nurse specialist-led engagement sessions with patients, families, and the members of the healthcare team who work in this environment every day, we talked about what is important in critical care. We used their words and thoughts to inform and shape a new sustainable model of critical care. The 4 components identified as essential to achieving this vision include an acuity-complexity-based approach to care, a transition from separate high-acuity and intensive care areas to integrated units, development of a career pathway to advance practice, and exploration of opportunities to optimize the scope of the interprofessional team. Embedding the values and experience of the people directly connected with providing and/or experiencing critical care increases the likelihood of success in developing, implementing, and sustaining a new model of care. This multifaceted approach resulted in 4 distinct components with achievable outcomes that support this re-envisioned patient-centered sustainable model of critical care.

Robotic assistants for the rehabilitation of communication disorders in children: A proposal based on MTO manufacturing for developing countries

Language is fundamental to human communication, allowing individuals to express and exchange ideas, thoughts, and emotions. In early childhood, some children experience communication disorders that impede their ability to articulate words correctly, posing significant challenges to their learning and development. This issue is exacerbated in developing countries, where limited resources and a lack of technological tools hinder access to effective speech therapy. Traditional speech therapy remains vital, but the latest technological advancements have introduced robotic assistants to enhance therapy for communication disorders. Despite their potential, these technologies are often inaccessible in developing regions due to high production costs and a lack of sustainable manufacturing models. For these reasons, this paper presents “FONA,” a robotic assistant that employs rule-based expert systems to provide tactile, auditory, and visual stimuli. FONA supports children aged 3 to 6 in speech therapy by delivering exercises such as syllable production, word formation, and pictographic storytelling of various phonemes. Notably, FONA was successfully tested on children with cochlear implants, reducing the number of sessions required to produce isolated phonemes. The paper also introduces an innovative analysis of the Make To Order (MTO) manufacturing system for producing FONA in developing countries. This analysis explores two key perspectives: collaborative networks and entrepreneurship, offering a sustainable production model. In a pilot experiment, FONA significantly improved children’s attention spans, increasing the period by 17 min. Furthermore, the economic analysis demonstrates that producing FONA through collaborative networks can significantly reduce costs, making it more accessible to institutions in developing countries. The findings suggest that the project is viable for a five-year period, providing a sustainable and effective solution for addressing communication disorders in children.

Remixing our cities – current research on circularity in the construction sector

The European Green Deal is aiming for a transition from the current linear economic model to a much more sustainable and resource-efficient circular model. Since the construction industry is responsible for 37% of Europe-wide waste, it will be a key sector for the successful implementation of this goal. However, we can currently find many sector-specific challenges slowing the pace. On the one hand, the complexity of the sector and the multiplicity of actors involved. On the other hand, the dichotomy between the immanent uncertainty that lies within all reuse strategies and an ever-rising pressure for an increased technical performance respectively liability exclusion of building components. A successful transformation of the construction industry towards a circular economy would hence require changes throughout the whole life cycle of the building stock, an extensive and comprehensive exchange of information and the implementation of strategies for dealing with uncertainties. This includes also the development of new construction standards, which in turn can be expected to have an influence on the resulting architectural design. The focus of this paper is to present two current research projects on these topics, with a focus on the potential implications and future fields of action for designing architects.

Management of Kemiren Tourist Village Based on Culture in Banyuwangi Regency

The tourism sector drives Indonesia's economy, utilizing cultural diversity for development and preservation. Village tourism focuses on rural experiences, emphasizing cultural, natural, and creative attractions. Kemiren Village in Banyuwangi, East Java, is known for preserving Osing heritage through traditional customs, attracting more tourists, especially during events like the Tumpeng Sewu festival. Challenges in managing cultural-based tourism include the need for professional and sustainable practices to benefit the local community and attraction owners. Further research is essential to create a sustainable model for cultural tourism management in Kemiren Village.

Navigating the Terrain of Sustainable Finance: A Phenomenological and Narrative Enquiry into Managerial Challenges

This research aims to identify the managers’ perspective on implementing and adopting sustainable financing models in Dubai. Firstly, Sustainable financing must be defined to differentiate the sustainable model from the traditional financing models, secondly, provide past implementation practices to investigate both external and internal factors in comparison with traditional finance (TF). Finally, record the manager’s feelings around this topic. The methodology used is a primary qualitative to dig deeper into understanding from past literature and identify managerial participants from Dubai concerning the implementation of sustainable financing. The paper developed findings that defined the link or difference between sustainable financing (SF) and traditional finance (TF). The propositions in the qualitative literature from studies entail that the UN SGDs heavily influence sustainable financing to adopt ESG practices. However, greenwashing, high costs and ambiguity discourage investors and managers from integrating SF efficiently and indicate challenges to SF implementation. The study implies that the Sustainable Financing model is extremely like the traditional financing model except for the ESG compliance. However, regarding management and operations, the system does not differ much. It is evident that Sustainable Financing standardization is a challenge the managers face.

A Multi-Objective Optimization Business Model for Non-Commercial Port Sustainability

A Multi-Objective Optimization Business Model for Non-Commercial Port Sustainability

The sustainable livelihood model of farmers in the peri-urban areas of Bandung city

Welfare is the goal of every endeavor undertaken by humans, including farmers. However, to achieve prosperity, it is necessary to ensure that the sustainable livelihood conditions of each farmer are in good condition, supported by good characteristics and mastery of the five development capitals. This research aims to · Analyze the sustainable livelihoods of farmers on the outskirts of Bandung City; · Analyze the dominant factors that influence the sustainable livelihoods of farmers in the outskirts of Bandung City; · Analyze the influence of sustainable livelihoods on the welfare of farmers on the outskirts of Bandung City. The method used in this research is a predominantly quantitative mixed method. Data analysis in this study used structural equation modeling (SEM) involving 177 samples of farmers in Andir Village, Baleendah District and Mekarwangi Village, Lembang District. The research results showed that: · Respondents perceived sustainable livelihoods in the quite high category with a score of (3.68); · Respondent characteristics, financial capital, social capital and physical capital have a significant influence on sustainable livelihoods, while natural capital and human capital do not have a significant influence on sustainable livelihoods; · Sustainable livelihoods have a significant influence on the welfare of farming households. Based on the research results, there is a need to increase control of the five development capitals through farmers' efforts and initiatives as well as intervention from the government.

Challenges and opportunities of sustained public involvement in maternal health research: a practice case study with reflections from researchers and public contributors

It is widely agreed that collaboration with people with lived experience of specific health conditions or health services is both a moral imperative and a utility to improve research quality, validity and impact. However, there is little agreement about how to practise public involvement. In this article, we describe the formation and work of the Nottingham Maternity Research Network, an ongoing research reference panel that supports public involvement in maternal health research. Drawing on nine years’ experience, researchers and public contributors reflect together on the key issues to consider when co-producing research with maternity service users: first, pragmatic considerations, and second, creating a safe space for drawing on intimate and sometimes traumatic experiences. We argue that a sustained model of public involvement and engagement – that is, a standing group rather than a series of project-based, time-limited opportunities for involvement – brings opportunities to build trust and to develop a community that is supportive and inclusive. However, the sustained model of public involvement also brings practical challenges.

The Effects of Green Intellectual Capital on Business Performance: Evidence from Serbia

Investing in green intellectual capital can create competitive advantage of companies in the long term. In short term, however, more orchestration is required for investment into green resources to boost financial and non-financial performance of business. The aim of this paper is to present the effects of Green Intellectual Capital (Green Human Capital, Green Structural Capital, and Green Relational Capital) on companies' business performance (including their financial and non-financial indicators). For this purpose, primary data were collected from targeted companies operating in the Serbian market (N=344) using a structured questionnaire. The results confirm the positive effects of Green Human Capital and Green Relational Capital on both financial and non-financial indicators of researched companies. Green Structural Capital was not found to have an impact on the companies' financial performance. These findings can contribute to 1) owners and managers in creating sustainable business models, 2) regulators in creating policy frameworks and incentives for sustainable development and 3) other business analysts focused on the green intellectual capital development in companies.

SWITCHtoHEALTHY: Switching Mediterranean Consumers to Mediterranean Sustainable Healthy Dietary Patterns

Abstract In the Mediterranean countries profound changes in diet are taking place, largely due to cultural and socio-economic changes in lifestyle, which are leading to the erosion of the Mediterranean food cultures. The diet modernization process is noticeable; it has generated not only a modification of food choices in the direction of unhealthy foods, but also the habit of sedentary behaviours leading to an imbalance between energy intake and consumption. All of this has negative health impacts, as shown by the ever-increasing prevalence of overweight and obesity, as well as the rise of chronic diet-related diseases. The SWITCHtoHEALTHY project aims to generate an overall change of approach to the modern problem of eating behaviours, by strengthening the role of families towards the promotion of the sustainable Mediterranean food model. The main goal is to generate an actual switch to healthier dietary models, that are more consistent with the Mediterranean Diet. The project SWITCHtoHEALTHY aims to generate a dietary behaviour change in the direction of a greater adherence to the Mediterranean food model, by strengthening the role of families in the process of acquiring and maintaining healthy eating habits. The Mediterranean Diet (MD) is a healthy and sustainable food model, with an essentially plant-based dietary pattern (high consumption of fresh fruits and vegetables, cereals, and legumes). This goal will be reached by making available to families a combination of hands-on educational material and digital tools and complementing the dietary and lifestyle recommendations with easy-to-eat healthier snacking products.

Harnessing biomass waste-to-energy for sustainable electricity generation: prospects, viability, and policy implications for low-carbon urban development

AbstractBiomass waste-to-energy (WtE) generation is a potential pathway for green urban transition in developing countries which can contribute significantly to sustainable development goal 7: affordable and clean energy. However, unlike fossil fuel energy systems, the economic returns from WtE systems are low because WtE generation is capital-intensive and requires subsidies. This study examines the prospects of a sustainable biomass electricity generation from rice husk (RH) using a large dataset of rice milling activities in a fast paced urban transition economy. The study analyzes the viability of several RH biomass electricity generation scenarios using indicators such as net electricity output, economic returns (benefits), and levelized cost of electricity (LCOE). The results show that several mills/mill clusters generate sufficient daily RH that can power between 0.8 and 2.2 MW plant with a combined electricity output of about 500,000 MWh per annum. The economic analyses show that all RH biomass electricity generation scenarios return positive economic benefits under reduced social discount rates of 2–6%. Moreover, the LCOE of all scenarios are less than those of electricity generated from other sources. These results demonstrate that biomass waste-to-energy generation is viable for green urban development through low-carbon decentralized energy systems. Several policy implications of the findings are highlighted, including the need for policymakers and energy stakeholders to adopt sustainable biomass energy generation models such as “design, build, and operate” (DBO) to achieve sustainable WtE generation regimes that ensure green urban transition. Such a model will contribute to a circular economy and facilitates sustainable urban development that satisfies climate-related SDGs. Graphic abstract

Future of Uremic Toxin Management

During the progression of chronic kidney disease (CKD), the retention of uremic toxins plays a key role in the development of uremic syndrome. Knowledge about the nature and biological impact of uremic toxins has grown exponentially over the past decades. However, the science on reducing the concentration and effects of uremic toxins has not advanced in parallel. Additionally, the focus has remained for too long on dialysis strategies, which only benefit the small fraction of people with CKD who suffer from advanced kidney disease, whereas uremic toxicity effects are only partially prevented. This article reviews recent research on alternative methods to counteract uremic toxicity, emphasizing options that are also beneficial in the earlier stages of CKD, with a focus on both established methods and approaches which are still under investigation or at the experimental stage. We will consequently discuss the preservation of kidney function, the prevention of cardiovascular damage, gastro-intestinal interventions, including diet and biotics, and pharmacologic interventions. In the final part, we also review alternative options for extracorporeal uremic toxin removal. The future will reveal which of these options are valid for further development and evidence-based assessment, hopefully leading to a more sustainable treatment model for CKD than the current one.