Search results for: hospital capacity planning

Authors: Xuzhen Yang, Yan Shan, Yabo Ding, Keke DIao, Yanjun Zhang, Yijia Huang

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Purpose: Our aim is to understand the unique experiences of patients with peritoneal dialysis and how they deal with issues brought on by disease and dialysis. Patients and Methods: Semi-structured interview was designed to collect information, and inpatients with peritoneal dialysis in a university-based tertiary hospital in the central province of China were purposively chosen as interviewees. The content analysis method was used to analyze the data. Results: Nine patients participated in the study, and three themes and eight subthemes were generated. Conclusion: Patients using peritoneal dialysis encounter numerous challenges and problems in the process of disease and dialysis, and they took attempt to cope with them well to adapt to living with peritoneal dialysis.

Keywords: peritoneal dialysis, experience, patient, coping strategy

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Authors: Simon Elias Bibri, Vera Minavere Bardici

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In this article, we investigate framing, discursive and material selectivity as important issues that need to be addressed in the planning of eco–city as a model of sustainable urban form. Focusing on the Stockholm region in Sweden, we discuss issues of the contribution of eco–city model to sustainability and examine key themes associated with the construction of the discourse on eco–city projects, namely the integration of environmental, economic, and social sustainability as well as design and technology as solutions in urban projects documents pertaining specifically to Hammarby Sjöstad and Stockholm Royal Seaport. The article is divided into four sections. First, we elucidate the concept and problem of framing and discursive and material selectivity. Second, we briefly discuss the discourse of sustainability, sustainable urban forms, and eco–city, pointing out some key issues that need to be addressed in sustainable urban planning. In the third and main section of the article, we investigate plans and projects for sustainable urban development, focusing on framing and discursive and material selectivity issues in the construction of the discourse on eco–city projects in Stockholm and discussing the findings in terms of the integration of sustainability dimensions, the economic benefits of and the negative environmental effects of energy efficiency and green technology, the shaping influence of cultural frames, the links of eco–city to macro–processes of regulation, the technological orientation of eco–city projects and the associated selectivity aspects. The article concludes with a call for further research for the possibilities for a more environmentally sound and holistic approach to sustainable urban forms.

Keywords: framing, selectivity, sustainability, eco–city, sustainable urban form, design, energy efficiency, green technology, Hammarby Sjöstad, Stockholm Royal Seaport

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Authors: Kirti Tewari, Rahul Dev

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Solar water heating is a thermodynamic process of heating water using sunlight with the help of solar water heater. Thus, solar water heater is a device used to harness solar energy. In this paper, a modified solar water heating system (MSWHS) has been proposed over flat plate collector (FPC) and Evacuated tube collector (ETC). The modifications include selection of materials other than glass, and glass wool which are conventionally used for fabricating FPC and ETC. Some modifications in design have also been proposed. Its collector is made of double layer of semi-cylindrical acrylic tubes and fibre reinforced plastic (FRP) insulation base. Water tank is made of double layer of acrylic sheet except base and north wall. FRP is used in base and north wall of the water tank. A concept of equivalent thickness has been utilised for calculating the dimensions of collector plate, acrylic tube and tank. A thermal model for the proposed design of MSWHS is developed and simulation is carried out on MATLAB for the capacity of 200L MSWHS having collector area of 1.6 m2, length of acrylic tubes of 2m at an inclination angle 25° which is taken nearly equal to the latitude of the given location. Latitude of Allahabad is 24.45° N. The results show that the maximum temperature of water in tank and tube has been found to be 71.2°C and 73.3°C at 17:00hr and 16:00hr respectively in March for the climatic data of Allahabad. Theoretical performance analysis has been carried out by varying number of tubes of collector, the tank capacity and climatic data for given months of winter and summer.

Keywords: acrylic, fibre reinforced plastic, solar water heating, thermal model, conventional water heaters

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Authors: Eunkyo Kang, Jihye Lee, Jiyeon Choo

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Background: Pediatric palliative care has been increasing, and the number of studies has focused on the age at which pediatric patient can be notified their terminal illness, pediatric advanced care planning (ACP) and palliative care. However, there is a lack of research on health professionals’ perception. Aim: We aimed to investigate the perceptions of healthcare professionals about appropriate age disclosing terminal illness, awareness of ACP, and the relationship between ACP knowledge and the preference for palliative care for children. Methods: We administered nationwide questionnaires to 928 physicians from the 12 hospitals and the Korean Medical Association and 1,241 individuals of the general Korean population. We asked about the age at which the pediatric patients could be notified of their terminal illness, by 4 groups; 4 years old or older, 12 years old or older, 15 years old or older, or not. In addition, we surveyed the questionnaires about the knowledge of ACP of the medical staff, the preference of the pediatric hospice palliative care, aggressive treatment, and life-sustaining treatment preference. Results: In the appropriate age disclosing terminal illness, there were more respondents in the physicians than in the general population who thought that it was possible even at a younger age. Palliative care preference in pediatric patients who were expected to expire within months was higher when health care professionals had knowledge of ACPs compared to those without knowledge. The same results were obtained when deaths were expected within weeks or days. The age of the terminal status notification, the health care professionals who thought to be available at a lower age have a higher preference for palliative care and has less preference for aggressive treatment and life-sustaining treatment. Conclusion: Despite the importance of pediatric palliative care, our study confirmed that there is a difference in the preference of the health care professionals for pediatric palliative care according to the ACP knowledge of the medical staff or the appropriate age disclosing terminal illness. Future research should focus on strategies for inducing changes in perceptions of health care professionals and identifying other obstacles for the pediatric palliative care.

Keywords: pediatric palliative care, disclosing terminal illness, palliative care, advanced care planning

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Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

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Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

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Authors: Saif Al Ghafri, Thomas Hughes, Armand Karimi, Kumarini Seneviratne, Jordan Oakley, Michael Johns, Eric F. May

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Knowledge of the thermophysical properties of complex mixtures at extreme conditions of pressure and temperature have always been essential to the Liquefied Natural Gas (LNG) industry’s evolution because of the tremendous technical challenges present at all stages in the supply chain from production to liquefaction to transport. Each stage is designed using predictions of the mixture’s properties, such as density, viscosity, surface tension, heat capacity and phase behaviour as a function of temperature, pressure, and composition. Unfortunately, currently available models lead to equipment over-designs of 15% or more. To achieve better designs that work more effectively and/or over a wider range of conditions, new fundamental property data are essential, both to resolve discrepancies in our current predictive capabilities and to extend them to the higher-pressure conditions characteristic of many new gas fields. Furthermore, innovative experimental techniques are required to measure different thermophysical properties at high pressures and over a wide range of temperatures, including near the mixture’s critical points where gas and liquid become indistinguishable and most existing predictive fluid property models used breakdown. In this work, we present a wide range of experimental measurements made for different binary and ternary mixtures relevant to LNG processing, with a particular focus on viscosity, surface tension, heat capacity, bubble-points and density. For this purpose, customized and specialized apparatus were designed and validated over the temperature range (200 to 423) K at pressures to 35 MPa. The mixtures studied were (CH4 + C3H8), (CH4 + C3H8 + CO2) and (CH4 + C3H8 + C7H16); in the last of these the heptane contents was up to 10 mol %. Viscosity was measured using a vibrating wire apparatus, while mixture densities were obtained by means of a high-pressure magnetic-suspension densimeter and an isochoric cell apparatus; the latter was also used to determine bubble-points. Surface tensions were measured using the capillary rise method in a visual cell, which also enabled the location of the mixture critical point to be determined from observations of critical opalescence. Mixture heat capacities were measured using a customised high-pressure differential scanning calorimeter (DSC). The combined standard relative uncertainties were less than 0.3% for density, 2% for viscosity, 3% for heat capacity and 3 % for surface tension. The extensive experimental data gathered in this work were compared with a variety of different advanced engineering models frequently used for predicting thermophysical properties of mixtures relevant to LNG processing. In many cases the discrepancies between the predictions of different engineering models for these mixtures was large, and the high quality data allowed erroneous but often widely-used models to be identified. The data enable the development of new or improved models, to be implemented in process simulation software, so that the fluid properties needed for equipment and process design can be predicted reliably. This in turn will enable reduced capital and operational expenditure by the LNG industry. The current work also aided the community of scientists working to advance theoretical descriptions of fluid properties by allowing to identify deficiencies in theoretical descriptions and calculations.

Keywords: LNG, thermophysical, viscosity, density, surface tension, heat capacity, bubble points, models

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Authors: S. Grinnell

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A PhD Research Project exploring the Social Health and Well-Being Impacts associated with Hydraulic Fracturing, with an aim to produce a Best Practice Support Guidance for those anticipating dealing with planning applications or submitting Environmental Impact Assessments (EIAs). Amid a possible global energy crisis, founded upon a number of factors, including unstable political situations, increasing world population growth, people living longer, it is perhaps inevitable that Hydraulic Fracturing (commonly referred to as ‘fracking’) will become a major player within the global long-term energy and sustainability agenda. As there is currently no best practice guidance for governing bodies the Best Practice Support Document will be targeted at a number of audiences including, consultants undertaking EIAs, Planning Officers, those commissioning EIAs Industry and interested public stakeholders. It will offer a robust, evidence-based criteria and recommendations which provide a clear narrative and consistent and shared approach to the language used along with containing an understanding of the issues identified. It is proposed that the Best Practice Support Document will also support the mitigation of health impacts identified. The Best Practice Support Document will support the newly amended Environmental Impact Assessment Directive (2011/92/EU), to be transposed into UK law by 2017. A significant amendment introduced focuses on, ‘higher level of protection to the environment and health.’ Methodology: A qualitative research methods approach is being taken with this research. It will have a number of key stages. A literature review has been undertaken and been critically reviewed and analysed. This was followed by a descriptive content analysis of a selection of international and national policies, programmes and strategies along with published Environmental Impact Assessments and associated planning guidance. In terms of data collection, a number of stakeholders were interviewed as well as a number of focus groups of local community groups potentially affected by fracking. These were determined from across the UK. A theme analysis of all the data collected and the literature review will be undertaken, using NVivo. Best Practice Supporting Document will be developed based on the outcomes of the analysis and be tested and piloted in the professional fields, before a live launch. Concluding statement: Whilst fracking is not a new concept, the technology is now driving a new force behind the use of this engineering to supply fuels. A number of countries have pledged moratoria on fracking until further investigation from the impacts on health have been explored, whilst other countries including Poland and the UK are pushing to support the use of fracking. If this should be the case, it will be important that the public’s concerns, perceptions, fears and objections regarding the wider social health and well-being impacts are considered along with the more traditional biomedical health impacts.

Keywords: fracking, hydraulic fracturing, socio-economic health, well-being

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Authors: Medani Prasad Rijal

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The study outlines the impacts of decentralized forest policy on natural Sal (shorea robusta) forests in the Terai region of Nepal. The government has implemented community forestry program to manage the forest resources and improve the livelihood of local people collectively. The forest management authorities such as conserve, manage, develop and use of forest resources were shifted to the local communities, however, the ownership right of the forestland retained by the government. Local communities took the decision on harvesting, distribution, and sell of forest products by fixing the prices independently. The local communities were putting the low value of forest products and distributed among the user households on the name of collective decision. The decision of low valuation is devaluating the worth of forest products. Therefore, the study hypothesized that decision-making capacities are equally prominent next to the decentralized policy and program formulation. To accomplish the study, individual to group level discussions and questionnaire survey methods were applied with executive committee members and user households. The study revealed that the local intuition called Community Forest User Group (CFUG) committee normally took the decisions on consensus basis. Considering to the access and affording capacity of user households having poor economic backgrounds, low pricing mechanism of forest products has been practiced, even though the Sal timber is far expensive in the local market. The local communities thought that low pricing mechanism is accessible to all user households from poor to better off households. However, the analysis of forest products distribution opposed the assumption as most of the Sal timber, which is the most valuable forest product of community forest only purchased by the limited households of better economic conditions. Since the Terai region is heterogeneous by socio-economic conditions, better off households always have higher affording capacity and possibility of taking higher timber benefits because of low price mechanism. On the other hand, the minimum price rate of forest products has poor contribution in community fund collection. Consequently, it has poor support to carry out poverty alleviation activities to poor people. The local communities have been fixed Sal timber price rate around three times cheaper than normal market price, which is a strong evidence of forest product devaluation itself. Finally, the study concluded that the capacity building of local executives as the decision-makers of natural Sal forests is equally indispensable next to the policy and program formulation for effective decentralized forest management. Unilateral decentralized forest policy may devaluate the forest products rather than devolve of power to the local communities and empower to them.

Keywords: community forestry program, decentralized forest policy, Nepal, Sal forests, Terai

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Authors: Eduzor Esther, Uhiara Ngozi, Ya’u Abubakar Umar, Anayo Jacob Gabriel, Umar Ahmed

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The study investigated the characteristic effect of treating okra seed and soybeans seed oil with crude enzymes extract from malted rice. The oils from okra seeds and soybeans were obtained by solvent extraction method using N-hexane solvent. Soybeans seeds had higher percentage oil yield than okra seed. 250ml of each oil was thoroughly mixed with 5ml of the malted rice extract at 400C for 5mins and then filtered and regarded as treated oil while another batch of 250ml of each oil was not mixed with the malted rice extract and regarded as untreated oil. All the oils were analyzed for specific gravity, refractive index, emulsification capacity, absortivity, TSS and viscosity. Treated okra seed and soybeans oil gave higher values for specific gravity, than the untreated oil for okra seed and soybeans oil respectively. The emulsification capacity values were also higher for treated oils, when compared to the untreated oil, for okra seed and soybeans oil respectively. Treated okra seed and soybeans oil also had higher range of values for absorptivity, than the untreated oil for okra seed and soybeans respectively. The ranges of T.S.S values of the treated oil were also higher, than those of the untreated oil for okra seed and soybeans respectively. The results of viscosity showed that the treated oil had higher values, than the untreated oil for okra seed and soybeans oil respectively. However, the results of refractive index showed that the untreated oils had higher values ranges of than the treated oils for okra seed and soybeans respectively. Treated oil show better quality in respect to the parameters analyst, except the refractive index which is slightly less but also is within the rangiest of standard, the oils are high in unsaturation especially okra oil when compared with soya beans oil. It is recommended that, treated oil of okra seeds and soya beans can serve better than many oils that presently in use such as ground nut oil, palm oil and cotton seeds oil.

Keywords: extract, malted, oil, okra, rice, seed, soybeans

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Authors: Eli Maria Pazzianotto-Forti, Patrícia Brigatto, Letícia Baltieri, Carolina Moraes Da Costa, Maura Rigoldi Simoes Da Rocha, Irineu Rasera Jr

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The application of positive pressure in airway can contribute to the restoration of lung volumes, capacities and prevent respiratory complications. The aim was to investigate the use of Bilevel Positive Airway Pressure (BIPAP) in morbidly obese in two moments in postoperative bariatric surgery: In the post-anesthetic recovery (PAR) and on the 1st postoperative day (1stPO). Twenty morbidly obese, aged between 25 and 55 years, underwent pulmonary function test and chest X-ray preoperatively and on the day of discharge (2nd day after surgery). They were randomly allocated in groups. GPAR: received BIPAP treatment in PAR, for an hour and G1stPO: received BIPAP for one hour, on the 1stPO. There were significant reductions in slow vital capacity (SVC) (p=0.0007), inspiratory reserve volume (IRV) (p=0.0016) and forced vital capacity (FVC) (p=0.0013) in the postoperative in GPAR and the expiratory reserve volume (ERV) remained (p=0.4446). In the G1stPO, there were significant reductions for: SVC p=<0.0001, ERV p=0.0191, IRV p= 0.0026 and FVC p=<0.0001. Comparing between groups, the SVC (p=0.0027) and FVC (p=0.0028) showed significant difference between the treatments. However, the GPAR showed fewer declines of these capacities. To the ERV (p= 0.1646) and IRV (p=0.3973) there was no significant difference between groups. The atelectasis prevalence was 10% for the GPAR and 30% for G1stPO, with significant difference between the proportions (p = 0.0027). The lowest reduction in SVC and FVC happens when positive pressure is applied in PAR. Thus, the use of BIPAP in the PAR can promote a restoration of ERV and contribute to the reduction of atelectasis. FAPESP 2013/06334-8.

Keywords: atelectasis, bariatric surgery, physiotherapy, pulmonary function, positive pressure

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Authors: Mark Opmeer

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The fruitful relationship between cultural heritage and digital technology is evident. Due to the development of user-friendly software, an increasing amount of heritage scholars use ict for their research activities. As a result, the implementation of information technology for heritage planning has become a research objective in itself. During the last decades, we have witnessed a growing debate and literature about the importance of computer technologies for the field of cultural heritage and ecotourism. Indeed, implementing digital technology in support of these domains can be very fruitful for one’s research practice. However, due to the rapid development of new software scholars may find it challenging to use these innovations in an appropriate way. As such, this contribution seeks to explore the interplay between geospatial technologies (geo-ict), civic engagement and cultural heritage and tourism. In this article, we discuss our findings on the use of geo-ict in support of civic participation, cultural heritage and sustainable tourism development in the southern Italian district of Brindisi. In the city of Latiano, three workshops were organized that involved local members of the community to distinguish and discuss interesting points of interests (POI’s) which represent the cultural significance and identity of the area. During the first workshop, a so called mappa della comunità was created on a touch table with collaborative mapping software, that allowed the participators to highlight potential destinations for tourist purposes. Furthermore, two heritage-based itineraries along a selection of identified POI’s was created to make the region attractive for recreants and tourists. These heritage-based itineraries reflect the communities’ ideas about the cultural identity of the region. Both trails were subsequently implemented in a dedicated mobile application (app) and was evaluated using a mixed-method approach with the members of the community during the second workshop. In the final workshop, the findings of the collaboration, the heritage trails and the app was evaluated with all participants. Based on our conclusions, we argue that geospatial technologies have a significant potential for involving local communities in heritage planning and tourism development. The participants of the workshops found it increasingly engaging to share their ideas and knowledge using the digital map of the touch table. Secondly, the use of a mobile application as instrument to test the heritage-based itineraries in the field was broadly considered as fun and beneficial for enhancing community awareness and participation in local heritage. The app furthermore stimulated the communities’ awareness of the added value of geospatial technologies for sustainable tourism development in the area. We conclude this article with a number of recommendations in order to provide a best practice for organizing heritage workshops with similar objectives.

Keywords: civic engagement, geospatial technologies, tourism development, cultural heritage

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Authors: Wahab Abdul Ghafar, Tao Zhong, Baba Kalan Enamullah

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Steel plate shear walls (SPSWs) are a robust lateral load resistance structure because of their high flexibility and efficient energy dissipation when subjected to seismic loads. This research investigates the seismic Performance of an innovative infill web strip (IWS-SPSW) and a typical unstiffened steel plate shear wall (USPSW). As a result, two 1:3 scale specimens of an IWS-SPSW and USPSW with a single story and a single bay were built and subjected to a cyclic lateral loading methodology. In the prototype, the beam-to-column connections were accomplished with the assistance of semi-rigid end-plate connectors. IWS-SPSW demonstrated exceptional ductility and shear load-bearing capacity during the testing process, with no cracks or other damage occurring. In addition, the IWS-SPSW could effectively dissipate energy without causing a significant amount of beam-column connection distortion. The shear load-bearing capacity of the USPSW was exceptional. However, it exhibited low ductility, severe infill plate corner ripping, and huge infill web plate cracks. The FE models were created and then confirmed using the experimental data. It has been demonstrated that the infill web strips of an SPSW system can affect the system's high Performance and total energy dissipation. In addition, a parametric analysis was carried out to evaluate the material qualities of the IWS, which can considerably improve the system's seismic performances. These properties include the steel's strength as well as its thickness.

Keywords: steel shear walls, seismic performance, failure mode, hysteresis response, nonlinear finite element analysis, parametric study.

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Authors: Harold P. Pareja

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This paper answers the question whether the minimum age of criminal responsibility under the Republic Act No. 9344 (Juvenile Justice Act) as amended by Republic Act No. 10630 should be lowered to 15 years of age or not in the light of international standards and domestic concerns both of which will definitely elicit strong views. It also explores the specific provision on the minimum age of criminal responsibility under the Republic Act No. 9344 (Juvenile Justice Act) and traces the bases of such law by discussing its presented evidences and justifications as reflected in the records of proceedings in the law-making phase. On one hand, the paper discusses the impact of lowering the minimum age to the state of juvenile delinquencies and to the rate of rehabilitation for those CICL who have undergone the DSWD-supervised recovery programs. On the other hand, it presents its impact to the international community specifically to the Committee of the Rights of the Child and the UNICEF considering that the even the current minimum age set in RA 9344 is lower than the international standards. Document review and content analysis are the major research tools. Primary and secondary sources were used as references such as Philippine laws on juvenile justice and from the different states international think-tanks. The absence of reliable evidences on criminal capacity made the arguments in increasing the MACR in the harder position. Studies on criminal capacity vary from different countries and from practitioners in in the fields of psychology, psychiatry and forensics. Juvenile delinquency is mainly contributed by poverty and dysfunctional families. On the other hand, the science of the criminal mind specifically among children has not been established yet. Philippines have the legal obligations to be faithful to the CRC and other related international instruments for the juvenile justice and welfare system. Decreasing MACR does not only send wrong message to the international community but the Philippines is violating its own laws.

Keywords: juvenile justice, minimum age of responsibility (MAR), juvenile justice act of the Philippines, children in conflict with the law, international standards on juvenile justice

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Authors: David de Oliveira Costa, Miguel Ângelo Lellis Moreira, Carlos Francisco Simões Gomes, Daniel Augusto de Moura Pereira, Marcos dos Santos

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Strategic management is a fundamental process for global companies that intend to remain competitive in an increasingly dynamic and complex market. To do so, it is necessary to maintain alignment with their principles and values. The Balanced Scorecard (BSC) proposes to ensure that the overall business performance is based on different perspectives (financial, customer, internal processes, and learning and growth). However, relying solely on the BSC may not be enough to ensure the success of strategic management. It is essential that companies also evaluate and prioritize strategic projects that need to be implemented to ensure they are aligned with the business vision and contribute to achieving established goals and objectives. In this context, the proposition involves the incorporation of the SAPEVO-M multicriteria method to indicate the degree of relevance between different perspectives. Thus, the strategic objectives linked to these perspectives have greater weight in the classification of structural projects. Additionally, it is proposed to apply the concept of the Impact & Probability Matrix (I&PM) to structure and ensure that strategic projects are evaluated according to their relevance and impact on the business. By structuring the business's strategic management in this way, alignment and prioritization of projects and actions related to strategic planning are ensured. This ensures that resources are directed towards the most relevant and impactful initiatives. Therefore, the objective of this article is to present the proposal for integrating the BSC methodology, the SAPEVO-M multicriteria method, and the prioritization matrix to establish a concrete weighting of strategic planning and obtain coherence in defining strategic projects aligned with the business vision. This ensures a robust decision-making support process.

Keywords: MCDA process, prioritization problematic, corporate strategy, multicriteria method

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Authors: Akhtar Nawaz, Sahar Noor, Iftikhar Hussain

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This paper considers advanced hybrid manufacturing planning both push and pull system in which each customer order has a due date by demand forecast and customer orders. We present a tool for model for tool development that requires an absolute due dates and customer orders in a manufacturing supply chain. It is vital for the manufacturing companies to face the problem of variations in demands, increase in varieties by maintaining safety stock and to minimize components obsolescence and uselessness. High inventory cost and low delivery lead time is expected in push type of system and on contrary high delivery lead time and low inventory cost is predicted in the pull type. For this tool for model we need an MRP system for the push and pull environment and control of inventories in push parts and lead time in the pull part. To retain process data quickly, completely and to improve responsiveness and minimize inventory cost, a tool is required to deal with the high product variance and short cycle parts. In practice, planning and scheduling are interrelated and should be solved simultaneously with supply chain to ensure that the due dates of customer orders are met. The proposed tool for model considers alternative process plans for job types, with precedence constraints for job operations. Such a tool for model has not been treated in the literature. To solve the model, tool was developed, so a new technique was required to deal with the issue of high product variance and short life cycles in assemble to order.

Keywords: hybrid manufacturing system, supply chain system, make to order, make to stock, assemble to order

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Authors: Zouhour Neji Ben Salem

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Microscopic evacuation focuses on the evacuee behavior and way of search of safety place in an egress situation. In recent years, several models handled microscopic evacuation problem. Among them, we have proposed Artificial Neural Network (ANN) as an alternative to mathematical models that can deal with such problem. In this paper, we present two ANN models: SOM map and Hopfield Network used to predict the evacuee behavior in a disaster situation. These models are tested in a real case, the second floor of Tunisian children hospital evacuation in case of fire. The two models are studied and compared in order to evaluate their performance.

Keywords: artificial neural networks, self-organization map, hopfield network, microscopic evacuation, fire building evacuation

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Authors: Ana Belon Hercilla

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The study is developed in “Reactivos Jeans” company, in the city of Arequipa, whose main business is the laundry of garments at an industrial level. In 2012 the company initiated actions to provide a dry cleaning service of alpaca fiber garments, recognizing that this item is in a growth phase in Peru. Additionally this company took the initiative to use a new greenwashing technology which has not yet been developed in the country. To accomplish this, a redesign of both the process and the plant layout was required. For redesigning the plant, the methodology used was the Systemic Layout Planning, allowing this study divided into four stages. First stage is the information gathering and evaluation of the initial situation of the company, for which a description of the areas, facilities and initial equipment, distribution of the plant, the production process and flows of major operations was made. Second stage is the development of engineering techniques that allow the logging and analysis procedures, such as: Flow Diagram, Route Diagram, DOP (process flowchart), DAP (analysis diagram). Then the planning of the general distribution is carried out. At this stage, proximity factors of the areas are established, the Diagram Paths (TRA) is developed, and the Relational Diagram Activities (DRA). In order to obtain the General Grouping Diagram (DGC), further information is complemented by a time study and Guerchet method is used to calculate the space requirements for each area. Finally, the plant layout redesigning is presented and the implementation of the improvement is made, making it possible to obtain a model much more efficient than the initial design. The results indicate that the implementation of the new machinery, the adequacy of the plant facilities and equipment relocation resulted in a reduction of the production cycle time by 75.67%, routes were reduced by 68.88%, the number of activities during the process were reduced by 40%, waits and storage were removed 100%.

Keywords: redesign, time optimization, industrial laundry, greenwashing

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Authors: Pornpote Nusen, Manop Kaewmoracharoen

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In recent years, there was an observable shift in fully developed countries from constructing new buildings to modifying existing buildings. The issue was that although an effective instrument like BIM (Building Information Modeling) was well developed for constructing new buildings, it was not widely used to renovate old buildings. BIM was accepted as an effective means to overcome common managerial problems such as project delay, cost overrun, and poor quality of the project life cycle. It was recently introduced in Thailand and rarely used in a renovation project. Today, in Thailand, BIM is mostly used for creating aesthetic 3D models and quantity takeoff purposes, though it can be an effective tool to use as a project management tool in planning and scheduling. Now the governmental sector in Thailand begins to recognize the uses of using BIM to manage a construction project, but the knowledge about the BIM implementation to governmental construction projects is underdeveloped. Further studies need to be conducted to maximize its advantages for the governmental sector. An educational extra large governmental building of 17,000 square-meters was used in this research. It is currently under construction for a two-year renovation project. BIM models of the building for the exterior and interior areas were created for the whole five floors. Then 4D BIM with combination of 3D BIM plus time was created for planning and scheduling. Three focus groups had been done with executive committee, contractors, and officers of the building to discuss the possibility of usage and usefulness of BIM approach over the traditional process. Several aspects were discussed in the positive sides, especially several foreseen problems, such as the inadequate accessibility of ways, the altered ceiling levels, the impractical construction plan created through a traditional approach, and the lack of constructability information. However, for some parties, the cost of BIM implementation was a concern, though, this study believes, its uses outweigh the cost.

Keywords: building information modeling, extra large building, governmental building renovation, project management, renovation, 4D BIM

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Authors: Jaehyung Jung, Kiman Kim, Heesang Eum

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Solar cell is one of the main technologies to reduce greenhouse gas (GHG). Thereby, accurate estimation of greenhouse gas reduction by solar cell technology is crucial to consider strategic applications of the solar cell. The bottom-up approach using operating data such as operation time and efficiency is one of the methodologies to improve the accuracy of the estimation. In this study, alternative GHG reductions from solar cell technology were estimated by a bottom-up approach to indirect emission source (scope 2) in Korea, 2015. In addition, the scenario-based analysis was conducted to assess the effect of technological change with respect to efficiency improvement and rate of operation. In order to estimate GHG reductions from solar cell activities in operating condition levels, methodologies were derived from 2006 IPCC guidelines for national greenhouse gas inventories and guidelines for local government greenhouse inventories published in Korea, 2016. Indirect emission factors for electricity were obtained from Korea Power Exchange (KPX) in 2011. As a result, the annual alternative GHG reductions were estimated as 21,504 tonCO2eq, and the annual average value was 1,536 tonCO2eq per each solar cell technology. Those results of estimation showed to be 91% levels versus design of capacity. Estimation of individual greenhouse gases (GHGs) showed that the largest gas was carbon dioxide (CO2), of which up to 99% of the total individual greenhouse gases. The annual average GHG reductions from solar cell per year and unit installed capacity (MW) were estimated as 556 tonCO2eq/yr•MW. Scenario analysis of efficiency improvement by 5%, 10%, 15% increased as much as approximately 30, 61, 91%, respectively, and rate of operation as 100% increased 4% of the annual GHG reductions.

Keywords: bottom-up approach, greenhouse gas (GHG), reduction, scenario, solar cell

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Authors: Gulcin Yildiz, Gokcen Izli

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Drying (dehydration) is the process of removing water from food in order to preserve the food. Drying is one of the oldest methods known for the preservation of agricultural products such as fruits and vegetables. Drying of agricultural products enhances their storage life, minimizes losses during storage, and save shipping and transportation costs. Apples are considered excellent candidates for drying. The objective of this research was to investigate the effects of microwave and oven processing on the quality of selected apple products. Red delicious and golden delicious apples were washed, peeled, and sliced. Drying experiments were performed in an oven at 50, 75 and 100 °C and in a microwave at 140 W and 210 W. Quality attributes such as color, total phenolic content and antioxidant capacity of dried samples with different methods were compared with the fresh sample. A Minolta CR-300 Chroma Meter was used to examine color changes in the apples. Total phenolic content was determined using the Folin-Ciocalteu reagent. The free radical scavenging activity of the extract was determined using 1,1-diphenyl-2-picrylhydrazyl (DPPH). It was found that the phenolic contents and antioxidant capacities of dried samples under all drying conditions were decreased compared to the fresh samples. The phenolic contents of microwave dried samples at 140 W and 210 W for both red and golden delicious apples were higher than those of the oven drying at 50, 75 and 100 °C. Similarly, the antioxidant activities of microwave dried samples at 140 W and 210 W were higher than those of the oven drying at 50, 75 and 100 °C for both types of apples. All color parameters (L*, a*, b*) were changed significantly depending on the drying methods and temperatures. The closest color values to the fresh sample were found for the microwave dried samples at 140 W. Microwave drying was proven to be more effective than oven drying.

Keywords: antioxidant capacity, color, golden delicious, microwave, red delicious, total phenolic content

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Authors: Neha Singh, Shristi Singh

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Accidents involving motor vehicles are more likely to cause serious injuries and fatalities. It also has a host of other perpetual issues, such as the regular loss of life and goods in accidents. To solve these issues, appropriate measures must be implemented, such as establishing an autonomous incident detection system that makes use of machine learning and artificial intelligence. In order to reduce traffic accidents, this article examines the overview of artificial intelligence and machine learning in autonomous event detection systems. The paper explores the major issues, prospective solutions, and use of artificial intelligence and machine learning in road transportation systems for minimising traffic accidents. There is a lot of discussion on additional, fresh, and developing approaches that less frequent accidents in the transportation industry. The study structured the following subtopics specifically: traffic management using machine learning and artificial intelligence and an incident detector with these two technologies. The internet of vehicles and vehicle ad hoc networks, as well as the use of wireless communication technologies like 5G wireless networks and the use of machine learning and artificial intelligence for the planning of road transportation systems, are elaborated. In addition, safety is the primary concern of road transportation. Route optimization, cargo volume forecasting, predictive fleet maintenance, real-time vehicle tracking, and traffic management, according to the review's key conclusions, are essential for ensuring the safety of road transportation networks. In addition to highlighting research trends, unanswered problems, and key research conclusions, the study also discusses the difficulties in applying artificial intelligence to road transport systems. Planning and managing the road transportation system might use the work as a resource.

Keywords: artificial intelligence, machine learning, incident detector, road transport systems, traffic management, automatic incident detection, deep learning

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Authors: M. Mashiur Rahman, Ulrik Birk Henriksen, Jesper Ahrenfeldt, Maria Puig Arnavat

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Using biomass gasification to make producer gas is one of the promising sustainable energy options available for small scale plant and rural applications for power and electricity. Tar content in producer gas is the main problem if it is used directly as a fuel. A low-tar biomass (LTB) gasifier of approximately 30 kW capacity has been developed to solve this. Moving bed gasifier with internal recirculation of pyrolysis gas has been the basic principle of the LTB gasifier. The gasifier focuses on the concept of mixing the pyrolysis gases with gasifying air and burning the mixture in separate combustion chamber. Five tests were carried out with the use of wood pellets and wood chips separately, with moisture content of 9-34%. The LTB gasifier offers excellent opportunities for handling extremely low-tar in the producer gas. The gasifiers producer gas had an extremely low tar content of 21.2 mg/Nm³ (avg.) and an average lower heating value (LHV) of 4.69 MJ/Nm³. Tar content found in different tests in the ranges of 10.6-29.8 mg/Nm³. This low tar content makes the producer gas suitable for direct use in internal combustion engine. Using mass and energy balances, the average gasifier capacity and cold gas efficiency (CGE) observed 23.1 kW and 82.7% for wood chips, and 33.1 kW and 60.5% for wood pellets, respectively. Average heat loss in term of higher heating value (HHV) observed 3.2% of thermal input for wood chips and 1% for wood pellets, where heat loss was found 1% of thermal input in term of enthalpy. Thus, the LTB gasifier performs better compared to typical gasifiers in term of heat loss. Equivalence ratio (ER) in the range of 0.29 to 0.41 gives better performance in terms of heating value and CGE. The specific gas production yields at the above ER range were in the range of 2.1-3.2 Nm³/kg. Heating value and CGE changes proportionally with the producer gas yield. The average gas compositions (H₂-19%, CO-19%, CO₂-10%, CH₄-0.7% and N₂-51%) obtained for wood chips are higher than the typical producer gas composition. Again, the temperature profile of the LTB gasifier observed relatively low temperature compared to typical moving bed gasifier. The average partial oxidation zone temperature of 970°C observed for wood chips. The use of separate combustor in the partial oxidation zone substantially lowers the bed temperature to 750°C. During the test, the engine was started and operated completely with the producer gas. The engine operated well on the produced gas, and no deposits were observed in the engine afterwards. Part of the producer gas flow was used for engine operation, and corresponding electrical power was found to be 1.5 kW continuously, and maximum power of 2.5 kW was also observed, while maximum generator capacity is 3 kW. A thermodynamic equilibrium model is good agreement with the experimental results and correctly predicts the equilibrium bed temperature, gas composition, LHV of the producer gas and ER with the experimental data, when the heat loss of 4% of the energy input is considered.

Keywords: biomass gasification, low-tar biomass gasifier, tar elimination, engine, deposits, condensate

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Authors: Adrián P. Gómez Mañas

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Autonomous vehicles have already transformed urban policies and cities. This is the main assumption of our research, which aims to understand how the representations of the possible arrival of autonomous vehicles already transform priorities or actions in transport and more largely, urban policies. This research is done within the framework of a Ph.D. doctorate directed by Professor Xavier Desjardins at the Sorbonne University of Paris. Our hypotheses are: (i) the perspectives, representations, and imaginaries on autonomous vehicles already affect the stakeholders of urban policies; (ii) the discourses on the opportunities or threats of autonomous vehicles reflect the current strategies of the stakeholders. Each stakeholder tries to integrate a discourse on autonomous vehicles that allows them to change as little as possible their current tactics and strategies. The objective is to eventually make a comparison between three different cases: Paris, United Arab Emirates, and Bogota. We chose those territories because their contexts are very different, but they all have important interests in mobility and innovation, and they all have started to reflect on the subject of self-driving mobility. The main methodology used is to interview actors of the metropolitan area (local officials, leading urban and transport planners, influent experts, and private companies). This work is supplemented with conferences, official documents, press articles, and websites. The objective is to understand: 1) What they know about autonomous vehicles and where does their knowledge come from; 2) What they expect from autonomous vehicles; 3) How their ideas about autonomous vehicles are transforming their action and strategy in managing daily mobility, investing in transport, designing public spaces and urban planning. We are going to present the research and some preliminary results; we will show that autonomous vehicles are often viewed by public authorities as a lever to reach something else. We will also present that speeches are very influenced by local context (political, geographical, economic, etc.), creating an interesting balance between global and local influences. We will analyze the differences and similarities between the three cases and will try to understand which are the causes.

Keywords: autonomous vehicles, self-driving mobility, urban planning, urban mobility, transport, public policies

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Authors: Chuang-Chun Chiou

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Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: lean, service improvement, SERVQUAL, care home service

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Authors: Gramza-Michalowska Anna, Skrety Joanna, Kobus-Cisowska Joanna, Kmiecik Dominik, Korczak Jozef, Anna Zywica

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Background: Recent research presented many evidences confirming that food besides its basic nutritional function, possess significant therapeutic and prophylactic potential. Conscious consumer is aware of diet habits and well being lifestyle influencing a proper functioning that is why there is a need of new pro-health products. Objective: Proposition of the technology of unsweetened almond drinks enriched with plant extracts for pro-health oriented individuals. Research investigated the influence of selected plant extracts addition on antioxidative activity and consumer’s acceptance of drinks as all day diet product representatives. Methods: The analysis of the basic composition and antioxidant properties of the almond drink was conducted. Research included analysis of basic composition (protein, lipids and fiber content) and antioxidant capacity of drink (DPPH, ABTS, ORAC value, and FRAP). Proposed drink was also characterized with sensory analysis, including color, aroma, taste, consistency, and overall acceptance. Results: Results showed that addition of plant extracts into an almond drink allowed to improve its antioxidant capacity and sensory value of the drinks. Profitable composition and pro-health properties of designed drink permits offering healthy product for all day consumption. Conclusion: Designed almond drink would be a significant supplement for pro-healthy life style of the consumers. Results showed that plant extracts enriched almond drink would be a good source of antioxidants and accepted by the consumers.

Keywords: phytonutrients, pro-health, almond, wellbeing, antioxidant potential, sensory value

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Authors: Kieren Wilson, Gulnaz Majeed

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NHS constitution gives rights to the patient with suspected cancer to be seen by a cancer specialist within 2 weeks of referral. Guys and St Thomas Hospital (GSTT) is one of the largest cancer centres in London. NICE guidelines have provided guidance for health professionals to refer patients appropriately to RAC. In GSTT suspected gynae cancer referrals are mostly by NHS e-Referral Service with some fax, emails as well as paper referrals. The objective of this study was to evaluate compliance with 2-week referral pathway with emphasis on one stop diagnostic service with supporting efficient pathways. A prospective evaluation over 3 months (1 Jan 2017 to 31 Mar 2017) was undertaken. There were 26 clinics, 761 patients were booked in the clinics with a DNA rate of 13% (n=101) hence 606 patients were seen. Majority of referrals were for post menopausal bleeding (PMB) 25% (n=194) followed by cervical, vaginal, vulval reasons 23% (n=179) (abnormal cytology excluded as patients directly referred to colposcopy unit in GSTT), ovarian 7% (n=54) and endometrial 5% (n=41). Women with new or previous established diagnosis of cancer were 24, cervical (n=17), vulva (n=6) and vagina (n=1). Multifocal preinvasive disease vulva (VIN), vagina (VAIN) and cervix (CIN) was confirmed in twenty-six patients 4% (high prevalence in HIV patients). Majority of cervical referrals: PCB (n=14), cervical erosion (n=7), polyps (n=9) and cervical cyst were benign. However, two women with PMB had cervical cancer. Only 2 out of 13 referrals with vaginal concerns had VAIN. One case with non-cervical glandular cytology was confirmed to have endometrial cancer. One stop service based on the diagnostic support of ultrasound, colposcopy and hysteroscopy was achieved in 54% (n=359). Patients were discharged to GP, benign gynaecology, endometriosis, combined vulval/dermatology clinic or gynae oncology. 33% (n=202) required a second visit, 12% (n=70) third visit, 3% (n=19) fourth visit, 1% (n=4) fifth visit and 1% (n=6) sixth visit. Main reasons for follow ups were the unavailability of diagnostic slots, patient choice, need for interpreters, the discussion following gynae MDM review for triage to benign gynae, delay in availability of diagnostic results like histology/MRI/CT. Recommendations following this study are multi disciplinary review of pathways with the availability of additional diagnostic procedure slots to aim for one stop service. Furthermore, establishment of virtual and telephone consultations to reduce follow ups.

Keywords: multifocal disease, post menopausal bleeding, preinvasive disease, rapid access clinic

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Authors: Jonathan Sahu, Jill Aylott

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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.

Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care

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Authors: Berna Istegun, Erkan Celebi

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The main objective of this experimental study is to assess the shear strength and the crack behavior of the triplets built of perforated brickwork masonry elements. In order to observe the influence of shear resistance and energy dissipating before and after retrofitting applications by using the reinforcing system, static-cyclic shear tests were employed in the structural mechanics laboratory of Sakarya University. The reinforcing system is composed of hybrid multiaxial seismic fabric consisting of alkali resistant glass and polypropylene fibers. The plaster as bonding material used in the specimen’s retrofitting consists of expanded glass granular. In order to acquire exact measuring data about the failure behavior of the two mortar joints under shear stressing, vertical load-controlled cylinder having force capacity of 50 kN and loading rate of 1.5 mm/min. with an internal inductive displacement transducers is carried out perpendicular to the triplet specimens. In this study, a total of six triplet specimens with textile reinforcement were prepared for these shear bond tests. The three of them were produced as single-sided reinforced triplets with seismic fabric, while the others were strengthened on both sides. In addition, three triplet specimens without retrofitting and plaster were also tested as reference samples. The obtained test results were given in the manner of force-displacement relationships, ductility coefficients and shear strength parameters comparatively. It is concluded that two-side seismic textile applications on masonry elements with relevant plaster have considerably increased the sheer force resistance and the ductility capacity.

Keywords: expanded glass granular, perforated brickwork, retrofitting, seismic fabric, triplet shear tests

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Bingying Liu, Dandong Ge, Xinlan Zhang, Haoyang Liang

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Over the past two years, a new generation of No-Pile Bike sharing, represented by the Ofo, Mobike and HelloBike, has sprung up in various cities in China, and spread rapidly in countries such as Britain, Japan, the United States and Singapore. As a new green public transportation mode, bike sharing can bring a series of benefits to urban space. At first, this paper analyzes the specific impact of bike sharing on urban space in China. Based on the market research and data analyzing, it is found that bike sharing can improve the quality of urban space in three aspects: expanding the radius of public transportation service, filling service blind spots, alleviating urban traffic congestion, and enhancing the vitality of urban space. On the other hand, due to the immature market and the imperfect system, bike sharing has gradually revealed some difficulties, such as parking chaos, malicious damage, safety problems, imbalance between supply and demand, and so on. Then the paper investigates the characteristics of shared bikes, business model, operating mechanism on Chinese market currently. Finally, in order to make bike sharing serve urban construction better, this paper puts forward some specific countermeasures from four aspects. In terms of market operations, it is necessary to establish a public-private partnership model and set up a unified bike-sharing integrated management platform. From technical methods level, the paper proposes to develop an intelligent parking system for regulating parking. From policy formulation level, establishing a bike-sharing assessment mechanism would strengthen supervision. As to urban planning, sharing data and redesigning slow roadway is beneficial for transportation and spatial planning.

Keywords: bike sharing, impact analysis, improvement strategy, urban space

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