Search results for: national service

Authors: Mohammad Arabi

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Business Process Reengineering (BPR) is a systematic approach to fundamentally redesign organizational processes to achieve significant improvements in organizational performance. At Fars Regional Electric Company, implementing BPR is deemed essential to increase productivity, reduce costs, and improve service quality. This article examines how BPR can help enhance the performance of Fars Regional Electric Company. The objective of this research is to evaluate and analyze the advancements in process modeling and reengineering at Fars Regional Electric Company and to provide solutions for improving the productivity and efficiency of organizational processes. This study aims to demonstrate how BPR can be used to improve organizational processes and enhance the overall performance of the company. This research employs both qualitative and quantitative research methods and includes interviews with senior managers and experts at Fars Regional Electric Company. The analytical tools include process modeling software such as Bizagi and ARIS, and statistical analysis software such as SPSS and Minitab. Data analysis was conducted using advanced statistical methods. The results indicate that the use of BPR techniques can lead to a significant reduction in process execution time and overall improvement in quality. Implementing BPR at Fars Regional Electric Company has led to increased productivity, reduced costs, and improved overall performance of the company. This study shows that with proper implementation of BPR and the use of modeling tools, the company can achieve significant improvements in its processes. Recommendations: (1) Continuous Training for Staff: Invest in continuous training of staff to enhance their skills and knowledge in BPR. (2) Use of Advanced Technologies: Utilize modeling and analysis software to improve processes. (3) Implementation of Effective Management Systems: Employ knowledge and information management systems to enhance organizational performance. (4) Continuous Monitoring and Review of Processes: Regularly review and revise processes to ensure ongoing improvements. This article highlights the importance of improving organizational processes at Fars Regional Electric Company and recommends that managers and decision-makers at the company seriously consider reengineering processes and utilizing modeling technologies to achieve developmental goals and continuous improvement.

Keywords: business process reengineering, electric company, Fars province, process modeling advancements

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Authors: Zita Fomukong Andam

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Civil disobedience according to John Rawls (1971) is a public nonviolent and conscientious breach of laws undertaken with the aim of bringing about a change in government laws and policies. Thus individuals who engage themselves in such an act are aware and ready to accept the consequences of their actions. Cameroon more precisely the Northwest and the Southwest region which are the English part are considered as one of the societies facing this act of civil disobedience. It has been a tormenting issue in the country affecting its economy and the tourism sector. This is because these regions known as one of the best touristic sites of the country is not more considered as a destination to be visited by tourist because of its insecurities. Many commercial buildings have been burning down, leaving many young Cameroonians jobless. Education has been hindered, and youths are forced to relocate to nearby cities in order to continue their education. This crisis has created a lot of insecurity throughout the regions thus youths now have one common interest to travel abroad either to seek refuge or to continue their education and even search for jobs. The purpose of this research is to assess the issue of civil disobedience, trying to understand why it is affected only by a specific region in a country while the others are doing fine. A deep research discourse was conducted with randomly selected individuals aging between 15 to 40 years living both in the destination and abroad. Survey questionnaires and interviews were carried out as a method to collect data. The results show that this crisis has impacted the local residents psychologically and has injected a lot of fears into tourists and they are no more willing to visit the destination. In addition, it has brought a negative impact on the county’s economy since tourism is considered as the key sector in a country’s economy. On the other hand, the results showed that many local residents have remained jobless, others have lost family members, and the daily routine life has been affected. Understanding these results, the national government and international bodies might be able to propose possible and efficient solutions in order to attain stability and security in this region.

Keywords: civil disobedience, economic impact, local residents, tourist

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Authors: Chijindu D. Mgbemere

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Mass killing also known as genocide is the systematic killing of people from national, ethnic, or religious group, or an attempt to do so. The act has been there before 1948, when it was officially recognized for what it is. From then, the world has continued to witness genocide in diverse forms- negating different measures by the United Nations and its agencies to curb it. So far, all the studies and documentations on this subject are biased in favor of radio and the print. This paper therefore extended the interrogation of genocide, drumming its devastating effects, using the film medium; and in doing so devised innovative and pragmatic approach to genocide scholarship. It further centered attention on the factors and impacts of genocide, with a view to determine how effective film can be in such a study. The study is anchored on Bateson’s Framing Theory. Four films- Hotel Rwanda, Half of a Yellow Sun, Attack on Darfur, and sarafina, were analyzed, based on background, factors/causes, impacts, and development of genocide, via Content Analysis. The study discovered that: as other continents strive towards peace, acts of genocide are on the increase in African. Bloodletting stereotypes give Africa negative image in the global society. Difficult political frameworks, the trauma of postcolonial state, aggravated by ethnic and religious intolerance, and limited access to resources are responsible for high cases of genocide in Africa. The media, international communities, and peace agencies often abet other than prevent genocide or mass killings in Africa. High human casualty and displacement, children soldering, looting, hunger, rape, sex-slavery and abuse, mental and psychosomatic stress disorders are some of the impacts of genocide. Genocidaires are either condemned or killed. Grievances can be vented using civil resistance, negotiation, adjudication, arbitration, and mediation. The cinema is an effective means of studying and documenting genocide. Africans must factor the image laundering of their continent into consideration. Punishment of genocidaires without an attempt to de-radicalize them is counterproductive.

Keywords: African film, genocide, framing theory, mass murder

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Authors: Melissa R. Quispe-Zuniga, Daniel Callo-Concha, Christian Borgemeister, Klaus Greve

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The Peruvian Andes have a high potential for mining, but many of the mining areas overlay with campesino community lands, being these key actors for agriculture and livestock production. Lead by economic incentives, some communities are renting their lands to mining companies for exploration or exploitation. However, a growing number of campesino communities, usually social and economically marginalized, have developed resistance, alluding consequences, such as water pollution, land-use change, insufficient economic compensation, etc. what eventually end up in Socio-Environmental Conflicts (SEC). It is hypothesized that disclosing the information on environmental pollution and enhance the involvement of communities in the decision-making process may contribute to prevent SEC. To assess whether such complains are grounded on the environmental impact of mining activities, we measured the heavy metals concentration in 24 indicative samples from rivers that run across mining exploitations and farming community lands. Samples were taken during the 2016 dry season and analyzed by inductively-coupled-plasma-atomic-emission-spectroscopy. The results were contrasted against the standards of monitoring government institutions (i.e., OEFA). Furthermore, we investigated the water/environmental complains related to mining in the neighboring 14 communities. We explored the relationship between communities and mining companies, via open-ended interviews with community authorities and non-participatory observations of community assemblies. We found that the concentrations of cadmium (0.023 mg/L), arsenic (0.562 mg/L) and copper (0.07 mg/L), surpass the national water quality standards for Andean rivers (0.00025 mg/L of cadmium, 0.15 mg/L of arsenic and 0.01 mg/L of copper). 57% of communities have posed environmental complains, but 21% of the total number of communities were receiving an annual economic benefit from mining projects. However, 87.5% of the communities who had posed complains have high concentration of heavy metals in their water streams. The evidence shows that mining activities tend to relate to the affectation and vulnerability of campesino community water streams, what justify the environmental complains and eventually the occurrence of a SEC.

Keywords: mining companies, campesino community, water, socio-environmental conflict

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Authors: Vichai Tienthavorn

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Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.

Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care

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Authors: Saidur R. Chowdhury, Mamme K. Addai, Ernest K. Yanful

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The research was performed to assess the potential of nickel smelter slag, an industrial waste, as an adsorbent in the removal of metals from aqueous solution. An investigation was carried out for Arsenic (As), Copper (Cu), lead (Pb) and Cadmium (Cd) adsorption from aqueous solution. Smelter slag was obtain from Ni ore at the Vale Inco Ni smelter in Sudbury, Ontario, Canada. The batch experimental studies were conducted to evaluate the removal efficiencies of smelter slag. The slag was characterized by surface analytical techniques. The slag contained different iron oxides and iron silicate bearing compounds. In this study, the effect of pH, contact time, particle size, competition by other ions, slag dose and distribution coefficient were evaluated to measure the optimum adsorption conditions of the slag as an adsorbent for As, Cu, Pb and Cd. The results showed 95-99% removal of As, Cu, Pb, and almost 50-60% removal of Cd, while batch experimental studies were conducted at 5-10 mg/L of initial concentration of metals, 10 g/L of slag doses, 10 hours of contact time and 170 rpm of shaking speed and 25oC condition. The maximum removal of Arsenic (As), Copper (Cu), lead (Pb) was achieved at pH 5 while the maximum removal of Cd was found after pH 7. The column experiment was also conducted to evaluate adsorption depth and service time for metal removal. This study also determined adsorption capacity, adsorption rate and mass transfer rate. The maximum adsorption capacity was found to be 3.84 mg/g for As, 4 mg/g for Pb, and 3.86 mg/g for Cu. The adsorption capacity of nickel slag for the four test metals were in decreasing order of Pb > Cu > As > Cd. Modelling of experimental data with Visual MINTEQ revealed that saturation indices of < 0 were recorded in all cases suggesting that the metals at this pH were under- saturated and thus in their aqueous forms. This confirms the absence of precipitation in the removal of these metals at the pHs. The experimental results also showed that Fe and Ni leaching from the slag during the adsorption process was found to be very minimal, ranging from 0.01 to 0.022 mg/L indicating the potential adsorbent in the treatment industry. The study also revealed that waste product (Ni smelter slag) can be used about five times more before disposal in a landfill or as a stabilization material. It also highlighted the recycled slags as a potential reactive adsorbent in the field of remediation engineering. It also explored the benefits of using renewable waste products for the water treatment industry.

Keywords: adsorption, industrial waste, recycling, slag, treatment

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Authors: Jose Daniel Giraldo Arias, Camilo Rojas Gomez, David Villegas Delgado, Gullermo Idarraga Alarcon, Juan Meza Meza

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The reverse engineering processes are widely used in the industry with the main goal to determine the materials and the manufacture used to produce a component. There are a lot of characterization techniques and computational tools that are used in order to get this information. A study case of a reverse engineering applied to a secondary sandwich- hybrid type structure used in a helicopter is presented. The methodology used consists of five main steps, which can be applied to any other similar component: Collect information about the service conditions of the part, disassembly and dimensional characterization, functional characterization, material properties characterization and manufacturing processes characterization, allowing to obtain all the supports of the traceability of the materials and processes of the aeronautical products that ensure their airworthiness. A detailed explanation of each step is covered. Criticality and comprehend the functionalities of each part, information of the state of the art and information obtained from interviews with the technical groups of the helicopter’s operators were analyzed,3D optical scanning technique, standard and advanced materials characterization techniques and finite element simulation allow to obtain all the characteristics of the materials used in the manufacture of the component. It was found that most of the materials are quite common in the aeronautical industry, including Kevlar, carbon, and glass fibers, aluminum honeycomb core, epoxy resin and epoxy adhesive. The stacking sequence and volumetric fiber fraction are a critical issue for the mechanical behavior; a digestion acid method was used for this purpose. This also helps in the determination of the manufacture technique which for this case was Vacuum Bagging. Samples of the material were manufactured and submitted to mechanical and environmental tests. These results were compared with those obtained during reverse engineering, which allows concluding that the materials and manufacture were correctly determined. Tooling for the manufacture was designed and manufactured according to the geometry and manufacture process requisites. The part was manufactured and the mechanical, and environmental tests required were also performed. Finally, a geometric characterization and non-destructive techniques allow verifying the quality of the part.

Keywords: reverse engineering, sandwich-structured composite parts, helicopter, mechanical properties, prototype

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Authors: Sandra Cecilia Bautista-Rodríguez, Vladimir Melgarejo

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Climate change, loss of ecosystems, increasing poverty, increasing marginalization of rural communities and declining food security are global issues that require urgent attention. In this regard, a great deal of research has focused on how agroecosystems respond to these challenges as they provide ecosystem services (ES) that lead to higher levels of resilience, adaptation, productivity and self-sufficiency. Hence, the valuing of ecosystem services plays an important role in the decision-making process for the design and management of agroecosystems. This paper aims to define the link between ecosystem service valuation methods and ES value dimensions in agroecosystems from ecological economics and agroecology. The method used to identify valuation methodologies was a literature review in the fields of Agroecology and Ecological Economics, based on a strategy of information search and classification. The conceptual framework of the work is based on the multidimensionality of value, considering the social, ecological, political, technological and economic dimensions. Likewise, the valuation process requires consideration of the ecosystem function associated with ES, such as regulation, habitat, production and information functions. In this way, valuation methods for ES in agroecosystems can integrate more than one value dimension and at least one ecosystem function. The results allow correlating the ecosystem functions with the ecosystem services valued, and the specific tools or models used, the dimensions and valuation methods. The main methodologies identified are multi-criteria valuation (1), deliberative - consultative valuation (2), valuation based on system dynamics modeling (3), valuation through energy or biophysical balances (4), valuation through fuzzy logic modeling (5), valuation based on agent-based modeling (6). Amongst the main conclusions, it is highlighted that the system dynamics modeling approach has a high potential for development in valuation processes, due to its ability to integrate other methods, especially multi-criteria valuation and energy and biophysical balances, to describe through causal cycles the interrelationships between ecosystem services, the dimensions of value in agroecosystems, thus showing the relationships between the value of ecosystem services and the welfare of communities. As for methodological challenges, it is relevant to achieve the integration of tools and models provided by different methods, to incorporate the characteristics of a complex system such as the agroecosystem, which allows reducing the limitations in the processes of valuation of ES.

Keywords: ecological economics, agroecosystems, ecosystem services, valuation of ecosystem services

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Authors: Wendy de Gomez

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Standardization is a critical element in the ability of a society to reduce uncertainty, subjectivity, misrepresentation, and interpretation while simultaneously contributing to innovation. Technological standardization is critical to codify specific operationalization through legal instruments that provide rules of development, expectation, and use. In the current emerging technology landscape Artificial Intelligence (AI) hardware as a general use technology has seen incredible growth as evidenced from AI technology patents between 2012 and 2018 in the United States Patent Trademark Office (USPTO) AI dataset. However, as outlined in the 2023 United States Government National Standards Strategy for Critical and Emerging Technology the codification through standardization of emerging technologies such as AI has not kept pace with its actual technological proliferation. This gap has the potential to cause significant divergent possibilities for the downstream outcomes of AI in both the short and long term. This original empirical research provides an overview of the standardization efforts around AI in different geographies and provides a background to standardization law. It quantifies the longitudinal trend of Artificial Intelligence hardware patents through the USPTO AI dataset. It seeks evidence of existing Standard Essential Patents from these AI hardware patents through a text analysis of the Statement of patent history and the Field of the invention of these patents in Patent Vector and examines their determination as a Standard Essential Patent and their inclusion in existing AI technology standards across the four main AI standards bodies- European Telecommunications Standards Institute (ETSI); International Telecommunication Union (ITU)/ Telecommunication Standardization Sector (-T); Institute of Electrical and Electronics Engineers (IEEE); and the International Organization for Standardization (ISO). Once the analysis is complete the paper will discuss both the theoretical and operational implications of F/Rand Licensing Agreements for the owners of these Standard Essential Patents in the United States Court and Administrative system. It will conclude with an evaluation of how Standard Setting Organizations (SSOs) can work with SEP owners more effectively through various forms of Intellectual Property mechanisms such as patent pools.

Keywords: patents, artifical intelligence, standards, F/Rand agreements

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Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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Authors: F. A. M. Safwan, H. N. N. Dilrukshi, P. U. S. Peiris

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Less availability of high quality green forages leads to low productivity of national dairy herd of Sri Lanka. Growing grass and fodder to suit the production system is an efficient and economical solution for this problem. CO-3 is placed in a higher category, especially on tillering capacity, green forage yield, regeneration capacity, leaf to stem ratio, high crude protein content, resistance to pests and diseases and free from adverse factors along with other fodder varieties grown within the country. An experiment was designed to determine the effect of organic sheep manure, inorganic fertilizers and liquid sheep manure on growth, yield and nutritive value of CO-3. The study was consisted with three treatments; sheep manure (T1), recommended inorganic fertilizers (T2) and liquid sheep manure (T3) which was prepared using bucket fermentation method and each treatment was consisted with three replicates and those were assigned randomly. First harvest was obtained after 40 days of plant establishment and number of leaves (NL), leaf area (LA), tillering capacity (TC), fresh weight (FW) and dry weight (DW) were recorded and second harvest was obtained after 30 days of first harvest and same set of data were recorded. SPSS 16 software was used for data analysis. For proximate analysis AOAC, 2000 standard methods were used. Results revealed that the plants treated with T1 recorded highest NL, LA, TC, FW and DW and were statistically significant at first and second harvest of CO-3 (p˂ 0.05) and it was found that T1 was statistically significant from T2 and T3. Although T3 was recorded higher than the T2 in almost all growth parameters; it was not statistically significant (p ˃0.05). In addition, the crude protein content was recorded highest in T1 with the value of 18.33±1.61 and was lowest in T2 with the value of 10.82±1.14 and was statistically significant (p˂ 0.05). Apart from this, other proximate composition crude fiber, crude fat, ash, moisture content and dry matter were not statistically significant between treatments (p ˃0.05). In accordance with the results, it was found that the organic fertilizer is the best fertilizer for CO-3 in terms of growth parameters and crude protein content.

Keywords: fertilizer, growth parameters, Hybrid Napier CO-3, proximate composition

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Authors: Louk Aourelien Andrianos, Edward Dommen, Athena Peralta

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Greed, as epitomized by overconsumption of natural resources, is at the root of ecological destruction and unsustainability of modern societies. Presently economies rely on unrestricted structural greed which fuels unlimited economic growth, overconsumption, and individualistic competitive behavior. Structural greed undermines the life support system on earth and threatens ecological integrity, social justice and peace. The World Council of Churches (WCC) has developed a program on ecological and economic justice (EEJ) with the aim to promote an economy of life where the economy is embedded in society and society in ecology. This paper aims at analyzing and assessing the economy of life (EcoLife) by offering an empirical tool to measure and monitor the root causes and effects of unsustainability resulting from human greed on global, national, institutional and individual levels. This holistic approach is based on the integrity of ecology and economy in a society founded on justice. The paper will discuss critical questions such as ‘what is an economy of life’ and ‘how to measure and control it from the effect of greed’. A model called GLIMS, which stands for Greed Lines and Indices Measurement System is used to clarify the concept of greed and help measuring the economy of life index by fuzzy logic reasoning. The inputs of the model are from statistical indicators of natural resources consumption, financial realities, economic performance, social welfare and ethical and political facts. The outputs are concrete measures of three primary indices of ecological, economic and socio-political greed (ECOL-GI, ECON-GI, SOCI-GI) and one overall multidimensional economy of life index (EcoLife-I). EcoLife measurement aims to build awareness of an economy life and to address the effects of greed in systemic and structural aspects. It is a tool for ethical diagnosis and policy making.

Keywords: greed line, sustainability indicators, fuzzy logic, eco-justice, World Council of Churches (WCC)

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Authors: Delaram Ghodsi, Nasrin Omidvar, Hassan Eini-Zinab, Arash Rashidian, Hossein Raghfar

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Food supplementary programs are policy approaches that aim to reduce financial barriers to healthy diets and tackle food insecurity. This study aimed to evaluate the effect of the supportive section of Multidisciplinary Supplementary Program for Improvement of Nutritional Status of Children (MuPINSC) on households’ food security status and nutritional status of mothers. MuPINSC is a national integrative program in Iran that distributes supplementary food basket to malnourished or growth retarded children living in low-income families in addition to providing health services, including sanitation, growth monitoring, and empowerment of families. This longitudinal study is part of a comprehensive evaluation of the program. The study participants included 359 mothers of children aged 6 to 72 month under coverage of the supportive section of the program in two provinces of Iran (Semnan and Qazvin). Demographic and economic characteristics of families were assessed by a questionnaire. Data on food security of family was collected by locally adapted Household Food Insecurity Access Scale (HFIAS) at the baseline of the study and six month thereafter. Weight and height of mothers were measured at the baseline and end of the study and mother’s BMI was calculated. Data were analysed, using paired t-test, GEE (Generalized Estimating Equation), and Chi-square tests. Based on the findings, at the baseline, only 4.7% of families were food-secure, while 13.1%, 38.7% and, 43.5% were categorized as mild, moderate and severe food insecure. After six months follow up, the distribution of different levels of food security changed significantly (P<0.001) to 7.9%, 11.6%, 42.6%, and 38%, respectively. At the end of the study, the chance of food insecurity was significantly 20% lower than the beginning (OR=0.796; 0.653-0.971). No significant difference was observed in maternal BMI based on food security (P>0.05). The findings show that the food supplementary program for children improved household food security status in the studied households. Further research is needed to assess other factors that affect the effectiveness of this large scale program on nutritional status and household’s food security.

Keywords: food security, food supplementary program, household, malnourished children

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Authors: Kyungsuk Cho, Seungun Chae, Jihun Choi

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Elevators are examined as one of evacuation methods in super-tall buildings. However, data on the use of elevators for evacuation at a fire are extremely scarce. Therefore, a test to measure delay time in using an evacuation elevator was conducted. In the test, time taken to get on and get off an elevator was measured and the case in which people gave up boarding when the capacity of the elevator was exceeded was also taken into consideration. 170 men and women participated in the test, 130 of whom were young people (20 ~ 50 years old) and 40 were senior citizens (over 60 years old). The capacity of the elevator was 25 people and it travelled between the 2nd and 4th floors. A video recording device was used to analyze the test. An elevator at an ordinary building, not a super-tall building, was used in the test to measure delay time in getting on and getting off an elevator. In order to minimize interference from other elements, elevator platforms on the 2nd and 4th floors were partitioned off. The elevator travelled between the 2nd and 4th floors where people got on and off. If less than 20 people got on the elevator which was empty, the data were excluded. If the elevator carrying 10 passengers stopped and less than 10 new passengers got on the elevator, the data were excluded. Getting-on an empty elevator was observed 49 times. The average number of passengers was 23.7, it took 14.98 seconds for the passengers to get on the empty elevator and the load factor was 1.67 N/s. It took the passengers, whose average number was 23.7, 10.84 seconds to get off the elevator and the unload factor was 2.33 N/s. When an elevator’s capacity is exceeded, the excessive number of people should get off. Time taken for it and the probability of the case were measure in the test. 37% of the times of boarding experienced excessive number of people. As the number of people who gave up boarding increased, the load factor of the ride decreased. When 1 person gave up boarding, the load factor was 1.55 N/s. The case was observed 10 times, which was 12.7% of the total. When 2 people gave up boarding, the load factor was 1.15 N/s. The case was observed 7 times, which was 8.9% of the total. When 3 people gave up boarding, the load factor was 1.26 N/s. The case was observed 4 times, which was 5.1% of the total. When 4 people gave up boarding, the load factor was 1.03 N/s. The case was observed 5 times, which was 6.3% of the total. Getting-on and getting-off time data for people who can walk freely were obtained from the test. In addition, quantitative results were obtained from the relation between the number of people giving up boarding and time taken for getting on. This work was supported by the National Research Council of Science & Technology (NST) grant by the Korea government (MSIP) (No. CRC-16-02-KICT).

Keywords: evacuation elevator, super tall buildings, evacuees, delay time

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Authors: Mohamed S. Selim, Nesreen A. Fatthallah, Shimaa A. Higazy, Hekmat R. Madian, Sherif A. El-Safty, Mohamed A. Shenashen

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After the 2003 prohibition on employing TBT-based antifouling coatings, polysiloxane antifouling nano-coatings have gained in popularity as environmentally friendly and cost-effective replacements. A series of non-toxic polydimethylsiloxane nanocomposites filled with nanosheets of graphene oxide (GO) decorated with magnetite nanospheres (GO-Fe₃O₄ nanospheres) were developed and cured via a catalytic hydrosilation method. Various GO-Fe₃O₄ hybrid concentrations were mixed with the silicone resin via solution casting technique to evaluate the structure–property connection. To generate GO nanosheets, a modified Hummers method was applied. A simple co-precipitation method was used to make spherical magnetite particles under inert nitrogen. Hybrid GO-Fe₃O₄ composite fillers were developed by a simple ultrasonication method. Superhydrophobic PDMS/GO-Fe₃O₄ nanocomposite surface with a micro/nano-roughness, reduced surface-free energy (SFE), high fouling release (FR) efficiency was achieved. The physical, mechanical, and anticorrosive features of the virgin and GO-Fe₃O₄ filled nanocomposites were investigated. The synergistic effects of GO-Fe₃O4 hybrid's well-dispersion on the water-repellency and surface topological roughness of the PDMS/GO-Fe₃O₄ nanopaints were extensively studied. The addition of the GO-Fe₃O₄ hybrid fillers till 1 wt.% could increase the coating's water contact angle (158°±2°), minimize its SFE to 12.06 mN/m, develop outstanding micro/nano-roughness, and improve its bulk mechanical and anticorrosion properties. Several microorganisms were employed for examining the fouling-resistance of the coated specimens for 1 month. Silicone coatings filled with 1 wt.% GO-Fe₃O₄ nanofiller showed the least biodegradability% among all the tested microorganisms. Whereas GO-Fe₃O4 with 5 wt.% nanofiller possessed the highest biodegradability% potency by all the microorganisms. We successfully developed non-toxic and low cost nanostructured FR composite coating with high antifouling-resistance, reproducible superhydrophobic character, and enhanced service-time for maritime navigation.

Keywords: silicone antifouling, environmentally friendly, nanocomposites, nanofillers, fouling repellency, hydrophobicity

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Authors: Thomas Ruppert, Shana Jones, J. Scott Pippin

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State and federal government agencies within the United States have recently invested substantial resources into studies of future flood risk conditions associated with climate change and sea-level rise. A review of numerous case studies has uncovered several key themes that speak to an overall incoherence within current flood risk assessment procedures in the U.S. context. First, there are substantial local differences in the quality of available information about basic infrastructure, particularly with regard to local stormwater features and essential facilities that are fundamental components of effective flood hazard planning and mitigation. Second, there can be substantial mismatch between regulatory Flood Insurance Rate Maps (FIRMs) as produced by the National Flood Insurance Program (NFIP) and other 'current condition' flood assessment approaches. This is of particular concern in areas where FIRMs already seem to underestimate extant flood risk, which can only be expected to become a greater concern if future FIRMs do not appropriately account for changing climate conditions. Moreover, while there are incentives within the NFIP’s Community Rating System (CRS) to develop enhanced assessments that include future flood risk projections from climate change, the incentive structures seem to have counterintuitive implications that would tend to promote moral hazard. In particular, a technical finding of higher future risk seems to make it easier for a community to qualify for flood insurance savings, with much of these prospective savings applied to individual properties that have the most physical risk of flooding. However, there is at least some case study evidence to indicate that recognition of these issues is prompting broader discussion about the need to move beyond FIRMs as a standalone local flood planning standard. The paper concludes with approaches for developing climate adaptation and flood resilience strategies in the U.S. that move away from the social welfare model being applied through NFIP and toward more of an informed risk approach that transfers much of the investment responsibility over to individual private property owners.

Keywords: climate change adaptation, flood risk, moral hazard, sea-level rise

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Authors: U. K. Tamuli

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Introduction: North East India is graced with natural beauty and hazards. This area is prone to major earthquakes, floods, landslides, accidents, terrorist activities etc. Academy of Trauma (AOT), an NGO of Doctors, conducts training programs, mock drills, field trials amongst the doctors and paramedics in North East India. The present study is to evaluate the efficacy of such training in terms of sensitivity, awareness, and delivery systems of the products. Here the health care delivery system for disaster management is inadequate. Clear guideline of mass casualty management is unavailable. AOT has initiated steps to increase the awareness and handling of mass casualty management to improve the emergency health care delivery system. Method: AOT has conducted training programmes on emergency health management, mass casualty management and hospital preparedness amongst 800 doctors and 1200 paramedics in twenty-two districts of Assam in Northeast India. The training module consists of lectures, hands-on workshop using manikins, mock drills, distribution of manuals, emergency management exercises, periodic exchange of experience and debriefings. AOT evaluates the impact of these trainings by conducting pre and post tests of delegates, trainer’s evaluation, delegate’s satisfaction and confidence level and their suggestions. Results: The module, training, hands-on workshops, mock drills were highly appreciated. There is significant improvement in scores on the post-training tests. The confidence level of the participants has risen to deal with emergency medical situation Conclusion: These kinds of trainings increase the awareness of the medical members to handle mass casualties in different situations. One such training actually sensitises the delegates. Repetition of such training, TOT (Training-of-Trainers) programs, and individual efforts of delegates are extremely important for sustenance and success of health care delivery service during disasters in the developing countries. Further collaboration, assistance, networking, suggestions from established global agencies in this field will be highly appreciated.

Keywords: capacity building, North East India, non-governmental organization, trauma

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Authors: Humphrey Agevi, Harrison Tsingalia, Richard Onwonga, Shem Kuyah

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Most of the world ecosystems have been affected by the effects of climate change. Efforts have been made to mitigate against climate change effects. While most studies have been done in forest ecosystems and pure plant plantations, trees on farms including agroforestry have only received attention recently. Agroforestry systems and tree cover on agricultural lands make an important contribution to climate change mitigation but are not systematically accounted for in the global carbon budgets. This study sought to: (i) determine tree diversity in different agroforestry practices; (ii) determine tree biomass in different agroforestry practices. Study area was determined according to the Land degradation surveillance framework (LSDF). Two study sites were established. At each of the site, a 5km x 10km block was established on a map using Google maps and satellite images. Way points were then uploaded in a GPS helped locate the blocks on the ground. In each of the blocks, Nine (8) sentinel clusters measuring 1km x 1km were randomized. Randomization was done in a common spreadsheet program and later be downloaded to a Global Positioning System (GPS) so that during surveys the researchers were able to navigate to the sampling points. In each of the sentinel cluster, two farm boundaries were randomly identified for convenience and to avoid bias. This led to 16 farms in Kakamega South and 16 farms in Kakamega North totalling to 32 farms in Kakamega Site. Species diversity was determined using Shannon wiener index. Tree biomass was determined using allometric equation. Two agroforestry practices were found; homegarden and hedgerow. Species diversity ranged from 0.25-2.7 with a mean of 1.8 ± 0.10. Species diversity in homegarden ranged from 1-2.7 with a mean of 1.98± 0.14. Hedgerow species diversity ranged from 0.25-2.52 with a mean of 1.74± 0.11. Total Aboveground Biomass (AGB) determined was 13.96±0.37 Mgha-1. Homegarden with the highest abundance of trees had higher above ground biomass (AGB) compared to hedgerow agroforestry. This study is timely as carbon budgets in the agroforestry can be incorporated in the global carbon budgets and improve the accuracy of national reporting of greenhouse gases.

Keywords: agroforestry, allometric equations, biomass, climate change

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Authors: Jonas Sanon

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The valorization of research is becoming a transversal instrument linking different sectors (academic, public and industrial). The practice of valorization seems to impact innovation techniques within companies where, there is often the implementation of industrial conventions of training through research (CIFRE), continuous training programs for employees, collaborations and partnerships around joint research and R&D laboratories focused on the needs of companies to improve or develop more efficient innovations. Furthermore, many public initiatives to support innovation and technology transfer have been developed at the international, European and national levels, with significant budget allocations. Thus, in the context of this work, we tried to analyze the way in which research transfer structures are evaluated within the Saclay ecosystem. In fact, the University-Paris-Saclay is one of the best French universities; it is made up of 10 university components, more than 275 laboratories and is in partnership with the largest French research centers This work mainly focused on how evaluations affected research transfer structures, how evaluations were conducted, and what the managers of research transfer structures thought about assessments. Thus, with the aid of the conducted interviews, it appears that the evaluations do not have a significant impact on the qualitative aspect of research and innovation, but is rather present a directive aspect to allow the structures to benefit or not from the financial resources to develop certain research work, sometimes directed and influenced by the market, some researchers might try to accentuate their research and experimentation work on themes that are not necessarily their areas of interest, but just to comply with the calls for proposed thematic projects. The field studies also outline the primary indicators used to assess the effectiveness of valorization structures as "the number of start-ups generated, the license agreements signed, the structure's patent portfolio, and the innovations of items developed from public research.". Finally, after mapping the actors, it became clear that the ecosystem of the University of Paris-Saclay benefits from a richness allowing it to better value its research in relation to the three categories of actors it has (internal, external and transversal), united and linked by a relationship of proximity of sharing and endowed with a real opportunity to innovate openly.

Keywords: research valorization, technology transfer, innovation, evaluation, impacts and performances, innovation policy

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Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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Authors: Cagdas Agirdas

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Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.

Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities

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Authors: Anna M. N. Shifotoka, Richard Walker, Katie Haighton, Richard McNally

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An analysis of trends in Case Notification Rates (CNR) can be used to monitor the impact of Tuberculosis (TB) control interventions over time in order to inform the implementation of current and future TB interventions. A retrospective analysis of trends in TB CNR for two urban regions in Namibia, namely Khomas and Erongo regions, was conducted. TB case notification data were obtained from annual TB reports of the national TB programme, Ministry of Health and Social Services, covering the period from 1997 to 2015. Joinpoint regression was used to analyse trends in CNR for different types of TB groups. A trend was considered to be statistically significant when a p-value was less than 0.05. During the period under review, the crude CNR for all forms of TB declined from 808 to 400 per 100 000 population in Khomas, and from 1051 to 611 per 100 000 population in Erongo. In both regions, significant change points in trends were observed for all types of TB groups examined. In Khomas region, the trend for new smear positive pulmonary TB increased significantly by an annual rate of 4.1% (95% Confidence Interval (CI): 0.3% to 8.2%) during the period 1997 to 2004, and thereafter declined significantly by -6.2% (95%CI: -7.7% to -4.3%) per year until 2015. Similarly, the trend for smear negative pulmonary TB increased significantly by 23.7% (95%CI: 9.7 to 39.5) per year from 1997 to 2004 and thereafter declined significantly by an annual change of -26.4% (95%CI: -33.1% to -19.8%). The trend for all forms of TB CNR in Khomas region increased significantly by 8.1% (95%CI: 3.7 to 12.7) per year from 1997 to 2004 and thereafter declined significantly a rate of -8.7% (95%CI: -10.6 to -6.8). In Erongo region, the trend for smear positive pulmonary TB increased at a rate of 1.2% (95%CI: -1.2% to 3.6%) annually during the earlier years (1997 to 2008), and thereafter declined significantly by -9.3% (95%CI: -13.3% to -5.0%) per year from 2008 to 2015. Also in Erongo, the trend for all forms of TB CNR increased significantly by an annual rate of 4.0% (95%CI: 1.4% to 6.6%) during the years between 1997 to 2006 and thereafter declined significantly by -10.4% (95%CI: -12.7% to -8.0%) per year during 2006 to 2015. The trend for extra-pulmonary TB CNR declined but did not reach statistical significance in both regions. In conclusion, CNRs declined for all types of TB examined in both regions. Further research is needed to study trends for other TB dimensions such as treatment outcomes and notification of drug resistant TB cases.

Keywords: epidemiology, Namibia, temporal trends, tuberculosis

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Authors: Fatemeh Dehghan Khangahi, Hakan Gunes

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Transforming a public necessity into a commercial commodity becomes more and more evident as time goes on, and it is one of the issues of water shortage. Development projects of countries, consume the water and waterbeds in various forms, ignoring the concepts such as sustainability and the negative effects they place on the environment, pollute and change the ways of waterways. Throughout these processes, the water basins and all the vital environments sometimes can suffer damage to the irreparable level. In this context, the issue of Lake Urmia that is located in the North West of Iran left alone by drought, has been researched. The lake, which is on the list of UNESCO's biosphere reserves, is now exposed to the danger of desiccation. If the desiccation is fully realized, more than 5.000.000 people that they are living around the lake, will have to migrate as a result of negative living conditions. As a matter of fact, along with the recent years of increasing drought level, regional migrations have begun. In addition to migration issues, it is also necessary to specify the negative effects on human and all-round’s life that depend on the formation of salt storms, mixing of salt into the air and soil, which threaten human health seriously because the lake is salty. The main aim of this work is to raise national and international awareness of this problem, which is an environment and a human tragedy at the same time. This research has two basic questions: 1) In the case of Lake Urmia, what are environmental problems and how they have emerged and what is the role of governments? 2) What is the social consequence of this problem in relation to the first question? In response, after the literature search, having a comparative view of the situation of the Aral Sea and the Great Salt Lake (Utah, USA), which involved the two major international examples. The first, one is related to the terms of population and migration, the second is about biological properties. Then, data and status information that provided after 3 years area research has been evaluated. Towards the end, with the support of qualitative and quantitative methods, the study of social mobilization in the region has been carried out. An example of it is using the public space of TRAXTOR matches like a protests area.

Keywords: environment problems, water, social mobilization, Lake Urmia, migration

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Authors: Atousa Khodadadyan, Gabe Mythen, Hirbod Assa, Beverley Bishop

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Risk assessment and the knowledge provided through this process is a crucial part of any decision-making process in the management of risks and uncertainties. Failure in assessment of risks can cause inadequacy in the entire process of risk management, which in turn can lead to failure in achieving organisational objectives as well as having significant damaging consequences on populations affected by the potential risks being assessed. The choice of tools and techniques in risk assessment can influence the degree and scope of decision-making and subsequently the risk response strategy. There are various available qualitative and quantitative tools and techniques that are deployed within the broad process of risk assessment. The sheer diversity of tools and techniques available to practitioners makes it difficult for organisations to consistently employ the most appropriate methods. This tools and techniques adaptation is rendered more difficult in public risk regulation organisations due to the sensitive and complex nature of their activities. This is particularly the case in areas relating to the environment, food, and human health and safety, when organisational goals are tied up with societal, political and individuals’ goals at national and international levels. Hence, recognising, analysing and evaluating different decision support tools and techniques employed in assessing risks in public risk management organisations was considered. This research is part of a mixed method study which aimed to examine the perception of risk assessment and the extent to which organisations practise risk assessment’ tools and techniques. The study adopted a semi-structured questionnaire with qualitative and quantitative data analysis to include a range of public risk regulation organisations from the UK, Germany, France, Belgium and the Netherlands. The results indicated the public risk management organisations mainly use diverse tools and techniques in the risk assessment process. The primary hazard analysis; brainstorming; hazard analysis and critical control points were described as the most practiced risk identification techniques. Within qualitative and quantitative risk analysis, the participants named the expert judgement, risk probability and impact assessment, sensitivity analysis and data gathering and representation as the most practised techniques.

Keywords: decision-making, public risk management organisations, risk assessment, tools and techniques

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Authors: Vilma Zydziunaite, Simona Kersiene

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The concept of focused leadership means that the leader gathers the entire community in various ways to communicate and cooperate with each other, to share their knowledge and responsibility, to get involved in problem-solving, to create a safe and trusting environment and to satisfy the needs and interests of each community member. The study's aim is to analyze the teamwork of teachers working in kindergartens and schools and its CEOs by implementing confused leadership. A mixed research design was used for the research study. Quantitative research used the teamwork test "Team-Puls" (2003). Data is processed by the IBM SPSS version 29.0 software package. Semi-structured interviews were used for data collection, and qualitative content analysis was applied for data analysis. The results of quantitative research show that there is no statistically significant difference between the evaluation averages of kindergarten and school teachers. Likewise, the effectiveness and evaluation of teacher teamwork in educational institutions depend on different characteristics and processes, such as the number of participating teachers, the involvement of the institution's administration or the stages of team formation. In the qualitative research, the components of the focused leadership categories applied by the kindergarten and school CEOs emerged. The categories reflect the components of shared leadership. In the study, the sharing of responsibilities and cooperation among teachers and the sharing of knowledge among themselves is distinguished. This shows that the action takes place between the teachers when they participate in the processes voluntarily, according to their wishes or for certain reasons. Distributed leadership components occurs when leadership responsibility is extended beyond the school CEO. The components of servant leadership are expressed when the CEO achieves organizational goals in the service of others. Servant leadership is helping and striving for others, creating a safe environment. The level of the educational institution does not affect working teachers in the evaluation of working in a team. Giving freedom to teachers, the role of the CEO is dividing responsibilities and creating cooperation between teachers as well as ensuring teachers' interests, needs, emotional well-being and professional development.

Keywords: teamwork, school, teacher, school CEO, school environment, mixed research, Team-Puls test, semi-structured interview, questioning survey, qualitative content analysis, focused leadership, teacher leadership

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Authors: Hong Wu, Naiji Lu

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Improvement of health behavior among people with chronic diseases is vital for increasing longevity and enhancing quality of life. This paper researched the causal effects of informal care on the compliance with doctor’s health advices – smoking control, dietetic regulation, weight control and keep exercising – among older people with chronic diseases in China, which is facing the challenge of aging. We addressed the selection bias by using propensity score matching in the estimation process. We used the 2011-2012 national baseline data of the China Health and Retirement Longitudinal Study. Our results showed informal care can help improve health behavior of older people. First, informal care improved the compliance of smoking controls: whether smoke, frequency of smoking, and the time lag between wake up and the first cigarette was all lower for these older people with informal care; Second, for dietetic regulation, older people with informal care had more meals every day than older people without informal care; Third, three variables: BMI, whether gain weight and whether lose weight were used to measure the outcome of weight control. There were no significant difference between group with informal care and that without for BMI and the possibility of losing weight. Older people with informal care had lower possibility of gain weight than that without; Last, for the advice of keeping exercising, informal care increased the probability of walking exercise, however, the difference between groups for moderate and vigorous exercise were not significant. Our results indicate policy makers who aim to decrease accidents should take informal care to elders into account and provide an appropriate policy to meet the demand of informal care. Our birth policy and postponed retirement policy may decrease the informal caregiving hours, so adjustments of these policies are important and urgent to meet the current situation of aged tendency of population. In addition, government could give more support to develop organizations to provide formal care, such as nursing home. We infer that formal care is also useful for health behavior improvements.

Keywords: chronic diseases, compliance, CHARLS, health advice, informal care, older people, propensity score matching

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Authors: Kingsley Agyapong

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Research conducted in recent years has delved into the concept of patient-perceived value within the context of co-creation, particularly in the realm of doctor-patient interactions within healthcare settings. However, existing scholarly discourse lacks exploration regarding the emergence of patient-derived value in the co-creation process, specifically within encounters involving patients and stakeholders such as doctors, nurses, pharmacists, and other healthcare professionals. This study aims to fill this gap by elucidating the perspectives of patients regarding the value they derive from their interactions with multiple stakeholders in the delivery of healthcare services. The fieldwork was conducted at a university clinic located in Ghana. Data collection procedures involved conducting 20 individual interviews with key informants on distinct value accrued from co-creation practices and interactions with stakeholders. The key informants consisted of patients receiving care at the university clinic during the Malaria Treatment Process. Three themes emerged from both the existing literature and the empirical data collected. The first theme, labeled as "patient value needs in co-creation," encapsulates elements such as communication effectiveness, interpersonal interaction quality, treatment efficacy, and enhancements to the overall quality of life experienced by patients during their interactions with healthcare professionals. The second theme, designated as "services that enhance patients' experience in value co-creation," pertains to patients' perceptions of services that contribute favourably to co-creation experiences, including initiatives related to health promotion and the provision of various in-house services that patients deem pertinent for augmenting their overall experiences. The third theme, titled "Challenges in the co-creation of patients' value," delineates obstacles encountered within the co-creation process, including health professionals' challenges in effectively following up with patients scheduled for review and prolonged waiting times for healthcare delivery. This study contributes to the patients' perceptions of value within the co-creation process during their interactions with service providers, particularly healthcare professionals. By gaining a deeper insight into this process, healthcare providers can enhance the delivery of patient-centered care, thereby leading to improved healthcare outcomes. The study further offers managerial implications derived from its findings, providing actionable insights for healthcare managers and policymakers aiming to optimize patient value creation in healthcare services. Furthermore, it suggests avenues for future research endeavors within healthcare settings.

Keywords: patient, healthcare, co-creation, malaria

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Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns

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There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.

Keywords: blood transfusion, quality improvement, orthopaedics, trauma

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Authors: Violina Angelova, Galina Pevicharova

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A comparative research had been carried out to allow us to determine the quantities and the centers of accumulation of Pb, Cu, Zn and Cd in the vegetative and reproductive organs of the sweet potatoes and to ascertain the possibilities for growing them on soils, polluted with heavy metals. The experiments were performed on agricultural fields contaminated by the (1) Non-Ferrous-Metal Works near Plovdiv, (2) Lead and Zinc Complex near Kardjali and (3) a copper smelter near Pirdop, Bulgaria. The soils used in this experiment were characterized by acid, neutral and slightly alkaline reaction, loamy texture and a moderate content of organic matter. The total content of Zn, Pb, and Cd was high and exceeded the limit value in agriculture soils. Sweet potatoes were in a 2-year rotation scheme on three blocks in the experimental field. On reaching commercial ripeness the sweet potatoes were gathered and the contents of heavy metals in their different parts – root, tuber (peel and core), leaves and stems, were determined after microwave mineralization. The quantitative measurements were carried out with inductively coupled plasma atomic emission spectroscopy. The contamination of the sweet potatoes was due mainly to the presence of heavy metals in the soil, which entered the plants through their root system, as well as by diffusion through the peel. Pb, Cu, Zn, and Cd were selectively accumulated in the underground parts of the sweet potatoes, and most of all in the root system and the peel. Heavy metals have an impact on the development and productivity of the sweet potatoes. The high anthropogenic contamination leads to an increased assimilation of heavy metals which reduces the yield and the quality of the production of sweet potatoes, as well as leads to decrease of the absolute dry substance and the quantity of sugars in sweet potatoes. Sweet potatoes could be grown on soils, which are light to medium polluted with lead, zinc, and cadmium, as they do not accumulate these elements. On heavily polluted soils, however, (Pb – 1504 mg/kg, Zn – 3322 mg/kg, Cd – 47 mg/kg) the growing of sweet potatoes is not allowed, as the accumulation of Pb and Cd in the core of the potatoes exceeds the Maximum Acceptable Concentration. Acknowledgment: The authors gratefully acknowledge the financial support by the Bulgarian National Science Fund (Project DFNI DH04/9).

Keywords: heavy metals, polluted soils, sweet potatoes, uptake

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Authors: Eunjung Lee

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This study aims to analyze the sentences generated by the beginners who learn ‘e,’ a postposition in Korean and to find out the regularity of learners’ interlanguage upon investigating the usages of ‘e’ that appears by meanings and functions in their interlanguage, and conditions that ‘e’ is used. This study was conducted with mainly two assumptions; first, the learner’s language has the specific type of interlanguage; and second, there is the regularity of interlanguage when students produce ‘e’ under the specific conditions. Learners’ output has various values and can be used as the useful data to understand interlanguage. Therefore, all the sentences containing a postposition ‘e’ by English speaking learners were searched in ‘Learners’ corpus sharing center in The National Institute of Korean Language’ in Korea, and the data were collected upon limiting the levels of learners with Level 1 and 2. 789 sentences that were used with ‘e’ were selected as the final subjects of the analysis. First, to understand the environmental characteristics to be used with a postposition, ‘e’ after summarizing 13 meaning and functions of ‘e’ appeared in three books of Korean dictionary that summarized the Korean grammar, 1) meaning function of ‘e’ that were used in each sentence was classified; 2) the nouns that were combined with ‘e,’ keywords of the sentences, and the characteristics of modifiers, linkers, and predicates appeared in front of ‘e’ were analyzed; 3) the regularity by the novice learners’ meaning and functions were reviewed; and 4) the differences of the regularity by level 1 and 2 learners’ meaning and functions were found. Upon the study results, the novice learners showed 1) they used the nouns related to ‘time(시간), before(전), after(후), next(다음), the next(그다음), then(때), day of the week(요일), and season(계절)’ mainly in front of ‘e’ when they used ‘e’ as the meaning function of time; 2) they used mainly the verbs of ‘go(가다),’ ‘come(오다),’ and ‘go round(다니다)’ as the predicate to match with ‘e’ that was the meaning function of direction and destination; and 3) they used mainly the nouns related to ‘locations or countries’ in front of ‘e,’ a meaning function postposition of ‘place,’ used mainly the verbs ‘be(있다), not be(없다), live(살다), be many(많다)’ after ‘e,’ and ‘i(이) or ka(가)’ was combined mainly in the subject words in case of ‘be(있다), not be(없다)’ or ‘be many(많다),’ and ‘eun(은) or nun(는)’ was combined mainly in the subject words in front of ‘live at’ In addition, 4) they used ‘e’ which indicates ‘cause or reason’ in the form of ‘because( 때문에),’ and 5) used ‘e’ of the subjects as the predicates to match with the predicates such as ‘treat(대하다), like(들다), and catch(걸리다).’ From these results, ‘e’ usage patterns of the Korean novice learners demonstrated very differently by the meaning functions and the learners’ interlanguage regularity could be deducted. However, little difference was found in interlanguage regularity between level 1 and 2. This study has the meaning to try to understand the interlanguage system and regularity in the learners’ acquisition process of postposition ‘e’ and this can be utilized to lessen their errors.

Keywords: interlanguage, interlagnage anaylsis, postposition ‘e’, Korean acquisition

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