Examples Of Green Technology Methods Environmental Sciences Essay

Examples Of Green Technology Methods Environmental Sciences Essay Green technology is a continuously evolving group of methods of using materials that are being disposed of and recycling them to be used for other things that will not harm the environment. Building materials and landscaping are just a couple of things that can be done with waste materials. Things that can be recycled so that we can reuse them for generating energy to nontoxic cleaning products and other non-harmful things-things that could/can be harmful to our planet, ozone, and environment. We need to find things that we can do to help clean up our environment and planet before we totally destroy what is left of it. By using green technology, we can [meet] the needs of society in ways that will continue indefinitely into the future and without damaging or depleting natural resources. (Green technology, 2010) Examples of green technology are energy, green building, environmentally preferred purchasing, green chemistry, and green nanotechnology. All of these resources can keep our planet clean and we will be able to recycle smartly. We will be able to use, then re-use, as needed. As we build and use, we will be able to tear down what we have built and reuse the waste for other things. According to Green-technology.org, here are the definitions of the examples from above: Energy the development of alternative fuels, new means of generating energy and energy efficiency. Green building encompasses everything from the choice of building materials to where a building is located. Environmentally Preferred Purchasing (EPP) government innovation that involves the search for products whose contents and methods of production have the smallest possible impact on the environment and mandates that these be the preferred products for government purchasing. Green-chemistry the invention, design, and application of chemical products and processes to reduce or eliminate the use and generation of hazardous substances. Green nanotechnology the application of green chemistry and green engineering principals in the field of manipulation of materials at the scale of the nanometer (one billionth of a meter). Green energy is the use of alternative energy other than gasoline. One such alternative is ethanol and corn fuels. These burn cleaner than gas and, in todays automobiles these fuels even provide greater fuel mileage. This has been a concern of consumers for a long time. However, in older model cars, these types of fuels do not work and dry out piston rings but car manufacturers are remedying this and designing cars to run on ethanol and corn fuels. This technology is already being used today. Even battery powered cars are on the roads; cars that dont use any type of fuel except battery power. This is another form of green technology. Solar heat and power are another form of energy that is green. Solar heat can be captured to heat water. This type of energy is already being implemented in the world today. Solar panels capture the suns heat and this is used to heat water plus used for power to run lights in homes. Some homes are totally powered by solar panels as are prototype solar cars. Even geothermal energy is used in certain geographical areas of the world to run generators by steam. Wind power also runs many items, including homes that would normally rely on electricity to power lights, appliances, etc. Manyà ¢Ã¢â€š ¬Ã‚ ¦fields of wind turbines are being built in areas of the world to take advantage of constant winds to provide economical and sustainable energy. (EzineArticles, 2010, para. 4) Another source of green energy would be the use of a Magnetic Power Generator (MPG). This would produce free energy indefinitely and power a whole house. This device would not cost much to build-not thousands of dollars-and if you are a do it yourself type of person, you could make one for fairly cheap. According to Greendepot.com, Green building practices, as well as the selection of the appropriate building materials, revolve around a few basic principles of science. (Greendepot, 2010). Using recycled materials to build will result in a totally green building with all parts of the building originating from recycled material from the floor to the walls, ceilings, cabinets, and even furniture can be made from recycled material and when old, can be recycled again. Not only can we build from recycled materials but we can do just about anything with those materials from building homes to landscaping. One material that is being used for home building is called Durisol. These are hollow-core blocks [that] are made from mineralized wood shavings and portland cement, stacked into walls then finished with reinforcing steel and concrete. (Greendepot, 2010) Environmentally Preferable Purchasing (EPP) helps the federal government buy green and uses the governments buying power to stimulate market demand for green products and services. (epa.gov, 2010) It helps agencies within the federal government comply with green requirements and agencies are directed by federal law and such to purchase things with the environment in mind. The EPA created the EPP in 1993 to help meet the already mentioned requirements. Green chemistry reduces or eliminates the use of hazardous substances. It applies across the life cycle of a chemical product, including its design, manufacture, and use (epa.gov, 2010) It reduces or eliminates negative environmental impact and is an effective approach to pollution prevention because it applies solutions to environmental problems and situations. The 12 Principles of Green Chemistry was originally published by Paul Anastas and John Warner in Green Chemistry: Theory and Practice (Oxford University Press: New York, 1998) and provides a guide for chemists to implement Green Technology (epa.org, 2010). The twelve principles are as follows: Prevention Atom Economy Less Hazardous Chemical Synthesis Designing Safer Chemicals Safer Solvents and Auxiliaries Design for Energy Efficiency Use of Reusable Feedstock Reduce Derivatives Catalysis Design for Degradation Real-time Analysis for Pollution Prevention Inherently Safer Chemistry for Accidental Prevention (Anastas, P.T; Warner, J.C.; Green, 1998) Currently, China is a world leader in the manufacture of solar panels and research into carbon capture, the process of burning coal while not emitting greenhouse gases. This country is providing a model of how countries should foster a green economy.(RONAN McGREEVY.   (2010,  November  13) Nanotechnology is defined as the art and science of manipulating matter at the nanoscale to create new and unique products and materials. (Project on Emerging Nanotechnologies, 2010). The nanoscale is the scale of atoms and molecules. As products are made using the nanometer-scale, there is a growing demand for this technology to help clean up the environment by reducing pollution and trying to produce a cleaner environment and economy. It is easier than we may think. Experiments with nanotechnology are happening all the time. Using this nanotechnology, science has been experimenting on all types of things. From using DNA molecules in processes to building nanoscale patterns on silicon chips and other surfaces to print things (versus lithography) to removing arsenic in a solution base and by being able to detect pollutants at the level of parts per billion. (Project on Emerging Technology nano (2007, April 26). Nanotechnology has opened promising routes to improving and lowering the cost of fuel cells and is leaning toward tools for removing toxic and hazardous materials in waste sites. This kind of technology is essential if we are going to clean up our planet and it is a growing technology to be sure and, according to Lux Research, in 2005, more than $30 billion in nanotech products were sold globally. This figure is estimated to grow to $2.6 trillion by the year 2014. Green technology is an every-growing technology to find what is best for our planet and its continued survival and evolution. We cannot continue down the path we started on years and years ago or we will not have a planet that will sustain life. Using green technology will allow us to clean up our rivers, lakes and waterways as well as our environment. Recycling is one way to do this. Not only does this help us use waste materials but it keeps these waste materials out of dumps and landfills. Even appliances are going green. A plug, developed by 2 brothers, called the GreenPlug, plugs into a normal wall outlet, between the wall and the appliance, and stops excess power to the appliance. It stops the flow of unused energy to the appliance thus saving on energy and power. The GreenPlug helps appliances cut down on the amount of energy that they consume and it will add to the life of older appliances as well. There are hopes that green technology can jump-start the economy which has been failing and struggling. By implementing green technology, it is going to be the next global job and wealth creation engine. (McNally, S., 2009) But green technology has a long way to go before it can become a key in the economy. It has not been around long enough to make an effect as yet. Green technology is still so new that it is going to take a long while before it will put any kind of dent in the recession we are currently in. It is going to take a lot of initiative on the parts of companies; both small and large. Green technology will more than likely come first to the health and transportation sector as both are made more efficient by governments. The economic downturn makes companies more susceptible to change and change, like green technology, will probably be embraced quickly because of the openness for change that is currently felt all over the world. There are so many ways that we have already begun to use this technology. The postal service in Key West, Florida, for example, has begun using electric delivery carts instead of automobiles. Not only the postal service but other government agencies as well are trying to make transportation eco-friendly. Other areas are seeing solar power as an alternative to electricity. There are solar powered homes, businesses, and just recently, electronics are becoming solar powered. Like the worlds first solar powered keyboard made my Logitech. It is also wireless which means it can be completely recharged just by putting it in the sun or any other light source. Every part of the keyboard, including the packaging, is recyclable making the first green keyboard. As we continue to evolve, so does the world around us. In order for this world and planet to get cleaned up, we need to keep experimenting with the things that will ultimately make this world cleaner and better. All the cleaning up in the world makes no difference if we do not have a plan to turn green and make things eco-friendly. We will always have some sort of solid waste but even some of that can be turned into something that is usable and reusable. Even sewage can be used as a means of a heat source. Cleaning up our planet is of the utmost importance and finding new way to do that can be done. Recycling and e-cycling need to be important and we need to pursue and continue to pursue every avenue until this planet goes totally green. That is our future; our goal. Social awareness about the need for cleaner, environmentally-friendly products and services is crucial if we are to clean up our environment. Academically, green technology needs to be taught to our children as well as learning about it ourselves. It should be mandatory that our children be taught; not only our elementary children but college students as well. The industrial segment needs to be pushed forward to come out with more environment-friendly production and consumption processes. Various incentives need to be given to the industrial sector, which is ready to innovate and implement green technology. (Green technology is the future at large.  (2010,  November  14). Businesses need to man up and do their part as well by going green and having their employees do the same and give incentives for doing so. We all have to start somewhere and the big and small businesses need to do their part too. By recycling products that we use every day, we come closer to turning our environment green and cleaning up our world. Other countries need to know this technology and need to implement it. Without the technology, we will inevitably end up destroying ourselves and our planet. Going green with green technology is the only viable conclusion.

Patient Safety

â€Å"There is a huge missed opportunity for health care professionals to contribute to hand hygiene as they miss 1 in 2 of all hand cleaning opportunities. † –WHO, 2006 â€Å"What kills women with childbed fever is you doctors who carry deadly microbes from sick women to healthy ones! †Ã¢â‚¬â€Louis Pasteur, 1870 1 . 1. Background of the Study 1. 1. 1. Nosocomial infection burden Nosocomial infections or healthcare acquired infections can truly be a grave toll for hospital management as much as it is for end-beneficiaries, customers, and stakeholders.Mortality reaches 80,000 annually ; 3 patients die per minute ; 10-20% % incidence globally, and figures are expectedly higher in Third World settings. This is not to mention the corollary problem of emerging microorganisms resistant to overuse of prophylactic and anticipatory shotgun antibiotic therapy as empirical solution. The damage wrought is paramount, reaching a cost of one billion pounds per year in Europe a lone, resulting from these. 1 excluding priceless, needless mortalities and morbidities 1 1. 1. 2.Role of Hand Hygiene Institute of Medicine has identified nosocomial Infection to be the most common complication for hospital patients and hands are the most common mode of transmission. In 1991, Harvard Practice Study on adverse events in health care indicated that surgical site infections were the second most frequent type of adverse event for inpatients, constituting 13%. One study established an excess mortality caused by NI to as high as 44% in ICU patients. 2 In a local study at Makati Medical Center by Tupasi & Littaua, mortality rate was reported to be all NI cases documented 4. 6 % of n the intensive care unit , and authors conclude that risk factors included invasive and manipulative procedures. â€Å"Majority of deaths from NI were associated with the use of respiratory equipment and Foley catheters which were potentially preventable by strict adherence to aseptic technique s†. 3 1. 1. 3 Reality of Poor Compliance Despite it being a seemingly simple practice, and despite the acknowledged fact that proper hand hygiene is considered the most critical, the most cost-effective measure of adequate infection program, compliance behavior management has been a protracted managerial headache globally.Indeed in our age of ever increasing sophistication, those seemingly simple practices but with grave implications ironically are difficult to address. While the techniques involved in hand hygiene are simple, the complex interdependence of factors that determine hand hygiene behavior makes the study and management of hand hygiene complex. 2 1. 1. 4. Hand Hygiene Compliance : A Managerial Challenge It is now recognized that improving compliance with hand hygiene recommendations depends on altering human behavior and managing the environment.Input from behavioral and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social need4 Speaking for all levels of health care workers , probably the major reason this seemingly simple problem is always taken for granted is the reality that the impact of something not so visible daily to the naked eye will always be swept under the rug amidst more outright demands concerns in patient care.The rest of the justifications like forgetfulness, lack of time, inconvenience, complications, etc. are simply alibis. Given this, the greater burden falls on health care managers to do something so that compliance can be improved, and for health sector in general to come up with more evidence-based materials to convince HCW as well as policy-makers and managers about its importance. 1. 1. 5 Nosocomial Infection & Patient Safety Nosocomial infection control is a large part of patient safety, whose importance is currently being highlighted in the light of increasing adverse even ts which are at most preventable.Prior to this study, the researcher delved into assessing the patient safety culture profile of QMMC, as a general backgrounder, and as part of re-packaging a new approach to an old problem. 3 1. 2. Statement of the Problem Understanding the patient safety culture profile of Quirino Memorial Medical Center gives us the over-all conceptual perspective to the problem at hand. The researcher finds it convenient to discuss it in terms of the Donabedian theme. 1. 2. 1. The Macroenvironment’s Patient Safety Profile 1. 2. 1. 1.The QMMC Patient Safety Structure In alignment with the recent health care thrust, QMMC has revised in 2008 its mission to being â€Å" a tertiary hospital providing a safe, accessible, affordable quality specialized healthcare that is dynamically responsive to the needs of its patients. † Its unwavering commitment is towards delivering health care to all its clients regardless of socio-economic status and to continuousl y upgrade the services offered in terms of technical expertise, support service, equipment and infrastructure. Patient safety is first and foremost in its goals.Its core values include cleanliness in all aspects including the physical environ, and Its fourth priority is â€Å" to develop and sustain a hospital environment that embraces and practices a culture of safety†. The 7 core values it internalizes include the 7Cs: clean physically, mentally, spiritually, Christ-centered, compassionate, competent, culture-friendly, community-oriented, communicative. At this time, the plus factor is having a medical director who is passionate about the cause, much involved in regular meetings with Department of Health advocates on the matter. â€Å"In QMMC, Dr.Rosalinda Arandia is seen as a charismatic figure in the improvement of health and medical 4 services offered by the hospital and in making recommendations on and implementing the hospital’s quality improvement program. â⠂¬  5 QMMC is a 350-bed national government hospital that stands in a 42,000-sqm lot between Katipunan Avenue and JP Rizal St, Project 4 Quezon City, Metro Manila. It has in recent years undergone a major upgrading and expansion of its buildings and facilities. Compared to the old infrastructure, the new building and facilities, provide a more sophisticated ambience.Better equipment and architectural upgrading seem to inspire and motivate employees, and the architectural design seems to promote greater staff interaction and communication. Its occupancy rate is 120%. . QMMC is a corporatized government hospital, still waiting for complete privatization. When faced with budgetary constraints and too bureaucratic processes they generate their own resources through private solicitations, the biggest of which are donations and affiliation fees from training institutions.As to equipment & supplies due to its being a government hospital, only about 60% of its equipment and supplies are pr ovided for and is functioning at any given time. Maintenance and regular checks are being done and complied with as required. It has a total of 564 employees, 35% of whom are contractual. Among the permanent about half have worked for more than 10 years. Among the 549 employees, 159 are doctors (consultants, residents, interns) , 180 are nurses and 225 are administrative personnel. This number does not include those who are fielded from affiliate institutions for training, such as clinical clerks and allied 5 rofessions (nursing, pulmonary therapy, radiologic therapy, medical technology, dental, dietary, midwifery and caregiving). For the consultants and doctors, ratio to patient load is quite acceptable.There are 69 resident physicians and 55 interns. In the wards, roughly the ratio is 1:5 per day; however in the out-patient department, the staff ratio is much higher 1:25 . In the intensive care unit, ratio can be improved to as good as 1:2 depending on the number of rotators from affiliate hospitals , for all professional groups. Attitudes of staff are an important aspects of culture. In QMMC, initial preliminary interviews ith staff revealed that there is some awareness of the concept of patient safety, in all levels of care and even administrative strata. Incident reporting is very minimal such as it is generally perceived that underreporting is rampant. 1. 2. 1. 2 The QMMC Patient Safety Process Profile Teamwork in respective clinical areas is perceived to be good by key administrators, although with the high rate of staff turnover due to training hospital affiliations, this is affected more often than not in a negative fashion. In terms of feedback and communication, there is no systematic evaluation of staff performance .QMMC has been active in the Patient Safety Task Force of the Department of Health. Underway are devising standardized hospital forms, such as interdepartmental referral forms to enhance communication and lower risks of errors being comm itted in patient care. 6 In lieu of risk reduction, hand hygiene educational program has been recently revived by the Infectious Disease Team headed by Dr. James Tiu. Educational trainings as well as policy reinforcement are being conducted as the need arises among nursing staff. 1. 2. 1. 3. The QMMC Patient Safety Outcome ProfileAt the time of study, there were no baseline data available as indicators such as compliance rates, nosocomial infection rates, or patient satisfaction surveys. There are no performance indicators that can be used as feedbacks to improve standards of care. This is a work in progress and hopefull this study becomes a tiny contribution. 1. 2. 2. QMMC’s UncontrolledNosocomial Infection Problem Analyzing the above profile of QMMC, and amidst the track record of physical and service upgrading efforts, the main problem of the hospital regarding patient safety is still nosocomial infection control.Evidences of uncontrolled nosocomial infection are certain o ccurrences pointing to infection control problems in QMMC in the past 12 months have caused alarm, as follows: (a) Post-surgical wound dehiscence Anecdotal incidents of nosocomial infection getting out of control have been almost part of everyday work in a public hospital like QMMC. However, a situation that occurred last AugustOctober 2008 was particularly notable, wherein dehiscence occurred in a succession of ten postsurgical patients in two wards including the surgical ICU, during Day 5 to Day 11 of their hospital stay.Culture studies revealed the usual notorious nosocomial Proteus microorganisms, E. coli, and 7 Staphylococcus areus , responsive to very expensive intravenous third generation cephalosporins and aminoglycosides, with or without re-suturing of the wounds (Appendix 1) . 6 Aside from the cost of these medications, the prolonged hospital stay with all its accompanying indirect costs to both patient and hospital were staggering. (b) Perennially high incidence of ICU pn eumonias and urinary tract infectionsBased on the latest QMMC Morbidity and Mortality Audit 2008, 7 among ICU patients hooked to ventilators for protracted duration, nosocomial pneumonias are still the leading cause of death. 1. 2. 3. Need for upgrading quality of hand hygiene practice During one root cause analysis done by the management, the Infectious Disease Committee, and the department concerned with the last year’s outbreak of dehiscence, the senior management surmised that the root problem or one of the root problems could be failure for proper andwashing among health staff. The intervention consisted of culture and sensitivity tests followed by proper antibiotic coverage. Policy on handwashing was also tightened up in terms of posting reminders on doors and walls and subsequent refresher educational modules by the Infectious Disease Head were conducted among nursing staff. However, no actual monitoring or evaluation of hand hygiene practices were done .Despite educat ional training interventions, and despite the presence institutional policies posted on walls and doors, compliance to the practice among QMMC hospital staff has persisted to be unsatisfactory. 8 1. 3. Objectives of the Study GENERAL OBJECTIVE This study aimed to demonstrate the impact of a hand hygiene intervention package to QMMC MICU and SICU, using comparison of intervention.SPECIFIC OBJECTIVES In more detail, this study aimed to : (a) Characterize the current hand hygiene practices in QMMC ICU according to its using structure-process-outcome dimensions; (b) Craft and implement an intervention package addressing manipulable areas of the structure issues identified in the structure-process-outcome dimensions of hand hygiene practices; (c) Measure hand hygiene structure-process-outcome variables as a function of healthcare worker factors and work area factors , pre- and post-intervention, as a way to evaluate impact of above intervention. d) Formulate recommendations to the QMMC m anagement and its stakeholders based on the findings and lessons learned. structure-process-outcome variables pre- and post- 9 1. 4. Significance of the Study The study is valuable in the following general areas of health concern: (a) Infection Control. The study’s advocacy counts very significantly in terms of contributing towards decreasing the grave toll on preventable morbidity and mortality burden on patients and their families.As we see more systematically the outcome of our efforts towards hand hygiene as it impacts infection control, we learn to rely less on antibiotic use which also lead to emergence of resistant microorganisms that are and will be potentially harder to control eventually. This study will then be part of fulfilling what WHO advocates to be done , i. e. â€Å"for better monitoring of outcomes for hand hygiene studies, reduction of infection rates must be demonstrated, high complexity to evaluate, but high priority requirement. 8 (b) Preventive thrust . Hospitals’ mission is supposedly preventive as much as curative. However, review of literature shows that hospitals, even in the First World settings, tend to so conveniently rely on antibiotic use both prophylactically and empirically in managing and controlling nosocomial infections. Hospital care need not be a double-edged sword nor do we need to stop mitigating phenomena which are in our hands to control, if only we heed the evidence-based principles put forth.Prevention remains to be the better direction that health care must devote its resources on. (c) Cost savings. According to WHO, â€Å"direct costs of intervention and indirect costs associated with hand hygiene time & its promotion corresponds to less than 1% of costs of managing nosocomial infection. Studies on the costs of nosocomial infection caused its toll in terms of protracted hospital stay, expensive drug and antibiotic acquisition in addition to intensive care 10 nit stay, hematological, biochemical, mi crobiological and radiological tests, extra surgical procedures and working hours. (d) Healthcare management learning. WHO asserts that â€Å"measurement of the compliance of health care workers to hand hygiene measures is a recommended performance indicator of the quality of care†. (e) Compliance behavior management has been a protracted universal problem, as lack of interventional studies to convince policy makers, esp. local, both government and private, predispose health care systems prevalent to sustain awareness and implementation.With the lack of attention given to the problem’s facets and determinants, this study can be a humble contribution. Relevance of this study to the institution and its various stakeholders include the following: (a) Study institution. Often, organizations take action based on some comparison of their measures to a set of benchmark measures. Armed with specific incidents about the organization's culture, effective action plans flow logica lly and integrate into existing change processes.QMMC can better select programs and tailor-fit strategies that will be most beneficial to upgrade the attitudes and mindset of the employees, to design the working environment, and to align with its vision-mission pursuit of quality and safety , and better service to patients. It will be helped to see patient and hospital outcomes in a better light. It will eventually have a baseline which will be useful for tracking impact of certain interventions for a sense of comparison. As it uses internationally known research methods, it will provide 1 internal as well as external benchmarking, especially with national government hospitals, both international and local. (b) Leadership. Since QMMC under the present leadership is into the process of advocating patient safety as a goal, this study will help them examine alignments of their policies and systems with their vision-mission statements , goals and core values. Later on when like in inte rnational settings and patient safety will be a government regulatory requirement, this hospital can provide benchmarking. (c) Hospital staff.This study provides the staff the much-needed feedback about themselves, the colleagues they work with, and the patients they serve. Feedback is the first step to change. Studies such as this are advantageous in themselves in that it just the simple process of assessment baseline will in itself raise awareness of not only patient safety, specifically, infection control, but of the need for structure (staff attitudes) as well as process variables (teamwork, communication) relevant to safety and other hospital performance.Moreover, they themselves can be target victims of nosocomial infection, so that studies like this could help boost their safety as well. (d) Affiliate training healthcare institutions. The importance of good hand hygiene practice and its observance will be highlighted among the trainees from more than 20 various health care sc hools, a value that they will most likely carry back to their respected institutions .This is rather crucial and innovative as patient safety, specifically preventive practices to 12 nosocomial control such as hand hygiene are not yet that well-emphasized in the traditional medical and para-medical curricula. (e) Hospital management trainees. The results of this study can be a benchmarking study to compare, study and upgrade other hospitals, both local and international. The study becomes a venue to validate some of the tools that will be used for the first time locally.Results of the study can be utilized by trainees for future research on patient safety and infection control and behavior modification techniques. (f) Healthcare community. This study will help control NI, emergence of resistant organisms for similar government hospitals. It provides significant research for Department of Health which is specific on approaching infection control through Total Quality Management asses sment and strategies under their recent thrust on patient safety and quality assurance.Since QMMC could very well be a good prototype of the other government hospitals , the results of this study can largely be of help in implementing the various enabling mechanisms stated in the Philhealth Benchbook. 9 (g) Patients. Above all, since awareness, education , and practice towards patient safety, specifically infection control will be highlighted in this study, the end beneficiary would ultimately be the patients and their families and guests whom this institution is servicing, no matter how indirect and long-term this impact would be. 3 1. 5 . Scope and Limitations of the Study †¢ Being a primarily TQM research project, this study does not attempt to establish cause-and-effect relationship between hand hygiene and nosocomial infection . †¢ This study does not include cost estimates and budgetary implications of intervention if eventually adopted by study institution. †¢ Relative merits of the specific parts of the intervention is beyond the scope of the design.†¢ Time and budget constraints were real such that research design were limited in various ways and means. . 6. Definition of Terms and Acronyms TERMS: For purposes of clarity and reference in the discussions all throughout this study, the following definitions and acronyms would be used and referred to: Hand hygiene (HH)- refers to one of the areas in infection control that deals with systems of diminishing pathogenic microbe transmission through evidence-based philosophy and set of practices regarding the hands in relation to direct patient handling during the process of care. 0 14 Hand hygiene practice/practices (HHP) – refer/s to any form of action referable to disinfecting the hands prior to and after patient handling, in the most basic terms defined as â€Å"washing hands with soap/water or (rubbing with) disinfectant, for at least 15 seconds before and after patient contac t, after any contact with a source of microorganism, and after removing gloves†. ( Healthcare Infection Control Practice Advisory ).Hand hygiene event (HHE) – defined as the event involving any of the HH practices (washing, rubbing with disinfectant, donning with gloves) done before or after patient contact; (if both done before and after, they are considered independent events ; if both washing and donning with /removing gloves are done during one instance, it was counted as one event; this regardless of the correctness or adherence to other details as presently prescribed by currently available universal guidelines. 1 Hand hygiene opportunity (HH0) – defined as any event with a high-risk of microbial transmission, executed before and/or immediately after patient contact, regardless of whether gloves. They included all contact with body fluids, or involving manipulative contact with anything in the patient’s body or immediate environment .Over-all hand hy giene compliance – includes all hand hygiene-related behavior in accordance with current institutional , (in this study, QMMC’s ) policy â€Å" to wash hands before and after patient contact† regardless of its alignment with the most currently recommended international standards based on indication, technique, cleansing agent and duration ; this by strict classification based in literature definition, falls under â€Å"incomplete compliance†. 12 15Complete compliance- refers to all hand hygiene-related practices aligned with the most-updated, most current evidence-based globally recommended guidelines, as required by WHO guidelines 2006 (with QMMC, being a government hospital). Hand hygiene structure-refers to staff factors and work area factors. Staff factors include inherent demographic characteristics, such as professional group, age, sex and duration of service. It also refers to more malleable factors such as staff attitude and training.Work area fac tors refer to existing policies or specific protocol, logistic infrastructure and supplies, staff volume, patient volume, hospital type, work settings, organizational structure, etc. Hand hygiene process- refers to practice as to how it is done in terms of indication for method, duration, temporal relation to patient contact, cleansing and technique, and how it abides to the currently recommended evidence-based a guideline or protocol .Hand hygiene outcome- refers to measurable events or indicators, for both patients, employees as well as organization; like overall healthcare worker compliance rates, as well as indirect outcomes of good hand hygiene proven in literature, such as nosocomial infection rates, transmission rates, colonization rates. ACRONYMS: For purposes of brevity of certain words and identities mentioned quite repeatedly all throughout the study, the following apply: 6 HCW- Healthcare worker; refers to any staff involved with direct handling of patients in a health f acility NI- nosocomial infection; also HAI (healthcare acquired infection); refers to infection developing after 48 hours after admission or confinement in a health care facility. ABHR- alcohol-based hand rub-refers to a hand rub disinfectant with any alcohol of any concentration as the basic ingredient.

The Career Path Of Attending College - 1656 Words

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Gentrification Of The South Parkdale Neighborhood - 857 Words

The gentrification process can be seen through the demographic and physical changes of the South Parkdale neighborhood. Gentrification is â€Å"the invasion of working-class areas by the upper- and middle-classes, who upgrade shabby, modest housing into elegant residences, resulting in the displacement of all, or most of the original working-class occupiers†. (Lyons, 1996) South Parkdale is a neighborhood in downtown Toronto that faces problems of gentrification. This problem has been ongoing since the nineteen fifty’s’. Thesis: Therefore, focusing on the principal factors that led to South Parkdales economic decline and social problems, consisting of The creation of the Gardiner Expressway started South Parkdales abrupt decline. By 1959, the neighborhood was detached from Lake Ontario; they no longer had access to the waterfront. Due to the placement of the Gardiner Expressway, â€Å"more than one hundred and seventy homes were torn down†. (Slater, 2004) Displacing those whom were forced to pick up and leave. As early as the beginning of the nineteen sixty’s, several high rise apartments were getting built. They built these apartments with the intent to keep those citizens who had lost their homes in the area. In spite of this, because they were low income rental properties, many of the higher and middle class occupants moved to the suburbs. Prior to building the Gardiner Expressway the intensions of building it were to make South Parkdale a place for business; advertising to the

Obesity The United States - 1268 Words

Joy Ekeoma Professor Beamen English 102 – OL 20 October, 2015 Obesity in America Over the past few decades, obesity rate has grown drastically in the United States. â€Å"A third of U.S. adults are obese† (Brady 519), placing them at a higher risk for diseases, and increased healthcare spending. It a preventable nutritional problem that affects people of all ages, gender and race, with minority groups and people of low socioeconomic status disproportionately affected. It is a multifaceted problem with many issues at its root. Obesity is the result of our agricultural policies, present economic condition, and unhealthy lifestyle. Food is critical to human survival; however, cheap food although an indispensable part of our current economy does†¦show more content†¦Astyk and Newton, in their essay: The Rich Get Richer, the Poor Go Hungry, explains that â€Å"around the world, industrial agriculture has consolidated land ownership into the hands of smaller and smaller populations† destroying local self-sufficiency (518). Individuals are no longer able to grow own fresh, healthy foods to feed their family. They now depend on industrially grown crops and processed foods loaded with chemicals for food. Additionally, because of the farm policy, farmers that continue to cultivate healthy produce like fruits and vegetables get little or no government support, thus the higher prices of fresh produce seen today at our grocery stores. With this increase in the productivity of farmers, came a proliferation of food processing industries and fast food restaurants. These food processing industries and restaurants capitalized on the abundant, overly cheap commodity crops to their advantage; to make profit, and to the disadvantage of poor Americans. During processing of these commodity crops, the natural nutrients that give these foods their natural flavors are destroyed. To replace these, food additives and flavorings are added to restore their taste and prolong their shelf life. Often these chemicals contain some harmful elements that affect the way our bodies use food. These highly processed foods, dense in calories,

Negotiation Between Countries Free Essays

I want to do that from three different fronts, namely; Cultural differences in communication The patterns of communication between the countries are different even though tooth countries communicates basically in English language as an accepted language of communication. Communication in this sense can be verbal or non-verbal. Non- verbal also Includes written communications. We will write a custom essay sample on Negotiation Between Countries or any similar topic only for you Order Now Nigeria has over 400 languages but English language Is the accepted lingua franca. The united States has other native languages but English Is still the accepted language of communication. Though I will communicate in English with my American business partners but I must also understand that the way the Americans write and pronounce some words is different from the way we write and pronounce our words in English language. The American counterparts for instance will write the word â€Å"favor as favor† but I will write the word â€Å"favor as favor† because Nigeria was colonized by the British, so we take our language after the British pattern of writing and communicating. Nigerian are exclusion minded in communication; we will tend to see how the conversation does not align with what we already know and would usually want the American counterpart to align with our own position of knowledge. The American partner will rather communicate based on an Inclusive mindedness; they will rather want to know how what I am saying makes sense. American look for the sense In the conversation, does the numbers tally, are the figures correct, so they have a broader view to the conversation. Also Most Nigerian communication style follow after the collectivists’ culture; (Grove Hallowed; 1994) â€Å"Collectivists convey negative feedback indirectly via an intermediary or by quiet withdrawal of a perquisite. Sometimes they omit saying anything that’s negative. If you are managing employees in (or from) a collectivist culture, you might not find out what’s going wrong in your operation until the proverbial eleventh hour; there’s deep reluctance to upset group harmony by ailing you the bad news†. This means we would rather not say â€Å"no† to you openly even though we disagree, but we will rather let the conversation go on peaceably until we have another time to object to most of the Initial points of our conversation. My American partner would rather tell It the way It Is If It doesn’t go down with them. (Grove Hallowed; 1994) They pattern after the Individualist culture In conversations. Generally speaking, American culture communication style are usually Comfort talks, they are emotionally objective and practical in approach, their interactions are usually very direct and open. They don’t hide any cards off the table, they play all the cards on the table. But when it comes to reactions, they react to issues analytically and they remain persistent in their analysis until otherwise convinced. These are the factors that influences how Americans communicate. Cultural differences in negotiation and conflict-resolution Let’s think of a scenario of negotiation with our U. S. Partner for a presentation from an IT company overseas. The American makes his presentation very apt and technically done by expressing his overwhelming objective points and reasons why the product is best for my company in Nigeria. Well, we would say â€Å"the presentation is brilliant but I still do not trust this guy. He thinks objectively while I think subjectively, so our negotiations can either stall or proceed based on how we handle this cultural differences between our cultures. (Mimicked, 2010) To most Americans, difference is a threat, they will naturally tend to overl ook similarities and take note of the difference when they first begin the negotiations. We Nigerian are looking for similarity with what we already know and experience, similarity makes us comfortable in the negotiation. During negotiations with Americans, you must understand that they hate silence, and they would often interrupt you at intervals during negotiations, while that is rude in my country, to interrupt someone while he is still talking, the Americans have that as a normal way of life. Cultural differences in problem-solving and decision-making In terms of problem solving, the American approaches it from a highly objective point of view, they would naturally first carry out a critical analysis of the problem and then cake decisions based on the facts on ground. While we Nigerian usually make decisions based on sentiments sometimes, we decide to enter a business agreement when we feel intuitively inclined to do so, there is mostly no objective reason except we feel convinced inside that this is a good buy so we make the money decision. I would first seek an understanding of the cultural differences that have been highlighted earlier. After which I will approach the negotiation objectively, knowing that is how my American partner thinks. I will also approach most of our negotiation room an individualist point of view while also letting my American friend understand the collectivist point of view. My approach would be to achieve a win-win situation. In my country I can afford to have a win-lose situation during negotiations but I understand that the American is highly objective and would not go by my sweet talks or by my expressing an overwhelming emotional conviction about the business I am trying to sell to him. So my thought pattern will naturally change from when negotiating with my fellow country man. The factors of negotiation and business allegations to consider in this case would be; Listening skills- I will need to be more active in listening so that I get the objective point the American is making rather than rely on my emotions to guide my decision making in the negotiation. People skills – I need to feel comfortable with our differences and not look hard for similarities between us before I connect with the American counterpart. BATAAN – I must establish what the Best Alternative To Negotiated Agreement is. This is vital to my than what I may have done otherwise. The BATAAN is what I can or might do if an agreement cannot be reached. This is my final position in case an agreement is difficult to reach. Have a Plan – I would consider having a plan ahead of the negotiation. My plan would likely include the following: (Yachted, D; ND) Trying to establish the negotiating style of the other party. This helps me think through how best to communicate and go through the process of negotiation and making educated guesses as I go along. What are my interests? This is gives me a perfect reason to answer the question of why? Before the negotiation. What is my real interest? What are the interests of the American Partner? I must understand where y American partner is coming from what are the shared interests we have and what are the opposing interests. Opposing interests is what I must negotiate. What do I have that I can trade that is of lesser value to me and of higher value to the American Partner? This helps me consider the options in the give and take phase of the negotiation. I must know beforehand what I can trade off at any time during the negotiation that is of a lesser value to me and of a higher value to my partner. What are three options I can implement to move the negotiation from compromising to joint problem solving? How to cite Negotiation Between Countries, Papers

Hospitality Management Crown Resorts Limited

Question: Discuss about the Hospitality Management Crown Resorts Limited. Answer: Introduction The hospitality industry entails the provision of quality goods and services in restaurants, casinos, hotels, and resorts (Brotherton, 2012, p. 6). Crown Resorts is an Australian based company ranked 92 out of the largest 200 companies in the country. Crown Resorts Limited operates in the casino, entertainment, and gaming sector which all fall under the hospitality industry. Crown Resorts operates various gaming and entertainment complexes in Australia such as Crown Melbourne, Crown Perth, Crown Aspinall's, and Cannery Casino Resorts among others. These complexes deal with hotels, casinos, entertainment, convention centers, online social games, and accommodation services to the tourists and other visitors. Domestically and globally, Crown Resorts faces stiff competition from other hospitality companies some of which include: Wynn Macau Limited, Wynn Resorts Limited, MGM Resorts International, Vail Resorts Inc, and Melco Resorts and Entertainment Limited among others. The target marke t of Crown Resorts is both children and adults of all ages, both local citizens, and tourists from other countries. The company is extending its venture across Asia and establishing a global luxury brand based on the highest quality hospitality services. Production Systems Production systems involve the processes, procedures, arrangements, and methods which comprise all functions needed to accumulate the inputs, processes, and deliver the marketable outputs to the target market by the company (Chermack and Kasshanna, 2007, p. 390). In the hospitality sector, a production system consists of inputs and processes aimed at delivering quality hotel, casino, gaming, and entertainment services to the tourists. The management practices of Crown Resorts in respect to the production systems are explained as below: Service Transactions The service transactions undertaken at Crown Resorts are characterized by guests experience and staff performance. The company offers site entertainment, food, casinos, convention centers, and online social games as the primary service transactions. The involvement of tourists and the internal employee's team at the company are critical elements of service operations (Coman and Ronen, 2009, p. 5680). The management recommends quality control where a high standard of service transactions is achieved at little or no defects. The company empowers employees to address guests issues by focusing on transaction services that improve the quality of hospitality services. The current strengths of Crown Resorts service transactions underly on the quality of hospitality services to guests and tourists, defect free services, efficient operations cost controls, positive employees behavior, ability to satisfy guests entertainment needs and desires, excellent responses to guests complaint, and simultaneous delivery of accommodation, online social games, and entertainment services (Evans, Stonehouse, and Campbell, 2012, p. 90). The company enjoys highly skilled and qualified staff who ensure that these input services are deliverable to the target market in the right processes, methods, and procedures. As a result, Crown Resorts has generated a long-term advantage in the hospitality sector, and this provides the firm with a competitive edge over the rivals. On the other side, there are weaknesses faced by the Crown Resorts in its internal entertainment, casino, hotel, food, and gaming services to the guests. These shortcomings include ineffective corporate culture, wrong public perception of the image of the firm, strict need to adhere to the set government regulations, adverse corporate governance issues that prohibit casino gambling, and lack of conducive business environment (Groover, 2007, p. 76). The weaknesses hinder the cash-flow sensitivity analysis since the hospitality manager is mandated to combine financial knowledge with the sector experience so as to offer comprehensive and reputable services to the target market in the hospitality industry. Maintenance The hospitality manager is entitled to set goals, plan, organize, and control all the operations of Crown Resorts. The inputs involved in the maintenance of entertainment, casino, and gaming services of Crown Resorts both domestically and globally include: minor electrical equipment for repair and replacement of appliances, casino gaming machines, computer repair technology programs, music system, and well furnished sleeping logins among others (Hall and Gssling, 2013, p. 45). The hospitality manager always directs the maintenance and repair of these inputs so as to provide high-quality output entertainment, casino, hotel, and gaming services in the hospitality sector. The set down work policies, procedures, and processes are strictly observed when offering these services to the guests and tourists. The strengths underlying this production system include consistent cross training of service employees, involvement of personnel in setting maintenance standards and processes, valuing staff as the most important asset of the firm, established technology reward programs, high quality music systems, technologically casino gaming machines, and high quality sleeping rooms (Ivanov, 2014, p. 12). These strengths provide the company with a competitive edge against the competitors and hence making it thrive in the market. Based on the analysis of inputs, processes, and outputs of maintenance production systems of Crown Resorts, the hospitality firm faces various internal weaknesses. These evident weaknesses include failure of the maintenance manager to make employees the product, high maintenance costs, insufficient capital for cross training employees, inability to understand visitors and restrain from beauracratic maintenance approaches, and poor record maintenance which leads to poor planning in the next summer event (Markham and Young, 2015, p. 58). Repairs Crown Resorts Limited has a reconfiguration model based on repairs approach. Crown Resorts deals with a broad range of services which require advancements, and this needs adaptable production system. The inputs used in repairs production system of Crown Resorts include refrigerators, certified technicians, digital matrix processors, wall mounted DCP1V4S panels, and MTX3 scene memory repair systems (Testa and Sipe, 2012, p. 650). The hospitality manager has assigned work to a repairs manager whose role is to sent technicians who can fix any problem that arises to the restaurant's HVAC system. The desired outputs of these technicians processes are ensuring that the HVAC hotel systems work well and keeping the entertainment site conducive and comfortable for the guests. The strengths involved under this production system of Crown Resorts Limited have helped the company reap the maximum profits and adaptability in the hospitality industry. These strengths include: highly qualified, skilled, and innovative technicians, comfortable restaurants, conducive HVAC fans, delicious meals which attract many tourists, the ability to understand duct and fans positioning, and well maintained walk-in coolers (Testa and Sipe, 2012. p. 640). Capacity to employ highly qualified technicians enables the company to run its restaurant, gaming, and casino services efficiently since the technicians are ever present to repair any breakdown occurring. However, grounded on the above inputs, processes, and outputs of the repairs production system, Crown Resorts if faced by various weaknesses (Slatten and Mehmetoglu, 2011, p. 98). The weaknesses underlying the replacement production system of Crown Resorts include high costs of repairs, potential disaster occurrence, the repair processes endanger the health inspection status of the company and customers, machine breakdowns, and the challenge of drafty conditions by the poorly functioning restaurant HVAC system. These weaknesses create a loophole over which the company gets competed out by its main competitors such as Wynn Resorts. Production The senior hospitality manager of Crown Resorts Limited acknowledges the production system as the best tool for estimating employees performance as well as maximizing the quality of service delivery to the target market. The key input elements of the production system in Crown Resorts include PA entertainment systems, qualified comedians and experts, attractive hotel structure across the country, and revenue management systems (Slatten and Mehmetoglu, 2011, p. 100). The desired outputs deliverable from these inputs include providing optimal room allocation to the guests, offering fun and quality entertainment to the tourists and visitors, and ensure dynamic pricing of hospitality services in the company. To achieve these desired inputs, the manager is aided by various internal strengths. These advantages present to the company in the production system include: highly equipped revenue management software, highly technology based entertainment and music systems, high quality hotel production structures, transformation systems, and top quality adhesive magic tape for automatic music production for the entertainment of the guests (Riley, 2014, p. 34). This ability of Crown Resorts to transform the production processes has made it difficult for the competitors to produce the same quality of entertainment, gaming, and hotel services to the guests. However, there are various weaknesses facing Crown Resorts internally which require the senior hospitality manager to address with immediate effect. These production related weaknesses within the company include: machines breakdowns, lack of logistical support, improper control and monitoring of tools and equipment, negligence by some departmental managers, and unpredictable production output levels due to climatic variations (Marodin and Saurin, 2013, p. 6680). These challenges lower the performance of Crown Resorts in the hospitality sector. Delivery Delivery is the final production system used by the management of Crown Resorts in delivering its entertainment, casino, hotels, and gaming services. The management of Crown Resorts uses various inputs to provide these services to the target market. The inputs include highly qualified hospitality staff, policy makers, delicious dishes, comfortable accommodation, and entertainment programs (Hjalager, 2010, p. 6). To deliver these services, the management uses transport agencies to carry guests from the airports to the company's premises, employ personnel to direct the visitors, and in strict adherence to the delivery processes and programs set by the enterprise. By this doing, quality entertainment, accommodation, gaming, and casino services get provided to the customers as the end output. The management of delivery production systems has assisted the senior hospitality management of Crown Resorts to achieve the set goals and deliver high-quality outputs (Chon, and Yu, 2012, p. 88). This has been enhanced by various strengths which include the recruitment of professional hospitality personnel, excellent service delivery processes, positive reputation from the public, loyalty by the target market, and customer recognition programs. On the other side, the company faces various challenges that to some extend hinder delivery of high-quality services to both the existing and potential target market. These weaknesses include unpredictable weather patterns, inability to use the previous data in designing the expected numbers of guests attendance, high delivery costs, large pays offered to hospitality personnel, competition from other companies, and unfavorable government policies (Chang, Gong, and Shum, 2011, p. 815). The managers have responded to these weaknesses by establishing rules, processes, and procedures of cost versus benefit analysis when initiating delivery production systems. Interrelationship of the Five Production Systems The five production systems interrelate with each other in various ways. In a hospitality firm, service transactions, repairs, maintenance, production, and delivery production systems are all based on forecasted demand spells out of the quantity of materials and time needed in delivering entertainment, hotel, gaming, and casino services (Tsang and Hsu, 2011, p. 890). The success of providing services, which in this case is the production goal of Crown Resorts depends upon the smooth integration of all production system segments under all departments in the company. There is the maintenance, repairs, service transactions, procurement, and production managers at Crown Resorts Plc who carefully work under instructions from the senior hospitality manager (Bharwani and Mathews, 2012, p. 410). The integration and interrelationships between these managers and their roles contribute to the success of production system of Crown Resorts since all entertainment, hotels, and gaming services are delivered at the highest quality. However, the interrelationship of these five production systems poses some management challenges for Crown Resorts and these challenges include: Lack of understanding between the different production systems managers which leads to delivery of poor quality of entertainment and hospitality services in the firm. There is high vulnerability to misuse of capital since every manager in a given production system provides a budget which may not be realistic when compared to the other projections in the other systems. There is a high possibility to confuse branding rationale. Interrelationships of these five production systems have made Crown Resorts mitigate customer confusion over brand proliferation and shareholder concerns over cross services impact. Recommendations for Tactical Strategies The analysis of strengths and weaknesses facing Crown Resorts has proved that there are various challenges that the hospitality company faces in its internal operations (Ariffin and Maghzi, 2012, p. 195). The following recommendations should be adopted by the management to overcome these challenges: To gain a positive public image of the company, the management should ensure a sustained delivery of high-quality guests services. Further, the company should engage in corporate social responsibilities by participating in community work. The company should strictly adhere to government policies when undertaking hospitality services to the visitors. For instance, the company should only offer services which it is licensed and always acquire intellectual property rights for the same. The management should train, motivate, and train hospitality personnel as the most crucial assets of the firm. This will encourage the employees to deliver high-quality services and thus retain the customers. The company should conduct thorough marketing of its services to attract more customers and gain a competitive edge against the rivals. In the estimation of guests who will tour the company in the summer time, the company should always maintain past records of visitors numbers, their demands, and their evaluation of the quality of services delivered. Conclusion In conclusion, the hospitality industry has been very competitive. The change in summer patterns on tourist trends remains key to economic growth and a firm's profitability.Production systems play a critical role in the success and functioning of entertainment businesses. The interrelationship of output systems creates uniformity of direction of company's goals. Production systems offer a broad range support and comprehensive management policies which lead to efficiency of business. The fact that production systems have both strengths and weaknesses that affect the functionality of firms means that managers should be ambitious and insightful in evaluating these situations. Therefore, production systems should get integrated into the management systems of business so as to enhance production efficiency. References Ariffin, A.A.M., and Maghzi, A., 2012. A preliminary study on customer expectations of hotel hospitality: Influences of personal and hotel factors.International Journal of Hospitality Management,31(1), pp.191-198. Bharwani, S. and Mathews, D., 2012. Risk identification and analysis in the hospitality industry: Practitioners' perspectives from India.Worldwide Hospitality and Tourism Themes,4(5), pp.410-427. Brotherton, B. ed., 2012.International Hospitality Industry. Routledge. Chang, S., Gong, Y. and Shum, C., 2011. Promoting innovation in hospitality companies through human resource management practices.International Journal of Hospitality Management,30(4), pp.812-818. Chermack, T.J., and Kasshanna, B.K., 2007. The use and misuse of SWOT analysis and implications for HRD professionals.Human Resource Development International,10(4), pp.383-399. Chon, K.S., and Yu, L., 2012.The international hospitality business: Management and operations. Routledge. Coman, A. and Ronen, B., 2009. Focused SWOT: diagnosing critical strengths and weaknesses.International Journal of Production Research,47(20), pp.5677-5689. Evans, N., Stonehouse, G. and Campbell, D., 2012.Strategic management for travel and tourism. Taylor Francis. Groover, M.P., 2007.Automation, production systems, and computer-integrated manufacturing. Prentice Hall Press. Hall, C.M., and Gssling, S., 2013.Sustainable culinary systems: Local foods, innovation, and tourism hospitality. Routledge. Hjalager, A.M., 2010. A review of innovation research in tourism.Tourism Management,31(1), pp.1-12. Ivanov, S.H., 2014. Hotel revenue management: From theory to practice.Browser Download This Paper. Markham, F. and Young, M., 2015. Big Gambling: The rise of the global industry-state gambling complex. Marodin, G.A. and Saurin, T.A., 2013. Implementing lean production systems: research areas and opportunities for future studies.International Journal of Production Research,51(22), pp.6663-6680. Riley, M., 2014.Human resource management in the hospitality and tourism industry. Routledge. Sltten, T. and Mehmetoglu, M., 2011. Antecedents and effects of engaged frontline employees: A study of the hospitality industry.Managing Service Quality: An International Journal,21(1), pp.88-107. Testa, M.R. and Sipe, L., 2012. Service-leadership competencies for hospitality and tourism management.International journal of hospitality management,31(3), pp.648-658. Tsang, N.K. and Hsu, C.H., 2011. Thirty years of research on tourism and hospitality management in China: A review and analysis of journal publications.International Journal of Hospitality Management,30(4), pp.886-896.