Logistics and cloud computing service providers’ cooperation: a resilience perspective

Cloud computing (CC) services can offer substantial cost-effective global operational and relationship benefits if the cooperation between logistics and CC services are resilient. Potential vulnerabilities to cooperation of CC and logistics service providers can occur with respect to vital factors such as security and trust. Extant studies have demonstrated CC benefits as well as few challenges associated with CC services application. However, no extant study has examined the inter-organisational benefits based on cooperative resilience between CC and logistics service providers in terms of both capability and trust vulnerability factors. This study examines the cooperative resilience of logistics and CC service providers based on innovation diffusion theory (IDT) within a supply-chain risk assessment framework. Using structural equation modelling techniques we investigate the relationship between the vulnerability factor (trust), capability factor (security) and collaboration benefits (relationship and operational) offered by CC service providers based on 236 Chinese logistics service firms’ perceptions of cloud computing adoption. The results indicate Chinese logistics companies perceive security impediments as a major factor affecting cooperative resilience between logistics service and CC service providers

Review of sustainable service-based business models in the Chinese truck sector

Growth of global sales of new trucks in emerging economies is substantial however, in China the growth of sales is expected to be only 1% for 2014–2024. The limited sales growth forecast and an intense market competition make it imperative for truck manufacturers in China to diversify their revenue earnings through service-based business models for the Chinese market. Typically, Chinese service based business models need to be sustainable by considering environmental and social factors in the manufacturer’s business model. This paper reviews existing product–service systems (PSS) and service-based business models in the automotive sector to identify how truck manufacturers could reorient their current business model with respect to the Chinese context to enhance customer satisfaction, profitability and sustainability. The analysis indicates that most of the studies in the automotive sector have focused on product-oriented or use-oriented business models with respect to car segment specifically in the developed markets. Besides, sustainability issues related to vehicle end-of-life management are rarely considered. Our findings suggest that the Chinese truck sector needs an integrated result-oriented PSS business model which could be implemented in other developing countries

Port sustainable services innovation: Ningbo port users’ expectation

Port sustainable services innovation depends on understanding and matching customers’ expectations with unique service offerings using advanced facilities. This study develops and validates a port sustainable services decision model to investigate customers’ port services expectations based on the views of companies and freight services providers located in major cities nearby Ningbo port. Thus, the study will enable better understanding of the port’s impact on sustainability of the economic and social prosperity of its immediate environment stakeholders by balancing three major aspects such as services, costs and facilities. The study employed a multi-criteria decision-making methodology Analytical Hierarchy Process (AHP) to analyze the model. The results show that while different port users have different views and expectations, port infrastructure improvement, cargo safety, and reductions in port charges are critical to attract businesses. Port-dependent companies that were investigated also cite reduced paper work and optimized e-business as well as reduced transport congestion as key areas for improvements. This study provides port administrators with insights on how to effectively improve business attractiveness for greater sustainability and competitive advantages with rival ports within the same geographical proximity. In addition it also suggests how to design cost-effective ways of meeting and even surpassing users’ expectations

Critical barriers in implementing reverse logistics in the Chinese manufacturing sectors

Reverse logistics (RL) is gaining momentum worldwide due to global awareness and as a consequence of resource depletion and environmental degradation. Firms encounter RL implementation challenges from different stakeholders, both internally and externally. On the one hand, various governmental agencies are coming out with different environmental regulations while on the other hand academics and researchers are contributing solutions and suggestions in different country contexts. In a real sense however, the benefits of RL implementation is not yet fully realized in the emerging economies. This paper proposes a theoretical RL implementation model and empirically identifies significant RL barriers with respect to management, financial, policy and infrastructure in the Chinese manufacturing industries such as automotive, electrical and electronic, plastics, steel/construction, textiles and paper and paper based products. Key barriers from our study, with respect to these four categories, are: within management category a lack of reverse logistics experts and low commitment, within financial category a lack of initial capital and funds for return monitoring systems, within policy category a lack of enforceable laws and government supportive economic policies and, finally, within infrastructure category a the lack of systems for return monitoring. Contingency effect of ownership was carried out to understand the similarities and differences in RL barriers among the multinational firms and domestic firms investigated

The impact of integrated practices of lean, green, and social management systems on firm sustainability performance—evidence from Chinese fashion auto-parts suppliers

To better satisfy various stakeholders, firms are seeking integrated practices that can enhance their sustainability performance, also well known as the Triple Bottom Line (3BL). The fashion industry exhibits potential conflicts with the spirit of sustainability because of the waste created by high levels of demand uncertainty and the extant usage of resources in production. Literature suggests that selected stand-alone practices of lean, green, and Corporate Social Responsibility (CSR) management systems have a positive impact on firm sustainability performance. However, how the combination of selected practices from these three management systems impacts the 3BL remains unclear. Based on case studies, we build an integrated sustainable practices model incorporating the most popular lean, green, and social practices and develop propositions for future tests. Our framework suggests the implementation of integrated practices would have a stronger influence on 3BL performance than individual practice implementation

Green competence framework: Evidence from China

© 2015 Taylor & Francis Recently human resources management functions such as recruitment, selection, training and performance evaluation are expected in considering environmental management issues. Environmental protective acts with adequate ecological knowledge and socio-economic behavior and skills are referred to in this paper as green competencies (GCs). However, a systematic approach for developing and understanding key factors that enhance individuals' GCs is lacking. This study contributes to green human resource literature by integrating environmental consumer behavior literature with traditional skills and competencies literature to help firms to select the right individuals to achieve their environmental goals. Using Robert's competencies framework and structural equation modeling, this paper empirically examines the influence of individual GCs on organizations' green practices and performance objectives. Our model is tested using a sample of 1230 employees working in key industries in the Chinese coastal city of Ningbo. The results indicate that acquired GCs are more positively associated with individuals' GCs and green behavior. The study empirically demonstrates that verifying acquired GC attributes such as environmental knowledge, green purchase attitude and intention during employee selection would certainly be helpful for firms to identify individual green performance potential

Protocol and statistical analysis plan for the mega randomised registry trial comparing conservative vs. liberal oxygenation targets in adults with sepsis in the intensive care unit (Mega-ROX Sepsis)

Background: The effect of conservative vs. liberal oxygen therapy on 90-day in-hospital mortality in adults with sepsis receiving unplanned invasive mechanical ventilation in the intensive care unit (ICU) is uncertain. Objective: The objective of this study was to summarise the protocol and statistical analysis plan for the Mega-ROX Sepsis trial. Design, setting, and participants: The Mega-ROX Sepsis trial is an international randomised clinical trial that will be conducted within an overarching 40,000-patient registry-embedded clinical trial comparing conservative and liberal ICU oxygen therapy regimens. We anticipate that between 10,000 and 13,000 patients with sepsis who are receiving unplanned invasive mechanical ventilation in the ICU will be enrolled in this trial. Main outcome measures: The primary outcome is in-hospital all-cause mortality up to 90 days from the date of randomisation. Secondary outcomes include duration of survival, duration of mechanical ventilation, ICU length of stay, hospital length of stay, and the proportion of patients discharged home. Results and conclusions: Mega-ROX Sepsis will compare the effect of conservative vs. liberal oxygen therapy on 90-day in-hospital mortality in adults with sepsis who are receiving unplanned invasive mechanical ventilation in the ICU. The protocol and a prespecified approach to analyses are reported here to mitigate analysis bias

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

© 2020 Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding: Bill & Melinda Gates Foundation

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020