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Introduction Nepal has pledged to substantially reduce maternal and newborn death by 2030. Improving quality of intrapartum health services will be vital to reduce these deaths. This paper examines quality of delivery and newborn services in health facilities of Nepal. Methods Data were sourced from the Nepal Health Facility Survey 2015, which covered a national representative sample of health facilities. The datasets were analysed to assess service readiness, availability and quality of delivery and newborn care in a sample of 992 health facilities. Results Of the 992 facilities in the sample, 623 provided delivery and newborn care services. Of the 623 facilities offering delivery and newborn care services, 13.3% offered comprehensive emergency obstetric care (CEmONC), 19.6% provided basic emergency obstetric care (BEmONC) and 53.9% provided basic delivery and newborn service. The availability of essential equipment for delivery and newborn care was more than 80% in health facilities. Except for the coverage of vitamin K injection, the coverage of immediate newborn care was more than 85% in all health facilities. The coverage of use of chlorhexidine ointment to all newborns was more than 70% in government hospitals and primary health care centers (PHCCs) and only 32.3% in private hospitals. Conclusions These findings show gaps in equipment and drugs, especially in PHCCs and private health facilities. Improving readiness and availability of equipment and drugs in PHCCs and private health facility will help improve the quality of care to further reduce maternal and newborn mortality in Nepal.

Malaysia as a developing country, is driving for implementing a new or modern construction method called Industrialised Building System (IBS), as an alternative towards enhancing construction productivity. The level of implementation of IBS however is still below the Government target. One of the key barriers of its implementation is related to project delivery and supply chain issues. The majority of IBS project developments in Malaysia are still conducted using the traditional construction process approach, which has resulted in a failure to form effective teams and thus impacted on a number of issues such as delay, wastages, and lack of communication and coordination. This paper, through the use of industry workshops, aims to validate this issue and investigate how far it affects the process of IBS implementation. Suggestions on how an integrated approach in design and construction in order to minimise the fragmentation gaps will be concluded.

© 2016 Elsevier Inc. Background Health care delivery in the United States has evolved in many ways over the past century, including the development of the specialty of Emergency Medicine (EM). With the creation of this specialty, many positive changes have occurred within hospital emergency departments (EDs) to improve access and quality of care of the nation's de facto "safety net." The specialty of EM has been further defined and held to high standards with regard to board certification, sub-specialization, maintenance of skills, and research. Despite these advances, problems remain. Objective This review discusses the history and evolution of for-profit corporate influence on EM, emergency physicians, finance, and demise of democratic group practice. The review also explores federal and state health care financing issues pertinent to EM and discusses potential solutions. Discussion The monopolistic growth of large corporate contract management groups and hospital ownership of vertically integrated physician groups has resulted in the elimination of many local democratic emergency physician groups. Potential downsides of this trend include unfair or unlawful termination of emergency physicians, restrictive covenants, quotas for productivity, admissions, testing, patient satisfaction, and the rising cost of health care. Other problems impact the financial outlook for EM and include falling federal, state, and private insurance reimbursement for emergency care, balance-billing, up-coding, unnecessary testing, and admissions. Conclusions Emergency physicians should be aware of the many changes happening to the specialty and practice of EM resulting from corporate control, influence, and changing federal and state health care financing issues.

This paper presents the energy policy of the Republic of Cyprus government controlled areas from 1960 till 2006. It describes the sectors of electricity, petroleum, natural gas and renewable energy sources. It also deals with the marine layers of oil and with environmental aspects. The energy policy of Cyprus is harmonized with that of the European Union according to its national obligations, having as its guidelines to secure competition in the market and to fulfill the energy needs of the country, with the least burden to the economy and to the environment. The future plans and targets of Cyprus related to its energy strategy are also presented. (c) 2008 Elsevier Ltd. All rights reserved.

Increasing energy prices, growing market competition, strict environmental legislations, concerns over global climate change and customer interaction incentivise manufacturing firms to improve their production efficiency and minimise bad impacts to environment. As a result, production processes are required to be investigated from energy efficiency perspective at early design phase where most benefits can be attained at low cost, time and risk. This article proposes a framework to predict energy-related key performance indicators (e-KPIs) of manufacturing systems at early design and prior to physical build. The proposed framework is based on the utilisation and incorporation of virtual models within VueOne virtual engineering (VE) tool and WITNESS discrete event simulation (DES) to predict e-KPIs at three distinct levels: production line, individual workstations and the components as individual energy consumption units (ECU). In this framework, alternative designs and configurations can be investigated and benchmarked in order to implement and build the best energy-efficient system. This ensures realising energy-efficient production system design while maintaining predefined production system targets such as cycle-time and throughput rate. The proposed framework is exemplified by a use case of a battery module assembly system. The results reveal that the proposed framework results meaningful e-KPIs capable of supporting manufacturing system designers in decision making in terms of component selection and process design towards an improved sustainability and productivity.

Over the years, leaked fluids from aircraft have caused severe deterioration of airfield pavement. The combined effect of hot exhaust from the auxiliary power unit of military aircraft and spilt aviation oils have caused rapid pavement spalling. If the disintegrated concreted pieces caused by spalling are sucked into the jet engine, they may cause catastrophic damage to the aircraft engine or physical injury to maintenance crews. This study investigates the effectiveness of incorporating hybrid fibres into ordinary concrete to improve the residual mechanical and thermal properties to prevent spalling damage of pavement. Three fibre-reinforced concrete samples were made with micro steel fibre and polyvinyl alcohol fibre with a fibre content of zero, 0.3%, 0.5% and 0.7% by volume fraction. These samples were exposed to recurring high temperatures and aviation oils. Tests were conducted to measure the effects of repeated exposure on the concrete's mechanical, thermal and chemical characteristics. The results showed that polyvinyl alcohol fibre-, steel fibreand hybrid fibre-reinforced concrete suffered a 52%, 40% and 26.23% of loss of initial the compressive strength after 60 cycles of exposure to the conditions. Moreover, due to the hybridisation of concrete, flexural strength and thermal conductivity was increased by 47% and 22%. Thus, hybrid fibrereinforced concrete performed better in retaining higher residual properties and exhibited no spalling of concrete.