Wastage Rates Research Articles

Coordinating a bi‐level blood supply chain with interactions between supply‐side and demand‐side operational decisions

AbstractIn most blood supply chains, blood centers and hospitals make individual decisions, resulting in an inefficient structure of the blood supply chain, which in turn renders supply and demand matching a challenging exercise. In this work, we make the very first attempt to optimize the interaction between blood centers and hospitals. To that end, this paper investigates collection, production, replenishment, issuing, inventory, and wastage decisions under three different blood supply chain channel structures, that is, the decentralized, centralized, and coordinated structures. We propose a bi‐level optimization program to model the decentralized system and use the Karush–Kuhn–Tucker optimality conditions to solve that. In such a system, hospitals tend to order more than their actual need, resulting in overcollection, overproduction, and high wastage rates. On the other hand, in a centralized system decisions are made by a central decision‐maker, which results in higher performance. Recognizing the challenges of implementing a centralized system, we design a novel coordination mechanism to motivate hospitals to operate in a centralized system. Analysis of a case study in Canada indicates that integration can significantly improve the performance of system; allowing substitution between blood products can decrease the total cost of the blood supply chain by 14.41%; an increase in supply or decrease in demand can be detrimental under inappropriate structure, facilitating coordination mechanism; offering subsidy beyond a threshold is not beneficial to the blood centers.

Assessment of magnitude of medicines wastage and the contributing factors in selected public health facilities of Hadiya Zone, Central Ethiopia Regional State

BackgroundMedicine wastage occurs when medicines are damaged, obsolete, or expired and become unsafe for use. In Ethiopia, although there are reports that reveal the presence of wasted medicines in the country, there is limited objective evidence on the type and extent of medicine wastage as well as its contributing factors.ObjectiveThe study aimed to assess the medicine wastage rate and identify its contributing factors in the sampled public health facilities (HFs) in Hadiya Zone, Central Ethiopia Regional State.MethodA facility-based cross-sectional study complemented by a qualitative study was conducted in selected public HFs in Hadiya Zone, Central Ethiopia Regional State, from November 1 to 31, 2022. All the hospitals were selected intentionally, and health centers were selected using simple random sampling techniques. For the qualitative study, the chief clinical officers and pharmacy department heads of HFs were purposefully selected as key informants because they were supposed to be more information-rich than other health professionals. The quantitative data were entered and analyzed using the Statistical Package for Social Sciences version 20.ResultThe total monetary value of wasted medicines in the assessed HFs in the Ethiopian Fiscal Year (EFY) 2011–2013 was 652,479.45 ETB (5.24%). The three-year trend showed that, in the 2011–2012–2013 EFY, medicine wastage was 7.57%, 6.44%, and 3.1%, respectively. Expiration solely accounted for 97.3% of this total value. The alleged explanations for the waste of such medicines were a lack of accurate data available for medicine quantifications, the presence of overstocked medicines due to improper forecasting, a lack of electronic stock management, an abrupt change in the treatment regimen, and improper use of stock management. Whether the perceived causes had an impact on the medicine wastage was assessed, and the results confirmed that a significant association between medicine wastage and overstock (p-value = 0.006, AOR = 8.57, 95% CI = 1.87–39.26), accurate data (p-value = 0.013, AOR = 5.43, 95% CI = 1.42–20.76), and electronic stock management (p-value = 0.05, AOR = 0.311, 95% CI = 0.094–1.03) was observed.ConclusionThe identified medicine wastage rate is significant for a nation that struggles to allocate limited resources fairly. It may negatively affect the initiatives taken by the government to increase public engagement in the healthcare system through insurance contributions. It is a glance for HFs to take immediate corrective action.

A comprehensive approach to continuous quality improvement of massive transfusion by developing key performance indicators.

To develop key performance indicators (KPI) for use in quality assessment of our institutional goal-directed massive transfusion (GDMT). A team comprising our transfusion and emergency medicine departments carried out a cross-sectional data analysis of GDMT in adult patients from January 2021 to December 2022. The study was rooted in the Define, Measure, Analyse, Improve, Control (DMAIC) approach. Features of KPIs were (a) importance, (b) scientific soundness and (c) feasibility. Study parameters were defined and analysed using measures of central tendencies and benchmark comparison. Ninety-two massive transfusion events occurred and 1405 blood components were used. Trauma was the leading cause, followed by postpartum haemorrhage and upper gastrointestinal bleeding. Appropriate GDMT activation was observed only in 43.47% of events. The turnaround time (TAT) was within the benchmark in 85.8% of events with an average of 16 ± 10 min. The average utilization of blood components was 20.5 (interquartile range [IQR] = 11.3) in the appropriate group and 5.5 (IQR = 4.25) in the inappropriate group with a wastage rate of 3.5%. Duration of activation was 6.19 ± 4.59 h, and the adherence to thromboelastography was 66.3%. Overall mortality was 45.65%, and the average duration of hospital stay was 6.1 ± 5.9 days. The KPIs developed were easy to capture, and the analysis provided a comprehensive approach to the quality improvement of the GDMT protocol.

Therapeutic diet plate waste and satisfaction among adult patients

Introduction: There are limited studies on plate waste and satisfaction levels among adult patients receiving therapeutic diets in hospitals, particularly in the local context. Therefore, this study aimed to determine the percentage of plate waste and the level of satisfaction among adult patients receiving therapeutic diets, as well as the contributing factors. Methods: This cross-sectional study was conducted at a university hospital during lunch and dinner hours on eleven types of therapeutic diets. Food weighing and photography-assisted visual estimation by the Comstock scale were used to measure plate waste. Interviews were conducted with patients using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) to collect information about their satisfaction towards food quality and service. Results: Mean overall plate waste rate for 96 patients receiving therapeutic diets was 43.6% (40.0% for lunch, 47.3% for dinner), with the highest rate of wastage in a combined diet low in fat and salt. Overall score for patient satisfaction was 3.7 out of 5. Patients had higher satisfaction levels with staff and food service (4.0) compared to food quality (3.4). Food quality negatively contributed to the rate of plate waste in terms of taste (r=-0.107, p=0.035), presentation (r=-0.078, p=0.043), and texture (r=-0.052, p=0.020). Conclusion: Therapeutic diet plate waste among adult patients in this study was high and primarily attributable to food quality. Efforts to minimise therapeutic diet plate waste should be made by improving food quality for the best possible outcomes for patients.

Whole Blood Program: Implementation in a Rural Trauma Center

BACKGROUND: The balanced transfusion of blood components plays a leading role in traumatic hemostatic resuscitation. Yet, previous whole blood studies have only focused on urban trauma center settings. OBJECTIVE: To compare component vs whole blood therapy on wastage rates and mortality in the rural setting. METHODS: This study was a nonrandomized, retrospective, observational, single-center study on a cold-stored whole blood program implementation for adult massive transfusions from 2020 to 2022 at a Level II trauma center. Trauma registry data determined the facility’s whole blood needs and facilitated sustainable blood supplies. Whole blood use protocols were established, and utilization and laboratory compliance for incompatible ABO antibody hemolysis was monitored and reviewed monthly at stakeholder and trauma services meetings. RESULTS: From 2018 to 2019, the facility initiated component therapy massive transfusions every 9 days (n = 41). Therefore, four units of low-titer, O-positive whole blood delivered fortnightly was determined to provide patient coverage and minimize wastage. Across the study time frame (2020–2022), there were n = 68 hemodynamically unstable patients, consisting of those receiving whole blood, n = 37, and patients receiving component therapy, n = 31. Mortality rates were significantly lower (p = .030) in the whole blood population (n = 3, 8%) compared to those solely receiving component therapy (n = 9, 29%). Wastage rates were constantly evaluated; in 2021, 43.4% was not utilized, and in 2022, this was reduced to 38.7%. Anecdotally, nurses appreciated the ease of administration and documentation of transfusing whole blood, as it negated ratio compliance. CONCLUSION: This evidence-based whole blood program provides vital care to severely injured trauma patients in a vast, rural region.

Minimizing Vaccine Wastage in Nigeria: A National Assessment of Vaccine Wastage Rates and Potential Determinants.

High vaccine wastage can serve as a critical barrier to achieving the gains of vaccination, especially in a country like Nigeria, where data on vaccine wastage are sparsely available. We determined the country-wide vaccine wastage rates and their determinants through a mixed-methods study conducted across 576 health facilities (primary and secondary) in 24 states in Nigeria. We collected facility-based immunization records from June 2018 to May 2019, in addition to healthcare workers' interviews and observations of fixed and outreach sessions. The results show that open-vial wastage ranged from 21.2% (95% CI: 20.2%, 22.2%) for the pentavalent vaccine to 72.6% (95% CI: 71.5%, 73.6%) for BCG. Open-vial wastage rates for BCG, measles, and yellow fever vaccines were higher during outreach sessions, with rates of 76.2%, 64.3%, and 65.2%, respectively. For the outreach and fixed sessions, PCV and Penta had the least wastages of 22.0% for fixed sessions and 20.4% for outreach sessions. This study identified vaccine presentation (liquid vs. lyophilized vaccines), vial size (4 dose vs. 5 dose vs. 10 dose vs. 20 dose), RI service delivery strategies (fixed vs. outreach sessions), number of children vaccinated, and human resources (healthcare workers position/cadre) as key determinants of vaccine wastages in Nigeria.

Analysis And Reason For Discard Of Blood Products: A Retrospective Study In A Tertiary Care Hospital Blood Bank From Parul Sevashram Hospital, Vadodara.

Background: A life-saving procedure is a blood transfusion, but there is often a shortage in blood supply due to various factors. Despite the enormous advancements in medical research, there is still no substitute for blood, making blood transfusions a crucial component of contemporary healthcare. The study aimed to evaluate the discard reasons for blood components, particularly Fresh Frozen Plasma, Platelet Concentration, and Red Cell Concentration and to suggest possible strategies to reduce wastage. Methods: The Retrospective analysis of discarded blood components was carried out from July, 1st 2023 to December 31st 2023 in the blood bank of Parul Sevashram. Data was collected using a discard register and computer data of discard available in blood bank and was analysed in SPSS software version 26.0 and Microsoft Excel. The wastage rate was calculated with a percentage of total number of units wastage against the total number of collections. Results: A total of 4990 blood component were prepared out of which 706 blood component was discarded. The total discard ratio of the study was 14.14%. Total replacement donors were 83.91% and 16.31% were voluntary donations. The discard rate for PC, RCC, and FFP was 86.30%, 6.82%, and 2.01%. HbsAg was the most common reason for the discard due to seropositivity of TTIs. Conclusion: The Most common component discarded was platelet and the reason for discard was the date of expiry due to non-utilization. Seropositivity was the reason for discarding red cell concentration and leakage was the most common reason for fresh frozen plasma. The wastage can be reduced by implementing proper strategies such as FIFO policy, avoiding Mega camps, proper staff training and wastage reduced protocol.

A Study of Replenishment And Pricing Strategies For Vegetable Commodities Based On Multiple Linear Regression

Vegetables, which can provide the human body with rich nutrients such as vitamins, minerals and dietary fiber, are indispensable necessities in people's daily life. Therefore, on the one hand, in order to ensure the quality of vegetables to provide fresh vegetables, superstores need to replenish goods in a timely manner; on the other hand, in order to improve the revenue, superstores need to reasonable pricing. This paper takes 251 kinds of vegetables sold in fresh food superstores as the research object, firstly, using Pearson's correlation coefficient to explore the correlation between the sales volume of vegetable single product and category, and obtains that the strongest correlation in vegetable category is cauliflower and edible mushrooms, with a correlation coefficient of -0.9989, and that the strongest correlation in vegetable single product is Hericium erinaceus and fresh zongzi leaves, with a correlation coefficient of 0.9973. Then, this paper set up a multivariate linear regression model to solve the problem for each vegetable. Linear regression model to solve the relationship between total sales volume and cost-plus pricing for each category. Finally, for the total daily replenishment, through the total daily replenishment = total predicted sales / (1 - wastage rate) processing to get the total daily replenishment of vegetables for 7 days, to obtain the cost matrix and markup rate matrix, and then get the pricing of vegetables for 7 days. For example, the replenishment of cauliflower on Monday should be 268.7238 kg, and the pricing is $2.5179/kg.

Mechanism and deterioration pattern of sandstone surrounding rock voiding at bottom of heavy-haul railway tunnel

This study combines laboratory experiments and discrete element simulation methods to analyze the mechanism and deterioration patterns of sandstone surrounding rock voiding the bottom of a heavy-haul railway tunnel. It is based on previously acquired measurement data from optical fiber grating sensors installed in the Taihangshan Mountain Tunnel of the Wari Railway. By incorporating rock particle wastage rate results, a method for calculating the peak strength and elastic modulus attenuation of surrounding rock is proposed. Research indicates that the operation of heavy-haul trains leads to an instantaneous increase in the dynamic water pressure on the bottom rock ranging 144.4–390.0%, resulting in high-speed water flow eroding the rock. After 1–2 years of operation, the bottom water and soil pressures increase by 526.5% and 390.0%, respectively. Focusing on sandstone surrounding rock with high observability, laboratory experiments were conducted to monitor the degradation stages of infiltration, particle loss, and voiding of rock under the action of dynamic water flow. The impact of water flow on the “cone-shaped” bottom rock deformation was also clarified. The extent of rock deterioration and voiding was determined using miniature water and soil pressure sensors in conjunction with discrete element numerical simulations. The measured rock particle loss was used as a criterion. Finally, a fitting approach is derived to calculate the peak strength and elastic modulus attenuation of surrounding rock, gaining insight into and providing a reference for the maintenance and disposal measures for the bottom operation of heavy-haul railway tunnels.

A Study of No-detention Policy on Pre-primary Children of Government School of Tripura State in Relation to Wastage and Attainment Level

This study delves into the ramifications of the No-detention Policy (NDP) on pre-primary children enrolled in government schools within Tripura State, with a particular emphasis on analyzing wastage rates and attainment levels. Employing a mixed-methods approach incorporating surveys, assessments, interviews, and observational data, the research seeks to offer comprehensive insights into how the NDP influences educational outcomes in the pre-primary education sector. By exploring these dimensions, the study aims to shed light on the efficacy of the NDP in fostering educational equity and quality within Tripura's pre-primary schools.

Genetic Algorithms Application for Pricing Optimization in Commodity Markets

The perishable nature of vegetable commodities poses challenges for superstores, as reselling them is often unfeasible due to their short freshness period. Reliable market demand analysis is crucial for boosting revenue. This study simplifies the pricing and replenishment decision-making process by making reasonable assumptions about the selling time, wastage rate, and replenishment time for vegetable commodities. A single-objective planning model with the objective of profit maximization was constructed by fitting historical data using the nonparametric method of support vector regression (SVR). The study reveals a specific relationship between sales volume and cost-plus pricing for each category and predicts future cost changes using an LSTM model. Combining these findings, we substitute the relationship between sales volume and pricing as well as the LSTM prediction data into the model, and solve it using genetic algorithms in machine learning to derive the optimal replenishment volume and pricing strategy. Practical results show that the method can provide reasonable pricing and replenishment strategies for vegetable superstores, and after careful accounting, we arrive at an expected profit of RMB 22,703.14. The actual profit of the supermarket was RMB 19,732.89. The method, therefore, increases the profit of the vegetable superstore by 13.08%. By optimizing inventory management and pricing decisions, the superstore can better meet the challenges of vegetable commodities and achieve sustainable development.

Coronavirus Disease 2019 Vaccination Status at a Tertiary Care Hospital of Uttarakhand: A Retrospective Record-Based Study

Abstract Background: Coronavirus disease 2019 (COVID-19) vaccination has proved its importance and effectiveness in the fight against COVID-19. India began the world’s largest vaccination campaign against COVID-19 on 16th January 2021 with two vaccines, namely, Covishield and Covaxin. Aims: The present study was conducted to understand the trend of COVID-19 vaccination during the 1st year of the vaccination drive at a COVID Vaccination Centre in a tertiary care hospital of Uttarakhand. Patients and Methods: It was a retrospective record-based study conducted at a COVID-19 Vaccination Centre in a tertiary care hospital of Uttarakhand. Vaccination-related data of 1-year period (16th January 2021–16th January 2022) had been collected from the CoWIN app and COVID-19 vaccination register and analysed. Results: The total dose administered was 63,015 over a time period of 1 year during 299 vaccination sessions that were conducted. Analysis of total doses administered in relation to vaccination sessions held during different months of 1-year study period shows that on average, 199 individuals per session were vaccinated. There was an overall declining trend in the COVID-19 vaccine wastage rate for 1-year period of COVID-19 vaccination. Conclusion: This study will help us to understand how this experience of the past 1 year can be utilised for further planning and policy making.

Research on Supermarket Replenishment Pricing Decision Making Based on BP Neural Network and Greedy Algorithm

The aim of this paper is to provide strong support for superstores through a data-driven approach. By analyzing and fitting the sales history data of each category and individual product, this paper uses BP-neural network model to predict the sales volume and transforms the replenishment problem into a knapsack problem, so as to plan the future pricing strategy and replenishment volume of the superstore. This helps to optimize the category structure of the superstore, increase the profit margin, reduce the wastage rate, and improve the service quality.

Research on Vegetable Sales Data Analysis and Cost Pricing Modeling

Vegetable commodities have a shorter freshness period, many varieties, and a special time of purchase, so it is important to comprehensively analyze the automatic replenishment and pricing strategy of vegetable commodities for the profitability of fresh food superstores. First of all, in the correlation of vegetable categories and single product sales volume, Pearson correlation coefficient analysis is used, to obtain the strong correlation between chili peppers and foliage categories and various vegetable categories. Then based on correlation the best clustering results were obtained by K-means clustering analysis divided into three main categories, namely solanula; flowers and leaves and cauliflower; peppers, aquatic rhizomes, and edible fungi. Next using entropy weights TOPSIS method is used to give the weights of four indicators: total sales, average unit price, average wholesale price, and average wastage rate of each category of vegetable commodities for seven days, and the top 27 vegetable items are sorted to get the best sellable vegetables. Based on the above ranking of the individual vegetable items, Excel was used to forecast the cost pricing of the vegetable commodities to get the cost pricing of the 27 individual vegetable items for the next seven days.

Optimizing the Sales Law and Replenishment Decision Analysis of Fresh Supermarket Products

In the field of fresh food supermarkets, due to the relatively limited shelf-life of vegetable products, their quality will gradually deteriorate with the sales time. Therefore, supermarkets need to perform daily rationing replenishment operations based on the historical sales data and demand of the products. This paper is based on the collected product information of vegetable categories, detailed vegetable sales flow data, wholesale prices of vegetable products, and recent vegetable product wastage rates. Data analysis and visualization techniques are used to analyze the distribution pattern of vegetable sales in each category and single product. Next, a functional relationship between total sales volume and cost-plus pricing of vegetable categories was constructed. Regression forecasts were used to simulate the future wholesale prices of vegetable categories.

Overcoming barriers to COVID‐19 herd immunity in Afghanistan

AbstractAfghanistan faces numerous obstacles in its endeavor to achieve herd immunity against COVID‐19. Inadequate resources, vaccine hesitancy, and the new government's lack of international recognition have impeded the country and harmed vaccine procurement and distribution. Although the recent power shift has led to a more secure situation, the country's vaccination coverage remains at 44.05% as of November 26, 2023. The main hurdles to herd immunity include limited vaccine accessibility, extensive vaccine hesitancy, an inefficient cold chain system causing high vaccine wastage rates, substandard service delivery, recent restrictions on women's healthcare access, low health literacy, and a weakened economy owing to decades of conflict and international sanctions. This article assesses vaccination progress, and herd immunity barriers, and provides solutions to overcome them in Afghanistan. A comprehensive approach is required, which involves enhancing public awareness of the benefits of vaccination, debunking vaccine‐related misconceptions through the media, expanding vaccine accessibility especially in remote areas, increasing vaccination personnel, promoting the cold chain and delivery system, reversing the ban on women's education and employment, boosting the economy, and increasing the inflow of humanitarian aid by lifting international sanctions. Successfully implementing these measures can help Afghanistan overcome obstacles to herd immunity, leading the country toward a safer and healthier future.

On the Construction Methodology of Microabrasion-Corrosion Maps Using Theoretical Approaches

In the field of microabrasion-corrosion, there has been limited research progress in modelling the process due to the complex interplay between the two processes involved. One of the crucial developments in the field has been the microabrasion-corrosion maps based on experimental results. However, mathematical modelling to develop the maps has not been attempted before. This work aimed to construct mathematical models for predicting the microabrasion-corrosion rate for mild steel and pure titanium in aqueous slurry conditions. The methodology developed was used for the construction of microabrasion-corrosion maps. The maps were constructed in two forms: (1) regime maps that identify the underlying mechanisms of microabrasion-corrosion and (2) wastage maps that identify the magnitude of the wastage rate. The effects of abrasive particle size and solution pH were shown on the maps. These maps have not been reported before and can form a basis for material selection and process optimisation for various microabrasion-corrosion applications, such as hip joint conditions. The advantages and applications of these maps are addressed in this paper.

Strategic Planning of a Joint SARS-CoV-2 and Influenza Vaccination Campaign in the UK.

The simultaneous administration of SARS-CoV-2 and influenza vaccines is being carried out for the first time in the UK and around the globe in order to mitigate the health, economic, and societal impacts of these respiratory tract diseases. However, a systematic approach for planning the vaccine distribution and administration aspects of the vaccination campaigns would be beneficial. This work develops a novel multi-product mixed-integer linear programming (MILP) vaccine supply chain model that can be used to plan and optimise the simultaneous distribution and administration of SARS-CoV-2 and influenza vaccines. The outcomes from this study reveal that the total budget required to successfully accomplish the SARS-CoV-2 and influenza vaccination campaigns is equivalent to USD 7.29 billion, of which the procurement costs of SARS-CoV-2 and influenza vaccines correspond to USD 2.1 billion and USD 0.83 billion, respectively. The logistics cost is equivalent to USD 3.45 billion, and the costs of vaccinating individuals, quality control checks, and vaccine shipper and dry ice correspond to USD 1.66, 0.066, and 0.014, respectively. The analysis of the results shows that the choice of rolling out the SARS-CoV-2 vaccine during the vaccination campaign can have a significant impact not only on the total vaccination cost but also on vaccine wastage rate.

Impact of Implementing a Standard Operating Procedure to Reduce Blood Wastage in Blood Centers of Iran.

Blood wastage leads to additional costs and reduced blood availability to patients. Above all is the moral issue of wasting donor gifts. This study aimed to determine the rate of blood wastage before and after implementing a new standard operating procedure (SOP) in Iran. In this interventional study, a SOP for wastage management was prepared and implemented in all blood centers throughout the country. Data were extracted from the integrated software of the Iranian Blood Transfusion Organization (IBTO). The wastage rate of blood components in the post-intervention years (2016-2017) was then compared with that in the pre-intervention years (2013-2015) using the Z test. The overall wastage rate decreased by 36.86% (P<0.001, 95% CI [36.84-36.88]) after the intervention. Red blood cell (RBC) wastage decreased from 2.6% to 2.5%, platelet wastage from 19.5% to 10.6% and plasma wastage from 15.5% to 7.3% (P<0.001). The highest percentage of waste reduction pertained to plasma components, which decreased by 52.90% (P<0.001, 95% CI [52.86-52.94]). Expiration was the most common cause of RBC and platelet wastage. The most common causes of plasma wastage were RBC contamination and rupture or leakage of the bags. The intervention resulted in a drop of over 250000 discarded components each year, equal to approximately thirty-six million dollars in savings. This intervention effectively reduced waste and increased efficiency. Ongoing blood wastage reviews, auditing, and receiving feedback from the central headquarters were powerful tools in following the compliance of blood centers. Further studies are recommended, especially concerning blood wastage in hospital blood banks and various wards.

Factors affecting secondary teacher wellbeing in England: Self‐perceptions, policy and politics

AbstractAfter the challenges of the Covid‐19 pandemic, the NEU (2021) report states that one in three teachers plan to leave the profession in the next 5 years. As previous studies published by the DfE focusing on workload have not affected the wastage rate of the profession, there is something deeper at work which needs to be explored. A critical theory, mixed‐methods approach is used to gain a breadth and depth of understanding of the attitudes of 55 respondents to a survey and 17 participants in semi‐structured interviews. All data collection was carried out in secondary schools in Lincolnshire, where teacher pay is good in comparison with the county average of workforce pay. These methods aim to test the assumption that concerns about workload and pay are causing teachers’ discontent. The findings reveal that teacher attitudes towards their working lives are complex owing to individuals trying to internalise the values of both traditional and new professionalisms. Owing to this, teachers can appear contradictory in their demands and tolerance of the demands of the profession and themselves. The characteristics of neoliberal management including transactional leadership, competition and ambivalence to processes in favour of outcomes, do not match traditional professional values of dedication, expertise and working for the greater good.