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Articles published on Resilience engineering

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  • Research Article
  • 10.21474/ijar01/23605
MODELS AND STRATEGIES FROM SOCIAL MARKETING 5.0 FOR A RESILIENT ROAD SAFETY: SYSTEMS AUDITING AND AFFECT MANAGEMENT IN DIGITAL PUBLIC POLICIES
  • Jun 30, 2026
  • International Journal of Advanced Research
  • Ramon Loaiza M

This research addresses road safety in Venezuela as a structural fracture, moving beyond the instrumental commercial view to approach it from the perspective of Social Marketing 5.0 and systemic resilience. The general objective was to analyze management models and strategies oriented toward co-designing safe environments and managing sustainable pro-social behaviors to strengthen public policies. The theoretical foundation was based on frontier management science, the Monism of Affects, and Resilience Engineering. Methodologically, a mixed methods approach with a sequential exploratory design (DEXPLOS) was adopted. In the qualitative phase, Grounded Theory was applied to in-depth interviews ; in the quantitative phase, a questionnaire was processed using descriptive and inferential statistics to audit institutional systems.The results revealed a Technological Inertia: 68% of the organizations possess digital infrastructure, but only 12% perform predictive analytics, thus operating as imposition (Gestell) rather than care (Sorge). Survival Resilience emerged, characterized by individual risk management in the face of environmental deterioration, evidencing a disconnect between the power to act of the social body and public policy. Furthermore, an increase in affective-cognitive vulnerability was detected due to the risks of hyperconnectivity.

  • New
  • Research Article
  • 10.59543/comdem.v3i.18292
Rapid Assessment of Hospital Emergency Department Performance from the Perspectives of Sustainability, Resilience, and Lean Management
  • Jun 25, 2026
  • Computer and Decision Making: An International Journal
  • Mohammad Nazemi + 1 more

The hospital emergency department, as one of the most critical units within the healthcare system, plays a vital role in saving patients' lives, improving the quality of medical services, and increasing public trust. However, challenges such as patient congestion, limited resources, high workloads, and exposure to unforeseen crises have made evaluating and enhancing the department's performance a significant challenge. Therefore, this study aimed to comprehensively and rapidly assess the hospital emergency department's performance based on the Goodson model, utilizing three complementary approaches: lean management, resilience, and sustainability. This applied, descriptive-analytical study was conducted cross-sectionally at a healthcare center in Iran. Data were collected through standardized questionnaires on lean management, resilience engineering, and organizational sustainability, and analyzed using the Goodson rapid assessment model. Experts confirmed the validity of the instruments, and their reliability was verified using Cronbach's alpha. The findings revealed that the emergency department's performance in the sustainability dimension was at an excellent level, surpassing the criteria of the assessment model, indicating a strong focus on social, economic, and environmental factors. The resilience dimension was rated as demonstrating relative readiness to handle critical situations. However, the lean management dimension showed incomplete implementation of lean principles and the presence of waste in some operational processes. These results highlight the importance of improving lean management practices while maintaining and strengthening resilience and sustainability to enhance the overall performance of the hospital emergency department.

  • Research Article
  • 10.1002/chem.71054
Proton-Exchanged Montmorillonite With Interlayer Accessibility as a Solid Acid Catalyst for the Upcycling of Polyoxymethylene.
  • Jun 16, 2026
  • Chemistry (Weinheim an der Bergstrasse, Germany)
  • José F Noboa + 3 more

Engineering plastics such as polyoxymethylene (POM) are highly resistant to depolymerization due to their robust C─O backbones, posing a major challenge for sustainable recycling. Herein, we report a solid acid catalyst based on proton-exchanged montmorillonite (H-Mont) that efficiently upcycles POM into cyclic acetals under mild conditions. H-Mont exhibits high catalytic performance, converting both pristine and post-consumer POM, outperforming conventional solid and liquid acid catalysts in both catalytic efficiency and reusability. Mechanistic studies reveal that interlayer accessibility generated by solvent-induced swelling, together with strong Brønsted acidity of H-Mont, synergistically overcomes interfacial limitations between the catalyst and semi-crystalline POM, enabling efficient depolymerization. This represents the first demonstration of a streamlined, reusable heterogeneous catalysis for POM upcycling toward cyclic acetals and establishes a strategy for transforming chemically resilient engineering plastics into valuable chemicals.

  • Research Article
  • 10.1186/s12909-026-09657-y
Pandemic to endemic: a longitudinal multinational study on COVID-19's effects on graduate medical education.
  • Jun 12, 2026
  • BMC medical education
  • Fatima Msheik-El Khoury + 4 more

This study applied a resilience engineering framework to understand how international graduate medical educations (GME) programs responded to the disruptions caused by the COVID-19 pandemic. Beyond describing early pandemic disruptions, we offer a multi-year, multi-country analysis of how training functions adapted, which elements durably changed, and what program design features may be associated with recovery. We conducted a retrospective longitudinal study of all 180 ACGME International (ACGME-I)-accredited programs across seven countries. Annual surveys were completed over three years (Year (Y)1 = Academic Year (AY)2021-22, Y2 = AY2022-23, Y3 = AY2023-24), assessing clinical experiences, educational activities, telemedicine use, and training modifications. Data were analyzed using mixed-effects and generalized linear mixed models, with exact logistic regression for small strata. Subgroup analyses compared specialty, training type, and World Bank income classification. Studying ACGME-I programs provides a common competency-based context, allowing us to describe trajectories of disruption, recovery, and persistence. Of 180 programs, most were residencies (68.3%) and medical specialties (53.3%), with 87.2% located in high-income countries. Clinical experiences were most disrupted in Y1, especially ambulatory continuity clinics (estimated marginal means [EMM] 1.489) and ambulatory rotations (1.571), both of which recovered by Y3 (1.863 and 1.874; p<.001). Inpatient admissions showed similar recovery (1.915→2.120; p<.001), while urgent procedures declined slightly (2.013→1.897; p=.007). Emergency and ICU exposures initially increased (2.242 and 2.342) but returned toward baseline by Y3 (2.232; 2.244; both p > .05). Educational activities were most disrupted for in-person didactics, which nearly ceased in Y1 (0.784) but improved by Y3 (1.386; p<.001), offset by a surge in live virtual conferences (2.821→2.476; p<.001). Elective rotations also declined (1.440→1.782; p<.001), whereas scholarly activity (1.836→1.956; p=.002) and direct observation (1.879→1.954; p=.005) showed slight disruptions and modest increases by Y3, while one-to-one advising (1.970→2.012; p > .05) remained stable. Telemedicine use peaked in Y1 (clinical care 1.020; supervision 0.544) and declined by Y3 (0.720; 0.386; both p<.001) but remained in use across programs. Training extensions declined substantially from 43.2% in Y1 to 23.0% in Y3 (OR = 0.11; p=.002). Differences by specialty and country income suggest heterogeneous recovery pathways rather than a uniform "return to normal." International GME programs demonstrated resilience, restoring clinical and educational activities, integrating telemedicine, and markedly reducing training extensions. Our longitudinal, multi-country data move the field beyond single-site, early pandemic reports by identifying which disruptions resolved, which practices persisted, and which gaps remained. Because all programs shared competency-based structures, findings suggest that specific design features may support adaptation. These results refine the prevailing "back to business as usual" narrative in international graduate medical education by showing a selective reversion with durable innovations.

  • Research Article
  • 10.1016/j.rineng.2026.109883
The impact of resilience engineering on safety performance in the Industry 4.0 context
  • Jun 1, 2026
  • Results in Engineering
  • Rasha Ali Abdelrahim + 5 more

The impact of resilience engineering on safety performance in the Industry 4.0 context

  • Research Article
  • Cite Count Icon 1
  • 10.1016/j.plipres.2025.101372
The plant lipid contactome: emerging roles of inter-organelle contact sites in lipid metabolism.
  • Jun 1, 2026
  • Progress in lipid research
  • Carolina Huercano + 6 more

Membrane contact sites (MCSs) are fundamental hubs of inter-organelle communication that mediate the non-vesicular exchange of lipids, ions, and metabolites, thereby sustaining cellular homeostasis. In plants, the "contactome"-the dynamic network of all membrane contact sites-has evolved distinctive features to accommodate the requirements of a sessile, photosynthetic lifestyle and the presence of plastids. Within this network, the endoplasmic reticulum (ER) functions as a central hub for lipid biosynthesis and distribution, forming functionally important contacts with multiple organelles. Recent advances in high-resolution imaging, lipidomics, and molecular genetics are beginning to uncover the complexity of these inter-organelle connections and their contribution to lipid homeostasis in plants. This review summarizes current knowledge of the plant contactome, with a focus on lipid transfer proteins and lipid-modifying enzymes that maintain lipid balance during organelle biogenesis, plant development, and stress adaptation. Plant lipid transfer at membrane contact sites can be broadly divided into two mechanistic modes: precision-regulated "shuttles," exemplified by the Ca2+-dependent SYT1-mediated diacylglycerol transfer at ER-plasma membrane interfaces, and high-capacity lipid transfer mechanisms, such those mediated by ATG2, that support rapid lipid flux during autophagosome biogenesis. Knowledge of lipid metabolism at plant membrane contact sites is still in its initial stages, and many of the underlying mechanisms remain unexplored. Major challenges include understanding how these sites integrate stress responses, metabolic fluxes, and organelle dynamics. Addressing these questions will be essential to unravel the unique aspects of plant lipid biology and may open opportunities for improving stress resilience and metabolic engineering in crops.

  • Research Article
  • Cite Count Icon 3
  • 10.1016/j.aap.2026.108443
Study on a multi-factor lane-changing risk resilience assessment model based on genetic algorithm and fault tree analysis.
  • Jun 1, 2026
  • Accident; analysis and prevention
  • Qiang Luo + 5 more

Study on a multi-factor lane-changing risk resilience assessment model based on genetic algorithm and fault tree analysis.

  • Research Article
  • 10.1061/jcemd4.coeng-17337
Monitoring and Improving Safety and Health in Construction Activities for Concrete Structures
  • May 1, 2026
  • Journal of Construction Engineering and Management
  • Francisco Salguero-Caparrós + 3 more

The construction industry is inherently high levels of risk, particularly in tasks such as formwork for concrete structures. To enhance safety and understand workers’ adaptive behaviors, this study employed the critical decision method (CDM), a semistructured interview technique that uses cognitive probes to identify disturbances that workers have to deal with in their work activity. This study focused on describing variability in formwork work on concrete structures, and understanding the resilience of workers to unexpected events. For this purpose, a series of semistructured interviews were conducted with construction employees with extensive experience in formwork work in Spain by applying the CDM adapted to the safety II framework aligned with the resilience engineering (RE) paradigm. Findings revealed that workers more frequently identified unthought-of situations—scenarios not previously anticipated by the formworkers beforehand —compared with potential unexpected situations, which are unforeseen but conceivable events as possible before the intervention. The study underscores the importance of leveraging workers’ first-hand experiences to enhance decision-making and resilience, thereby improving risk assessment processes and facilitating proactive accident prevention in the construction industry. Furthermore, a key theoretical contribution of this study is the adaptation of the CDM in conjunction with RE to the construction industry.

  • Research Article
  • Cite Count Icon 1
  • 10.1016/j.ress.2025.112089
Resilience enhancer: Conceptualization, categorization, and quantitative evaluation with case studies of subsea systems
  • May 1, 2026
  • Reliability Engineering &amp; System Safety
  • Yiliu Liu + 2 more

• Resilience enhancer, as a new concept, is proposed and defined. • Four categorization methods are presented for systematic identification of resilience enhancers. • Quantitative evaluation metrics of resilience enhancers are developed. • Case studies are conducted to illustrate the functions of the new concept. This article introduces a new concept of resilience enhancer, as an entity and/or non-entitative approach for a sociotechnical system to provide additional resilience to the system during disruptive events. Inspired by the role of safety barrier in process safety management, resilience enhancer is expected to facilitate systematic identification, evaluation, and comparison of resilience improvement strategies using unified metrics. Resilience enhancers are categorized by their operational phases, implementation formats, locations and operational modes. Effectiveness and probable effectiveness coefficient are then proposed as the quantifiable metrics for assessing them. Case studies of subsea transportation systems demonstrate the practical applications of the new concept and its evaluation framework, in which six distinct resilience enhancers are quantitatively analyzed and compared. The results reveal variations in the effectiveness of resilience enhancers, emphasizing the importance of context-based selection. This study advances methodologies for resilience engineering and provides a foundation for future research in designing and operating resilient sociotechnical systems.

  • Research Article
  • 10.5194/gc-9-185-2026
Multi-hazard risk assessment and management: pathways for the Sendai Framework and beyond
  • Apr 21, 2026
  • Geoscience Communication
  • Timothy Tiggeloven + 40 more

Abstract. Multi-hazard events pose increasingly complex challenges as natural hazards interact in cascading and compounding ways that amplify risks beyond individual hazards. Understanding these interactions – from hazard processes to cascading effects across social, economic, governance, and infrastructure systems – is critical for effective disaster risk management. National and international frameworks increasingly recognise these risk dynamics, most notably the United Nations Sendai Framework for Disaster Risk Reduction 2015–2030. The Sendai Framework Mid-Term Review (MTR) in 2023, however, identified substantial implementation challenges across its four priorities; these challenges include gaps in risk data governance, fragmented multi-scale coordination, insufficient investment mechanisms, and limited coverage of multi-hazard early warning systems. With the Sendai Framework approaching its conclusion, there is a pressing need to address these current shortcomings. Responding to this need, the 3rd International Conference on Natural Hazards and Risks in a Changing World took place in Amsterdam, the Netherlands, on 12–13 June 2024, with the objective of: (1) assessing current progress in multi-hazard risk research and policy practice; and (2) identifying scientific priorities to support further implementation of Sendai Framework until 2030 and beyond. Here, we document the arc of the scientific discussions held at the conference, synthesise the main findings from sessions, and set forth expert knowledge on how state-of-the-art science can fill gaps outlined by the MTR by identifying four perspective themes: (1) assessments and tools for risk understanding and decision-making; (2) understanding and management of complex risk landscapes; (3) emerging technologies for risk and resilience; and (4) multi-level governance for coordinated risk management. Ultimately, we call for governance reform enabling multi-scale coordination, investment in knowledge brokers translating across systems and scales, and participatory technology deployment ensuring emerging tools are applied to reduce disaster risk management inequalities. This perspective emphasises that effective Disaster Risk Reduction requires both incremental technical improvements and fundamental shifts in governance, data sharing, and inclusive engagement to address systemic risks and implementation gaps.

  • Research Article
  • 10.53941/ubs.2026.100013
Coupling Mechanism of Ecological Resilience and Flood Control Engineering: A Four-Dimensional Framework for Coastal Park Disaster Reduction—A Case Study of the Dike Improvement Project of Dajiaoshan Coastal Park in Nansha
  • Apr 21, 2026
  • Urban and Building Science
  • Meng Meng + 1 more

Aiming at the dual challenges of storm surge safety and landscape conservation in coastal parks, existing studies often separate ecological resilience from flood control engineering, lacking an integrated framework to coordinate the two, thus failing to provide effective technical support. This study proposes their coupling mechanism and constructs a four-dimensional framework centered on engineering, ecological, social and governance resilience. Adhering to the “adapting measures to local conditions and time” strategy, it integrates four technical systems to build a safe, adaptive and sustainable natural-artificial collaborative disaster prevention barrier. Taking Nansha Dajiaoshan Coastal Park’s flood control improvement as an empirical case, the model solves traditional pain points such as sea view obstruction and ecological damage, raising the flood control standard from less than 20-year to 200-year return period, and achieving multi-dimensional balance. It fills the research gap, provides a global reference, enriches coastal disaster risk management research, and promotes the integrated development of ecological resilience and engineering technology.

  • Research Article
  • 10.1080/13632469.2026.2653609
Seismic Analysis of Retaining Walls through a Newly Developed Time-Domain Framework of Steedman and Zeng’s Pseudo-Dynamic Method
  • Apr 17, 2026
  • Journal of Earthquake Engineering
  • Saikat Kuili + 1 more

ABSTRACT Deciphering earthquake record complexity is vital for designing resilient engineering solutions. Steedman and Zeng’s pseudo-dynamic method captures single-frequency harmonic responses but overlooks broad frequency content and propagation characteristics of seismic waves. This study introduces a novel analytical framework conveying the applicability of this method for time-domain analysis of retaining walls under earthquakes. Newly derived formulations incorporate interference from all seismic harmonics, revealing distinct non-linear trends in active stress distribution. Parametric assessments indicate that low shear wave velocity backfills amplify non-linearity in active stress distribution, while smooth walls, low-friction backfills, and elevated unit weights increase seismic response magnitudes.

  • Research Article
  • 10.1108/ecam-04-2025-0562
The silent transmission belt: testing safety bullying's indirect effects on construction incident learning failures via voice suppression
  • Apr 14, 2026
  • Engineering, Construction and Architectural Management
  • Lingna Lin

Purpose This study aims to conduct a theoretical reconstruction of the phenomenon of failure to learn from incidents (FLFI) in construction projects by conceptualizing safety bullying (SB) not as episodic interpersonal misconduct, but as an institutionalized governance mechanism that structurally suppresses voice. We examine how project participant silence (PPS) operates as the transmission channel through which coercive control cultures translate managerial pressure into learning breakdowns, thereby challenging dominant explanations that attribute learning failure primarily to weak implementation or individual error. Design/methodology/approach Data from 215 valid questionnaires were analyzed using partial least squares structural equation modeling (PLS-SEM). The structural model's stability was verified via a bootstrapping procedure with 3,000 resamples. Findings PPS exerts a significant and substantial effect on FLFI. SB shows no direct impact on learning outcomes but operates entirely through PPS, indicating a full mediation effect. This indirect-only pattern reveals that learning failures emerge when governance-induced silence distorts feedback loops and fragments safety knowledge flows. Originality/value The study advances theory by reframing learning failure as a systemic managerial pathology rather than an implementation deficit. By identifying PPS as a structural inhibitor embedded in temporary project governance, it bridges organizational silence research with resilience engineering and extends high-reliability organization theory into project-based contexts. Practically, it shifts managerial focus from correcting frontline errors to redesigning silence-producing governance structures.

  • Research Article
  • 10.1002/sys.70055
Evaluating Complex System Resilience Through BARD: A Bifurcation Analysis for Resilience Diagnostics Framework
  • Apr 3, 2026
  • Systems Engineering
  • Rogelio Gracia Otalvaro + 1 more

ABSTRACT Understanding and managing modern systems is becoming more challenging as they grow in complexity and become more integrated, as emphasized in the INCOSE Systems Engineering Vision for 2035. These new challenges increase the risk of system failure. Resilience Engineering is a subfield within Systems Engineering that studies system performance in the face of disruptions. Due to the term resilience having multiple connotations, many methods measure resilience in systems differently. Moreover, traditional methods to measure resilience, such as linear recovery or probability‐based models, can become insufficient as systems grow in size, complexity, and nonlinearity. Bifurcation Analysis (BA) is a mathematical approach to understanding system behavior under changing conditions. BA is commonly used to study nonlinear systems and transition states known as bifurcations. While it has been extensively used in many fields, BA is not widely used in Resilience Engineering. This paper suggests the BARD—Bifurcation Analysis for Resilience Diagnostics—framework to aid Resilience Engineering practitioners in addressing system resilience in complex systems. While drawing from control theory, the framework is used solely as a diagnostic instrument to help system engineers identify risks and performance regimes; the framework does not attempt to design or tune control systems. The BARD framework is applied to two cases to demonstrate its uses and potential. Contributions are an overview of the current state of Resilience Engineering and Bifurcation Analysis, the introduction of BARD as a general‐use framework to assess resilience via Bifurcation Analysis, and two applications of the framework.

  • Research Article
  • Cite Count Icon 1
  • 10.1016/j.biotechadv.2026.108908
Closing the loop: AI-driven integration of multi-omics and phenomics for systematic resilient crop engineering.
  • Apr 1, 2026
  • Biotechnology advances
  • Zheng Yang + 1 more

Closing the loop: AI-driven integration of multi-omics and phenomics for systematic resilient crop engineering.

  • Research Article
  • 10.54414/jivx3192
TOURISM INDUSTRY IN ISLAMIC COUNTRIES
  • Apr 1, 2026
  • Scientific bulletin
  • Javad Abdulhasan Aliyev

The tourism industry has become an increasingly important driver of economic growth, diversification, and employment in Islamic countries. This article examines the tourism sector from an economic and institutional perspective, focusing on its development potential, regulatory environment, and structural challenges. Islamic countries possess significant tourism advantages, including rich cultural heritage, religious pilgrimage sites, historical landmarks, and diverse natural resources. At the same time, tourism development in these countries is shaped by Islamic cultural values, social norms, and Shariah-influenced regulatory frameworks, which distinguish their tourism models from conventional destinations. The study analyzes the economic contribution of tourism through income generation, employment creation, and foreign exchange earnings, while also assessing institutional capacity, governance quality, and policy coherence. Special attention is given to halal tourism as a rapidly growing market segment that aligns tourism services with ethical and religious principles. Despite its strong potential, the tourism industry in many Islamic countries faces challenges related to infrastructure gaps, regulatory inefficiencies, geopolitical risks, and environmental sustainability. The article concludes that effective institutional reforms, human capital development, and sustainable tourism policies are essential for transforming tourism into a resilient and inclusive engine of long-term economic growth in Islamic countries. Keywords: Tourism industry, Islamic countrie,; economic development, institutional framework, sustainable tourism.

  • Research Article
  • 10.3390/catal16040291
Global Research Evolution in Catalytic Water and Wastewater Treatment: A Bibliometric Analysis Toward Sustainable and Resilient Technologies
  • Mar 27, 2026
  • Catalysts
  • Motasem Y D Alazaiza + 6 more

The increasing global demand for sustainable water purification technologies has accelerated research on catalytic degradation and advanced oxidation processes for the removal of refractory pollutants. This study provides a comprehensive bibliometric analysis of global research trends in catalytic water and wastewater treatment from 2010 to 2025, combining quantitative mapping with a qualitative synthesis of emerging technological directions. Bibliographic data were retrieved from the Scopus database and screened using the PRISMA framework, followed by analysis using VOSviewer (v1.6.20) and OriginPro (version 2023, OriginLab Corporation, Northampton, MA, USA) to examine publication growth, citation patterns, international collaboration networks, and thematic evolution. A total of 1550 publications, including 1265 research articles and 285 review papers, were analyzed. The results show a significant increase in research output after 2015, reflecting growing global attention to water sustainability and environmental remediation. China, the United States, and India were identified as the leading contributors, with strong international collaboration networks. Keyword co-occurrence analysis revealed three dominant research themes: photocatalytic degradation and semiconductor engineering, Fenton and Fenton-like advanced oxidation processes, and emerging hybrid catalytic systems involving carbon-based materials and metal–organic frameworks. The analysis also indicates a recent shift toward multifunctional hybrid catalysts designed to improve efficiency, stability, and performance in complex wastewater systems. These findings highlight key scientific developments and suggest future research priorities, including green catalyst synthesis, reactor and process scale-up, AI-assisted catalyst design, and life-cycle sustainability assessment to support the transition from laboratory research to practical water treatment applications.

  • Research Article
  • 10.9734/jeai/2026/v48i44141
Muga Silk Production: Challenges, Advances in Rearing Technologies and Strategies for Climate Resilience
  • Mar 23, 2026
  • Journal of Experimental Agriculture International
  • Abhishek Singh + 5 more

The significance of sericulture in rural economies is profound, as it not only secures livelihoods but also preserves cultural heritage and biodiversity. Across silk-producing nations, sericulture sustains rural communities by generating employment—particularly for women and marginalized groups—and by supporting cottage-based industries. Muga silk which is prized for its natural golden color, is produced mainly in the Northeastern state of India. The larvae are usually reared in the outdoors on two primary host plants i.e., som and soalu, which directly influence the quality and natural golden colour of the muga silk. However, muga farmers faces major challenges such as host plant’s diseases and pests, muga larvae’s disease and pest, difficulties in seed production because of increasing effects of climate change and air pollution. In this review we have collected the relevant literature from the various database such as Scopus, ScienceDirect, Research Gate and Google Scholar and reviewed the current state and future prospects of the muga silk industry. Here we identify the key research gaps and priority areas, which include climate change adaptation strategies like rescheduling the rearing time, host plant breeding programs, the development of disease-resistant biotypes and the establishment of effective technology transfer advisory services.

  • Research Article
  • 10.1093/intqhc/mzag032
Resilience practices of healthcare professionals during the hospital discharge process: a qualitative study
  • Mar 15, 2026
  • International Journal for Quality in Health Care
  • Jee-In Hwang + 3 more

BackgroundEfficient hospital discharge is critical for improving patient experience and post-discharge safety. This study aimed to understand the daily hospital discharge process and explore healthcare professionals’ experiences with the challenges, adjustments, and outcomes from a Safety-II perspective.MethodsThis qualitative study was conducted with 30 healthcare professionals from two general hospitals using semi-structured interviews and focused ethnography observations. Each interview lasted an average of one hour, and the total observation time was 99.6 h over 41 observation sessions. Data were analysed using the Functional Resonance Analysis Method and the Concepts for Applying Resilience Engineering model 2.0, along with thematic analysis.ResultsFunctions with high variability impact were ‘to interview patient/family for discharge’ and ‘to share patient/family requests’ in terms of endogenous and cross variability. Healthcare professionals frequently encountered challenges related to ‘process’ and ‘communication’, mainly owing to patient/family requests and conditions. The emergent theme was ‘ameliorating variabilities due to couplings between healthcare professionals’ behaviours and unpredicted patient/family requests under time pressure’. Most adjustments to cope with challenges were made in the ‘process-how’ and ‘process-when’ categories. The theme was ‘meeting discharge time expected by patient/family by utilizing internal and external resources and performing additional work’. While these adjustments frequently led to positive outcomes, participants sometimes experienced dissatisfaction and concerns about potential errors. The main themes of post-discharge contact from patients and families included managing medications, wounds, and symptoms.ConclusionDuring the time-constrained discharge process, healthcare professionals primarily adjusted their work processes to adapt to the challenges they faced, which resulted in both positive and negative outcomes. The discharge process should focus on strengthening functions to enhance the post-discharge care management of individual patient/family by reducing unnecessary variability in communicating patient/family requests. Implementing support systems to promote adaptive practices among healthcare professionals is recommended.

  • Research Article
  • 10.1080/23311932.2026.2641276
Impact of climate smart agricultural practices on technical efficiency among high value vegetable farming in Northwestern Ethiopia
  • Mar 11, 2026
  • Cogent Food &amp; Agriculture
  • Mezgebu Aynalem + 2 more

Climate change and variability increasingly constrains the technical efficiency (TE) of smallholder vegetable production. This study analyzes the impact of climate smart agricultural (CSA) practices on TE among high value vegetable production in Northwestern Ethiopia. The analysis draws on cross sectional data from 550 smallholder farmers selected through a multistage sampling procedure from the North Gojjam, Awi, and South Gondar zones of Amhara region. TE was first estimated using stochastic frontier analysis, after which a multinomial endogenous switching regression (MESR) model was employed. Through factor analysis, CSA practices were categorized into three bundled domains: soil management (S), climate resilient technology (C), and water management (W). Integrated CSA adoption enhanced TE in onion 19.1% to 20.5%, potato 38.3% to 39.5%, and tomato 22.0% to 23.1% efficiency, depending on the combination of CSA practices. The greatest efficiency gains were, however, realized from the joint adoption of soil management and water management practices and integration of soil management and climate resilient technologies. The study concludes that bundled CSA adoption improves resource use efficiency among vegetable producers. Based on these findings, policy implications point to prioritizing context specific, bundled CSA interventions tailored to crop type and agro ecological conditions, rather than one size fits all approaches. Strengthening extension services, improving access to credit, and expanding climate advisory support can facilitate adoption and increase efficiency.

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