Secondary Resources Research Articles

Effects of International Climate Policy on Renewable Energy Consumption: The Context of the Kyoto Protocol

Purpose: The key objective of this study is to explore the effect of the Kyoto Protocol on Renewable Energy Consumption at the national level.
 Methodology: The study employed the matching and difference-in-differences (DiD) estimation approaches. The study analysis is based on secondary resources assessed through openly access documents, journals, and libraries. Data used in the analysis were collected from publicly available data sources.
 Findings: The study finds that the Kyoto Protocol has a significant and positive impact on renewable energy consumption at the national level in the Annex I countries compared to non-Annex I countries. It indicates that there has been a specific effect of the Kyoto Protocol on renewable energy in Annex I countries since these countries were legally bound with emissions reduction commitments of the Protocol. Findings indicate that Annex I countries overlooked environmental pollution at the early stages of their economic and industrial development, but with their higher economic development, they are taking measures to prevent environmental pollution, such as increasing REC. Findings here reckon with the argument of the effectiveness of global climate governance in mitigating climate change effects.
 Unique Contribution to Theory, Practice and Policy: Findings support the Environmental Kuznets Curve (EKC) proposition. Results stresses on the effectiveness of global climate governance for mitigating climate change effects. In this context, rich countries should deliver more financial and technological supports to poor countries.

Evaluation of a digital patient education programme for Chinese immigrants after a heart attack.

To evaluate a self-administered digital education resource for patients after a heart attack (adapted simplified Chinese version of Cardiac College™) on secondary prevention knowledge and health behaviour change outcomes. Chinese immigrants recovering from a heart attack were recruited from cardiac rehabilitation programmes at four metropolitan tertiary hospitals. Participants provided access to Cardiac College™ (adapted simplified Chinese version), a self-learning secondary prevention virtual education resource over 4 weeks. The web-based resources include 9 booklets and 10 pre-recorded video education sessions. Assessments included health literacy, secondary prevention knowledge, self-management behaviours, self-reported physical activity, and a heart-healthy diet. Satisfaction, acceptability, and engagement were also assessed.From 81 patients screened, 67 were recruited, and 64 (95.5%) completed the study. The participants' mean age was 67.2 ± 8.1 years old, 81.2% were males, and the majority had no English proficiency (65.6%). Following the intervention, significant improvements were observed for secondary prevention knowledge overall and in all subdomains, with the most improvement occurring in medical, exercise, and psychological domains (P < 0.001). Dietary and self-management behaviours also improved significantly (P < 0.05). According to participants, the educational materials were engaging (100%), and the content was adequate (68.8%); however, 26.6% found the information overwhelming. Overall, 46.9% were highly satisfied with the resources. A self-learning virtual patient-education package improved secondary prevention knowledge and self-care behaviour in Chinese immigrants after a heart attack. The culturally adapted version of Cardiac College™ offers an alternative education model where bilingual staff or translated resources are limited.

Adsorption of rare earth elements on a magnetic geopolymer derived from rice husk: studies in batch, column, and application in real phosphogypsum leachate sample.

There is a growing need to develop new strategies for rare earth element (REE) recovery from secondary resources. Herein, a novel approach to utilize biogenic silica (from rice husk) and metakaolin was employed to fabricate magnetic geopolymer (MGP) by incorporating metallic iron. The fabricated MGP adsorbent material was used to uptake Ce3+, La3+, and Nd3+ from synthetic solutions and real phosphogypsum leachate in batch and column modes. The MGP offers a negatively charged surface at pH above 2.7, and the uptake of REEs rises from pH 3 to 6. The kinetic study validated that the kinetics was much faster for Nd3+, followed by La3+ and Ce3+. A thermodynamic investigation validated the exothermic nature of the adsorption process for all selected REEs. The desorption experiment using 2mol L-1 H2SO4 as the eluent demonstrated approximately 100% desorption of REEs from the adsorbent. After six adsorption-desorption cycles, the MGP maintained a high adsorption performance up to cycle five before suffering a significant decrease in performance in cycle six. The effectiveness of MGP was also assessed for its applicability in recovering numerous REEs (La3+, Ce3+, Pr3+, Sm3+, and Nd3+) from real leachate from phosphogypsum wastes, and the highest recovery was achieved for Nd3+ (95.03%) followed by Ce3+ (86.33%). The operation was also feasible in the column presenting suitable values of the length of the mass transfer zone. The findings of this investigation indicate that MGP adsorbent prepared via a simple route has the potential for the recovery of REEs from synthetic and real samples in both batch and continuous operations modes.

The Potential Material Flow of WEEE in a Data-Constrained Environment—The Case of Jordan

The rising concerns about electric and electronic equipment waste (WEEE) come from the rapid increase in demand for appliances and the decreasing lifetimes of equipment. Setting a sustainable WEEE management system that exploits this secondary resource is paramount to maximize resource efficiency, mitigate its environmental impact, and stimulate the circular economy. This paper aims, for the first time, to quantify the material flow expected from recycling the generated WEEE, propose the number of plants required to recycle this secondary resource, and outline the expected economic and environmental benefits that could be achieved from recycling operations. The findings of material flow calculations show that the amount of steel, copper, and aluminum is predominant in the WEEE composition. Also, the expected metal content in WEEE in 2022 is approximately 26 kt, 3.3 kt, and 2.5 kt, respectively. These are expected to substantially increase to approximately 109 kt, 11.9 kt, and 9 kt for the three metals in 2050, respectively. Other valuable metals are doubling their quantities between 2022 and 2050 to reach approximately 1133 kg silver and 475 kg gold. Approximately, four treatment plants are required to recover these materials in 2030 with relative installation costs of USD 100 million. The forecasted financial revenues of recovering materials included in WEEE and indicators for environmental impact based on life cycle assessment (LCA) are calculated. The results of this study can serve as a preliminary reference for future usage in guiding effective planning for WEEE recycling and sustainable management in the country.

The Characterization of Residues Related to the Roasting– Leaching–Electrowinning Zinc Production Route for Further Metal Extraction

Super-hot acid leach residue is generated during zinc production in the roasting–leaching–electrowinning route, where both primary and secondary resources are used as feed material. This residue may contain valuable metals, such as lead, zinc, and iron, as well as precious metals, such as gold and silver. Four materials, namely super-hot acid leach residue, a residue formed when super-hot acid leach residue is selectively leached for lead with triethylenetetramine, as well as flotation concentrate, and flotation tailings formed in a selective silver flotation process with super-hot acid leach residue as the feed material were characterized to obtain a deeper understanding of possible further metal extraction. These four materials were characterized for chemical composition, mineralogy, and mineral distribution via chemical analyses, X-ray diffraction, and energy-dispersive scanning electron microscopy, respectively. The scanning electron microscope images showed that the materials have large variations in particle size distribution and composition. The results showed that the main lead phase in super-hot acid leach residue is lead sulfate, whereas it is mostly converted to lead sulfide during the selective lead leaching of the super-hot acid leach residue. The remaining lead sulfate is found in a solid solution with barium sulfate. Extracting lead from super-hot acid leach residue via triethylenetetramine leaching resulted in increased concentrations of gold and silver by 41% and 42%, respectively. The identified silver phases in super-hot acid leach residue may correspond to silver sulfide, silver chloride, and elementary silver, where silver sulfide was the most commonly occurring silver phase. After leaching this selectively for lead with triethylenetetramine, similar silver phases were identified, but silver sulfide and silver chloride occurred to a similar extent. Additionally, silver copper sulfide was detected. The presence of different silver phases might pose a challenge to reaching high silver recovery during leaching as the optimum leaching conditions differ somewhat. Furthermore, elemental sulfur, with a tendency to coat gold and silver particle surfaces, which is indicated to be present in all materials except the silver flotation tailings, may hinder metal extraction.

Specific features of wood resources processing at forest industry enterprises

The paper presents the results of scientific research of certain features of wood resources processing at the enterprises of the forest industry. Considering that the forest industry is actively developing, the volumes of processed raw materials are increasing, the amount of generated secondary wood resources (waste) is increasing. The purpose of the work is to identify some key features of their use. For this purpose, the analysis of literary sources was used. Practical experience of domestic and foreign timber companies was also considered. As a result, a significant lag of the Russian timber industry from foreign best practices was revealed. In particular, the volume of manufactured products is significantly inferior to those of timber reserves and processed raw materials. This is due to the low share of participation and efficiency in the utilization of secondary wood resources. Another important conclusion was that the main problem in terms of the secondary wood resources utilization is to find optimal ways of using secondary wood raw materials. Significant volumes of wood waste generation in various technological processes were shown. Separate requirements were revealed and demonstrated to the initial raw materials to obtain products from the raw materials of wood. An important outcome was that the higher feedstock requirements of large-scale production facilities were identified. Smaller production facilities are often more flexible and adaptable to the available resources.

Enhancing technical solutions to reduce fuel energy consumption of drilling equipment during well drilling with air cleaning

Efficient fuel and energy resource utilization in drilling equipment can be attained through strategies such as decreasing the relative consumption in technological systems during well drilling, enhancing the integration of secondary energy resources in the equipment's power supply system, and refining the design of drilling equipment and technologies. This article showcases the outcomes of pilot studies conducted on a diesel power plant within a drilling rig and a device designed for recycling secondary energy resources from a compressor.

Heat pump technology for utilizing the heat of secondary energy resources in the catalytic method of obtaining biodiesel

Heat pump technology for utilisation of heat of secondary energy resources in catalytic method of production of biodiesel fuel is implemented. Algorithm for control of technological parameters at all stages of production of biodiesel fuel is proposed and analysis of parameters of its quality is performed. Heat pump system is represented in the form of two recirculation circuits of low-potential and high-potential heat carriers, preparation of which was carried out in stages of low and high pressure of heat pump. Exergetic analysis was performed, functional dependencies of exergy flows coming out of the considered types of process equipment were obtained. The obtained hybesel fuel complied with the requirements of GOST 23513-79. The proposed heat pump technology reduced specific energy consumption by 13-14%; improve environmental safety at all stages of the process; maximum reduction of spent heat carriers emission into the ambient atmosphere.

Effect of secondary material resources on quality indicators of fabric fabrics

In this article 100% cotton fiber waste, 70% rogoza plant fiber waste 30% cotton fiber waste bedding, 50% rogose plant fiber waste 50% cotton fiber waste bedding, 30% rogose plant fiber waste 70 % Air permeability, longitudinal and transverse penetration, hygroscopicity and dye strength of upholstery fabrics obtained from a mixture of cotton fiber waste were determined, and the optimal variant of secondary material resources in the production of upholstery fabric was recommended.

A holistic review on lithium-ion battery direct recycling from electrolyte to electrodes

Lithium-ion batteries (LIB) present a global challenge in managing their end-of-life (EOL). As LIB's raw materials are critical and valuable, they are considered a secondary resource. The annual volume of...

Поєднання енерго-ресурсозберігаючих та екологічно безпечних технологій в проєктах ДП «ГИПРОКОКС»

DOI: 10.31081/1681-309X-2024-0-1-21-26 Specialty 161. U.D.C. 621.311 COMBINATION OF ENERGY-SAVING, RESOURCE-SAVING AND ENVIRONMENTALLY FRIENDLY TECHNOLOGIES IN THE PROJECTS OF THE SE "GIPROKOKS" © T.F. Trembach, M.V. Mezentseva, I.O. Radychuk (STATE ENTERPRISE "STATE INSTITUTE FOR DESIGNING ENTERPRISES OF COKE OVEN AND BY-PRODUCT PLANTS'' (SE "GIPROKOKS''), 61002, 60 Sumska str., Kharkiv, Ukraine) The article deals with the issues of energy efficiency and implementation of environmental technologies in coke production, which is one of the most energy-intensive and environmentally hazardous, but at the same time has a great potential of fuel and energy resources. The experience and achievements of SE GIPROKOKS in the use of modern technologies aimed at reducing energy and resource consumption, as well as ensuring environmental safety, are reflected. Particular attention is paid to innovative approaches to the development, design and implementation of environmentally friendly technologies in production, which help reduce emissions and negative impact on the environment. The article analyses the application of organisational, technical, design, technological and other energy saving measures in the projects of SE “GIPROKOKS” for metallurgical and coke-chemical enterprises. The most effective of these are technological: improving the quality of coke, what, when used in the blast furnace process, leads to a reduction in energy consumption; using less energy-intensive technologies and secondary energy resources. These technologies primarily include the coal charge stumping technology. Flue gas heat from the coke oven battery heating system has a significant energy potential that is released into the atmosphere, leading to irreversible heat losses and causing a negative impact on the environment. The use of a heat recovery unit with thermal flue gas treatment will significantly reduce emissions of harmful components in flue gases into the atmosphere. In its projects, SE “GIPROKOKS” pays considerable attention to the use of secondary resources generated in coke production processes, which is a vivid example of combining energy-saving, resource-saving and environmentally friendly technologies. Keywords: coke production, secondary products, utilisation, energy saving, resource saving, environmental safety, technological measures. Corresponding author: T.F. Trembach, e-mail: ozos@giprokoks.com

Eco-friendly hybrid binders based on waste from the chemical industry

The purpose of the study is to show the possibility of using high-tonnage waste from the chemical industry in the production of building materials. Methods and materials. Methods of data comparison and analysis were used. Solid residues of distiller sludge with a moisture content of 25-30%, an active calcium oxide content of 12-13% and quartz sand with a grain size of 2.2, humidity of 5-6% were used as materials. Results. Compositions and methods for obtaining a cement-free binder based on the solid residue of soda and quartz sand production are proposed. The possibility of obtaining a binder based on the solid residue of distiller slurries according to two technological schemes: drying of the solid residue and grinding together with quartz sand; firing of the solid residue and grinding together with quartz sand, has been confirmed by our tests. The introduced concept of “Eco-friendly hybrid cements” (Eco-friendly hybrid binders (EHB)) emphasizes that they are binders made up of multicomponent mineral raw materials of secondary resources. Practical significance. Solid by-products of the chemical industry can be used as an auxiliary inorganic component. This will make it possible to create eco-friendly hybrid cements ready for use, which are sealed only with water, which contributes to the development of such binders by industry and the rational use of secondary mineral resources.

Decarbonization of an economy: creating economic prerequisites through the development of the waste recycling accounting at landfills

Reforming the methodology of waste accounting to decarbonize the environment is an ecological innovation in information support. Reformation allows organizations to understand their environmental responsibility, economic benefits from involving waste in re-production. The purpose of this study is a theoretical justification and development of accounting methodology for municipal waste operating in unequipped landfills. To get the purpose, the article presents the economic essence of “organic municipal waste”. The natural transformation of organic municipal waste into a biogas in the landfill body requires the allocation of two new accounting objects: “biomass of municipal waste” and “biogas reserves”. The article suggests an interconnected methodology for accounting for “biomass of municipal waste” as a secondary resource, and “biogas reserves” as renewable natural capital reflecting the economic potential of the landfill. The presented methodology will provide users with information about: the contribution of organic waste to reproduction; the energy value of the landfill and its economic potential; consumption of renewable natural capital; reduction of greenhouse gas emissions. The developed recommendations regarding the accounting of municipal waste in organizations operating unequipped landfills increase the information content, which is important for making management decisions, attracting investments, aimed at the disposal of carbon gases.

Experiment-based conceptualization of an automated disassembly process chain for the recycling of lithium-ion battery modules

As the volume of end-of-life lithium-ion batteries (LIB) used in electric vehicles increases, so does the demand for recycling to recover valuable active materials as secondary resources, reducing the need for primary raw materials and minimizing supply dependencies. In addition to pyro- and hydrometallurgy recycling processes, an increasingly examined approach is the direct recycling route, which involves disassembling battery systems into modules, modules to cells, and ultimately cells to electrodes. To minimize passive materials such as various metals from the housing, joints, arresters, plastics, foams, and adhesives in the subsequent crushed mass, the introduction of module disassembly processes into the existing LIB recycling process chain is promising for the resulting increase in recyclate purity. This study presents the conceptualization of a LIB module disassembly process chain which aims to elevate the depth of disassembly of LIB during early recycling stages. A reverse engineering approach is used to recover individual cells from two battery modules of one specific automotive manufacturer by removing their casing through milling and disconnecting the cells from the arresters. The experimental results are analyzed for influences on the disassembly possibilities for individual components as well as the interactions within the system, enabling the elaboration of a priority graph and a disassembly plan. In order to allow for scalable recycling process chains suitable for very high quantities, a concept for a fully automated and variant-compatible robot application based on the experiment is derived. Furthermore, the depth of disassembly is compared with the corresponding reduction of passive materials in the crushed mass. The findings indicate that several module components can be disassembled, resulting in cell recovery and a reduction of metal and plastic in the crushed mass by about 17 %, highlighting the importance of robotic disassembly in enhancing material separation efficiency during LIB recycling.

SDG-16 and Access to Justice for Marginalized Dalit: A Study of Patepur Village of Ghazipur District of Uttar Pradesh

SDG-16, one of the 17 Sustainable Development Goals set by the United Nations in 2015, aims to promote peaceful and inclusive societies, ensure access to justice for everyone, and establish effective, accountable, and inclusive institutions at all levels. Within SDG-16, the third target specifically addresses the importance of equal access to justice. Access to justice is an important legal right in any democratic society. It ensures that everyone is treated fairly and equally under the law. This essential entitlement plays a crucial role in upholding justice principles and creating an environment where legal solutions are fair for all. It’s a cornerstone in protecting individual freedom and rights, emphasizing that legal protections should be available to everyone, regardless of their background or status in society. However, this right remains elusive for a significant portion of the population – the Dalit communities, often characterized by untouchables, socially marginalized and downtrodden. This study delves into the nuanced dimensions of justice accessibility for marginalized Dalit communities, with a specific focus on Patepur village situated in Ghazipur district of Uttar Pradesh. This research paper aims to evaluate the current state of justice accessibility for Dalit individuals and pinpoints the major barriers impeding their access to justice. One of the most fundamental challenges is the limited awareness of legal rights. They are often unaware of their rights and the available legal remedies, leaving them at a significant disadvantage when faced with legal issues. This lack of awareness further exacerbates their vulnerability and perpetuates a cycle of injustice. Socioeconomic barriers are equally daunting. Economic constraints and the associated difficulties in affording legal representation often leave these communities without recourse when confronted with legal problems. These barriers effectively deny them access to the justice they are entitled to. Furthermore, the inadequacy of legal infrastructure in marginalized areas compounds the issue. Often, individuals from Dalit communities are forced to travel long distances to access legal services, incurring additional expenses and hardships. Disparities in legal representation are yet another major obstacle. The study employs a mixed-methods approach, incorporating semi-structured interviews, and secondary resources such as Government reports, media reports, and relevant legal and research documents. By applying these sources, the research seeks to provide a comprehensive understanding of the multifaceted challenges that marginalized Dalits of this area face in their pursuit of justice. The key findings of this study are expected to highlight several critical aspects, including the limited awareness of legal rights among Dalit communities, the influence of socio-economic barriers, inadequate infrastructure, and disparities in legal representation.

Water treatment sludge management in the context of changing environmental legislation in Russia

To consider changes in the regulation of sludge handling in natural and waste water treatment, national projects that contribute to the greening of the sludge handling process, and to present an overview of the market of domestic equipment for sludge treatment and disposal. The changes in regulatory, technical and legal documentation were analysed in the environmental protection sphere and in the field of sludge handling at centralised water treatment plants. Using open sources of information, the market of Russian equipment for sludge dewatering, drying and incineration was reviewed. Taking into account the changes in legislation in the field of waste management, clarifications of the Ministry of Natural Resources and Ecology of the Russian Federation, natural and sewage sludge can be positioned not only as a waste, but also as a secondary resource, secondary raw material or by-product. The adopted amendments do not reduce the responsibility of water supply and sewerage organisations in matters of sludge handling; they are aimed at increasing the interest of industrialists in the involvement of sludge in industrial turnover and simplification of sludge disposal processes. The amendments to the regulatory and legal documentation are likely to contribute to the elimination of such low-ecological objects of natural and sewage sludge disposal as deposition sites. It seems necessary to take incentives for organisations willing to use sludge in their production.

ВОПРОСЫ ОБЕСПЕЧЕНИЯ ЭКОЛОГИЧЕСКОЙ БЕЗОПАСНОСТИ ГОРОДСКОЙ СРЕДЫ НА ОСНОВЕ РЕСУРСОСБЕРЕГАЮЩЕЙ МОДЕЛИРЕМОНТНО-СТРОИТЕЛЬНЫХ РАБОТ

The relevance of the study is caused by unresolved problems of preventing the negative impact of production and consumption waste generated in the process of life support of settlements. According to the authors, the most promising area for the study of such a life–threatening technosphere object as waste is the sphere of construction and urban management and its most important sector - construction, reconstruction, repair, renovation of real estate. During the study, it was found that the waste of repair and construction production, most of its mass, which are low-hazard and practically harmless to the environment, serve as a source of various types of valuable secondary raw materials. This raw material can be used in the production of a wide range of construction and other products, the production of works for various purposes, as sources of alternative energy sources. The purpose of this study was to form the configuration of a resource-saving model of repair and construction works as a mechanism for ensuring the environmental safety of the urban environment, preventing natural emergencies, their adverse consequences for the life of the population, the sustainable functioning of economic facilities, conservation and protection of the natural environment and natural resources. The scientific approach proposed in the work is aimed at obtaining two important scientific and practical results: preventing the negative impact of waste on the environment at the source of their formation: the processes of repair and construction work and, at the same time, the technological transformation of useful resource components of waste into secondary material and energy resources. This ensures the second important result: the preservation of the country's natural resources by replacing them with secondary raw materials and alternative energy sources. The research is applied in nature, its results can be used in the implementation of measures for the transition of the construction and urban management system to a resource-saving technological way of environmentally safe life support for settlements.

Recycling of yeast multifunctional autolysates and extracts in the food industry

Recycling of industrial waste is one of the most crucial problems for the food industry. The forces of modern researchers are focused on solving this problem and using the biopotential of spent resources. Residual yeast from fermentation industries, in particular brewing, is of particular interest among the variety of food production waste. This is due to the extremely rich chemical composition of the yeast cell, and the possibility of obtaining a wide range of ingredients that exhibit both biological activity and technologically significant properties. Spent brewer's yeast is rich in proteins and carbohydrates, as well as vitamins B and minerals. The protein fraction, which accounts for 45–60% by dry weight (dw), contains all essential amino acids in sufficient quantities, which allows considering this secondary material resource an excellent source of protein with high biological value and a well-balanced AA profile. The carbohydrate fraction, comprising approximately 40% by dw, consists of intracellular carbohydrates (such as simple sugars and glycogen) as well as cell wall polysaccharides (such as β-glucan and α-mannan). Special emphasis is placed on the cell wall components due to their significant multidirectional biological activity and technologically important properties. Thus, β-glucan and α-mannan, along with emulsifying, sorbing and stabilizing properties, exhibit antioxidant and antimicrobial activity, immunomodulatory and prebiotic properties. This review presents an analysis of yeast autolysates and extracts sources as well as the influence of cultivation conditions and production methods on their chemical composition.

Energy efficiency analysis of caustic soda production process

The increase in the cost of fuel and energy resources motivates industrial enterprises to introduce new technical solutions for their effective use. At the same time, as a result of the production ac-tivities of industrial enterprises, a significant amount of waste is generated that negatively affect human health and the environment. Such enterprises include caustic soda production plants, the technology of which is associated with the formation of thermal and combustible secondary energy resources in the form of steam, condensate, process water, etc. Such types of resources may be useful to use for the production of thermal energy for the company's own needs, or heating of raw materials or material flows involved in the technological chain. The technology of caustic soda production is considered it this paper, the basic structure of production is discussed, the material balance is given, options for improving the efficiency of energy resources are proposed.

Genetic kidney disease has a higher likelihood and cost of inpatient admissions compared to other aetiologies

PurposeThere is increasing recognition of monogenic aetiologies for kidney disease. We sought to identify whether genetic kidney disease (GKD) has distinct hospitalization patterns compared to other forms of chronic kidney disease (CKD). MethodsHealth service utilization analysis was undertaken in a CKD cohort study across public hospital services in Queensland, Australia. CKD due to clinically coded potential monogenic causes was compared to all other causes in terms of annual frequency, cost, and type of hospital admission. ResultsWe analyzed 7 years of hospital admissions data (809,188 admissions) among 29,046 patients. Compared to non-genetic CKD, GKD was associated with a higher likelihood and cost of admissions. GKD had consistently more admissions (mean excess annual number of admissions increasing from 5.2 in year 1 to 13.4 in year 7) and more costly admissions (mean excess annual cost increasing from $5,265 in year 1 to $12,993 in year 7). This gap in hospitalization likelihood and cost increased over time for both surgical and medical admission episodes, but not for all (immunological, cancer) causes of admissions. ConclusionUnderstanding the nature and extent of differences in healthcare needs between GKD and other CKD will enable better secondary prevention and inform resource allocation decisions to reduce healthcare system pressures attributable to knowable causes.