Service Area Research Articles

Requirements and Barriers for Human-Centered SMEs.

With the advantages of new technologies and rising demand from customers, it is necessary to improve the manufacturing process. This necessity was recognized by the industry; therefore, the concept of Industry 4.0 has been implemented in various areas of manufacturing and services. The backbone and main aspect of Industry 4.0 is digitalization and the implementation of technologies into processes. While this concept helps manufacturers with the modernization and optimization of many attributes of the processes, Industry 5.0 takes a step further and brings importance to the human factor of industry practice, together with sustainability and resilience. The concept of Industry 5.0 contributes to the idea of creating a sustainable, prosperous, and human-friendly environment within companies. The main focus of the article is to analyze the existing literature regarding what is missing from the successful implementation of human centricity into industry practice, namely in small and medium-sized factories (SMEs). These findings are then presented in the form of requirements and barriers for the implementation of human centricity into SME factories, which can serve as guidelines for implementing human-centered manufacturing using axiomatic design theory in SMEs, which can serve as a roadmap for practitioners.

Mental health care use and quality among Medicaid adults with serious mental illness receiving care at Federally Qualified Health Centers vs. other settings

BackgroundFederally Qualified Health Centers (FQHCs) are a critical source of care for medically underserved populations and often serve as medical homes for individuals with serious mental illness (SMI). Many FQHCs provide mental health services and could facilitate access to mental health treatment within and outside of FQHCs. This study compared mental health care utilization and acute care events for adult Medicaid enrollees with SMI who receive care at Federally Qualified Health Centers (FQHCs) vs. other settings.MethodsThis study used the 2015–2016 Massachusetts All-Payer Claims Database to examine outpatient mental health care and acute care events for 32,330 Medicaid adults, ages 18–64 and with major depressive, bipolar, or schizophrenia spectrum disorders (SSD), who resided in FQHC service areas and received care from FQHCs vs. other settings in 2015. Multivariable linear regressions assessed associations between receiving care at FQHCs and outpatient mental health visits, psychotropic medication fills, and acute care events in 2016.ResultsThere were 8,887 (27.5%) adults in the study population (N = 32,330) who had at least one FQHC visit in 2015. Those who received care at FQHCs were more likely to have outpatient mental health visits (73.3% vs. 71.2%) and psychotropic medication fills (73.2% vs. 69.0%, both p < .05), including antidepressants among those with depressive disorders and antipsychotics among those with SSD. They were more likely to have ED visits (74.0% vs. 68.7%), but less likely to be hospitalized (27.8% vs. 31.9%, both p < .05). However, there was no significant difference in the likelihood of having an acute psychiatric hospitalization (9.5% vs. 9.8%, p = .35).ConclusionsAmong Medicaid enrollees with SMIs who had access to care at FQHCs, those receiving care at FQHCs were more likely to have outpatient mental health visits and psychotropic medication fills, with lower rates of hospitalization, suggesting potentially improved quality of outpatient care. Higher ED visit rates among those receiving care at FQHCs warrant additional investigation.

Impact of cluster farming on wheat productivity and net benefit among smallholder farmers in Lemu-Bilbilo and Hetosa districts of Arsi Zone, Ethiopia

This study focuses on identifying the determinants of cluster farming participation decisions and the impact of cluster farming on smallholder wheat farmer’s productivity in the two districts of Arsi Zone, Ethiopia. The study utilized cross-sectional data and a multistage sampling procedure to select a total of 381 respondents from the two districts of Arsi Zone, Ethiopia. The endogenous switching regression model was employed to achieve the research objectives. The study result indicates that sex of the household head, education level, size of cultivated land, access to training, membership in a farmer's cooperative, access to information and social responsibility of the household head influenced cluster farming participation positively and significantly, while distance from the nearest market had a negative and significant effect on cluster farming participation. Furthermore, the study shows that, if participants had decided not to practice cluster farming, their wheat yield and net benefit would have decreased by 33.57 and 40.08%, respectively. Similarly, had non-participants decided to participate, their wheat yield and net benefit would have increased by 46.79 and 102.49%, respectively. The study recommends that policymakers and development organizations should consider cluster farming as a main strategy to increase smallholder farmer’s productivity. Moreover, the study calls for government and institutional assistance in the areas of education services, training, extension services, infrastructure (particularly access to markets), and cooperative development. Moreover, policy and development measures should address the issue of gender disparities in cluster farming participation.

Essence of Establishing Fully Equipped Emergency Medicine Department for Medical Professionals: Key Informants Interview

Background: Medical profession is a combination of multi- sectoral and multi-departmental approach. Emergency department is such type of service area which deals with emergent condition of patients by skilled professionals, staffs and necessary equipment. So, it is important to find out the necessity of establishment of fully equipped Emergency Medicine and Causality Department in health professional training institutes. Methods: This qualitative section representing a larger cross-sectional study that was conducted from July 2022 to June 2023 to identify current status of emergency care among interns and medical students of Bangladesh. This information were obtained by conducting in-depth interviews with 10 emergency physicians of eight medical college hospitals to find out essence of Emergency Medicine and Causality Department. Results: Most (80%) of the interviewees mentioned that learning Emergency Medicine is very vital for medical students and interns. They also mentioned that due to identity crisis of the Emergency Medicine, creating challenges for medical graduates to trained upon emergent cases. Majorities (70%) of the interviewees clearly defined that medical professionals are continuously losing skills to handle medical emergencies due to improper training facility by proper trainer and staffs. Many (60%) of the interviewees mentioned a hopeless situation that the learners’ skills not up to mark to deal emergency cases. It’s not only the learner fault, it’s also for lacking in our educational policy. Majorities (70%) of the interviewees agreed that if we want to flourish the essence of emergency Medicine care for our learners it is mandatory to establish separate Emergency Medicine Department by skilled trainers, staffs and required equipment. Conclusion: This study recommended to produce competent medical graduates by fully equipped of separate Emergency Medicine Department. CME J 2024; 3(2); 38-42

Drinking water source and exposure to regulated water contaminants in the California Teachers Study cohort.

Pollutants including metals/metalloids, nitrate, disinfection byproducts, and volatile organic compounds contaminate federally regulated community water systems (CWS) and unregulated domestic wells across the United States. Exposures and associated health effects, particularly at levels below regulatory limits, are understudied. We described drinking water sources and exposures for the California Teachers Study (CTS), a prospective cohort of female California teachers and administrators. Participants' geocoded addresses at enrollment (1995-1996) were linked to CWS service area boundaries and monitoring data (N = 115,206, 92%); we computed average (1990-2015) concentrations of arsenic, uranium, nitrate, gross alpha (GA), five haloacetic acids (HAA5), total trihalomethanes (TTHM), trichloroethylene (TCE), and tetrachloroethylene (PCE). We used generalized linear regression to estimate geometric mean ratios of CWS exposures across demographic subgroups and neighborhood characteristics. Self-reported drinking water source and consumption at follow-up (2017-2019) were also described. Medians (interquartile ranges) of average concentrations of all contaminants were below regulatory limits: arsenic: 1.03 (0.54,1.71) µg/L, uranium: 3.48 (1.01,6.18) µg/L, GA: 2.21 (1.32,3.67) pCi/L, nitrate: 0.54 (0.20,1.97) mg/L, HAA5: 8.67 (2.98,14.70) µg/L, and TTHM: 12.86 (4.58,21.95) µg/L. Among those who lived within a CWS boundary and self-reported drinking water information (2017-2019), approximately 74% self-reported their water source as municipal, 15% bottled, 2% private well, 4% other, and 5% did not know/missing. Spatially linked water source was largely consistent with self-reported source at follow-up (2017-2019). Relative to non-Hispanic white participants, average arsenic, uranium, GA, and nitrate concentrations were higher for Black, Hispanic and Native American participants. Relative to participants living in census block groups in the lowest socioeconomic status (SES) quartile, participants in higher SES quartiles had lower arsenic/uranium/GA/nitrate, and higher HAA5/TTHM. Non-metropolitan participants had higher arsenic/uranium/nitrate, and metropolitan participants had higher HAA5/TTHM. Though average water contaminant levels were mostly below regulatory limits in this large cohort of California women, we observed heterogeneity in exposures across sociodemographic subgroups and neighborhood characteristics. These data will be used to support future assessments of drinking water exposures and disease risk.

Study on the Design Scheme of Vehicle Flow Lines in Unilateral Agglomerative Open Service Area

In recent years, with the introduction of the strategy to strengthen the country’s transportation infrastructure and the continuous implementation of new economic development models such as integrating transportation with tourism, various open service areas integrating highway service areas with local tourism have emerged nationwide. Examples include the Yangcheng Lake service area in Jiangsu and the Lengshui service area in Chongqing. This paper focuses on the design example of the Dazu Stone Carving service area on the Chongqing section of the Yurong Expressway, comprehensively considering factors such as construction scale, terrain conditions, and local urban planning. It analyzes and studies the traffic flow design of unilateral agglomerative open service areas around two vehicle traffic conversion links: between the main expressway and the service area, and between the service area and local roads. The aim is to provide a case study reference for similar projects.

Police reform in public housing contexts: Body‐worn cameras, surveillance, and harm reduction in New York City Housing Authority Developments

AbstractResearch summaryThe concern of crime in New York City public housing complexes motivated heightened police patrol of buildings and the enforcement of trespass laws. The 2013 federal court settlement of Davis et al. v. City of New York et al. mandated that the New York City Police Department (NYPD) implement a series of reforms, including the deployment of body‐worn cameras (BWCs) on officers, to address unconstitutional use of criminal trespass enforcement and stop and frisk practices in public housing developments. This study employed a stepped wedge quasi‐experimental design that involved the sequential crossover of public housing service area clusters from control to BWC implementation until all NYPD housing bureau officers were equipped with BWCs. Panel regression models at the individual officer and service area levels were used to estimate BWC program impacts on outcomes between 2015 and 2019. Logistic regression models were used to estimate the impact of the BWCs on the lawfulness of officer stop reports that were randomly selected for audit between 2017 and 2019. Results show that BWC deployment in public housing reduced excessive enforcement, citizen complaints, and use of force by NYPD housing officers. Findings further suggest that BWCs can help reduce constitutionally problematic stops and frisks of citizens.Policy implicationsProblematic police activities in public housing contexts can be reformed using BWCs. When coupled with routine supervisory review of video footage, the deployment of BWCs on public housing officers can improve compliance with department directives to reduce enforcement actions and increase documentation of citizen stops.

Food Safety Knowledge, Attitude, and Practices of Restaurant Food Handlers in Jeddah City, Saudi Arabia.

Improper food handler (FH) practices in food service areas, such as restaurants, can result in foodborne diseases (FBD). To reduce FBD cases, the food safety knowledge, attitudes, and practices (KAP) of FHs working in restaurants in Jeddah City and the correlation between their sociodemographic information and KAP scores were investigated in this study. A self-administered questionnaire comprising four parts (socioeconomic information and food safety KAP) was distributed among 389 FHs. Out of the FHs surveyed, 94.1% were male and 68% were certified. The average scores were 9.3 ± 1.8, 9.3 ± 1.3, and 8.9 ± 1.1 for KAP, respectively. Most FHs (82.2%) belonged to the good KAP group, and the rest (17.7%) were in the poor KAP group. FHs aged 50 years and above (9.6 ± 0.6), those with over 10 years of working experience (9.2 ± 0.9), and are married (9.1 ± 1.1) had the highest scores for practice compared with other FHs (p = 0.01 for all). Salary is directly correlated with food safety attitudes (p = 0.04). The findings confirmed a high score for KAP among FHs working in Jeddah. Nevertheless, more focus must be given to training younger, single, and less-experienced FHs, necessitating education courses with practical and theoretical aspects. Further studies from all regions of Saudi Arabia are necessary to generalize the study findings.

Bayesian hierarchical modeling for bivariate multiscale spatial data with application to blood test monitoring

Public health spatial data are often recorded at different spatial scales (or geographic regions/divisions) and over different correlated variables. Motivated by data from the Dartmouth Atlas Project, we consider jointly analyzing average annual percentages of diabetic Medicare enrollees who have taken the hemoglobin A1c and blood lipid tests, observed at the hospital service area (HSA) and county levels, respectively. Capitalizing on bivariate relationships between these two scales is not immediate as counties are not nested within HSAs. It is well known that one can improve predictions by leveraging correlations across both variables and scales. There are very few methods available that simultaneously model multivariate and multiscale correlations. We propose three new hierarchical Bayesian models for bivariate multiscale spatial data, extending spatial random effects, multivariate conditional autoregressive (MCAR), and ordered hierarchical models through a multiscale spatial approach. We simulated data from each of the three models and compared the corresponding predictions, and found the computationally intensive multiscale MCAR model is more robust to model misspecification. In an analysis of 2015 Texas Dartmouth Atlas Project data, we produced finer resolution predictions (partitioning of HSAs and counties) than univariate analyses, determined that the novel multiscale MCAR and OH models were preferable via out-of-sample metrics, and determined the HSA with the highest within-HSA variability of hemoglobin A1c blood testing. Additionally, we compare the univariate multiscale models to the bivariate multiscale models and see clear improvements in prediction over univariate analyses.

Factors Associated with Blood Sugar Control Behavior on Patients with Diabetes Mellitus in Blang Kuta Community Health Center Area, Pidie Jaya District in 2023

Introduction: Diabetes mellitus has become one of the increasingly alarming global health challenges. As a chronic disease, diabetes results in various detrimental consequences, including high mortality rates and significant healthcare costs. Objective: This research aims to determine the factors associated with blood sugar control behavior among diabetes mellitus patients in the Blang Kuta Community Health Center's service area. Method: This study is a quantitative research with a cross-sectional approach. The population in this study consists of all DM patients in 4 villages in the Blang Kuta Community Health Center's service area, totaling 252 individuals. Sampling was conducted using proportional random sampling techniques, involving 72 DM patients. Data collection was performed through interviews using questionnaires and analyzed through univariate, bivariate analysis using chi-square test, and multivariate analysis using logistic regression test using the SPSS program. Result: The univariate analysis results revealed that the majority of respondents exhibited poor behavior (54.2%). Bivariate analysis results indicated a significant relationship between knowledge (p-value 0.000), level of education (p-value 0.002), gender (p-value 0.005), and self-efficacy (p-value 0.000) with blood sugar control behavior. However, variables such as family history (p-value 0.471) and duration of diabetes mellitus (p-value 0.277) did not show a significant relationship. Multivariate analysis results indicated that knowledge (p-value = 0.035, OR = 5.114) and self-efficacy (p-value = 0.000, OR = 13.278) are important determinants of blood sugar control among patients with diabetes mellitus. Conclusion: There is a significant relationship between knowledge, education, gender, and self-efficacy with blood sugar control behavior. However, variables such as family history of diabetes mellitus and duration of diabetes mellitus do not show a significant relationship. Nonetheless, factors strongly associated with blood sugar control behavior in diabetic patients are knowledge and self-efficacy.

Analysis of paratransit crimes in Akure, Nigeria

BackgroundParatransit is a system that operates along a more or less defined route and then stops to take passengers on demand. They offer on-demand door-to-door service from any origin to any destination in a service area, and are operated by public transit agencies, community groups or not-for-profit organizations, and for-profit private companies or operators. In transit, criminal acts including rape, kidnapping and/or abduction, robbery, carjacking, vehicle theft, and even acts of terrorism are committed. These crimes are occasionally committed by other passengers since not every individual who boards a vehicle is a real traveller. This study examined the incidence of paratransit crimes in Akure, Nigeria using a Secured System Approach.ResultsThis study employed a household-based form of sampling to select the study locations in Akure. Convenient sampling was used to select two streets in each of the residential areas from which one hundred and twenty (120) houses were sampled purposively. The questionnaire was used to gather the primary data, with descriptive analysis. The study found that most of the transit crimes were perpetuated with taxi and motorcycles. Also, kidnapping was the major transit crimes in Akure. The Oba-Adesida road and Arakale road (situated along the study areas) were the hotspots for transit crimes in Akure. Finally, the respondents did not have a good perception of the proactiveness, integrity, reliability, respectability, and trustworthiness of security agencies regarding paratransit crimes in Akure.ConclusionsIncidence of paratransit crimes in Akure, Nigeria was explored among residents in Akure households. Kidnapping was dominant in Akure along Oba-Adesida and Arakale road, and mostly perpetuated with taxi and motorcycles. Since the participant did not have a good perception concerning the proactiveness, integrity, reliability, respectability, and trustworthiness of security agencies in Akure. Recommendations were suggested.

Investigate the efficiency of primary care facilities in emergency situations by application of geographical and demographic standards using GIS.

This study applied geographical standards (coverage distance) and demographic standards to investigate the capabilities of primary healthcare facilities to cover the largest area of the study area and the service area that can be accessed. This study was conducted to find out the sufficient number of primary healthcare (PHC) centers required to provide healthcare services to the entire community. Data was obtained by applying geographic information system (GIS) techniques to analyze primary care facilities using the demographic and geographic standards for primary care facilities. PHC centers cover 79% of the study area according to the geographical standard. The study area needs 41 additional centers to cover the shortfall in service provision per the demographic and geographic standards. A significant deficiency in the number of primary care centers found in the study area compared to the large population at the geographical and demographic standards level.

Towards digital-twin-enabled facility management: the natural language processing model for managing facilities in buildings

ABSTRACT Facility management is an essential part of the building which encompasses multiple service areas and processes to ensuring optimum functionality of the facility. Digital twin (DT) has been increasingly introduced to the FM domain to facilitate FM tasks such as decision-making. Despite the advancements in DT-enabled FM, there still exists a problem in the disconnections between DT academics and FM practitioners. The emergence of knowledge management can act as a bridge between academics and FM practitioners. To mine knowledge in the DT-enabled FM industry for a better communication between different stakeholders and timely decisions in the case of emergency, this study proposes a natural language processing (NLP)-based approach. A detailed classification of FM-related entities is first presented, which divides the FM into five categories. The NLP model is used to extract entities and knowledge from a large volume of text data. The results indicate that an NLP-based approach can accurately extract FM-related knowledge. The findings of this study not only provide a basis for automatic DT-enabled FM-related knowledge extraction but also support the downstream tasks such as knowledge graph construction and FM-related emergency decision-making.

A two-stage game-theoretical framework for Pricing & Management problem of shared mobility in a competitive market

ABSTRACT With the global proliferation of shared mobility systems, the vehicle-sharing market has witnessed an influx of companies and investors, thereby intensifying competition and potentially leading to suboptimal decision-making. Consequently, there is a pressing need for a modelling framework that specifically addresses operational and strategic-level policy design for multiple vehicle-sharing companies in a competitive market. In this study, we develop a two-stage game-theoretical framework to simulate the competitive process between multiple vehicle-sharing companies, facilitating their business decisions regarding pricing and management (P&M) problem, where management mainly include service area design, vehicle deployment, redirecting, and rebalancing. In the first stage of the framework, two companies operating under the same shared mobility service form a strategic alliance to compete against another vehicle-sharing service. Subsequently, in the second stage, these two companies engage in competition to maximise their individual profits. Based on the factors such as generalised travel cost, average acceptance level and vehicle availability, the competition process of each stage is formulated as a generalised Nash equilibrium problem. A linearisation method is employed for solving the equilibrium solution. Finally, we apply our proposed models to various vehicle-sharing systems and application scenarios to demonstrate their applicability. The numerical results illustrate that our model assists companies in making rational management decisions amidst intense competition while also revealing market competition landscape of vehicle-sharing systems based on different travel distances in the shared mobility market.

Waiting for a Liver Transplant in New Mexico; Understanding the State's Multi-layered Adversity.

Contrary to the assumption of consistent medical care for patients with specific illnesses in the United States, research reveals vast inconsistencies and inequalities in healthcare delivery, affecting various aspects such as mental illness diagnosis and management, life expectancy differences, overall mortality rates, and healthcare accessibility due to racial, ethnic, and cultural disparities. Liver transplantation, particularly studied in the context of the state of New Mexico (NM), highlights the multilayered inherent disadvantages faced by its citizens. Despite these challenges, the new liver transplantation allocation system implemented by the Organ Procurement and Transplantation Network (OPTN) in 2020, which focuses on geographic concentric circles rather than donor service areas (DSA), cautiously raises hope for reducing these inequities. The future of decades' worth of adversity remains uncertain, but we are optimistic that New Mexicans' systemic difficulty in getting a new liver would eventually be eased.

Associations between natural blue and green space and preschool children's movement behaviours

Abstract Natural outdoor environments provide important settings for children to engage in physical activity. It is unclear if these relationships also exist in preschool aged children. We examined associations between amount and type of neighbourhood vegetation and blue space, proximity to the beach and preschooler's device‐measured movement behaviours. Accelerometer data from 1081 preschool children were processed into physical activity and sedentary behaviours using a machine learned random forest physical activity classification model specifically developed for children under five. High‐resolution aerial imagery data and Geographic Information Systems were used to identify total percentage of neighbourhood vegetation and vegetation components (grass, shrubs and trees) and presence and total percentage of blue space (ocean, riverways and lakes and swamps) for 500, 1600 and 5000 m service areas around children's residences. Distance to the closest beach, patrolled beach, and dog beach were also calculated. Amount of neighbourhood vegetation was inversely associated with boys sedentary time in the 500 m (β = −0.91 min/day, p = 0.006, 95% CI [−1.55, −0.33]) and 1600 m (β = −1.30 min/day, p = 0.001, 95% CI [−2.08, −0.53]) service area, and positively associated with walking time in the 1600 m (β = 0.12 min/day, p = 0.045, 95% CI [0.02, 0.22]) service area. The presence of local riverways was positively associated with girls walking time in the 1600 m (β = 2.34 min/day, p = 0.009, 95% CI [0.59, 4.09]), and 5000 m (β = 1.67 min/day, p = 0.019, 95% CI [0.27, 3.06]) buffer. Distance to dog beach was positively associated with boys sedentary behaviours. Presence of lake and swamps were negatively associated with boys walking, and presence of riverways was negatively associated with girls moderate‐to‐vigorous activities and games and boys running in the 5000 m service area. These findings suggest higher amounts of neighbourhood vegetation and certain types of blue space such as riverways and dog beaches could facilitate positive movement behaviours in young children. Our findings that natural outdoor environments are associated with preschool children's movement behaviours add to evidence which could contribute to policy implications for urban planning and the provision and protection of natural environments within cities. Read the free Plain Language Summary for this article on the Journal blog.

Matrícula escolar de nivel superior por área de conocimiento y regiones en México 2010–2022

The objective of the research is to describe the behavior of enrollment in Mexico from the school year 2010-2011 to 2021-2022 divided by area of knowledge in the eight regions of the country. A quantitative approach was used, with a non-experimental type and an exploratory-descriptive scope in an evolutionary way, taking information from the ANUIES about public higher education institutions, and schooling modality. Throughout the country, from the 2010-2011 cycle there was an enrollment were 1,933,907 to 2021-2022 with 3,493,562 students. The areas with the highest enrollment are Engineering, Manufacturing and Construction; Social Sciences and Law; along with Administration and Business. In the last twelve years, enrollment in Mexico has increased by 44.64%; being the area of Services the one that grew the most with 63.94% along with that of Natural Sciences, Mathematics and Statistics with 58.7%. The one that had a decrease was the Area of Education Sciences with -52.24%; and Information and Communication Sciences with just 5.12% growth. In the last school year 2021-2022 with respect to the previous one; the ones that grew the most were Education Sciences (10.49%) and Information and Communication Technologies (12.23%).

Spatial analysis of educational services in Soran

Educational services are one of the services that cities provide to their residents, in order to develop the city and the education sector and to provide an intelligent, understanding and mature generation to the country, and through this generation to produce a healthy environment for society. The main objective of this study is to become familiar with the current spatial distribution of educational services in Soran, and their compatibility with the criteria of spatial planning of educational services, and to identify the problems of spatial distribution of educational services in Soran. Therefore, the number and area of educational services has increased year after year. In 2010-2022, the number of kindergartens reached 12 kindergartens with an area of 1.7 hectares and the number of primary schools reached 56 schools with an area of 16) hectares, and the number of high schools has reached (29) high schools with an area of (15.66) hectares, distributed in different ways in Soran.

The implementation of the elective subject "Public Health" in the final year for medical students at Göttingen University Medical Center: results of the UNITE project

International and national frameworks and initiatives call for strengthening the training of health professionals in the public health service (PHS) through cooperation with universities. The German Medical Licensing Regulations of 21st Sep 2021 provides for an integration of PHS into undergraduate medical training in the final year since 1st May 2022. The present study presents the procedure and results of the final year elective Public Health (PH) implementation for medical students at the University Medical Center Göttingen (UMG) in cooperation with the local PHS. In the twelve-month project UNITE (07/21-06/22), the final year elective PH was implemented in seven steps: analysis of the framework conditions, conception of the elective, preparation of a logbook, pilot phase with five students in one-week rotations, public relations for students, introduction of a medical didactic training for staff of the health department and implementation of the elective PHS with students. A cooperation agreement between UMG and the Health Department regulates the training of medical students. Students complete four-week rotations in the areas of public health service and funeral services, paediatric and adolescent medical service, infection control and social psychiatric service. The logbook for students contains learning objectives for individuals specialised in services for self-assessment of the acquired competences. The didactics training was implemented with high learning success of the participating staff. So far three final year students have successfully completed the elective. The implementation of final year elective PHS strengthens the anchoring of public health topics in the education of medical students in Göttingen and makes PHS more visible as a professional perspective. Essential for the successful implementation were the establishment of a continuous cooperation between the university and the health department, student-oriented teaching-learning concept with a logbook suitable for the location, a trained multiprofessional team in the health department, and the evaluation of the elective for quality assurance and further development of the training. The concept presented here can help other locations in establishing the final year elective in PH and can be adapted to specific local conditions.

Next Generation Public Supply Water Withdrawal Estimation for the Conterminous United States Using Machine Learning and Operational Frameworks

AbstractEstimation of human water withdrawals is more important now than ever due to uncertain water supplies, population growth, and climate change. Fourteen percent of the total water withdrawal in the United States is used for public supply, typically including deliveries to domestic, commercial, and occasionally including industrial, irrigation, and thermoelectric water withdrawal. Stewards of water resources in the USA require estimates of water withdrawals to manage and plan for future demands and sustainable water supplies. This study compiled the most comprehensive conterminous United States water withdrawal data set to date and developed a machine learning framework for estimating public supply withdrawals and associated uncertainty for the period 2000–2020. The modeling approach provides service area resolution estimates to allow for annual and monthly water withdrawal estimation while incorporating a complex array of driving factors that include hydroclimatic, demographic, socioeconomic, geographic, and land use factors. Model results reveal highly variable and lognormally distributed per‐capita water withdrawal, spanning from 30 to 650 gallons per capita per day (GPCD), across community, regional, and national scales, with pronounced seasonal variations. Analysis of estimated withdrawal trends indicates that the national annual average withdrawal experienced a decline at a rate of 0.58 GPCD/year during the period from 2000 to 2020. Model interpretation reveals a complex interplay between public supply withdrawal and key predictors, including population size, warm‐season precipitation, counts of large buildings and houses, and areas of urban and commercial land use. The developed models can forecast future public supply driven by various climate, demographic, and socioeconomic scenarios.