Contextual background. Accident and Emergency Departments (A&E), otherwise referred to as an Emergency Department (ED) are ‘consultant led 24 hour service with full resuscitation facilities and designated accommodation for the reception of accident and emergency patients (Health and Social Care Information Centre 2015a). They specialise in the acute care of patients who present unexpectedly to hospital and manage patients with a variety of medical conditions and traumatic injuries, of which approximately 25% are children between 0- 16 years of age (Royal College of Paediatrics and Child Health (RCPCH) 2012, International Federation of Emergency Medicine (IFEM) 2012). The Royal College of Nursing (RCN) refers to a ‘child’ as “any individual from birth through infancy (including neonates), childhood and adolescence, recognising the particular needs of specific ages, particularly the transition period to adulthood” (RCN 2003a, p.7). Consistent with the United Nations Convention on the Rights of the Child (UNCRC) (UNICEF 1989, p.2), the Intercollegiate Committee for Standards for Children in Emergency Care Settings (RCPCH 2012) and International Federation for Emergency Medicine (IFEM 2012) describe a child as any person under the age of eighteen years. Three million children attended A&E Departments during 2006/7 (Institute for Innovation and Improvement 2008). More recently, attendances to emergency care facilities (A&E Departments, Walk-in-Centres (WIC), Minor Injury Units (MIU)) in England have seen an increase in attendances from 18.3 million (2012/3) to 18.5 million (2013/4). Of these, children less than 4 years of age account for 9.8% (1.8 million) attendances, while children less than 10 years of
Contextual background. 2.1. The case of the amaranth agri-food system in Mexico City Amaranth (by its scientific name Amaranthus hypochondriacus L.) is an ancestral crop of Mesoamerican origin, whose first archaeobotanical registers can be located just over 4 thousand years ago (Xxxxxxxx and Xxxxxxxx, 2019). Although little information exists regarding global amaranth production, it is possible to find extensive literature on the exceeding food properties of amaranth and its possibilities to tackle complex problems, such as malnutrition (Xxxxxxx et al., 2010; Xxxxxxxx et al., 2014). In Mexico amaranth can be found in at least 18 of the 32 federal entities; however, by 2018, most production came from the state of Puebla, followed by Tlaxcala, State of Mexico, and Mexico City, with a maximum of 5,125 tons in the case of Puebla, and a minimum of 152 tons for Mexico City (SAGARPA, 2020) therefore mayor production is concentrated in central Mexico. Mexico City, one of the most densely populated cities in the country, concentrates the largest number of amaranth agro-industrial productive units, especially in the town hall of Xochimilco. In this town, those units have made the production, transformation, and marketing of amaranth its main economic activity, which means that they invested efforts into rescuing the cultural, agronomic, and nutritional value of the seed, while adding up value into their food products. These amaranth agro- industrial units require an enormous amount of amaranth seed as it is a primary raw material. Therefore, Mexico City has become an anchor for the amaranth agri-food system in the country´s central region. The town hall of Xochimilco in Mexico City is considered as "[the] traditional [region] of amaranth production" (Xxxxxxx et al., 2010: 64) where the tradition, the tangible and intangible knowledge, and the know-how around amaranth- activities in this region have been inherited from parents and grandparents (Xxxxx and Xxxxxxx, 2011). For Xxxxxxx and collaborators (Xxxxxxx et al., 2010), the amaranth producers of Xochimilco have managed to preserve the cultivation of amaranth, and its genetic diversity, due to a vision of collective identity and common roots. The innovation around amaranth crop in the region has also taken place through a series of (organizational) innovations aimed at the rescue of natural areas and landscapes (Xxxxxxxxx, 2010) and environmental restoration. Product and process innovations can be materialized through the generation of n...
Contextual background. In the BPM context, NFPs are constraints that have to be imposed to ensure quality and meet other business process requirements (Xxxxxxxxx and Xxx, 2008). However, NFPs are not yet widely accepted and often receive less attention than the functional properties in the BPM approaches. BPMN, for instance, in its official version, does not deal with NFPs although there are some limited proposals in the literature. Taking into account some similarities, BPM approaches should be given the same conduct as that given to the functional and non-functional requirements in the Software Engineering approaches (Xxxxxxxxxxx, 2010). The functional performance of IT services depends on a number of NFPs, such as: availability, response time and accuracy. The QoS assurance provided by IT is one of the most important factors for business success, as well as improving competitiveness (Khaluf, Xxxxx and Xxxxxx, 2011). SLAs can formalize and ensure that these operating and quality constraints are overcome. SLAs are thus able to assess whether the service provided complies with the terms agreed between parties (Theilmann et al., 2010). With regard to the specific BPM/SOA context, the most commonly languages employed to formalize SLAs are WS-Agreement and WS-Policy, both based on XML and recommended by W3C. SLAs address the QoS attributes and levels, and are linked to the web services that provide an executable process that is implemented to meet the functional requirements of a process model (Caseau, 2005). The SLAs specified in one of these two languages have their own structures and can, for example, be used to define goals, metrics, fines and bonuses. A BLA, in turn, can be considered to be equivalent to a SLA at a business level. SLA features are, hence, found in a BLA, and include: agreement validity, fines and bonuses (Bratanis, Xxxxxxxx and Simons, 2010). Thus, a BLA, linked to a sub-process, can be hierarchically mapped to a set of SLAs. During the process modelling, a BLA is regarded as a “father” agreement that is related to a set of activities in the process model. During the process implementation, this BLA can derive a set of SLAs that are linked to the respective services. These services, in turn, were derived from the business process model to perform its set of activities. This top-down derivation, as illustrated in Figure 1, defines a set of SLAs that, if all are met, allows the BLA goal to be achieved in an induced way (Xxxx, Xxxxx and Xxxxxxxxxxxx, 2011). BLA B...
Contextual background. The recent emphasis on compassion in the NHS is influenced by both political and professional drivers (DOH, 2008, DOH, 2009; DOH, 2012a, Xxxxxxx, 2013). Both Xxxx Xxxxx’x review of the NHS and the NHS Constitution place compassion at the heart of care delivery and perceive compassion as an aspect of high quality care (DOH, 2008, DOH, 2009). In a drive to promote the delivery of compassionate care in the NHS, a number of nursing initiatives have been implemented to redress the poor standards of care associated with the perceived lack of compassion in nursing (RCN, 2010; DOH, 2012). This section discusses the political context for making compassion a priority in the NHS and for the professional drivers to promote compassionate care.
