Abstract

Abstract
This article presents a critical review of lean assessment in manufacturing and service settings as a base for development of a lean assessment framework for healthcare organizations, aiming to help them throughout a long journey. Having as starting point lean projects’ failures in four public hospitals, the authors discover the lack of monitoring (among other reasons) as the main issue. This article proposes a monitoring instrument for preventing returns to the comfort zone and guiding the lean journey. The healthcare lean assessment (HLA) can be used as an “as is” diagnosis tool, assessing whether each process should be improved, disrupted, or eliminated and also as an ongoing implementation assessment, providing control measures and correction actions. Although the framework proposed requires empirical testing in further research for universal application, it can help healthcare organizations by providing a transformation roadmap and monitoring instrument and also contributes to the growing stream of academic research in this area. © IIE, INCOSE.

Abstract
Wastewater and greywater have different scales of end-uses in irrigation in Portugal. Wastewater is treated in a central wastewater treatment plant and reused in public/private large areas of irrigation, like agriculture, public gardens and golf courses. On the contrary, greywater reuse is generally applied in in situ small scales, treated and used in the same place, generally in the production site. The main aim of this paper is to compare the two types of systems: a wastewater centralized reuse system (WWCRS) and a greywater decentralized reuse system (GWDRS) in terms of water quality, energy consumption and CO2 emissions. In this paper, the main characteristics of both streams are presented and the degree of treatment required in each stream is analyzed. The advantages and disadvantages of its reuse in different scales, in terms of water quality, energy consumption and CO2 emissions are discussed. A methodology to calculate the energy consumptions and CO2 emissions related to wastewater treatment that may be applied in different cases is presented. A hypothetical example of the two systems: one referring to a WWCRS and the other to a GWDRS is presented. The energy consumption and the CO2 emissions are analyzed and compared. The WWCRS needs a higher degree of treatment and so it spends more energy and leads to more CO2 emissions to the environment than the GWDRS that consumed between 11.8 and 37.5% of the energy consumed in the WWCRS considering the same number of inhabitants served.

Abstract
This paper explores the content of various Sustainable Energy Action Plans (SEAPs) necessary to the Covenant of Mayors. This study has the aim of providing an overview of existing methodologies for the development and implementation of SEAPs by municipalities. As the number and complexity of issues related with energy are very broad, it is very important to know and identify good practices and guidelines to increasing participant municipalities. Based on the methodologies collected in several studies, it is possible to identify key aspects and issues municipalities might consider for the development of their own plan. The SEAP can't be only a collection of measures; it must have a coherent strategy with the European and National policies. This study also shows that a good coordinator with project management skills is necessary to overcome obstacles due to the lack of communication or collaboration among the different municipality's departments. (C) 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

Abstract
This paper explores the content of various web based information systems which presents knowledge about energy technology, energy research, energy projects best practice, energy related statistics and energy patents. As the number and complexity of issues related with energy are very broad, it is essential the use of information systems. Evaluating sources of information is an important step in any research activity. This study also shows that system design depends must more from the original objective of websites creation and target groups of users. A positive finding from user expectations is information free access and in some cases only requiring free registration. This paper discusses a new approach must be studied to diminish content dispersion and significant differences between European energy related sites. (C) 2014 The Authors. Published by Elsevier Ltd.

Abstract
Joint implant-related infections, namely by Staphylococci, are a worldwide problem, whose consequences are dramatic Various methods are studied to fight against these infections. Here, the proposed solution consists in grafting a bioactive polymer on joint implant surfaces in order to allow the control of the interactions with the living system. In this study, sodium styrene sulfonate, bearing sulfonate groups, was grafted on the surface of titanium alloys. Scanning Electron Microscopy, colorimetric method, Fourier-transformed infrared spectroscopy and contact angle measurements were applied to characterize the surfaces. Bacterial adhesion studies were studied on poly(sodium styrene sulfonate) grafted Ti6Al4V and Ti6Al4V surfaces previously adsorbed by proteins involved in the bacteria adhesion process. Fibrinogen and fibronectin were demonstrated to increase staphylococcal adhesion on Ti6Al6V surfaces. Ti6Al4V grafted sodium styrene sulfonate surfaces inhibited the adhesion of Staphylococcus epidermidis in 37% and 13% on pre-adsorbed surfaces with fibrinogen anal fibronectin, respectively. The mechanism of the observed inhibiting bacteria adhesion properties is related to the differences of proteic conformations induced by poly(sodium styrene sulfonate) grafting.