Cities with their populations in each climatological region of the Anatolian Peninsula (TUIK, 2012)
\r\n\tFurther development of geophysical methods in the direction of constructing more and more adequate models of media and phenomena necessarily leads to more and more complex problems of mathematical geophysics, for which not only inverse, but also direct problems become significantly incorrect. In this regard, it is necessary to develop a new concept of regularization for simultaneously solving a system of heterogeneous operator equations.
\r\n\r\n\tCurrently, the study of processes associated not only with geophysics and astrophysics but also with biology and medicine requires even more complication of interpretation models from non-linear and heterogeneous to hierarchical. This book will be devoted to the creation of new mathematical theories for solving ill-posed problems for complicated models.
",isbn:null,printIsbn:"979-953-307-X-X",pdfIsbn:null,doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,hash:"d93195bb64405dd9e917801649f991b3",bookSignature:"Prof. Olga Alexandrovna Hachay",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/8253.jpg",keywords:"Ill-Posed, Inverse Problems, Geophysics, Seismic, Electromagnetic, Thermal, Magnetic, Medicine, \r\nMathematical, Algorithms, Hierarchical, Nonlinear, Historical Description, Regularization",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:0,numberOfTotalCitations:0,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 7th 2019",dateEndSecondStepPublish:"March 27th 2020",dateEndThirdStepPublish:"May 26th 2020",dateEndFourthStepPublish:"August 14th 2020",dateEndFifthStepPublish:"October 13th 2020",remainingDaysToSecondStep:"a year",secondStepPassed:!0,currentStepOfPublishingProcess:5,editedByType:null,kuFlag:!1,biosketch:null,coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"150801",title:"Prof.",name:"Olga",middleName:"Alexandrovna",surname:"Hachay",slug:"olga-hachay",fullName:"Olga Hachay",profilePictureURL:"https://mts.intechopen.com/storage/users/150801/images/system/150801.jpg",biography:"Dr. Olga A. Hachay graduated with a degree in Astrophysics from Ural State University in 1969. She obtained her PhD from the Pushkov Institute of Terrestrial Magnetism, Ionosphere and Radiowave Propagation of the Russian Academy of Sciences (IZMIRAN) in 1979 with her thesis 'The inverse problem for electromagnetic research of one-dimensional medium.”\nSince 1969, she has been a scientific member of the Institute of Geophysics Ural Branch of Russian Academy of Sciences (UB RAS), Ekaterinburg, Russia. From 1995 to 2004, she served as chief of the group of seismic and electromagnetic research. Her research interests include developing new methods for searching the structure and the state of the Earth’s upper crust, as well as elaborating a new theory of interpretation of electromagnetic and seismic fields. From 2002, she has been the main scientific researcher of the Institute of geophysics UB RAS. Since 2008, she has been a lead scientific researcher for UB RAS in the laboratory of borehole geophysics. 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From chapter submission and review to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"878",title:"Phytochemicals",subtitle:"A Global Perspective of Their Role in Nutrition and Health",isOpenForSubmission:!1,hash:"ec77671f63975ef2d16192897deb6835",slug:"phytochemicals-a-global-perspective-of-their-role-in-nutrition-and-health",bookSignature:"Venketeshwer Rao",coverURL:"https://cdn.intechopen.com/books/images_new/878.jpg",editedByType:"Edited by",editors:[{id:"82663",title:"Dr.",name:"Venketeshwer",surname:"Rao",slug:"venketeshwer-rao",fullName:"Venketeshwer Rao"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"4816",title:"Face Recognition",subtitle:null,isOpenForSubmission:!1,hash:"146063b5359146b7718ea86bad47c8eb",slug:"face_recognition",bookSignature:"Kresimir Delac and Mislav Grgic",coverURL:"https://cdn.intechopen.com/books/images_new/4816.jpg",editedByType:"Edited by",editors:[{id:"528",title:"Dr.",name:"Kresimir",surname:"Delac",slug:"kresimir-delac",fullName:"Kresimir Delac"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3621",title:"Silver Nanoparticles",subtitle:null,isOpenForSubmission:!1,hash:null,slug:"silver-nanoparticles",bookSignature:"David Pozo Perez",coverURL:"https://cdn.intechopen.com/books/images_new/3621.jpg",editedByType:"Edited by",editors:[{id:"6667",title:"Dr.",name:"David",surname:"Pozo",slug:"david-pozo",fullName:"David Pozo"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"40840",title:"Quantification of the Urban Heat Island Under a Changing Climate over Anatolian Peninsula",doi:"10.5772/51244",slug:"quantification-of-the-urban-heat-island-under-a-changing-climate-over-anatolian-peninsula",body:'More than half of the world’s population (i.e. approximately 3.5 billion) has been living in urban areas in 2010 and by 2030 this number will rise to almost 5 billion (UNFPA, 2011). In the meantime, global average surface temperature has been increasing significantly: last century saw an approximately 0.7 °C warming (IPCC, 2007; WMO, 2009). Urban growth and climate change are two major forcings on local climate (IPCC, 2007). Urbanization reshapes the surface of the earth causing changes in the energy budget at the ground surface while altering the surrounding atmospheric circulation characteristics leading changes in local climate (Huang et al., 2009; Oke et al., 1992). Urban heat island (UHI) refers to warmer air temperatures observed in urban areas as compared to those over surrounding non-urban regions. When naturally vegetated areas (e.g., grass and trees) are replaced with impervious surfaces having relatively low reflectivity and evapotranspiration rates, additional energy heats the atmosphere causing the phenomena. After sunset, non-urban areas cool more rapidly than urban regions resulting in a temperature differential. The UHI is presented as the difference between temperatures recorded within and outside the urban settlement. It has been suggested that UHI is influenced by population; topography; level of industrialization as well as the regional climate (Oke, 1987; Rosenzweig et al., 2005; Gill et al., 2008; Kolokotroni & Giridharan, 2008).
Anatolian peninsula, (i.e. Asian part of Turkey), is lying in the Eastern Mediterranean, and has seven distinct geographical regions: Eastern Anatolia; Central Anatolia; Black Sea Region; Mediterranean Region; Aegean Region; Marmara Region; and Southeastern Anatolia (Unal et al., 2003; Kindap, 2010). The Aegean and Mediterranean coastal regions have cool rainy winters, and hot moderately dry summers. Mountains along the coast prevent the Mediterranean influences from extending inland, giving interior of Anatolian Peninsula a continental climate and distinct seasons.
As urbanization rate has increased significantly, UHI has become a significant issue in the Anatolian Peninsula. There have been a few studies focusing on UHI effect over Anatolian Peninsula (Karaca et al., 1995; Tayanc & Toros, 1997; and Ezber et al., 2007). For example, Karaca et al. (1995) investigated the effects of urbanization on climates of two cities, Istanbul and Ankara in the Anatolian Peninsula with varying periods (1912-1992) and reported significant upward trend for the urban temperatures when compared to the rural temperatures in the southern part of Istanbul. Tayanc & Toros (1997) studied 4 urban areas (i.e., Adana, Bursa, Gaziantep, Izmir) suggesting that temperature is more sensitive to UHI than precipitation and their results showed that the Anatolian Region is under a cooling trend after the period ending by 1990. Ezber et al. (2007) used statistical and numerical modeling tools to investigate the climatic effects of urbanization in Istanbul from the period of 1951 to 2004, and they found statistically positive trends in the urban stations of the city. These studies focused on cities individually and have not conducted a comprehensive evaluation of all urban environments in Anatolian Peninsula. The objective of this study, hence, is to quantify the UHI effect of the all major cities (population>1,000,000) with quality meteorological data extending back to 1965. Climate forecasts using a regional climate model output are also analyzed to understand the effect of UHI under a changing climate.
Minimum daily temperature is the primary indicator of UHI (Rosenzweig et al., 2005). We have, therefore, compiled a database of minimum daily temperatures over urban cities in Anatolia. As a first step, we have developed and implemented the following criteria: Urban stations are selected in regions having population over 500,000, and rural stations with population of less than 100,000 (Hua et al., 2007); high quality temperature data (i.e., passes homogeneity test, have representative urban and rural stations); continuous data from 1965 to 2006. After comprehensive evaluation, especially for representativeness, we have identified 8 cities to analyze, a total of 25 meteorological stations (9 urban and 16 rural). These cities are highlighted in Table 1.
Selected cities have significant increase in urban population between 1935 and 2011, are shown in Fig. 1. Ratio of the center population is calculated by dividing the center population (urban districts of the city, not the rural) of the selected cities to the total population of the city. Dark colored bar in the figure is the ratio of the year 1935, and the total bar including the shaded and the dark is the ratio in 2011. For example, in 1935 approximately 50% of Istanbul’s population is urbanized, which increased to approximately to 100% in 2011. In 1935, number of cities that have urban ratio of 50% or more was only one (i.e. Istanbul), whereas in 2011 all of the selected cities have urban population ratio of more than 50%.
The rate of urbanization in terms of urban over total population (%) in 1935 and 2011
Locations of meteorological monitoring stations
\n\t\t\t\t | \n\t\t
Cities with their populations in each climatological region of the Anatolian Peninsula (TUIK, 2012)
Regarded by many as the cradle of civilization of the world, the Anatolian Peninsula is located at the confluence of Europe, Asia and Africa. This region has 75 million inhabitants (TUIK, 2012). The population has grown almost 4.7 times between 1935 and 2012, from 16 million to 75 million (TUIK, 2012). Ratio of rural to urban population has changed dramatically especially after 1980s and urban population ratio reached to about 80% in 2010 (Fig. 3). Table 1 lists the cities in each climate regions with their population. Approximately, 74% of the cities have the population between 100,000 and 1 million; 22% between 1 million and 5 million. Only 2 cities are below 100,000, and Istanbul is the only megacity (i.e., the city which has a population of five million or more) in the region having a population of over 13 million. Table 2 gives a classification about the site characteristics of the selected meteorological stations.
The population ratio of urban and rural parts of the region over total population from 1950 to 2010 (TUIK, 2012)
Station | \n\t\t\tLatitude | \n\t\t\tLongitude | \n\t\t\tAltitude (m) | \n\t\t\tLand-use | \n\t\t\tLocation and siting | \n\t\t
Ankara | \n\t\t\t39° 57’ | \n\t\t\t32° 53’ | \n\t\t\t891 | \n\t\t\tUrban | \n\t\t\tIn a residential area at the city center on the ground | \n\t\t
Polatli (Ankara) | \n\t\t\t39° 35’ | \n\t\t\t32° 09’ | \n\t\t\t886 | \n\t\t\tSuburban | \n\t\t\t70 km away from the city center on the ground | \n\t\t
Kizilcahamam (Ankara) | \n\t\t\t40° 28’ | \n\t\t\t32° 39’ | \n\t\t\t1033 | \n\t\t\tRural | \n\t\t\t50 km away from the city center on the ground | \n\t\t
Beypazari (Ankara) | \n\t\t\t40° 10’ | \n\t\t\t31° 56’ | \n\t\t\t682 | \n\t\t\tRural | \n\t\t\t75 km away from the city center on the ground | \n\t\t
Esenboga (Ankara) | \n\t\t\t40° 07’ | \n\t\t\t33° 00’ | \n\t\t\t959 | \n\t\t\tUrban | \n\t\t\tAt the airport in the city center on the ground | \n\t\t
Nallihan (Ankara) | \n\t\t\t40° 11’ | \n\t\t\t31° 22’ | \n\t\t\t650 | \n\t\t\tRural | \n\t\t\t120 km away from the city center on the ground | \n\t\t
Bursa | \n\t\t\t40° 23’ | \n\t\t\t29° 01’ | \n\t\t\t100 | \n\t\t\tUrban | \n\t\t\t5 km away from the city center at the airport on the ground | \n\t\t
Keles (Bursa) | \n\t\t\t39° 54’ | \n\t\t\t29° 13’ | \n\t\t\t1063 | \n\t\t\tRural | \n\t\t\t60 km away from the city center on the ground | \n\t\t
Gaziantep | \n\t\t\t37° 08’ | \n\t\t\t37° 37’ | \n\t\t\t900 | \n\t\t\tUrban | \n\t\t\tIn a residential area at the city center on the ground | \n\t\t
Islahiye (Gaziantep) | \n\t\t\t37° 02’ | \n\t\t\t36° 61’ | \n\t\t\t706 | \n\t\t\tRural | \n\t\t\t50 km away from the city center on the ground | \n\t\t
Istanbul (Goztepe) | \n\t\t\t40° 97’ | \n\t\t\t29° 06’ | \n\t\t\t33 | \n\t\t\tUrban | \n\t\t\tIn a residential area at the city center on the ground | \n\t\t
Istanbul (Florya) | \n\t\t\t40° 97’ | \n\t\t\t28° 79’ | \n\t\t\t37 | \n\t\t\tUrban | \n\t\t\tIn a residential area at the city center on the ground | \n\t\t
Kirecburnu (Istanbul) | \n\t\t\t41° 15’ | \n\t\t\t29° 05’ | \n\t\t\t58 | \n\t\t\tRural | \n\t\t\t25 km away from the city center on the ground | \n\t\t
Kumkoy (Istanbul) | \n\t\t\t41° 25’ | \n\t\t\t29° 04’ | \n\t\t\t38 | \n\t\t\tRural | \n\t\t\t30 km away from the city center on the ground | \n\t\t
Sile (Istanbul) | \n\t\t\t41° 17’ | \n\t\t\t29° 60’ | \n\t\t\t83 | \n\t\t\tRural | \n\t\t\t50 km away from the city center on the ground | \n\t\t
Izmir | \n\t\t\t38° 39’ | \n\t\t\t27° 08’ | \n\t\t\t29 | \n\t\t\tUrban | \n\t\t\tIn a residential area at the city center on the ground | \n\t\t
Dikili (Izmir) | \n\t\t\t39° 07’ | \n\t\t\t26° 89’ | \n\t\t\t3 | \n\t\t\tRural | \n\t\t\t75 km away from the city center on the ground | \n\t\t
Kayseri | \n\t\t\t38° 77’ | \n\t\t\t35° 49’ | \n\t\t\t1092 | \n\t\t\tUrban | \n\t\t\tIn a residential area at the city center on the ground | \n\t\t
Develi (Kayseri) | \n\t\t\t38° 28’ | \n\t\t\t35° 54’ | \n\t\t\t1180 | \n\t\t\tRural | \n\t\t\t40 km away from the city center on the ground | \n\t\t
Pinarbasi (Kayseri) | \n\t\t\t38° 77’ | \n\t\t\t36° 61’ | \n\t\t\t1500 | \n\t\t\tRural | \n\t\t\t75 km away from the city center on the ground | \n\t\t
Tomarza (Kayseri) | \n\t\t\t38° 27’ | \n\t\t\t35° 48’ | \n\t\t\t1397 | \n\t\t\tRural | \n\t\t\t35 km away from the city center on the ground | \n\t\t
Mersin | \n\t\t\t36° 78’ | \n\t\t\t34° 60’ | \n\t\t\t3 | \n\t\t\tUrban | \n\t\t\tIn a residential area at the city center on the ground | \n\t\t
Erdemli Alata (Mersin) | \n\t\t\t36° 38’ | \n\t\t\t33° 94’ | \n\t\t\t9 | \n\t\t\tSuburban | \n\t\t\t35 km away from the city center on the ground | \n\t\t
Sanliurfa | \n\t\t\t37° 16’ | \n\t\t\t38° 79’ | \n\t\t\t547 | \n\t\t\tUrban | \n\t\t\tIn a residential area at the city center on the ground | \n\t\t
Birecik (Sanliurfa) | \n\t\t\t37° 02’ | \n\t\t\t37° 96’ | \n\t\t\t345 | \n\t\t\tRural | \n\t\t\t65 km away from the city center on the ground | \n\t\t
Site characteristics of selected meteorological stations
The UHI effect refers to an increase in urban air temperatures as compared to surrounding suburban and rural temperatures (Oke, 1982; Quattrochi et al., 2000).
UHI effect is defined as:
where
Heat islands develop in areas that contain a high percentage of non-reflective, water-resistant surfaces and a low percentage of vegetated and moisture-trapping surfaces (Rosenzweig et al., 2005). In particular, materials such as stone, concrete, and asphalt tend to trap heat at the surface (Landsberg, 1981; Oke, 1982; Quattrochi et al., 2000) and a lack of vegetation reduces heat lost due to evapotranspiration (Lougeay et al., 1996). The addition of anthropogenic heat and pollutants into the urban atmosphere further contributes to the intensity of the UHI effect (Taha, 1997). The pollution created by emissions from power generation increases absorption of radiation in the boundary layer (Oke, 1982) and contributes to the creation of inversion layers. Inversion layers prevent rising air from cooling at the normal rate in urban areas.
Globally average surface warming is projected to increase for the end of the 21st century (2090 to 2099), relative to 1980 to 1999 within the six different scenarios between 1.1 - 6.4 ºC (IPCC, 2007). Climate change has the potential to significantly alter the intensity and increase the spatial extent of heat islands in urban environments. As temperature warms, the frequency with which UHI conditions occur could grow (Rosenzweig et al., 2005).
Trend analysis can be used to assess the climatic variations of the atmosphere and the Mann-Kendall trend test (Mann, 1945; Kendall, 1975) is one of the widely used non-parametric tests to detect significant trends in time series. The Mann-Kendall trend test is not affected by the actual distribution of the data and is less sensitive to outliers rather than parametric trend tests, which are more powerful, but more sensitive to outliers. Therefore, Mann-Kendall test is more suitable for detecting trends in temperature time series, which may have outliers (Hamed, 2008). Climate change can be detected by the Kendall coefficient t (Mann test) and when a time series shows a significant trend, the period from which the trend is demonstrated can be obtained effectively by this test. In a time series, for each element yi, the number ni of elements yj preceding it (i > j) is calculated such that yi > yj.
The test statistic t is then given by,
and is distributed very nearly as a Gaussian normal distribution with an expected value of E(t) = n(n-1)/4 and a variance of vart = n(n-1)(2n+5)/72. A trend can be seen for high values of │u(t)│, where,
This principle can be usefully extended to the backward series and
Observation data over the Anatolian Peninsula were analyzed to understand trends in average temperature. As can be seen in Fig. 4a, as of 2009, average temperatures in all 8 cities are higher than temperature in 1960s. For example, average temperature increase in Kayseri, Gaziantep, and Mersin is over 2 ºC. Fig. 4b presents anomaly in mean temperatures in Anatolian Peninsula as estimated using gridded dataset obtained by the Climate Research Unit (CRU - TS3.0). The results suggest an increase of 0.5 ºC starting in 1990s.
Trends in daily minimum temperatures at individual meteorological stations were investigated with the Mann-Kendall trend test (Mann, 1945; Kendall, 1975). As an example, annual time series of minimum temperatures for the urban stations of Istanbul (Goztepe & Florya) and its sequential version of the Mann-Kendall test graph is presented in Fig. 5. In Mann-Kendall plots, as of 1965, Goztepe station has a minimum temperature of 10 °C, which increased to 11.5 °C in 2006. Similar trend is seen for Florya station. Significance of the trend has been identified by Mann-Kendall statistics where the area above the line passing 1.96 represents the 95% significance level. Both Goztepe and Florya stations show a significant increase starting by mid to late 1990s.
The Mann-Kendall statistic of the annual minimum temperatures for the urban and rural stations are presented in Table 3. In all urban stations, Mann-Kendall statistics suggest statistically significant increase. In rural stations, however, out of 16 stations, 13 stations do not show any significant trend; only 1 of them have statistically significant increase and 2 of them show decreasing trend. After 1990s, the population of Beypazari and Tomarza are on the decline, and this may be the reason for the negative trends in these two rural stations. These results suggest that an additional factor: possibly UHI, is in motion to cause significant increase in minimum temperatures over urban areas. In order to further investigate this hypothesis, we have studied trends in temperature differences between urban and rural environment for the selected cities.
a) Observation mean temperature variation in large Anatolian Cities and (b) anomaly in yearly mean temperatures in the Anatolian Peninsula from 1965 to 2006
The annual time series of minimum temperature for the urban stations of Istanbul and its sequential version of the Mann-Kendall test; a) Goztepe, b) Florya
Urban Station | \n\t\t\tTmin Statistics (1965-2006) | \n\t\t
Ankara* | \n\t\t\t2,93 | \n\t\t
Bursa* | \n\t\t\t2,20 | \n\t\t
Gaziantep* | \n\t\t\t4,87 | \n\t\t
Istanbul (Goztepe)* | \n\t\t\t4,19 \n\t\t\t | \n\t\t
Istanbul (Florya)* | \n\t\t\t3,46 | \n\t\t
Izmir* | \n\t\t\t2,61 | \n\t\t
Kayseri* | \n\t\t\t5,08 | \n\t\t
Mersin* | \n\t\t\t7,06 | \n\t\t
Sanliurfa* | \n\t\t\t4,35 | \n\t\t
(a) \n\t\t\t | \n\t\t|
Rural Station | \n\t\t\tTmin Statistics (1965-2006) | \n\t\t
Polatli (Ankara) | \n\t\t\t0,38 | \n\t\t
Kizilcahamam (Ankara) | \n\t\t\t0,99 | \n\t\t
Beypazari (Ankara) | \n\t\t\t-2,87 | \n\t\t
Esenboga (Ankara) | \n\t\t\t0,55 | \n\t\t
Nallıhan (Ankara) | \n\t\t\t-0,73 | \n\t\t
Islahiye (Gaziantep)* | \n\t\t\t2,18 | \n\t\t
Kirecburnu (Istanbul) | \n\t\t\t1,81 | \n\t\t
Kumkoy (Istanbul) | \n\t\t\t1,22 | \n\t\t
Sile (Istanbul) | \n\t\t\t-0,14 | \n\t\t
Dikili (Izmir) | \n\t\t\t1,46 | \n\t\t
Develi (Kayseri) | \n\t\t\t-1,51 | \n\t\t
Pinarbasi (Kayseri) | \n\t\t\t0,49 | \n\t\t
Tomarza (Kayseri) | \n\t\t\t-2,29 | \n\t\t
Keles (Bursa) | \n\t\t\t-0,64 | \n\t\t
Erdemli Alata (Mersin) | \n\t\t\t1,48 | \n\t\t
Birecik (Sanliurfa) | \n\t\t\t0,40 | \n\t\t
(b) | \n\t\t
Annual minimum temperature statistics of stations; a) urban, b) rural
The Mann-Kendall results of the other urban-rural pairs are given in Table 4. Example of the results are given in Fig. 6. Time series and the statistics for the city of Ankara, the capital of Turkey show strongly increasing warming trend (Fig. 6a). Ankara is the most crowded city of Turkey after Istanbul and located in the center of Anatolia. Because of the migration from rural sites to the center of the city (Fig. 2), Ankara has become a highly populated city, although there is not a significant industrial activity in the area. Eventually, urban-rural pairs of Ankara have high Mann-Kendall statistics over 1.96 (Table 4), which demonstrates the UHI effect in the capital of Turkey.
Bursa, which is located in the south of the Marmara Sea, has a growing population (Fig. 2) with a highly industrialized area, producing the urbanization phenomenon in the city with the human migration to the city like Istanbul. The minimum temperature difference series for Bursa-Keles station pair shows significantly increasing warming trend (Fig. 6b) with a Mann-Kendall statistic of 4.30 (Table 4). The city of Gaziantep is located in the southeastern part of Anatolia and has a growing population like the other large cities in the region and has a developing industry. The Mann Kendall statistics of the urban-rural pair shows a significantly increasing trend (Fig. 6c) with 5.82.
Istanbul and Bursa are the cities located in the north-west of Anatolia. This region is the most industrialized part of the country. Istanbul is the largest city of Turkey with over 13 million population (TUIK, 2012). Due to the cultural and financial features of the city, migration is generating the urbanization and making the Istanbul a mega city. It is located on the Bosporus and extends both on the European and Asian sides; therefore to investigate the UHI for Istanbul, two urban stations are selected on the both sides for representing the all city. The urban stations used in the European and the Asian sides are Florya and Goztepe, respectively. The annual minimum temperature statistics of the urban stations of the city show significantly increasing trend (Table 3). The urban-rural pairs show significantly increasing UHI effect (>2.5) in the city (Fig. 6d and\n\t\t\t\tTable 4), which is an accepting result for a highly urbanized city of Istanbul.
The annual time series and Mann-Kendall tests for the minimum temperature differences between; a) Ankara Bolge – Beypazari, b) Bursa – Keles, c) Gaziantep – Islahiye, d) Istanbul (Goztepe) – Kirecburnu, e) Izmir Bolge – Dikili, f) Kayseri Bolge – Tomarza
Izmir is the third largest city in Turkey with respect to population and comprising significant amount of economic activity in its region. The city is located in the west coast of Anatolia (Aegean Region) and has a typical Mediterranean climate. The city has encountered important amount of urban growth and with the 2007 above the 70% of the city live in the urban parts of the city (Fig. 2). Urban station, Izmir Bolge has a significant increasing trend in annual minimum temperature statistics (Table 3a). The Izmir Bolge-Dikili difference has a significant increasing trend above 95% (Fig. 6e). Kayseri is the other city studied in the same region of Anatolia along with Ankara. Kayseri is another big and also industrialized city in the region. Three rural stations are selected for the Kayseri with a one urban station. All the urban-rural pairs show a positive trend above the 95% with Mann Kendall values over 5.0 (Table 4), pointing out the UHI effect strongly in Kayseri (Fig. 6f).
Station pairs (urban-rural) | \n\t\t\tTmin Statistics (1965-2006) | \n\t\t
Ankara Bolge – Polatli | \n\t\t\t5.88 | \n\t\t
Ankara Bolge - Kizilcahamam | \n\t\t\t2.92 | \n\t\t
Ankara Bolge – Beypazari | \n\t\t\t6.25 | \n\t\t
Ankara Bolge - Esenboga | \n\t\t\t4.30 | \n\t\t
Ankara Bolge - Nallihan | \n\t\t\t5.13 | \n\t\t
Bursa - Keles | \n\t\t\t4,30 | \n\t\t
Gaziantep - Islahiye | \n\t\t\t5.82 | \n\t\t
Istanbul (Florya) - Kirecburnu | \n\t\t\t2.66 | \n\t\t
Istanbul (Florya) - Kumkoy | \n\t\t\t3.74 | \n\t\t
Istanbul (Florya) - Sile | \n\t\t\t4.63 | \n\t\t
Istanbul (Goztepe) - Kirecburnu | \n\t\t\t6.01 | \n\t\t
Istanbul (Goztepe) - Kumkoy | \n\t\t\t4.63 | \n\t\t
Istanbul (Goztepe) - Sile | \n\t\t\t5.75 | \n\t\t
Izmir Bolge - Dikili | \n\t\t\t2.13 | \n\t\t
Kayseri Bolge - Develi | \n\t\t\t5.06 | \n\t\t
Kayseri Bolge - Pinarbasi | \n\t\t\t5.86 | \n\t\t
Kayseri Bolge - Tomarza | \n\t\t\t6.93 | \n\t\t
Mersin - Erdemli Alata | \n\t\t\t6.82 | \n\t\t
Sanliurfa Bolge - Birecik | \n\t\t\t5.54 | \n\t\t
Mann Kendall statistics of the urban and rural minimum temperature differences
In 1965, practically there was no difference in daily minimum temperatures between urban and rural stations. However, as of 1985, urban station is approximately 2 °C warmer than the rural station. This trend accelerated and as of 2006, the urban station is over 4 °C warmer than rural. Mann-Kendall plot verifies this finding; since by 1985 the trend is estimated to be significant. Results for other urban-rural pairs are given in Table 4. All of the 19 pairs show a statistically significant increase in urban temperatures as compared to rural values.
The intensity of maximum UHI of the selected cities with respect to the logarithm of 2007 populations
Fig. 7 presents the intensity of maximum UHI in relation with the logarithm of the population. Magnitude of maximum UHI effect is calculated by subtracting the minimum rural temperature from the minimum urban temperature and the maximum difference between them is taken as the maximum UHI intensity (Tayanc & Toros, 1997). The linear curves of Oke (1973) for the maximum UHI intensity of European and North American cities are illustrated in the figure. Maximum UHI intensities of the stations are almost positively correlated with Oke’s fit for European cities; Istanbul (Goztepe - Sile), Izmir (Izmir – Dikili), Ankara (Ankara - Beypazari), Mersin (Mersin - Erdemli Alata), and Gaziantep (Gaziantep - Islahiye). But the cities; Kayseri, Sanliurfa, and Bursa are correlated with the North America line. This difference may be about the lower population densities or different sizes of settlements, which may generate higher ∆Tu-r values.
Mean temperature anomaly of the Anatolian Peninsula; winter, and summer season
Urbanization makes significant changes in the surface of the earth, and this change makes variations in the trends of the temperatures. In this study, urbanization effects on the temperature trends are investigated at the selected stations in the Anatolian Peninsula, which is located at the confluence of Europe, Asia, and Africa. Interactions between the climates of these continents, which have different characteristics, affect the Mediterranean region including the Anatolian Peninsula causing temporal and spatial variations (Giorgi & Lionello, 2008). Complex terrain of the study area, presence of water bodies as well as urbanization effects on local climate further complicates the system. In this study, we aim to quantify the UHI effect by contrasting the temperatures between urban-rural areas. Study area includes 81 cities of which 79 of them have population over 100,000. We have chosen 9 urban and 16 rural meteorological stations (in the close proximity of the city) in 8 cities.
The findings of this study suggest that there is no statistically significant increase in rural daily minimum temperatures between 1965-2006. However, all the urban sites show significant increase, which is a strong indication for the existence of UHI effect over this region. These findings are different from the previous studies (Karaca et al., 1995; Tayanc & Toros, 1997), which suggest either no significant or is a cooling trend existing for this region. This is mainly due to the fact that our study includes the period between 1960 and 2006, where a clear upward trend is seen especially after 1990s. Similar to our findings, Kataoka et al. (2009) demonstrated the UHI in several Asian cities.
IPCC has identified Eastern Mediterranean covering Anatolian Peninsula as one of the most vulnerable zones in terms of Climate Change (Stern Review, 2006). Our group conducted research studies (Scientific and Technical Research Council of Turkey-TUBITAK Project No: 105G015) to investigate climate change over Anatolia via regional climate models. Fig. 8 presents anomaly of temperature for Anatolian Peninsula, which were estimated by regional model in a 27 km resolution for the period 2000-2100 as compared to reference period 1961-1990, following the International Panel on Climate Change Special Report on Emission Scenarios (IPCC SRES) A2 forcing. In winter, temperatures do not show increasing trend until 2030. However, there is almost linear increase reaching up to 3°C at the end of the century. In summer the trend is much more significant and reaches up to 5 °C (Fig. 8b). It should be pointed out that most of the climate models do not take UHI effect into account, since climate models use fixed Land Use/Land Classification (LU/LC) for the simulation period. Therefore, there is a possibility of greater increase in temperatures over urban areas, when UHI effect is considered. Such analysis is definitely required to better understand future climate.
This study is partly supported by a grant (108Y064) from TUBITAK (The Scientific and Technological Research Council of Turkey).
Health care is vulnerable to error, and so all health care environments and professionals are involved in complex care processes. Since the IOM report [1], almost all countries and health care organizations are attending to Patient Safety issues. In more recent years, the European Council launched a recommendation [2] that shows the importance of establishing patient safety culture in all health care settings. We can read in this recommendation that a poor patient safety represents both a severe public health problem and a high economic burden on limited health resources. A large proportion of adverse events, both in the hospital sector and in primary care, are preventable with systemic factors appearing to account for a majority of them.
\nBefore implementing patient safety programs, health care staff must understand their safety culture [3]. Quantitative instruments designed to assess safety culture have been developed, and a few review articles have been published, which allows a more comprehensive way of implementing models of safety culture [4]. Measuring health care safety culture enables us to identify improvements, safety behaviors, and outcomes for both patients and staff. These instruments should also serve as decision making tools, especially for managers.
\nMuch has been done in hospital environment, and more recently, primary care has also been in the sights. A few review articles were published allowing researchers and primary care staff to take robust decisions on tools to assess patient safety culture [5, 6, 7].
\nWith the publication of the National Patient Safety Plan (2015–2020), the Portuguese Directory of Health along with the Portuguese Hospital Association carried out patient safety culture assessment either in hospitals or in primary care. It was published as a national standard, and every 2 years, patient safety culture is assessed either in primary care or in hospitals nationwide.
\nThe purpose of this study was to translate, adapt, validate, and analyze the reliability and validity of the Portuguese version of the Medical Office Survey on Patient Safety Culture.
\nThe Medical Office Survey on Patient Safety Culture (MOSPSC) is a self-administered tool, which was developed by the Agency for Healthcare Research and Quality (AHRQ) in 2007 [8], and is designed specifically for outpatient medical office providers and other staff and asks for their opinions about the culture of patient safety and health care quality in their medical offices. Although in Portugal the health system is completely different than in the United States, we considered that the primary care environment and culture are similar, which lead us to test its use.
\nThis survey has 38 items grouped into 10 composites and includes questions that ask respondents about problems related to exchange information with other settings and about access to care. Respondents are also asked to rate their medical office in five areas of health care quality (patient centered, effective, timely, efficient, and equitable) and to provide an overall rating on patient safety (Table 1).
\nComposites | \nItems | \n
---|---|
1. Teamwork | \nC1; C2; C5; C13 | \n
2. Patient Care Tracking/Follow Up | \nD3; D5; D6; D9 | \n
3. Organizational Learning | \nF1; F5; F7 | \n
4. Overall Perceptions of Patient Safety and Quality | \nF2; F3; F4R; F6R | \n
5. Staff Training | \nC4; C7; C10R | \n
6. Owner/Managing Partner/Leadership Support for Patient Safety | \nE1R; E2R; E3; E4R | \n
7. Communication about Error | \nD7R; D8R; D11; D12 | \n
8. Communication Openness | \nD1; D2; D4R; D10R | \n
9. Office Processes and Standardization | \nC8R; C9; C12R; C15 | \n
10. Work Pressure and Pace | \nC3R; C6R; C11; C14R | \n
MOSPSC composites and items.
According to the MOSPSC author’s [8], patient safety culture composites and its definitions are:
Teamwork—the extent to which the office has a culture of teamwork, mutual respect, and close working relationships among staff and providers.
Patient Care Tracking/Follow Up—the extent to which the office reminds patients about appointments, documents how well patients follow treatment plans, follows up with patients who need monitoring, and follows up when reports from an outside provider are not received.
Organizational Learning—the extent to which the office has a learning culture that facilitates making changes in office processes to improve the quality of patient care and evaluates changes for effectiveness.
Overall Perceptions of Patient Safety and Quality—the extent to which the quality of patient care is more important than getting more work done, office processes are good at preventing mistakes, and mistakes do not happen more than they should.
Staff Training—the extent to the office gives providers and staff effective on-the-job training, trains them on new processes, and does not assign tasks they have not been trained to perform.
Owner/Managing Partner/Leadership Support for Patient Safety—the extent to which office leadership actively supports quality and patient safety, places a high priority on improving patient care processes, does not overlook mistakes, and makes decisions based on what is best for patients.
Communication about Error—the extent to which providers and staff are willing to report mistakes they observe and do not feel like their mistakes are held against them, and providers and staff talk openly about office problems and how to prevent errors from happening.
Communication Openness—the extent to which providers in the office are open to staff ideas about how to improve office processes, and staff are encouraged to express alternative viewpoints and do not find it difficult to voice disagreement.
Office Processes and Standardization—the extent to which the office is organized, has an effective workflow, has standardized processes for completing tasks, and has good procedures for checking the accuracy of work performed.
Work Pressure and Pace—the extent to which there are enough staff and providers to handle the patient load, and the office work pace is not hectic.
Since the publication of the National Patient Safety Plan (2015–2020), the Portuguese Directory of Health along with the Portuguese Hospital Association carried out patient safety culture assessment either in hospitals or in primary care. For this purpose, the MOSPSC was the chosen tool because [8]:
it raises provider and staff awareness about patient safety;
it assesses the current status of patient safety culture;
it identifies strengths and areas for patient safety culture improvement;
it examines trends in patient safety culture change over time;
it evaluates the cultural impact of patient safety initiatives and interventions;
it conducts comparisons within and across organizations;
it has been used in several countries in Europe (which makes benchmark possible) [9, 10], and the results of the LINEUS study [9] show that it is useful and applicable to assess patient safety culture at primary health care services in Europe.
The European Society for Quality and Safety in Family Practice (EQuiP) and the World Family Doctors. Caring for People (WONCA Europe) [11] conducted a study to spread the MOSPSC among EQuiP delegates, explore their views and opinions on the MOSPSC, and explore with them the feasibility of the MOSPSC among European countries. Nineteen countries were involved, and 63% of respondents find it would be interesting to use MOSPSC.
\nImmediately after author’s permission for MOSPSC use, the survey was translated from English to Portuguese (T1) and backward (T2) by two independent translators, native speakers of Portuguese, and bilingual in English/Portuguese, experienced in this method and knowledgeable about the research objective (Step 1). The two versions (T1 and T2) were compared with the original version of the MOSPSC (Step 2). Back translation by two independent translators (R-T1 and R-T2) was carried out by bilingual native English, who were unfamiliar with the original version of tool and not knowledgeable about the study objectives (Step 3). Discrepancies were assessed, and the cross-cultural adaptations were undertaken (Step 4). Content validity and semantic analysis were undertaken by six experts chosen from the primary care sector and knowledge on this topic and with research experience (Step 5).
\nThe pretest was applied (Step 6), which was aimed at assessing whether the MOSPSC was understandable to a larger number of people in the target population. The last version of the MOSPSC was then administered in Web-based format, and we used all recommendations from AHRQ [11] to publicize and promote the survey.
\nThe Portuguese Directory of Health published a national standard that requires patient safety culture assessment in primary care units (PCUs) nationwide (52 PCUs) every 2 years. A personalized link was sent to all PCUs, where a focal point was in charge of facilitating the administration of the survey. In order to track and maximize response rates, a link was sent to each office PCU. We sent another link so that the focal point could check response rates along the administration period, which occurred from March 16 till April 30, 2017.
\nOur goal was to assess the validity and reliability of the Portuguese version of the MOSPSC, by verifying if the 10 patient-safety culture composites were appropriate for the Portuguese population. The R software was used for statistical analysis, and the negatively worded items were reverse-scored and they are denoted by R letter.
\nDescriptive statistics were used to examine response variability and missing data. To identify and eliminate those items with missing data, an individual descriptive item analysis was performed. A missing-value analysis was performed to verify if it was necessary to remove surveys from the data set. Every survey with missing values was removed, and surveys with more than 1 response in the option “not applicable” were removed. For the remaining surveys with only one answer in option “not applicable,” it was replaced by the middle category in a five-point Likert scale. An empirical rule of 10 respondents per patient safety culture item in a survey with 38 items means that at least 380 completed surveys were needed.
\nA reliability analysis (internal consistency) was performed using Cronbach’s α, where it indicates the extent to which surveys items can be treated as a single latent construct. Values >0.7 reliability is considered adequate for a survey instrument [12], although some authors consider >0.6 adequate [13]. For the entire survey, Cronbach’s α should be at least 0.9 [12]. However, the validity of this measure has been questioned, and several authors have suggested alternative measures. In this study, we also used the average inter-item correlation (AIIC), which is independent of the number of items and sample size. This measure evaluates how items within a composite correlate, i.e., there is evidence that the items are measuring the same underlying composite. A rule-of-thumb is that AIIC should be between 0.15 and 0.5 [14].
\nAn exploratory factor analysis (EFA) was performed. EFA is a cluster of common methods used to explore the underlying pattern of relationships among multiple observed variables. EFA is useful for assessing the dimensionality of questionnaire scales that measure underlying latent variables. Researchers use EFA to hypothesize and, later, confirm, through replication or confirmatory factor analysis (CFA), the model that gave rise to the interrelationships among the scale?s variables. EFA for ordinal data, a benefit over conventional criteria, where the Pearson correlation matrix is used. Pearson correlations assume that data have been measured on, at least, an equal interval scale, and a linear relationship exists between the variables. These assumptions are typically violated in the case of variables measured using ordinal rating scales. Pearson correlations have been found to underestimate the strength of relationships between ordinal items.
\nEFA is useful for assessing the dimensionality of survey scales that measure underlying latent variables. This factor analysis gives an indication of the number of factors that the survey appears to measure of its intended subject. In this way, through EFA, we can investigate if the Portuguese data will produce different factors from the American structure.
\nSince the data are ordinal, it was used a polychoric correlation matrix for EFA analysis and a Varimax rotation. To decide on the number of factors, it was used a parallel analysis [15, 16]. Items with a factor loading lower than 0.4 on all factors were excluded. Libraries psych and polycor from R were used [17, 18].
\nWe used confirmatory factor analysis (CFA) for ordinal data to compare the Portuguese sample factor structure to the factor structure reported for the original HSOPSC. CFA for ordinal data will use diagonally weighted least squares (DWLS) to estimate the model parameters, but it will use the full weight matrix to compute robust standard errors and a mean- and variance-adjusted test statistic. We used the goodness-of-fit index (GFI), which accounts for the proportion of observed covariance between the manifest variables (items), explained by the fitted model (a concept similar to the coefficient of determination in linear regression). Generally, GFI values between 0.9 and 0.95 indicate good fit, and GFI values above 0.95 indicate a very good fit. Bentler’s comparative fit index (CFI) was used to correct the underestimation that can occur when samples are small. CFI is independent from the sample size. Values between 0.9 and 0.95 indicate good fit, and values equal to or above 0.95 indicate a very good fit. The Tucker-Lewis index (TLI) varies between 0 and 1; values close to 1 indicate a good fit. Parsimony GPI (PGFI) is obtained to compensate for the “artificial” improvement in the model, which is achieved simply by adding more parameters, i.e., a more complex model may have better fit than a simpler model (parsimonious). Values between 0.6 and 0.8 indicate a reasonable fit and values above 0.8 a good fit. The index root mean square error of approximation (RMSEA) was used to adjust the model simply by adding more parameters. Empirical studies suggest that the model fit is considered good for values ranging between 0.05 and 0.08 and very good for values less than 0.05. The lavaan library from R was used [19].
\nA total of 7299 respondents provided feedback (response rate of 32.2%), 38% were nurses, 27% physicians, and 19% secretary/clerk (Table 2).
\n\n | Respondents | \n|
---|---|---|
N | \n% | \n|
Physicians | \n1954 | \n27 | \n
Nurses | \n2729 | \n38 | \n
Assistant | \n456 | \n6 | \n
Secretary | \n1380 | \n19 | \n
Technicians | \n560 | \n7 | \n
Others | \n136 | \n2 | \n
Total | \n7215 | \n\n |
Missing values | \n84 | \n\n |
Total | \n7299 | \n\n |
Demographic characteristics.
Average composite positive responses were obtained (Table 3). The lowest positive scores were found in composites Work Pressure and Pace, Owner/Managing Partner/Leadership Support for Patient Safety, and Staff Training. The composites with highest scores were Teamwork, Patient Care Tracking/Follow Up, and Organization Learning.
\nComposite | \nAverage positive responses (%) | \n
---|---|
1. Teamwork | \n76 | \n
2. Patient Care Tracking/Follow Up | \n76 | \n
3. Organization Learning | \n71 | \n
4. Overall Perceptions of Patient Safety and Quality | \n69 | \n
5. Staff Training | \n44 | \n
6. Owner/Managing Partner/Leadership Support for Patient Safety | \n31 | \n
7. Communication about Error | \n54 | \n
8. Communication Openness | \n52 | \n
9. Office Processes and Standardization | \n53 | \n
10. Work Pressure and Pace | \n21 | \n
Composite average positive responses.
From an initial data set of 7299 respondents, it was removed 587 surveys with missing values and 2408 surveys with more than 2 answers on the option “not applicable,” getting a final data set with 4304 surveys, exceeding the minimum necessary. The surveys with one answer in the option “not applicable” were replaced by the middle category in a five-point Likert scale.
\nReliability analysis using Cronbach’s α was performed on the 10 composites to ensure that individuals were responding consistently to items (Table 4). Considering Cronbach’s α, all composites had values higher than 0.6, where composite 1 achieved the highest value and composite 9 the lowest. Analyzing AIIC coefficient, only composites 1 and 3 obtained values outside from the reference. In terms of global consistency, both coefficients lead to a good overall consistency.
\nComposite | \nNo of items | \nCronbach’s α | \nAIIC | \n
---|---|---|---|
1. Teamwork | \n4 | \n0.82 | \n0.53 | \n
2. Patient Care Tracking/Follow Up | \n4 | \n0.71 | \n0.38 | \n
3. Organization Learning | \n3 | \n0.79 | \n0.56 | \n
4. Overall Perceptions of Patient Safety and Quality | \n4 | \n0.69 | \n0.38 | \n
5. Staff Training | \n3 | \n0.69 | \n0.43 | \n
6. Owner/Managing Partner/Leadership Support for Patient Safety | \n4 | \n0.69 | \n0.36 | \n
7. Communication about Error | \n4 | \n0.75 | \n0.43 | \n
8. Communication Openness | \n4 | \n0.73 | \n0.40 | \n
9. Office Processes and Standardization | \n4 | \n0.63 | \n0.31 | \n
10. Work Pressure and Pace | \n4 | \n0.75 | \n0.42 | \n
Total | \n38 | \n0.92 | \n0.24 | \n
Internal consistency statistics.
To examine whether a different structure would give a better fit to the data, an exploratory factor analysis was performed. To determine how many composites should be retained, it was obtained the path diagram in Figure 1, where a new structure is proposed. Eight composites were obtained with 37 items (item F6R was not considered since he had an eigenvalue lower than 0.4). Comparing this structure with the one proposed by MOSPSC, composites 1, 5, and 6 did not suffer any changes, composites 2 and 10 gained one item each, composite 4 lost 2 items, composite 8 gained one item and changed other, and composite 3 gained several items from composites 4, 7 and 9.
\nPath diagram of exploratory factor analysis. Rectangles represent items, circles represent factors (composites), and the values on the arrows are the eigenvalues.
It was obtained the coefficients for internal consistency for the new proposed structure by EFA (Table 5). In a general way, it was obtained better internal consistency coefficients than with the original structure.
\nComposite | \nNo. of items | \nCronbach’s α | \nAIIC | \n
---|---|---|---|
1. Teamwork* | \n4 | \n0.82 | \n0.53 | \n
2. Patient Care Tracking/Follow Up + 8. Communication Openness (D1) | \n5 | \n0.73 | \n0.35 | \n
3. Organization Learning + 7. Communication about Error (D11, D12) + 9. Office Processes and Standardization (C9, C15) + 4. Overall Perceptions of Patient Safety and Quality (F2) | \n8 | \n0.88 | \n0.48 | \n
4. Overall Perceptions of Patient Safety and Quality [F2, F6R] | \n2 | \n0.76 | \n0.61 | \n
5. Staff Training* | \n3 | \n0.69 | \n0.43 | \n
6. Owner/Managing Partner/Leadership Support for Patient Safety* | \n4 | \n0.69 | \n0.36 | \n
8. Communication Openness [D1] + 7. Communication about Error (D7R) + 2. Patient Care Tracking/Follow Up (D8) | \n5 | \n0.78 | \n0.41 | \n
10. Work Pressure and Pace + 9. Office Processes and Standardization (C12R) | \n5 | \n0.79 | \n0.42 | \n
Total | \n38 | \n0.92 | \n0.243 | \n
Internal consistency statistics after structure proposed by exploratory factor analysis.
Composites who did not suffer any changes after EFA.
Curve brackets represent added items and rectangular brackets represent removed items from the composite.
The fit of the data to the dimensional structure proposed in the original instrument was analyzed using structural equations models through confirmatory factor analysis (CFA). Correlations between composites are presented in Table 6, where it can be observed that there are high values between some composites. This will produce a nonpositive definite matrix of the covariances of the latent variables. In this sense, composite 9 was removed.
\n\n | 1 | \n2 | \n3 | \n4 | \n5 | \n6 | \n7 | \n8 | \n9 | \n10 | \n
---|---|---|---|---|---|---|---|---|---|---|
1 | \n1 | \n\n | \n | \n | \n | \n | \n | \n | \n | \n |
2 | \n0.495 | \n1 | \n\n | \n | \n | \n | \n | \n | \n | \n |
3 | \n0.758 | \n0.588 | \n1 | \n\n | \n | \n | \n | \n | \n | \n |
4 | \n0.591 | \n0.533 | \n0.859 | \n1 | \n\n | \n | \n | \n | \n | \n |
5 | \n0.570 | \n0.368 | \n0.538 | \n0.516 | \n1 | \n\n | \n | \n | \n | \n |
6 | \n0.405 | \n0.302 | \n0.520 | \n0.515 | \n0.549 | \n1 | \n\n | \n | \n | \n |
7 | \n0.736 | \n0.679 | \n0.841 | \n0.659 | \n0.499 | \n0.487 | \n1 | \n\n | \n | \n |
8 | \n0.788 | \n0.622 | \n0.773 | \n0.648 | \n0.498 | \n0.463 | \n0.893 | \n1 | \n\n | \n |
9 | \n0.820 | \n0.606 | \n0.929 | \n0.765 | \n0.669 | \n0.571 | \n0.798 | \n0.763 | \n1 | \n\n |
10 | \n0.147 | \n0.117 | \n0.191 | \n0.270 | \n0.357 | \n0.326 | \n0.230 | \n0.153 | \n0.530 | \n1 | \n
Correlations of the 10 composites.
Figure 2 shows the relation of the individual items to the composites. The standardized path between coefficients shows the strength of these relations. A coefficient less than 0.1 indicates a low effect; coefficients around 0.3 indicate a medium effect, while large effects are suggested by coefficients higher or equal of 0.5. In this model, coefficients ranged between 0.45 and 0.87.
\nConfirmatory factor model where composite 9 was removed (34 items).
Table 7 shows the fit of the confirmatory factor analysis for the model proposed in Figure 2. The indices CFI and GFI showed a very good fit; RMSEA and TLI showed a good fit and PGFI a reasonable fit.
\nGoodness of fit indices | \nValues | \n
---|---|
CFI | \n0.98 | \n
TLI | \n0.97 | \n
PGFI | \n0.69 | \n
GFI | \n0.99 | \n
RMSEA | \n0.064 (p value < 0.001) | \n
Confirmatory factor analysis model fit indices.
It was also obtained a good overall internal consistency (Cronbach’s α = 0.91, AICC = 0.243).
\nConsidering the model proposed by EFA (Figure 1), it was obtained the CFA model in Figure 3. In this model, coefficients ranged between 0.45 and 0.88.
\nConfirmatory factor model for model proposed by EFA (37 items).
The goodness-of-fit indices (Table 8) obtained for EFA model (Figure 3) are very similar to the ones obtained for the model proposed in Figure 2.
\nGoodness of fit indices | \nValues | \n
---|---|
CFI | \n0.98 | \n
TLI | \n0.97 | \n
PGFI | \n0.72 | \n
GFI | \n0.98 | \n
RMSEA | \n0.066 (p value < 0.001) | \n
Confirmatory factor analysis model fit indices for model proposed by EFA.
We have described the results of a translation, an adaptation, and a validation and analyzed the reliability of the Medical Office Survey on Patient Safety Culture in Portuguese Primary Health Care. As far as we know, this is the first study on patient safety culture in primary health care in Portugal with this depth of analysis of the structure of the survey proposed by the Medical Office Survey.
\nThe lowest positive scores were found in composites Work Pressure and Pace, Owner/Managing Partner/Leadership Support for Patient Safety, and Staff Training. The composites with highest scores were Teamwork, Patient Care Tracking/Follow Up, and Organization Learning.
\nThe original survey had a good overall consistency, where the composite Office Processes and Standardization had the lowest values on internal consistency statistics and the composite Teamwork the highest. The exploratory factor analysis proposed a structure with eight composites, where just one item was removed, and several items were spread out by the others composites. Through confirmatory factor analysis, it was obtained another model structure where the composite Office Processes and Standardization was removed, leading to a survey with nine composites with 34 items. In terms of goodness of fit and internal consistency, there were no substance differences, both achieved good internal consistency and very good fit. It was decided to choose the structure proposed by CFA, since the differences in terms of structure to the original one are only by the removal of one composite, allowing comparison of the Portuguese results with the EUA results and other countries that get the same structure. Furthermore, this structure has a less number of items, getting a more parsimonious model.
\nA limitation of the study is the low response rate; however, it is not unusual for an open population study once it was Web-only administrated, although we have identified ways to publicize your survey and tracked response rates.
\nAnother limitation of the study was the number of missing values. It reduced the representativeness of the sample and can therefore distort inferences about the population. In future studies, the results will be compared using imputation methods on missing values and the impact on the results will be evaluated.
\nA strength of this study is the statistical method used, particularly in exploratory factor analysis and confirmatory factor analysis, since they are the most appropriate to the data type of this study, where bias was reduced. The majority of the studies on the context of this study still use methods assuming that data are continuous.
\nAs it is well known in Portugal, the Directory of Health has been doing patient safety culture assessment every 2 years since 2014, which allows all health units to enhance patient safety.
\nThe Portuguese version of the MOSPSC resulted in nine composites with good reliability and construct validity, where the structure differs from the original by removing one composite. In further studies, it will be performed longitudinal studies to evaluate the impact of patient safety culture interventions on staff and patients.
\nPatient safety culture assessment is of a vital importance for all levels of care. In Portugal, we are caring out this assessment every 2 years, which allows institutions to identify patient safety culture status in primary care, and it is also seen as an intervention to raise staff awareness about patient safety issues and a mechanism to evaluate the impact of patient safety improvement initiatives. This assessment also allows primary care institutions to compare their patient safety culture survey results with others and is a way to track changes in patient safety culture over time.
\nThe authors would like to extend their gratitude to all staff that took time to complete the MOSPSC. This work is partially financed by national funds through FCT Fundação para a Ciência e a Tecnologia under the project UID/MAT/00006/2013 and by the Health and Technology Research Centre (H&TRC).
\nThe authors declare that there are no conflicts of interest.
The research complied with every one of the dilemmas concerned with ethics. The privacy and secrecy or anonymity of staff made certain.
\nIntechOpen aims to ensure that original material is published while at the same time giving significant freedom to our Authors. To that end we maintain a flexible Copyright Policy guaranteeing that there is no transfer of copyright to the publisher and Authors retain exclusive copyright to their Work.
',metaTitle:"Publication Agreement - Chapters",metaDescription:"IN TECH aims to guarantee that original material is published while at the same time giving significant freedom to our authors. For that matter, we uphold a flexible copyright policy meaning that there is no transfer of copyright to the publisher and authors retain exclusive copyright to their work.\n\nWhen submitting a manuscript the Corresponding Author is required to accept the terms and conditions set forth in our Publication Agreement as follows:",metaKeywords:null,canonicalURL:"/page/publication-agreement-chapters",contentRaw:'[{"type":"htmlEditorComponent","content":"The Corresponding Author (acting on behalf of all Authors) and INTECHOPEN LIMITED, incorporated and registered in England and Wales with company number 11086078 and a registered office at 5 Princes Gate Court, London, United Kingdom, SW7 2QJ conclude the following Agreement regarding the publication of a Book Chapter:
\\n\\n1. DEFINITIONS
\\n\\nCorresponding Author: The Author of the Chapter who serves as a Signatory to this Agreement. The Corresponding Author acts on behalf of any other Co-Author.
\\n\\nCo-Author: All other Authors of the Chapter besides the Corresponding Author.
\\n\\nIntechOpen: IntechOpen Ltd., the Publisher of the Book.
\\n\\nBook: The publication as a collection of chapters compiled by IntechOpen including the Chapter. Chapter: The original literary work created by Corresponding Author and any Co-Author that is the subject of this Agreement.
\\n\\n2. CORRESPONDING AUTHOR'S GRANT OF RIGHTS
\\n\\n2.1 Subject to the following Article, the Corresponding Author grants and shall ensure that each Co-Author grants, to IntechOpen, during the full term of copyright and any extensions or renewals of that term the following:
\\n\\nThe aforementioned licenses shall survive the expiry or termination of this Agreement for any reason.
\\n\\n2.2 The Corresponding Author (on their own behalf and on behalf of any Co-Author) reserves the following rights to the Chapter but agrees not to exercise them in such a way as to adversely affect IntechOpen's ability to utilize the full benefit of this Publication Agreement: (i) reprographic rights worldwide, other than those which subsist in the typographical arrangement of the Chapter as published by IntechOpen; and (ii) public lending rights arising under the Public Lending Right Act 1979, as amended from time to time, and any similar rights arising in any part of the world.
\\n\\nThe Corresponding Author confirms that they (and any Co-Author) are and will remain a member of any applicable licensing and collecting society and any successor to that body responsible for administering royalties for the reprographic reproduction of copyright works.
\\n\\nSubject to the license granted above, copyright in the Chapter and all versions of it created during IntechOpen's editing process (including the published version) is retained by the Corresponding Author and any Co-Author.
\\n\\nSubject to the license granted above, the Corresponding Author and any Co-Author retains patent, trademark and other intellectual property rights to the Chapter.
\\n\\n2.3 All rights granted to IntechOpen in this Article are assignable, sublicensable or otherwise transferrable to third parties without the Corresponding Author's or any Co-Author’s specific approval.
\\n\\n2.4 The Corresponding Author (on their own behalf and on behalf of each Co-Author) will not assert any rights under the Copyright, Designs and Patents Act 1988 to object to derogatory treatment of the Chapter as a consequence of IntechOpen's changes to the Chapter arising from translation of it, corrections and edits for house style, removal of problematic material and other reasonable edits.
\\n\\n3. CORRESPONDING AUTHOR'S DUTIES
\\n\\n3.1 When distributing or re-publishing the Chapter, the Corresponding Author agrees to credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen. The Corresponding Author warrants that each Co-Author will also credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen, when they are distributing or re-publishing the Chapter.
\\n\\n3.2 When submitting the Chapter, the Corresponding Author agrees to:
\\n\\nThe Corresponding Author will be held responsible for the payment of the Open Access Publishing Fees.
\\n\\nAll payments shall be due 30 days from the date of the issued invoice. The Corresponding Author or the payer on the Corresponding Author's and Co-Authors' behalf will bear all banking and similar charges incurred.
\\n\\n3.3 The Corresponding Author shall obtain in writing all consents necessary for the reproduction of any material in which a third-party right exists, including quotations, photographs and illustrations, in all editions of the Chapter worldwide for the full term of the above licenses, and shall provide to IntechOpen upon request the original copies of such consents for inspection (at IntechOpen's option) or photocopies of such consents.
\\n\\nThe Corresponding Author shall obtain written informed consent for publication from people who might recognize themselves or be identified by others (e.g. from case reports or photographs).
\\n\\n3.4 The Corresponding Author and any Co-Author shall respect confidentiality rights during and after the termination of this Agreement. The information contained in all correspondence and documents as part of the publishing activity between IntechOpen and the Corresponding Author and any Co-Author are confidential and are intended only for the recipient. The contents may not be disclosed publicly and are not intended for unauthorized use or distribution. Any use, disclosure, copying, or distribution is prohibited and may be unlawful.
\\n\\n4. CORRESPONDING AUTHOR'S WARRANTY
\\n\\n4.1 The Corresponding Author represents and warrants that the Chapter does not and will not breach any applicable law or the rights of any third party and, specifically, that the Chapter contains no matter that is defamatory or that infringes any literary or proprietary rights, intellectual property rights, or any rights of privacy. The Corresponding Author warrants and represents that: (i) the Chapter is the original work of themselves and any Co-Author and is not copied wholly or substantially from any other work or material or any other source; (ii) the Chapter has not been formally published in any other peer-reviewed journal or in a book or edited collection, and is not under consideration for any such publication; (iii) they themselves and any Co-Author are qualifying persons under section 154 of the Copyright, Designs and Patents Act 1988; (iv) they themselves and any Co-Author have not assigned and will not during the term of this Publication Agreement purport to assign any of the rights granted to IntechOpen under this Publication Agreement; and (v) the rights granted by this Publication Agreement are free from any security interest, option, mortgage, charge or lien.
\\n\\nThe Corresponding Author also warrants and represents that: (i) they have the full power to enter into this Publication Agreement on their own behalf and on behalf of each Co-Author; and (ii) they have the necessary rights and/or title in and to the Chapter to grant IntechOpen, on behalf of themselves and any Co-Author, the rights and licenses expressed to be granted in this Publication Agreement. If the Chapter was prepared jointly by the Corresponding Author and any Co-Author, the Corresponding Author warrants and represents that: (i) each Co-Author agrees to the submission, license and publication of the Chapter on the terms of this Publication Agreement; and (ii) they have the authority to enter into this Publication Agreement on behalf of and bind each Co-Author. The Corresponding Author shall: (i) ensure each Co-Author complies with all relevant provisions of this Publication Agreement, including those relating to confidentiality, performance and standards, as if a party to this Publication Agreement; and (ii) remain primarily liable for all acts and/or omissions of each such Co-Author.
\\n\\nThe Corresponding Author agrees to indemnify and hold IntechOpen harmless against all liabilities, costs, expenses, damages and losses and all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of or in connection with any breach of the aforementioned representations and warranties. This indemnity shall not cover IntechOpen to the extent that a claim under it results from IntechOpen's negligence or willful misconduct.
\\n\\n4.2 Nothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\\n\\n5. TERMINATION
\\n\\n5.1 IntechOpen has a right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Corresponding Author or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Corresponding Author or any Co-Author (being an individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Corresponding Author or any Co-Author (being a company) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for or enters into any compromise or arrangement with any of its creditors.
\\n\\nIn case of termination, IntechOpen will notify the Corresponding Author, in writing, of the decision.
\\n\\n6. INTECHOPEN’S DUTIES AND RIGHTS
\\n\\n6.1 Unless prevented from doing so by events outside its reasonable control, IntechOpen, in its discretion, agrees to publish the Chapter attributing it to the Corresponding Author and any Co-Author.
\\n\\n6.2 IntechOpen has the right to use the Corresponding Author’s and any Co-Author’s names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Chapter and has the right to contact the Corresponding Author and any Co-Author until the Chapter is publicly available on any platform owned and/or operated by IntechOpen.
\\n\\n6.3 IntechOpen is granted the authority to enforce the rights from this Publication Agreement, on behalf of the Corresponding Author and any Co-Author, against third parties (for example in cases of plagiarism or copyright infringements). In respect of any such infringement or suspected infringement of the copyright in the Chapter, IntechOpen shall have absolute discretion in addressing any such infringement which is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\\n\\n7. MISCELLANEOUS
\\n\\n7.1 Further Assurance: The Corresponding Author shall and will ensure that any relevant third party (including any Co-Author) shall, execute and deliver whatever further documents or deeds and perform such acts as IntechOpen reasonably requires from time to time for the purpose of giving IntechOpen the full benefit of the provisions of this Publication Agreement.
\\n\\n7.2 Third Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\\n\\n7.3 Entire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces and extinguishes all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by or on behalf of the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (together "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of its pre-contract fraudulent misrepresentation or fraudulent concealment.
\\n\\n7.4 Waiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\\n\\n7.5 Variation: No variation of this Publication Agreement shall be effective unless it is in writing and signed by the parties (or their duly authorized representatives).
\\n\\n7.6 Severance: If any provision or part-provision of this Publication Agreement is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable. If such modification is not possible, the relevant provision or part-provision shall be deemed deleted.
\\n\\nAny modification to or deletion of a provision or part-provision under this clause shall not affect the validity and enforceability of the rest of this Publication Agreement.
\\n\\n7.7 No partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Corresponding Author or any Co-Author, nor authorize any party to make or enter into any commitments for or on behalf of any other party.
\\n\\n7.8 Governing law: This Publication Agreement and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or formation shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of or in connection with this Publication Agreement (including any non-contractual disputes or claims).
\\n\\nLast updated: 2020-11-27
\\n\\n\\n\\n
\\n"}]'},components:[{type:"htmlEditorComponent",content:"
The Corresponding Author (acting on behalf of all Authors) and INTECHOPEN LIMITED, incorporated and registered in England and Wales with company number 11086078 and a registered office at 5 Princes Gate Court, London, United Kingdom, SW7 2QJ conclude the following Agreement regarding the publication of a Book Chapter:
\n\n1. DEFINITIONS
\n\nCorresponding Author: The Author of the Chapter who serves as a Signatory to this Agreement. The Corresponding Author acts on behalf of any other Co-Author.
\n\nCo-Author: All other Authors of the Chapter besides the Corresponding Author.
\n\nIntechOpen: IntechOpen Ltd., the Publisher of the Book.
\n\nBook: The publication as a collection of chapters compiled by IntechOpen including the Chapter. Chapter: The original literary work created by Corresponding Author and any Co-Author that is the subject of this Agreement.
\n\n2. CORRESPONDING AUTHOR'S GRANT OF RIGHTS
\n\n2.1 Subject to the following Article, the Corresponding Author grants and shall ensure that each Co-Author grants, to IntechOpen, during the full term of copyright and any extensions or renewals of that term the following:
\n\nThe aforementioned licenses shall survive the expiry or termination of this Agreement for any reason.
\n\n2.2 The Corresponding Author (on their own behalf and on behalf of any Co-Author) reserves the following rights to the Chapter but agrees not to exercise them in such a way as to adversely affect IntechOpen's ability to utilize the full benefit of this Publication Agreement: (i) reprographic rights worldwide, other than those which subsist in the typographical arrangement of the Chapter as published by IntechOpen; and (ii) public lending rights arising under the Public Lending Right Act 1979, as amended from time to time, and any similar rights arising in any part of the world.
\n\nThe Corresponding Author confirms that they (and any Co-Author) are and will remain a member of any applicable licensing and collecting society and any successor to that body responsible for administering royalties for the reprographic reproduction of copyright works.
\n\nSubject to the license granted above, copyright in the Chapter and all versions of it created during IntechOpen's editing process (including the published version) is retained by the Corresponding Author and any Co-Author.
\n\nSubject to the license granted above, the Corresponding Author and any Co-Author retains patent, trademark and other intellectual property rights to the Chapter.
\n\n2.3 All rights granted to IntechOpen in this Article are assignable, sublicensable or otherwise transferrable to third parties without the Corresponding Author's or any Co-Author’s specific approval.
\n\n2.4 The Corresponding Author (on their own behalf and on behalf of each Co-Author) will not assert any rights under the Copyright, Designs and Patents Act 1988 to object to derogatory treatment of the Chapter as a consequence of IntechOpen's changes to the Chapter arising from translation of it, corrections and edits for house style, removal of problematic material and other reasonable edits.
\n\n3. CORRESPONDING AUTHOR'S DUTIES
\n\n3.1 When distributing or re-publishing the Chapter, the Corresponding Author agrees to credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen. The Corresponding Author warrants that each Co-Author will also credit the Book in which the Chapter has been published as the source of first publication, as well as IntechOpen, when they are distributing or re-publishing the Chapter.
\n\n3.2 When submitting the Chapter, the Corresponding Author agrees to:
\n\nThe Corresponding Author will be held responsible for the payment of the Open Access Publishing Fees.
\n\nAll payments shall be due 30 days from the date of the issued invoice. The Corresponding Author or the payer on the Corresponding Author's and Co-Authors' behalf will bear all banking and similar charges incurred.
\n\n3.3 The Corresponding Author shall obtain in writing all consents necessary for the reproduction of any material in which a third-party right exists, including quotations, photographs and illustrations, in all editions of the Chapter worldwide for the full term of the above licenses, and shall provide to IntechOpen upon request the original copies of such consents for inspection (at IntechOpen's option) or photocopies of such consents.
\n\nThe Corresponding Author shall obtain written informed consent for publication from people who might recognize themselves or be identified by others (e.g. from case reports or photographs).
\n\n3.4 The Corresponding Author and any Co-Author shall respect confidentiality rights during and after the termination of this Agreement. The information contained in all correspondence and documents as part of the publishing activity between IntechOpen and the Corresponding Author and any Co-Author are confidential and are intended only for the recipient. The contents may not be disclosed publicly and are not intended for unauthorized use or distribution. Any use, disclosure, copying, or distribution is prohibited and may be unlawful.
\n\n4. CORRESPONDING AUTHOR'S WARRANTY
\n\n4.1 The Corresponding Author represents and warrants that the Chapter does not and will not breach any applicable law or the rights of any third party and, specifically, that the Chapter contains no matter that is defamatory or that infringes any literary or proprietary rights, intellectual property rights, or any rights of privacy. The Corresponding Author warrants and represents that: (i) the Chapter is the original work of themselves and any Co-Author and is not copied wholly or substantially from any other work or material or any other source; (ii) the Chapter has not been formally published in any other peer-reviewed journal or in a book or edited collection, and is not under consideration for any such publication; (iii) they themselves and any Co-Author are qualifying persons under section 154 of the Copyright, Designs and Patents Act 1988; (iv) they themselves and any Co-Author have not assigned and will not during the term of this Publication Agreement purport to assign any of the rights granted to IntechOpen under this Publication Agreement; and (v) the rights granted by this Publication Agreement are free from any security interest, option, mortgage, charge or lien.
\n\nThe Corresponding Author also warrants and represents that: (i) they have the full power to enter into this Publication Agreement on their own behalf and on behalf of each Co-Author; and (ii) they have the necessary rights and/or title in and to the Chapter to grant IntechOpen, on behalf of themselves and any Co-Author, the rights and licenses expressed to be granted in this Publication Agreement. If the Chapter was prepared jointly by the Corresponding Author and any Co-Author, the Corresponding Author warrants and represents that: (i) each Co-Author agrees to the submission, license and publication of the Chapter on the terms of this Publication Agreement; and (ii) they have the authority to enter into this Publication Agreement on behalf of and bind each Co-Author. The Corresponding Author shall: (i) ensure each Co-Author complies with all relevant provisions of this Publication Agreement, including those relating to confidentiality, performance and standards, as if a party to this Publication Agreement; and (ii) remain primarily liable for all acts and/or omissions of each such Co-Author.
\n\nThe Corresponding Author agrees to indemnify and hold IntechOpen harmless against all liabilities, costs, expenses, damages and losses and all reasonable legal costs and expenses suffered or incurred by IntechOpen arising out of or in connection with any breach of the aforementioned representations and warranties. This indemnity shall not cover IntechOpen to the extent that a claim under it results from IntechOpen's negligence or willful misconduct.
\n\n4.2 Nothing in this Publication Agreement shall have the effect of excluding or limiting any liability for death or personal injury caused by negligence or any other liability that cannot be excluded or limited by applicable law.
\n\n5. TERMINATION
\n\n5.1 IntechOpen has a right to terminate this Publication Agreement for quality, program, technical or other reasons with immediate effect, including without limitation (i) if the Corresponding Author or any Co-Author commits a material breach of this Publication Agreement; (ii) if the Corresponding Author or any Co-Author (being an individual) is the subject of a bankruptcy petition, application or order; or (iii) if the Corresponding Author or any Co-Author (being a company) commences negotiations with all or any class of its creditors with a view to rescheduling any of its debts, or makes a proposal for or enters into any compromise or arrangement with any of its creditors.
\n\nIn case of termination, IntechOpen will notify the Corresponding Author, in writing, of the decision.
\n\n6. INTECHOPEN’S DUTIES AND RIGHTS
\n\n6.1 Unless prevented from doing so by events outside its reasonable control, IntechOpen, in its discretion, agrees to publish the Chapter attributing it to the Corresponding Author and any Co-Author.
\n\n6.2 IntechOpen has the right to use the Corresponding Author’s and any Co-Author’s names and likeness in connection with scientific dissemination, retrieval, archiving, web hosting and promotion and marketing of the Chapter and has the right to contact the Corresponding Author and any Co-Author until the Chapter is publicly available on any platform owned and/or operated by IntechOpen.
\n\n6.3 IntechOpen is granted the authority to enforce the rights from this Publication Agreement, on behalf of the Corresponding Author and any Co-Author, against third parties (for example in cases of plagiarism or copyright infringements). In respect of any such infringement or suspected infringement of the copyright in the Chapter, IntechOpen shall have absolute discretion in addressing any such infringement which is likely to affect IntechOpen's rights under this Publication Agreement, including issuing and conducting proceedings against the suspected infringer.
\n\n7. MISCELLANEOUS
\n\n7.1 Further Assurance: The Corresponding Author shall and will ensure that any relevant third party (including any Co-Author) shall, execute and deliver whatever further documents or deeds and perform such acts as IntechOpen reasonably requires from time to time for the purpose of giving IntechOpen the full benefit of the provisions of this Publication Agreement.
\n\n7.2 Third Party Rights: A person who is not a party to this Publication Agreement may not enforce any of its provisions under the Contracts (Rights of Third Parties) Act 1999.
\n\n7.3 Entire Agreement: This Publication Agreement constitutes the entire agreement between the parties in relation to its subject matter. It replaces and extinguishes all prior agreements, draft agreements, arrangements, collateral warranties, collateral contracts, statements, assurances, representations and undertakings of any nature made by or on behalf of the parties, whether oral or written, in relation to that subject matter. Each party acknowledges that in entering into this Publication Agreement it has not relied upon any oral or written statements, collateral or other warranties, assurances, representations or undertakings which were made by or on behalf of the other party in relation to the subject matter of this Publication Agreement at any time before its signature (together "Pre-Contractual Statements"), other than those which are set out in this Publication Agreement. Each party hereby waives all rights and remedies which might otherwise be available to it in relation to such Pre-Contractual Statements. Nothing in this clause shall exclude or restrict the liability of either party arising out of its pre-contract fraudulent misrepresentation or fraudulent concealment.
\n\n7.4 Waiver: No failure or delay by a party to exercise any right or remedy provided under this Publication Agreement or by law shall constitute a waiver of that or any other right or remedy, nor shall it preclude or restrict the further exercise of that or any other right or remedy. No single or partial exercise of such right or remedy shall preclude or restrict the further exercise of that or any other right or remedy.
\n\n7.5 Variation: No variation of this Publication Agreement shall be effective unless it is in writing and signed by the parties (or their duly authorized representatives).
\n\n7.6 Severance: If any provision or part-provision of this Publication Agreement is or becomes invalid, illegal or unenforceable, it shall be deemed modified to the minimum extent necessary to make it valid, legal and enforceable. If such modification is not possible, the relevant provision or part-provision shall be deemed deleted.
\n\nAny modification to or deletion of a provision or part-provision under this clause shall not affect the validity and enforceability of the rest of this Publication Agreement.
\n\n7.7 No partnership: Nothing in this Publication Agreement is intended to, or shall be deemed to, establish or create any partnership or joint venture or the relationship of principal and agent or employer and employee between IntechOpen and the Corresponding Author or any Co-Author, nor authorize any party to make or enter into any commitments for or on behalf of any other party.
\n\n7.8 Governing law: This Publication Agreement and any dispute or claim (including non-contractual disputes or claims) arising out of or in connection with it or its subject matter or formation shall be governed by and construed in accordance with the law of England and Wales. The parties submit to the exclusive jurisdiction of the English courts to settle any dispute or claim arising out of or in connection with this Publication Agreement (including any non-contractual disputes or claims).
\n\nLast updated: 2020-11-27
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