2.3 want better goods and services. it

2.3 service quality the emergence of quality of service as a top preference in several corporate entities is primarily because of the globalization of world trade and the competitive pressure brought about by the elevating demands of consumers who want better goods and services. it ensures that the voice of the customer is always coincided by the voice of the processes khoshafian s. 2016 since the service quality is very vital in surviving and in profit making of an organization it affects both customers satisfaction and motivation whether after shopping positively or before shopping positively hussain r. al nasser a. hussain y. k. 2015 service quality can have many different meanings in different contexts. for example bansal h. s. taylor s. 2015? defined service quality as the consumers overall effect of the relative inferiority or superiority of the organization and its services. While theodorakis n. d. kaplanidou k. karabaxoglou i. 2015 defined perceived service quality as a universal judgment or attitude relating to the excellence of a service. in their efforts to reach a model for service quality hussain r. al nasser a. hussain y. k. 2015 identified 5 determinants of service quality used by customers to build their own perceptions which are: reliability responsiveness empathy assurance and tangibles. 2.4 customer satisfaction satisfaction is a psychological outcome emerging from an experience a definition by heino j. 2015 also satisfaction can be defined as an overall customer attitude towards a service provider or an emotional reaction to the difference between what customers anticipate and what they receive lalaram j. j. s. cassim n. karodia a. m. 2016 another definition was given by wto 1985 as follows customer satisfaction is a psychological concept that includes the feeling of well-being and a pleasure that results from obtaining what one hopes for and expects from an interesting product/service. 2.5 relationship between service quality and customer satisfaction nagle t. t. müller g. 2017 stated that the company survives only when it has customers and grows only when it can retain them and attract new ones therefore it should be structured and managed around these concepts. customers always stay with those companies that are special for them and they become devoted to the brands that make them feel special. on the other hand kerzner h. kerzner h. r. 2017 mentioned that changes in the business environment and in the market place have changed customer behavior. if organizations fail to treat customer well and give them what they want they will leave. current and even perceived customers are today faced with an unprecedented range of choices not only choices of what to buy but where to buy. it is virtually impossible for a company to succeed today if its products/services are inferior. while lasserre p. 2017 said that during the 1980s customer awareness led to a higher degree of customer sovereignty and organizations could no longer neglect customer needs. the differentiator that provided a competitive advantage was the quality of service. accordingly one main hypotheses and five sub-hypotheses are proposed: h3: there is a direct link between service quality and customers satisfaction. h31: there is a direct correlation between responsiveness as a service quality dimension and customers satisfaction. h32: there is a direct correlation between assurance as a service quality dimension and customers satisfaction. h33: there is a direct correlation between tangibles as a service quality dimension and customers satisfaction. h34: there is a direct correlation between empathy as a service quality dimension and customers satisfaction. h35: there is a direct correlation between reliability as a service quality dimension and customers satisfaction. summary the first issue of the research was to determine the performance drivers that have a positive influence on ports performance taking quality of service and customer satisfaction as a performance indicators. the second objective was to develop a theoretical framework that can be utilized as a guide for ports managers to establish and maintain a superior quality of service to carry out this stage of the research the key csfs service quality and customers satisfaction have been extensively investigated through an intensive literature review. based upon them a conceptual model of csfs implementation in relation with port performance utilizing service quality customers satisfaction as a performance indicators was proposed 3 main hypotheses and 25 sub-hypotheses were generated.

2. Materials and Methods

2.1. Study design and setting
This was a retrospective, descriptive study based on analysis of autopsy and external corpse examination report files of all cases involving dark-skinned persons whose deaths were investigated at the Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf between January 1994 and December 2017.

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2.2. Case selection and statistical analysis

All records of external corpse examinations as well as medico-legal, clinical and anatomical autopsies that were done in the Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf during the period from January 1994 to December 2017 were retrieved and analyzed using the keywords and search terms “Schwarze Hautfarbe” (Black skin color), “Afrikaner”(African), “Afrikanerin” (African), “Afro-Amerikanisch” (Afro-American), “dunkler Hautfarbe”(dark skin color),”dunkle Hautfarbe”(dark skin color), “Schwarzafrikaner” (black African) and “Schwarzafrikanerin” (black African).

With the help of a pre-established data collection form, the files retrieved were then reviewed for demographic and clinical data concerning the deceased person such as age; sex; country of origin/place of birth; social status/occupation; type of autopsy done; place where body was found/place where death occurred; authority who requested the autopsy; manner of death as well as cause of death. Furthermore, the information regarding social status/occupation of the deceased was further analyzed into residence status of the individual such as whether the deceased was homeless; a refugee/asylum seeker; had own accommodation or not, employed or not; or whether the deceased was a student or not. For the cases in which an autopsy was done, the type of autopsy was further classified into medico-legal, clinical or others (those that were done to determine whether the disease condition leading to death was occupational-related or not). The manner of death was further classified into natural, unnatural and in cases where the definitive cause of death was not known, as unascertained. Furthermore, to determine the commonest causes of death in dark-skinned individuals examined during this period, we recorded the causes of death as indicated on the death certificate for all cases in which an autopsy was not requested or done. For the cases in which an autopsy was done, the cause of death recorded was that indicated in the autopsy report following completion of the autopsy and the respective necessary complementary investigations such as histology, toxicological analysis etc.

The deaths certified as natural were further classified according to the diseased body system or organ i.e. respiratory, cardiovascular, gastrointestinal tract, nervous system or systemic infections. All disease conditions not fitting in the above categories were then classified as others. On the other hand, all deaths certified as unnatural were further classified according to the primary event leading to death i.e. whether it was suicide, homicide, accident, post-op complications, drowning or intoxication. The rest were then classified as others. To further determine the frequency, precipitating factors as well as events leading to homicides and suicides, data on social status/occupation of the individual, deceased and perpetrator’s countries of origin/birth and the crime trigger were collected. Furthermore, data on previous history of psychotic or psychiatric conditions, mode of crime execution, history of prior suicide attempts or criminal record, crime scene, the perpetrator-victim relationship as well as the possible influence of drugs/alcohol were collected.

In a separate chapter of this dissertation, we also present cases in which the deaths were investigated by a team of forensic pathologists from the Hamburg Institute of Legal Medicine in collaboration with Rwandan doctors through yearly interdisciplinary forensic summer schools held in Kigali-Rwanda every year since 2012. The annual forensic summer schools are conducted within the framework of a cooperation project between the Institute of Legal Medicine/University Medical Center Hamburg-Eppendorf and various academic and administrative institutions in Rwanda aimed at the transfer of knowledge in the field of legal medicine.

2. Materials and Methods

2.1. Study design and setting
This was a retrospective, descriptive study based on analysis of autopsy and external corpse examination report files of all cases involving dark-skinned persons whose deaths were investigated at the Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf between January 1994 and December 2017.

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2.2. Case selection and statistical analysis

All records of external corpse examinations as well as medico-legal, clinical and anatomical autopsies that were done in the Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf during the period from January 1994 to December 2017 were retrieved and analyzed using the keywords and search terms “Schwarze Hautfarbe” (Black skin color), “Afrikaner”(African), “Afrikanerin” (African), “Afro-Amerikanisch” (Afro-American), “dunkler Hautfarbe”(dark skin color),”dunkle Hautfarbe”(dark skin color), “Schwarzafrikaner” (black African) and “Schwarzafrikanerin” (black African).

With the help of a pre-established data collection form, the files retrieved were then reviewed for demographic and clinical data concerning the deceased person such as age; sex; country of origin/place of birth; social status/occupation; type of autopsy done; place where body was found/place where death occurred; authority who requested the autopsy; manner of death as well as cause of death. Furthermore, the information regarding social status/occupation of the deceased was further analyzed into residence status of the individual such as whether the deceased was homeless; a refugee/asylum seeker; had own accommodation or not, employed or not; or whether the deceased was a student or not. For the cases in which an autopsy was done, the type of autopsy was further classified into medico-legal, clinical or others (those that were done to determine whether the disease condition leading to death was occupational-related or not). The manner of death was further classified into natural, unnatural and in cases where the definitive cause of death was not known, as unascertained. Furthermore, to determine the commonest causes of death in dark-skinned individuals examined during this period, we recorded the causes of death as indicated on the death certificate for all cases in which an autopsy was not requested or done. For the cases in which an autopsy was done, the cause of death recorded was that indicated in the autopsy report following completion of the autopsy and the respective necessary complementary investigations such as histology, toxicological analysis etc.

The deaths certified as natural were further classified according to the diseased body system or organ i.e. respiratory, cardiovascular, gastrointestinal tract, nervous system or systemic infections. All disease conditions not fitting in the above categories were then classified as others. On the other hand, all deaths certified as unnatural were further classified according to the primary event leading to death i.e. whether it was suicide, homicide, accident, post-op complications, drowning or intoxication. The rest were then classified as others. To further determine the frequency, precipitating factors as well as events leading to homicides and suicides, data on social status/occupation of the individual, deceased and perpetrator’s countries of origin/birth and the crime trigger were collected. Furthermore, data on previous history of psychotic or psychiatric conditions, mode of crime execution, history of prior suicide attempts or criminal record, crime scene, the perpetrator-victim relationship as well as the possible influence of drugs/alcohol were collected.

In a separate chapter of this dissertation, we also present cases in which the deaths were investigated by a team of forensic pathologists from the Hamburg Institute of Legal Medicine in collaboration with Rwandan doctors through yearly interdisciplinary forensic summer schools held in Kigali-Rwanda every year since 2012. The annual forensic summer schools are conducted within the framework of a cooperation project between the Institute of Legal Medicine/University Medical Center Hamburg-Eppendorf and various academic and administrative institutions in Rwanda aimed at the transfer of knowledge in the field of legal medicine.

2.2 Population/Sample
A sample is a subset of a population from which data can potentially be collected (Parahoo,2006) of which there are two main types; Probability and Non Probability sampling. Probability sampling often known as random sampling is primarily used in quantitative research and refers to the fact that every element (member) of the population has an equal chance of being selected for a study (Burns and Grove, 2009).
Within Non-Probability sampling there are three primary sampling methods employed in qualitative research which are, Purposive, Snowball, and Convenience sampling (Polit and Beck, 2008). The goal of the sampling strategy in qualitative research is credibility where the researcher must utilise judgement in purposively selecting participants who can best inform the study (Houser, 2008). In addition (Holloway and Wheeler 2002) also identify homogenous sampling as selection of a particular group of people who share similar characteristics or circumstances such as occupation. Therefore the researcher proposes to use purposive sampling of a homogenous group which will allow the researcher to select

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