Search results for: healthcare waste disposal
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4375

Search results for: healthcare waste disposal

955 Use of Alternative and Complementary Therapies in Patients with Chronic Pain in a Medical Institution in Medellin, Colombia, 2014

Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez

Abstract:

Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.

Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia

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954 Scientific Production on Lean Supply Chains Published in Journals Indexed by SCOPUS and Web of Science Databases: A Bibliometric Study

Authors: T. Botelho de Sousa, F. Raphael Cabral Furtado, O. Eduardo da Silva Ferri, A. Batista, W. Augusto Varella, C. Eduardo Pinto, J. Mimar Santa Cruz Yabarrena, S. Gibran Ruwer, F. Müller Guerrini, L. Adalberto Philippsen Júnior

Abstract:

Lean Supply Chain Management (LSCM) is an emerging research field in Operations Management (OM). As a strategic model that focuses on reduced cost and waste with fulfilling the needs of customers, LSCM attracts great interest among researchers and practitioners. The purpose of this paper is to present an overview of Lean Supply Chains literature, based on bibliometric analysis through 57 papers published in indexed journals by SCOPUS and/or Web of Science databases. The results indicate that the last three years (2015, 2016, and 2017) were the most productive on LSCM discussion, especially in Supply Chain Management and International Journal of Lean Six Sigma journals. India, USA, and UK are the most productive countries; nevertheless, cross-country studies by collaboration among researchers were detected, by social network analysis, as a research practice, appearing to play a more important role on LSCM studies. Despite existing limitation, such as limited indexed journal database, bibliometric analysis helps to enlighten ongoing efforts on LSCM researches, including most used technical procedures and collaboration network, showing important research gaps, especially, for development countries researchers.

Keywords: Lean Supply Chains, Bibliometric Study, SCOPUS, Web of Science

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953 A Scoping Review of Psychosocial Interventions for the Survivors and/or Victims of Intimate Partner Violence in Low- and Middle-Income Countries

Authors: Mukondi Nethavhakone

Abstract:

The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

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952 Biomass Energy: "The Boon for the Would"

Authors: Shubham Giri Goswami, Yogesh Tiwari

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In today’s developing world, India and other countries are developing different instruments and accessories for the better standard and life to be happy and prosper. But rather than this we human-beings have been using different energy sources accordingly, many persons such as scientist, researchers etc have developed many Energy sources like renewable and non-renewable energy sources. Like fossil fuel, coal, gas, petroleum products as non-renewable sources, and solar, wind energy as renewable energy source. Thus all non-renewable energy sources, these all Created pollution as in form of air, water etc. due to ultimate use of these sources by human the future became uncertain. Thus to minimize all this environmental affects and destroy the healthy environment we discovered a solution as renewable energy source. Renewable energy source in form of biomass energy, solar, wind etc. We found different techniques in biomass energy, that good energy source for people. The domestic waste, and is a good source of energy as daily extract from cow in form of dung and many other domestic products naturally can be used eco-friendly fertilizers. Moreover, as from my point of view the cow is able to extract 08-12 kg of dung which can be used to make wormy compost fertilizers. Furthermore, the calf urine as insecticides and use of such a compounds will lead to destroy insects and thus decrease communicable diseases. Therefore, can be used by every person and biomass energy can be in those areas such as rural areas where non-renewable energy sources cannot reach easily. Biomass can be used to develop fertilizers, cow-dung plants and other power generation techniques, and this energy is clean and pollution free and is available everywhere thus saves our beautiful planet or blue or life giving planet called as “EARTH”. We can use the biomass energy, which may be boon for the world in future.

Keywords: biomass, energy, environment, human, pollution, renewable, solar energy, sources, wind

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951 Revitalization of Industrial Brownfields in Historical Districts

Authors: Adel Menchawy, Noha Labib

Abstract:

Many cities have quarters that confer on them sense of identity and place through its cultural history. They are often vital part of the cities charm and appeal, their functional and visual qualities are important to the city’s image and identity. Brownfield sites present an important part of our built landscape. They provide tangible and intangible links to our past and have great potential to play significant roles in the future of our cities, towns and rural environments. Brownfield sites are places that were previously industrial factories or areas that might have had waste kept at that location or been exposed to many types of hazards. Thus its redevelopment revitalizes and strengthens towns and communities as it helps in economic growth, builds community pride and protects public health and the environment Three case studies are discussed in this paper; the first one is the city of Sterling which was developed and revitalized entirely and became a city with identity after it was derelict, the Second is the city of Castlefield with was a place no one was eager to visit now it became a touristic area. And finally the city of Cleveland which adopted a strategy that transferred it from being a polluted, derelict place into a mixed use development city Brownfield revitalization offers a great opportunity to transfer the city from being derelict, useless and contaminated into a place where tourists would love to come. Also it will increase the economy of the place, increase the social level, it can improve energy efficiency, reduce natural consumption, clean air, water and land and take advantage of existing buildings and sites and transfers them into an adaptive reuse after being remediated

Keywords: Brownfield Revitalization, Sustainable Brownfield, Historical conservation, Adaptive reuse

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950 Green Concrete for Sustainable Indonesia Structures: Lightweight Concrete Using Oil Palm Shell as Coarse Aggregate with Superplasticizer and Fly Ash

Authors: Feny Acelia Silaban

Abstract:

The development of Indonesia’s infrastructure in many islands is significantly increased through the years. Based on this condition, concrete materials which are extracted from natural resources are over exploited and slowly becoming rare, thus the demand for alternative materials becomes so urgently crucial. Oil Palm is one of the biggest commodities in Indonesia with the total amount of 31 million tons in the last 2014. The production of palm oil also generates lots of solid wastes in the form of Oil Palm Shell (OPS). Constructing more environmentally sustainable structures can be achieved by producing lightweight concrete using the Oil Palm Shell (OPS). This paper investigated the effects of OPS and combination of Superplasticizer and fly ash proportion of lightweight concrete mix design to the compressive strength, flexure strength, modulus of elasticity, shrinkage behavior, and water absorption. The Oil Palm Shell had undergone special treatment by washing it with hot water and soap to reduce the oil content. This experiment used four different proportions of Superplasticizer with fly ash and 30 % OPS proportion from the weight of total compositions mixture by the result of trial mix. The experiment result showed that using OPS coarse aggregates and Superplasticizer with fly ash, the average of 28-day compressive strength reached 30-35 MPa. The highest 28-day compressive strength comes from 1.2 % Superplasticizer with 5 % fly ash proportion samples with the strength by 33 MPa. The sample with proportion of 1 % Superplasticizer and 7.5 % fly ash has the highest shrinkage value compared to other proportions. The characteristic of OPS as coarse aggregates is in a standard range of natural coarse aggregates. In general, this lightweight concrete using OPS coarse aggregate and Superplasticizer has high potential to be green-structural lightweight concrete alternative in Indonesia.

Keywords: lightweight concrete, oil palm shell, waste materials, superplasticizer

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949 Return to Bowel Function after Right versus Extended Right Hemicolectomy: A Retrospective Review

Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

Abstract:

Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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948 Challenges in the Characterization of Black Mass in the Recovery of Graphite from Spent Lithium Ion Batteries

Authors: Anna Vanderbruggen, Kai Bachmann, Martin Rudolph, Rodrigo Serna

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Recycling of lithium-ion batteries has attracted a lot of attention in recent years and focuses primarily on valuable metals such as cobalt, nickel, and lithium. Despite the growth in graphite consumption and the fact that it is classified as a critical raw material in the European Union, USA, and Australia, there is little work focusing on graphite recycling. Thus, graphite is usually considered waste in recycling treatments, where graphite particles are concentrated in the “black mass”, a fine fraction below 1mm, which also contains the foils and the active cathode particles such as LiCoO2 or LiNiMnCoO2. To characterize the material, various analytical methods are applied, including X-Ray Fluorescence (XRF), X-Ray Diffraction (XRD), Atomic Absorption Spectrometry (AAS), and SEM-based automated mineralogy. The latter consists of the combination of a scanning electron microscopy (SEM) image analysis and energy-dispersive X-ray spectroscopy (EDS). It is a powerful and well-known method for primary material characterization; however, it has not yet been applied to secondary material such as black mass, which is a challenging material to analyze due to fine alloy particles and to the lack of an existing dedicated database. The aim of this research is to characterize the black mass depending on the metals recycling process in order to understand the liberation mechanisms of the active particles from the foils and their effect on the graphite particle surfaces and to understand their impact on the subsequent graphite flotation. Three industrial processes were taken into account: purely mechanical, pyrolysis-mechanical, and mechanical-hydrometallurgy. In summary, this article explores various and common challenges for graphite and secondary material characterization.

Keywords: automated mineralogy, characterization, graphite, lithium ion battery, recycling

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947 Water Quality and Coastal Management Profile Assessment of Puerto Galera Bay, Philippines

Authors: Ma. Manna Farrel B. Pinto

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As global industrialization progresses, the environment remains to be at risk of disturbances brought by developments of cities and communities. Impacts of flourishing industries such as tourism require rapid growth of establishments and may threaten ecosystems and natural resources. Puerto Galera as a biosphere reserve and declared as the Center of the World’s Center of Marine Shorefish Biodiversity is on the brink of ecological deterioration as tourism further develops in its coastal areas. Apparently, attempts were initiated to establish a baseline for designation of protection in the economic and coastal marine zones of Puerto Galera but continuity of its implementation and coordination of concerned units remains deficient. Indications of eutrophication have been observed based on water quality analysis although parameter values still comply with the national standards for coastal waters. Water quality data, biodiversity and hydrodynamic information, gathered from studies, and local government units were analysed to assess the condition of the coast as well as acting policies implemented by the local authorities. Sources of contaminants were also located in its three main communities, and their shores wherein in recommendations for installing wastewater treatment facilities and further improvement of policies of waste discharge must be addressed. With a conceptual framework proposed in the study, a comprehensive data analysis and coordinated management are necessary to form an integrated coastal management for further protection and preservation of the sustainable coastal marine ecosystem of Puerto Galera.

Keywords: coastal management, environmental management, integrated resource management, Puerto Galera

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946 Using Machine Learning to Classify Different Body Parts and Determine Healthiness

Authors: Zachary Pan

Abstract:

Our general mission is to solve the problem of classifying images into different body part types and deciding if each of them is healthy or not. However, for now, we will determine healthiness for only one-sixth of the body parts, specifically the chest. We will detect pneumonia in X-ray scans of those chest images. With this type of AI, doctors can use it as a second opinion when they are taking CT or X-ray scans of their patients. Another ad-vantage of using this machine learning classifier is that it has no human weaknesses like fatigue. The overall ap-proach to this problem is to split the problem into two parts: first, classify the image, then determine if it is healthy. In order to classify the image into a specific body part class, the body parts dataset must be split into test and training sets. We can then use many models, like neural networks or logistic regression models, and fit them using the training set. Now, using the test set, we can obtain a realistic accuracy the models will have on images in the real world since these testing images have never been seen by the models before. In order to increase this testing accuracy, we can also apply many complex algorithms to the models, like multiplicative weight update. For the second part of the problem, to determine if the body part is healthy, we can have another dataset consisting of healthy and non-healthy images of the specific body part and once again split that into the test and training sets. We then use another neural network to train on those training set images and use the testing set to figure out its accuracy. We will do this process only for the chest images. A major conclusion reached is that convolutional neural networks are the most reliable and accurate at image classification. In classifying the images, the logistic regression model, the neural network, neural networks with multiplicative weight update, neural networks with the black box algorithm, and the convolutional neural network achieved 96.83 percent accuracy, 97.33 percent accuracy, 97.83 percent accuracy, 96.67 percent accuracy, and 98.83 percent accuracy, respectively. On the other hand, the overall accuracy of the model that de-termines if the images are healthy or not is around 78.37 percent accuracy.

Keywords: body part, healthcare, machine learning, neural networks

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945 Preliminary Flow Sheet for Recycling of Spent Lithium-Ion Batteries

Authors: Mohammad Ali Rajaeifar, Oliver Heidrich

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Nowadays, Li-ion batteries are vastly disseminated and the battery market is expected to experience a huge growth during next decade especially in terms of traction batteries. As the automotive industry moving towards the electrification of the powertrain, more raw/critical materials and energy are extracted while on the other hand, concerns are made regarding the scarcity of the materials as well as environmental issues regarding the destiny of the spent batteries. In this regards, recycling could play a vital role in the supply chain, leading reutilization of key battery materials and also reducing environmental burden related to the use of batteries. The aim of this paper is to review the previous and state-of-the-art treatments for recycling of Li-ion batteries. All the treatments method from mechanical, mild-thermal, pyrometallurgical and hydrometallurgical as well as combined methods for recycling of Li-ion batteries were considered in the study. There are various treatment methods that are economical, but they are not environmentally friendly or vice versa. This is due to the fact that the benefits of the Li-ion batteries recycling could be affected by different factors such as the amount of spent batteries available, the quality of the recovered material, the energy and material consumption by the process itself and environmental burdens caused by required logistics. Finally, a preliminary work sheet of possible route for recycling of spent Li-ion batteries was presented through the course of this study. Overall, it is worth quoting that recycling processes generally consumes a great deal of energy and auxiliary materials. Moreover, the collection of spent products from waste streams represents additional environmental efforts. Therefore, developing and optimizing efficient collection and separation technologies is essential to achieve sustainability goals.

Keywords: hydrometallurgical treatment, Li-ion batteries, mild-thermal treatment, mechanical treatment, recycling, pyrometallurgical treatment

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944 The Effect of Additive Acid on the Phytoremediation Efficiency

Authors: G. Hosseini, A. Sadighzadeh, M. Rahimnejad, N. Hosseini, Z. Jamalzadeh

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Metal pollutants, especially heavy metals from anthropogenic sources such as metallurgical industries’ waste including mining, smelting, casting or production of nuclear fuel, including mining, concentrate production and uranium processing ends in the environment contamination (water and soil) and risk to human health around the facilities of this type of industrial activity. There are different methods that can be used to remove these contaminants from water and soil. These are very expensive and time-consuming. In this case, the people have been forced to leave the area and the decontamination is not done. For example, in the case of Chernobyl accident, an area of 30 km around the plant was emptied of human life. A very efficient and cost-effective method for decontamination of the soil and the water is phytoremediation. In this method, the plants preferentially native plants which are more adaptive to the regional climate are well used. In this study, three types of plants including Alfalfa, Sunflower and wheat were used to Barium decontamination. Alfalfa and Sunflower were not grown good enough in Saghand mine’s soil sample. This can be due to non-native origin of these plants. But, Wheat rise in Saghand Uranium Mine soil sample was satisfactory. In this study, we have investigated the effect of 4 types of acids inclusive nitric acid, oxalic acid, acetic acid and citric acid on the removal efficiency of Barium by Wheat. Our results indicate the increase of Barium absorption in the presence of citric acid in the soil. In this paper, we will present our research and laboratory results.

Keywords: phytoremediation, heavy metal, wheat, soil

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943 Integrating Cost-Benefit Assessment and Contract Design to Support Industrial Symbiosis Deployment

Authors: Robin Molinier

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Industrial symbiosis (I.S) is the realization of Industrial Ecology (I.E) principles in production systems in function. I.S consists in the use of waste materials, fatal energy, recirculated utilities and infrastructure/service sharing as resources for production. Environmental benefits can be achieved from resource conservation but economic profitability is required by the participating actors. I.S indeed involves several actors with their own objectives and resources so that each one must be satisfied by ex-ante arrangements to commit toward I.S execution (investments and transactions). Following the Resource-Based View of transactions we build a modular framework to assess global I.S profitability and to specify each actor’s contributions to costs and benefits in line with their resource endowments and performance requirements formulations. I.S projects specificities implied by the need for customization (asset specificity, non-homogeneity) induce the use of long-term contracts for transactions following Transaction costs economics arguments. Thus we propose first a taxonomy of costs and value drivers for I.S and an assignment to each actor of I.S specific risks that we identified as load profiles mismatch, quality problems and value fluctuations. Then appropriate contractual guidelines (pricing, cost sharing and warranties) that support mutual profitability are derived from the detailed identification of contributions by the cost-benefits model. This analytical framework helps identifying what points to focus on when bargaining over contracting for transactions and investments. Our methodology is applied to I.S archetypes raised from a literature survey on eco-industrial parks initiatives and practitioners interviews.

Keywords: contracts, cost-benefit analysis, industrial symbiosis, risks

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942 Kinetics Analysis of Lignocellulose Hydrolysis and Glucose Consumption Using Aspergillus niger in Solid State

Authors: Akida Mulyaningtyas, Wahyudi Budi Sediawan

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One decisive stage in bioethanol production from plant biomass is the hydrolysis of lignocellulosic materials into simple sugars such as glucose. The produced glucose is then fermented into ethanol. This stage is popularly done in biological method by using cellulase that is produced by certain fungi. As it is known, glucose is the main source of nutrition for most microorganisms. Therefore, cutting cellulose into glucose is actually an attempt of microorganism to provide nutrition for itself. So far, this phenomenon has received less attention while it is necessary to identify the quantity of sugar consumed by the microorganism. In this study, we examined the phenomenon of sugar consumption by microorganism on lignocellulosic hydrolysis. We used oil palm empty fruit bunch (OPEFB) as the source of lignocellulose and Aspergillus niger as cellulase-producing fungus. In Indonesia, OPEFB is plantation waste that is difficult to decompose in nature and causes environmental problems. First, OPEFB was pretreated with 1% of NaOH at 170 oC to destroy lignin that hindered A.niger from accessing cellulose. The hydrolysis was performed by growing A.niger on pretreated OPEFB in solid state to minimize the possibility of contamination. The produced glucose was measured every 24 hours for 9 days. We analyzed the kinetics of both reactions, i.e., hydrolysis and glucose consumption, simultaneously. The constants for both reactions were assumed to follow the Monod equation. The results showed that the reaction constant of glucose consumption (μC) was higher than of cellulose hydrolysis (μH), i.e., 11.8 g/L and 0.62 g/L for glucose consumption and hydrolysis respectively. However, in general, the reaction rate of hydrolysis is greater than of glucose consumption since the cellulose concentration as substrate in hydrolysis is much higher than glucose as substrate in the consumption reaction.

Keywords: Aspergillus niger, bioethanol, hydrolysis, kinetics

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941 Investigating the Effectiveness of a 3D Printed Composite Mold

Authors: Peng Hao Wang, Garam Kim, Ronald Sterkenburg

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In composite manufacturing, the fabrication of tooling and tooling maintenance contributes to a large portion of the total cost. However, as the applications of composite materials continue to increase, there is also a growing demand for more tooling. The demand for more tooling places heavy emphasis on the industry’s ability to fabricate high quality tools while maintaining the tool’s cost effectiveness. One of the popular techniques of tool fabrication currently being developed utilizes additive manufacturing technology known as 3D printing. The popularity of 3D printing is due to 3D printing’s ability to maintain low material waste, low cost, and quick fabrication time. In this study, a team of Purdue University School of Aviation and Transportation Technology (SATT) faculty and students investigated the effectiveness of a 3D printed composite mold. A steel valve cover from an aircraft reciprocating engine was modeled utilizing 3D scanning and computer-aided design (CAD) to create a 3D printed composite mold. The mold was used to fabricate carbon fiber versions of the aircraft reciprocating engine valve cover. The carbon fiber valve covers were evaluated for dimensional accuracy and quality while the 3D printed composite mold was evaluated for durability and dimensional stability. The data collected from this study provided valuable information in the understanding of 3D printed composite molds, potential improvements for the molds, and considerations for future tooling design.

Keywords: additive manufacturing, carbon fiber, composite tooling, molds

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940 Gendered Economic, Social, and Health Effects of the Mobile Health and Nutritional Services of the International Medical Corps (IMC) in Vulnerable Areas of Ethiopia

Authors: Abdela Zeinu Yasin

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The current research aimed to assess the status of IMC in providing treatment for malnourished children and programs in water, sanitation, and hygiene (WASH), food and livelihood security, and comprehensive healthcare through Mobile health and nutrition programs during the last 5 years period. We have conducted 60 in-depth interviews with women during the period from conception to a child’s birthday, health facility staff, and female community health volunteers (FCHVs), as well as 12 focus group discussions with health facility staff and other household decision-makers. We employed thematic analysis using framework matrices and analytical memorandums. The study revealed that 78% of the respondents, of whom 97% were women, have benefited from the selected vulnerable areas. The use of the clear water and sanitization program has reached the 81% of selected households. The use of a modern baby delivery system among the respondent has been 68% of the women and health facilities among the decision-makers/focal person. More than 8 in 10 participants (84%) could read and understand the health facility instructions, and the majority (82%) of women, health facility staff, and male decision-makers can also read and write bulletins and instructions. We found that decision-maker women preferred participative education, whereas health facilities and the IMC desired educational and motivational bulletins. A Mobile Health and Nutrition program intervention by the IMC is acceptable in the conditions of the Ethiopian community and has the potential to improve community health and nutrition service utilization, particularly by providing clean water and sanitization; women’s birth control, and health improvement in the vulnerable regions of the country. The current research findings shall contribute to text IMC Mobile Health and Nutritional intervention design in under-resourced settings.

Keywords: clean water, health and nutrition services, hygiene, IMC, mobile health, sanitation

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939 Collective Problem Solving: Tackling Obstacles and Unlocking Opportunities for Young People Not in Education, Employment, or Training

Authors: Kalimah Ibrahiim, Israa Elmousa

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This study employed the world café method alongside semi-structured interviews within a 'conversation café' setting to engage stakeholders from the public health and primary care sectors. The objective was to collaboratively explore strategies to improve outcomes for young people not in education, employment, or training (NEET). The discussions were aimed at identifying the underlying causes of disparities faced by NEET individuals, exchanging experiences, and formulating community-driven solutions to bolster preventive efforts and shape policy initiatives. A thematic analysis of the qualitative data gathered emphasized the importance of community problem-solving through the exchange of ideas and reflective discussions. Healthcare professionals reflected on their potential roles, pinpointing a significant gap in understanding the specific needs of the NEET population and the unclear distribution of responsibilities among stakeholders. The results underscore the necessity for a unified approach in primary care and the fostering of multi-agency collaborations that focus on addressing social determinants of health. Such strategies are critical not only for the immediate improvement of health outcomes for NEET individuals but also for informing broader policy decisions that can have long-term benefits. Further research is ongoing, delving deeper into the unique challenges faced by this demographic and striving to develop more effective interventions. The study advocates for continued efforts to integrate insights from various sectors to create a more holistic and effective response to the needs of the NEET population, ensuring that future strategies are informed by a comprehensive understanding of their circumstances and challenges.

Keywords: multi-agency working, primary care, public health, social inequalities

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938 Green Synthesis of Spinach Derived Carbon Dots for Photocatalytic Generation of Hydrogen from Sulfide Wastewater

Authors: Priya Ruban, Thirunavoukkarasu Manikkannan, Sakthivel Ramasamy

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Sulfide is one of the major pollutants of tannery effluent which is mainly generated during the process of unhairing. Recovery of Hydrogen green fuel from sulfide wastewater using photocatalysis is a ‘Cleaner Production Method’, since renewable solar energy is utilized. It has triple advantages of the generation of H2, waste minimization and odor or pollution control. Designing of safe and green photocatalysts and developing suitable solar photoreactor is important for promoting this technology to large-scale application. In this study, green photocatalyst i.e., spinach derived carbon dots (SCDs 5 wt % and 10 wt %)/TiO2 nanocomposite was synthesized for generation of H2 from sulfide wastewater using lab-scale solar photocatalytic reactor. The physical characterization of the synthesized solar light responsive nanocomposites were studied by using DRS UV-Vis, XRD, FTIR and FESEM analysis. The absorption edge of TiO2 nanoparticles is extended to visible region by the incorporation of SCDs, which was used for converting noxious pollutant sulfide into eco-friendly solar fuel H2. The SCDs (10 wt%)-TiO2 nanocomposite exhibits enhanced photocatalytic hydrogen production i.e. ~27 mL of H2 (180 min) from simulated sulfide wastewater under LED visible light irradiation which is higher as compared to SCDs. The enhancement in the photocatalytic generation of H2 is attributed to combining of SCDs which increased the charge mobility. This work may provide new insights to usage of naturally available and cheap materials to design novel nanocomposite as a visible light active photocatalyst for the generation of H2 from sulfide containing wastewater.

Keywords: carbon dots, hydrogen fuel, hydrogen sulfide, photocatalysis, sulfide wastewater

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937 Bio Ethanol Production From the Co-Mixture of Jatropha Carcus L. Kernel Cake and Rice Straw

Authors: Felix U. Asoiro, Daniel I. Eleazar, Peter O. Offor

Abstract:

As a result of increasing energy demands, research in bioethanol has increased in recent years all through the world, in abide to partially or totally replace renewable energy supplies. The first and third generation feedstocks used for biofuel production have fundamental drawbacks. Waste rice straw and cake from second generation feedstock like Jatropha curcas l. kernel (JC) is seen as non-food feedstock and promising candidates for the industrial production of bioethanol. In this study, JC and rice husk (RH) wastes were characterized for proximate composition. Bioethanol was produced from the residual polysaccharides present in rice husk (RH) and Jatropha seed cake by sequential hydrolytic and fermentative processes at varying mixing proportions (50 g JC/50 g RH, 100 g JC/10 g RH, 100 g JC/20 g RH, 100 g JC/50 g RH, 100 g JC/100 g RH, 100 g JC/200 g RH and 200 g JC/100 g RH) and particle sizes (0.25, 0.5 and 1.00 mm). Mixing proportions and particle size significantly affected both bioethanol yield and some bioethanol properties. Bioethanol yield (%) increased with an increase in particle size. The highest bioethanol (8.67%) was produced at a mixing proportion of 100 g JC/50g RH at 0.25 mm particle size. The bioethanol had the lowest values of specific gravity and density of 1.25 and 0.92 g cm-3 and the highest values of 1.57 and 0.97 g cm-3 respectively. The highest values of viscosity (4.64 cSt) were obtained with 200 g JC/100 g RH, at 1.00 mm particle size. The maximum flash point and cloud point values were 139.9 oC and 23.7oC (100 g JC/200 g RH) at 1 mm and 0.5 mm particle sizes respectively. The maximum pour point value recorded was 3.85oC (100 g JC/50 g RH) at 1 mm particle size. The paper concludes that bioethanol can be recovered from JC and RH wastes. JC and RH blending proportions as well as particle sizes are important factors in bioethanol production.

Keywords: bioethanol, hydrolysis, Jatropha curcas l. kernel, rice husk, fermentation, proximate composition

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936 Development of Methods for Plastic Injection Mold Weight Reduction

Authors: Bita Mohajernia, R. J. Urbanic

Abstract:

Mold making techniques have focused on meeting the customers’ functional and process requirements; however, today, molds are increasing in size and sophistication, and are difficult to manufacture, transport, and set up due to their size and mass. Presently, mold weight saving techniques focus on pockets to reduce the mass of the mold, but the overall size is still large, which introduces costs related to the stock material purchase, processing time for process planning, machining and validation, and excess waste materials. Reducing the overall size of the mold is desirable for many reasons, but the functional requirements, tool life, and durability cannot be compromised in the process. It is proposed to use Finite Element Analysis simulation tools to model the forces, and pressures to determine where the material can be removed. The potential results of this project will reduce manufacturing costs. In this study, a light weight structure is defined by an optimal distribution of material to carry external loads. The optimization objective of this research is to determine methods to provide the optimum layout for the mold structure. The topology optimization method is utilized to improve structural stiffness while decreasing the weight using the OptiStruct software. The optimized CAD model is compared with the primary geometry of the mold from the NX software. Results of optimization show an 8% weight reduction while the actual performance of the optimized structure, validated by physical testing, is similar to the original structure.

Keywords: finite element analysis, plastic injection molding, topology optimization, weight reduction

Procedia PDF Downloads 280
935 Water Quality of Cengkareng Drain in Maritime Security Perspective

Authors: Febri Ramadhan, Sigid Hariyadi, Niken Tunjung Murti Pratiwi, Budiman Djoko Said

Abstract:

The scope about maritime security copes all of the problems emanating from maritime domain. Those problems can give such threats to national security of the state. One of threats taking place nowadays in maritime domain is about pollution. Pollution coming from many sources may increase water-borne disease risk that can cause the instability of national security. Pollution coming from many sources may increase water-borne disease risk. Hence the pollution makes an improper condition of environments for humans and others biota dwelling in the waters. One of the tools that can determine about pollution is by measuring about the water quality of its waters. In this case, what brings the waste and pollutants is there an activity of tidal waves introducing substances or energy into the natural environment. Cengkareng Drain is one of the water channels which is affected by tidal waves. Cengkareng Drain was become an observation area to examine the relation between water quality and tide waves. This research was conducted monthly from July to November 2015. Sampling of water was conducted every ebb and tide in every observation. Pollution index showed that the level of pollution on Cengkareng drain was moderately polluted, with the score about 7.7-8.6. Based on the results of t-test and analysis of similarity, the characteristic of water quality on rising tide does not significantly differ from the characteristic of water quality on ebbing tide. Therefore, we need a proper management as a means to control the pollutants in order to make good maritime security strategy.

Keywords: maritime security, Cengkareng drain, water quality, tidal waves

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934 The Role of Phycoremediation in the Sustainable Management of Aquatic Pollution

Authors: Raymond Ezenweani, Jeffrey Ogbebor

Abstract:

The menace of aquatic pollution has become increasingly of great concern and the effects of this pollution as a result of anthropogenic activities cannot be over emphasized. Phycoremediation is the application of algal remediation technology in the removal of harmful products from the environment. Harmful products also known as pollutants are usually introduced into the environment through variety of processes such as industrial discharge, agricultural runoff, flooding, and acid rain. This work has to do with the capability of algae in the efficient removal of different pollutants, ranging from hydrocarbons, eutrophication, agricultural chemicals and wastes, heavy metals, foul smell from septic tanks or dumps through different processes such as bioconversion, biosorption, bioabsorption and biodecomposition. Algae are capable of bioconversion of environmentally persistent compounds to degradable compounds and also capable of putting harmful bacteria growth into check in waste water remediation. Numerous algal organisms such as Nannochloropsis spp, Chlorella spp, Tetraselmis spp, Shpaerocystics spp, cyanobacteria and different macroalgae have been tested by different researchers in laboratory scale and shown to have 100% efficiency in environmental remediation. Algae as a result of their photosynthetic capacity are also efficient in air cleansing and management of global warming by sequestering carbon iv oxide in air and converting it into organic carbon, thereby making food available for the other organisms in the higher trophic level of the aquatic food chain. Algae play major role in the sustenance of the aquatic ecosystem by their virtue of being photosynthetic. They are the primary producers and their role in environmental sustainability is remarkable.

Keywords: Algae , Pollutant, ., Phycoremediation, Aquatic, Sustainability

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933 Temperature Dependence and Seasonal Variation of Denitrifying Microbial Consortia from a Woodchip Bioreactor in Denmark

Authors: A. Jéglot, F. Plauborg, M. K. Schnorr, R. S. Sørensen, L. Elsgaard

Abstract:

Artificial wetlands such as woodchip bioreactors are efficient tools to remove nitrate from agricultural wastewater with a minimized environmental impact. However, the temperature dependence of the microbiological nitrate removal prevents the woodchip bioreactors from being an efficient system when the water temperature drops below 8℃. To quantify and describe the temperature effects on nitrate removal efficiency, we studied nitrate-reducing enrichments from a woodchip bioreactor in Denmark based on samples collected in Spring and Fall. Growth was quantified as optical density, and nitrate and nitrous oxide concentrations were measured in time-course experiments to compare the growth of the microbial population and the nitrate conversion efficiencies at different temperatures. Ammonia was measured to indicate the importance of dissimilatory nitrate reduction to ammonia (DNRA) in nitrate conversion for the given denitrifying community. The temperature responses observed followed the increasing trend proposed by the Arrhenius equation, indicating higher nitrate removal efficiencies at higher temperatures. However, the growth and the nitrous oxide production observed at low temperature provided evidence of the psychrotolerance of the microbial community under study. The assays conducted showed higher nitrate removal from the microbial community extracted from the woodchip bioreactor at the cold season compared to the ones extracted during the warmer season. This indicated the ability of the bacterial populations in the bioreactor to evolve and adapt to different seasonal temperatures.

Keywords: agricultural waste water treatment, artificial wetland, denitrification, psychrophilic conditions

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932 A Magnetic Hydrochar Nanocomposite as a Potential Adsorbent of Emerging Pollutants

Authors: Aura Alejandra Burbano Patino, Mariela Agotegaray, Veronica Lassalle, Fernanda Horst

Abstract:

Water pollution is of worldwide concern due to its importance as an essential resource for life. Industrial and urbanistic growth are anthropogenic activities that have caused an increase of undesirable compounds in water. In the last decade, emerging pollutants have become of great interest since, at very low concentrations (µg/L and ng/L), they exhibit a hazardous effect on wildlife, aquatic ecosystems, and human organisms. One group of emerging pollutants that are a matter of study are pharmaceuticals. Their high consumption rate and their inappropriate disposal have led to their detection in wastewater treatment plant influent, effluent, surface water, and drinking water. In consequence, numerous technologies have been developed to efficiently treat these pollutants. Adsorption appears like an easy and cost-effective technology. One of the most used adsorbents of emerging pollutants removal is carbon-based materials such as hydrochars. This study aims to use a magnetic hydrochar nanocomposite to be employed as an adsorbent for diclofenac removal. Kinetics models and the adsorption efficiency in real water samples were analyzed. For this purpose, a magnetic hydrochar nanocomposite was synthesized through the hydrothermal carbonization (HTC) technique hybridized to co-precipitation to add the magnetic component into the hydrochar, based on iron oxide nanoparticles. The hydrochar was obtained from sunflower husk residue as the precursor. TEM, TGA, FTIR, Zeta potential as a function of pH, DLS, BET technique, and elemental analysis were employed to characterize the material in terms of composition and chemical structure. Adsorption kinetics were carried out in distilled water and real water at room temperature, pH of 5.5 for distilled water and natural pH for real water samples, 1:1 adsorbent: adsorbate dosage ratio, contact times from 10-120 minutes, and 50% dosage concentration of DCF. Results have demonstrated that magnetic hydrochar presents superparamagnetic properties with a saturation magnetization value of 55.28 emu/g. Besides, it is mesoporous with a surface area of 55.52 m²/g. It is composed of magnetite nanoparticles incorporated into the hydrochar matrix, as can be proven by TEM micrographs, FTIR spectra, and zeta potential. On the other hand, kinetic studies were carried out using DCF models, finding percent removal efficiencies up to 85.34% after 80 minutes of contact time. In addition, after 120 minutes of contact time, desorption of emerging pollutants from active sites took place, which indicated that the material got saturated after that t time. In real water samples, percent removal efficiencies decrease up to 57.39%, ascribable to a possible mechanism of competitive adsorption of organic or inorganic compounds, ions for active sites of the magnetic hydrochar. The main suggested adsorption mechanism between the magnetic hydrochar and diclofenac include hydrophobic and electrostatic interactions as well as hydrogen bonds. It can be concluded that the magnetic hydrochar nanocomposite could be valorized into a by-product which appears as an efficient adsorbent for DCF removal as a model emerging pollutant. These results are being complemented by modifying experimental variables such as pollutant’s initial concentration, adsorbent: adsorbate dosage ratio, and temperature. Currently, adsorption assays of other emerging pollutants are being been carried out.

Keywords: environmental remediation, emerging pollutants, hydrochar, magnetite nanoparticles

Procedia PDF Downloads 179
931 Reallocation of Bed Capacity in a Hospital Combining Discrete Event Simulation and Integer Linear Programming

Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

Abstract:

The number of inpatient admissions in the UK has been significantly increasing over the past decade. These increases cause bed occupancy rates to exceed the target level (85%) set by the Department of Health in England. Therefore, hospital service managers are struggling to better manage key resource such as beds. On the other hand, this severe demand pressure might lead to confusion in wards. For example, patients can be admitted to the ward of another inpatient specialty due to lack of resources (i.e., bed). This study aims to develop a simulation-optimization model to reallocate the available number of beds in a mid-sized hospital in the UK. A hospital simulation model was developed to capture the stochastic behaviours of the hospital by taking into account the accident and emergency department, all outpatient and inpatient services, and the interactions between each other. A couple of outputs of the simulation model (e.g., average length of stay and revenue) were generated as inputs to be used in the optimization model. An integer linear programming was developed under a number of constraints (financial, demand, target level of bed occupancy rate and staffing level) with the aims of maximizing number of admitted patients. In addition, a sensitivity analysis was carried out by taking into account unexpected increases on inpatient demand over the next 12 months. As a result, the major findings of the approach proposed in this study optimally reallocate the available number of beds for each inpatient speciality and reveal that 74 beds are idle. In addition, the findings of the study indicate that the hospital wards will be able to cope with 14% demand increase at most in the projected year. In conclusion, this paper sheds a new light on how best to reallocate beds in order to cope with current and future demand for healthcare services.

Keywords: bed occupancy rate, bed reallocation, discrete event simulation, inpatient admissions, integer linear programming, projected usage

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930 Study of Causes and Effects of Road Projects Abandonment in Nigeria

Authors: Monsuru Oyenola Popoola, Oladapo Samson Abiola, Wusamotu Alao Adeniji

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The prevalent and incessant abandonment of road construction projects are alarming that it creates several negative effects to social, economic and environmental values of the project. The purpose of this paper is to investigate and determined the various causes and effects of abandoning road construction projects in Nigeria. Likert Scale questionnaire design was used to administered and analysed the data obtained for the stydy. 135 (Nr) questionnaires were completed and retrieved from the respondents, out of 200 (Nr) questionnaires sent out, representing a response rate of 67.5%. The analysis utilized the Relative Importance Index (R.I.I.) method and the results are presented in tabular form. The findings confirms that at least 20 factors were the causes of road projects abandonment in Nigeria with most including Leadership Instability, Improper Project Planning, Inconsistence in government policies and Design, Contractor Incompetence, Economy Instability and Inflation, Delay in remittance of money, Improper financial analysis, Poor risk management, Climatic Conditions, Improper Project Estimates etc. The findings also show that at least eight (8) effect were identified on the system, and these include; Waste of Financial Resources, Loss of economic value, Environmental degradation, Loss of economic value, Reduction in standard of living, Litigation and Arbitration, etc. The reflection is that allocating reasonable finance, developing appropriate and effective implementation plans and monitoring, evaluation and reporting on development project activities by key actors should enhance in resolving the problem of road projects abandonment.

Keywords: road construction, abandonment of road projects, climatic condition, project planning, contractor

Procedia PDF Downloads 290
929 Wood Energy in Bangladesh: An Overview of Status, Challenges and Development

Authors: Md. Kamrul Hassan, Ari Pappinen

Abstract:

Wood energy is the single most important form of renewable energy in many parts of the world especially in the least developing countries in South Asia like Bangladesh. The last portion of the national population of this country depends on wood energy for their daily primary energy need. This paper deals with the estimation of wood fuel at the current level and identifies the challenges and strategies related to the development of this resource. Desk research, interactive research and field survey were conducted for gathering and analyzing of data for this study. The study revealed that wood fuel plays a significant role in total primary energy supply in Bangladesh, and the contribution of wood fuel in final energy consumption in 2013 was about 24%. Trees on homestead areas, secondary plantation on off forest lands, and forests are the main sources of supplying wood fuel in the country. Insufficient supply of wood fuel against high upward demand is the main cause of concern for sustainable consumption, which eventually leads deterioration and depletion of the resources. Inadequate afforestation programme, lack of initiatives towards the utilization of set-aside lands for wood energy plantations, and inefficient management of the existing resources have been identified as the major impediments to the development of wood energy in Bangladesh. The study argued that enhancement of public-private-partnership afforestation programmes, intensifying the waste and marginal lands with short-rotation tree species, and formulation of biomass-based rural energy strategies at the regional level are relevant to the promotion of sustainable wood energy in the country.

Keywords: Bangladesh, challenge, supply, wood energy

Procedia PDF Downloads 178
928 The Right of Taiwanese Individuals with Mental Illnesses to Participate in Medical Decision-Making

Authors: Ying-Lun Tseng Chiu-Ying Chen

Abstract:

Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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927 Application of Value Engineering Approach for Improving the Quality and Productivity of Ready-Mixed Concrete Used in Construction and Hydraulic Projects

Authors: Adel Mohamed El-Baghdady, Walid Sayed Abdulgalil, Ahmad Asran, Ibrahim Nosier

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This paper studies the effectiveness of applying value engineering to actual concrete mixtures. The study was conducted in the State of Qatar on a number of strategic construction projects with international engineering specifications for the 2022 World Cup projects. The study examined the concrete mixtures of Doha Metro project and the development of KAHRAMAA’s (Qatar Electricity and Water Company) Abu Funtas Strategic Desalination Plant, in order to generally improve the quality and productivity of ready-mixed concrete used in construction and hydraulic projects. The application of value engineering to such concrete mixtures resulted in the following: i) improving the quality of concrete mixtures and increasing the durability of buildings in which they are used; ii) reducing the waste of excess materials of concrete mixture, optimizing the use of resources, and enhancing sustainability; iii) reducing the use of cement, thus reducing CO₂ emissions which ensures the protection of environment and public health; iv) reducing actual costs of concrete mixtures and, in turn, reducing the costs of construction projects; and v) increasing the market share and competitiveness of concrete producers. This research shows that applying the methodology of value engineering to ready-mixed concrete is an effective way to save around 5% of the total cost of concrete mixtures supplied to construction and hydraulic projects, improve the quality according to the technical requirements and as per the standards and specifications for ready-mixed concrete, improve the environmental impact, and promote sustainability.

Keywords: value management, cost of concrete, performance, optimization, sustainability, environmental impact

Procedia PDF Downloads 342
926 Assessment of the Impact of Family Care Team in the District Health System of Regional Health, Thailand

Authors: Nithra Kitreerawutiwong, Sunsanee Mekrungrongwong, Artitaya Wongwonsin, Chakkraphan Phetphoom, Buaploy Phromjang

Abstract:

Background: Thailand has implemented a district health system based on the concept of primary health care. Since 2014, Family Care Team (FCT) was launched to improve the quality of care through a multidisciplinary team include not only the health sector but also social sector work together. FCT classified into 3 levels: district, sub-district, and community. This system now consists of 66,353 teams, including 3,890 teams at district level, 12,237 teams at the sub-district level, and 50,326 teams at the community level. There is a report regarding assessment the situation and perception on FCT, however, relatively few examined the operationality of this policy. This study aimed to explore the perception of district manager on the process of the implementation of FCT policy and the factors associating to implement FCT in the district health system. Methods/Results: Forty in-depth interviews were performed: 5 of primary care manager at the provincial medical health office, 5 of community hospital director, 5 of district administrative health office, 10 of sub-district health promoting hospital, and 10 of local organization. Semi-structure interview guidelines were used in the discussions. The data was analyzed by thematic analysis. This policy was formulated based on the demographic change and epidemiology transition to serve a long term care for elderly. Facilitator factors are social capital in district health systems such as family health leader and multidisciplinary team. Barrier factors are communication to the frontline provider and local organization. The output of this policy in relation to the structure of FCT is well-defined. Unanticipated effects include training of FCT in community level. Conclusion: Early feedback from healthcare manager is valuable information for the improvement of FCT to function optimally. Moreover, in the long term, health outcome need to be evaluated.

Keywords: family care team, district health system, primary care, qualitative study

Procedia PDF Downloads 401