Search results for: healthcare waste disposal

Authors: Mumtaz Khan, Adeel Shahid, Waqas Khan

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Heavy metals presence in water streams is a big danger for aquatic life and ultimately effects human health. Removal of copper (Cu) by ispaghula husk, maize fibre, and maize oil cake from synthetic solution in batch conditions was studied. Different experimental parameters such as contact time, initial solution pH, agitation rate, initial Cu concentration, biosorbent concentration, and biosorbent particle size has been studied to quantify the Cu biosorption. The rate of adsorption of metal ions was very fast at the beginning and became slow after reaching the saturation point, followed by a slower active metabolic uptake of metal ions into the cells. Up to a certain point, (pH=4, concentration of Cu = ~ 640 mg/l, agitation rate = ~ 400 rpm, biosorbent concentration = ~ 0.5g, 3g, 3g for ispaghula husk, maize fiber and maize oil cake, respectively) increasing the pH, concentration of Cu, agitation rate, and biosorbent concentration, increased the biosorption rate; however the sorption capacity increased by decreasing the particle size. At optimized experimental parameters, the maximum Cu biosorption by ispaghula husk, maize fibre and maize oil cake were 86.7%, 59.6% and 71.3%, respectively. Moreover, the results of the kinetics studies demonstrated that the biosorption of copper on ispaghula husk, maize fibre, and maize oil cake followed pseudo-second order kinetics. The results of adsorption were fitted to both the Langmuir and Freundlich models. The Langmuir model represented the sorption process better than Freundlich, and R² value ~ 0.978. Optimizations of physical and environmental parameters revealed, ispaghula husk as more potent copper biosorbent than maize fibre, and maize oil cake. The sorbent is cheap and available easily, so this study can be applied to remove Cu impurities on pilot and industrial scale after certain modifications.

Keywords: biosorption, copper, ispaghula husk, maize fibre, maize oil cake, purification

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Authors: Mulubrhan Berihu, Supratic Gupta, Zena Gebriel

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Due to the design versatility, availability, and cost efficiency, concrete is continuing to be the most used construction material on earth. However, the production of Portland cement, the primary component of concrete mix is causing to have a serious effect on environmental and economic impacts. This shows there is a need to study using of supplementary cementitious materials (SCMs). The most commonly used supplementary cementitious materials are wastes and the use of these industrial waste products has technical, economical and environmental benefits besides the reduction of CO2 emission from cement production. The study aims to document the effect on strength property of concrete due to use of low cement by maximizing supplementary cementitious materials like fly ash or marble powder. Based on the different mix proportion of pozzolana and marble powder a range of mix design was formulated. The first part of the project is to study the strength of low cement concrete using fly ash replacement experimentally. The test results showed that using up to 85 kg/m3 of cement is possible for plain concrete works like hollow block concrete to achieve 9.8 Mpa and the experimental results indicates that strength is a function of w/b. In the second part a new set of mix design has been carried out with fly ash and marble powder to study the strength of both binary and ternary mixes. In this experimental study, three groups of mix design (c+FA, c+FA+m and c+m), four sets of mixes for each group were taken up. Experimental results show that c+FA has maintained the best strength and impermeability whereas c+m obtained less compressive strength, poorer permeability and split tensile strength. c+FA shows a big difference in gaining of compressive strength from 7 days to 28 days compression strength compared to others and this obviously shows the slow rate of hydration of fly ash concrete. As the w/b ratio increases the strength decreases significantly. At the same time higher permeability has been seen in the specimens which were tested for three hours than one hour.

Keywords: efficiency factor, cement content, compressive strength, mix proportion, w/c ratio, water permeability, SCMs

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Authors: Polina Prokopovich

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Despite the well-established dependence of cartilage mechanical properties on the frequency of the applied load, most research in the field is carried out in either load-free or constant load conditions because of the complexity of the equipment required for the determination of time-dependent properties. These simpler analyses provide a limited representation of cartilage properties thus greatly reducing the impact of the information gathered hindering the understanding of the mechanisms involved in this tissue replacement, development and pathology. More complex techniques could represent better investigative methods, but their uptake in cartilage research is limited by the highly specialised training required and cost of the equipment. There is, therefore, a clear need for alternative experimental approaches to cartilage testing to be deployed in research and clinical settings using more user-friendly and financial accessible devices. Frequency dependent material properties can be determined through rheometry that is an easy to use requiring a relatively inexpensive device; we present how a commercial rheometer can be adapted to determine the viscoelastic properties of articular cartilage. Frequency-sweep tests were run at various applied normal loads on immature, mature and trypsinased (as model of osteoarthritis) cartilage samples to determine the dynamic shear moduli (G*, G′ G″) of the tissues. Moduli increased with increasing frequency and applied load; mature cartilage had generally the highest moduli and GAG depleted samples the lowest. Hydraulic permeability (KH) was estimated from the rheological data and decreased with applied load; GAG depleted cartilage exhibited higher hydraulic permeability than either immature or mature tissues. The rheometer-based methodology developed was validated by the close comparison of the rheometer-obtained cartilage characteristics (G*, G′, G″, KH) with results obtained with more complex testing techniques available in literature. Rheometry is relatively simpler and does not require highly capital intensive machinery and staff training is more accessible; thus the use of a rheometer would represent a cost-effective approach for the determination of frequency-dependent properties of cartilage for more comprehensive and impactful results for both healthcare professional and R&D.

Keywords: tissue, rheometer, biomaterial, cartilage

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Authors: Paschal A. Ubi, Salawu Abdul Rahman Asipita

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The use of suitable engineering materials which poses less harm to ,an and the environment is sort for in recent times, thus giving rise to polymer composites filled with natural organic reinforcement which are biodegradable. Treatment of natural fibres is essential in improving matrix to filler adhesion, hence improving its mechanical properties. In this study, investigations were carried out to determine the effect of sodium hydroxide treatment on the tensile, flexural, impact and hardness properties of crushed and uncrushed luffa cylindrica fibre reinforced recycled low density polyethylene composites. The LC (Luffa Cylindrica) fibres were treated with 0%, 2%, 4%, 6%, 8%, and 10% wt. NaOH concentrations for a period of 24 hours under room temperature conditions. The compounding of the waste LDPE was done using a two roll mill at a temperature of 150 oC and cured in a hydraulic press at a temperature of 150oC for 3 minutes at 3 metric tonnes. A formulation of 20/80g (reinforcement to matrix ratio in grams) was maintained for all fabricated samples. Analysis of the results showed that the uncrushed luffa fibre samples gave better mechanical properties compared with the crushed luffa fibre samples. The uncrushed luffa fibre composites had optimum tensile and flexural strengths of 7.65MPa and 17.08Mpa respectively corresponding to a young modulus and flexural modulus of 21.08MPa and 232.22MPa for the 8% and 4%wt. NaOH concentration respectively. Results obtained in the research showed that NaOH treatment with the 8% NaOH concentration improves the mechanical properties of the LC fibre reinforced composites when compared with other NaOH treatment concentration values.

Keywords: LC fibres, NaOH concentration, LC/rLDPE composite, tensile strength, flexural strength

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Authors: Junaid Asimiyu Mohammed, Olakunle Docas Tosin

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The housing environment in many developing countries is fraught with risks that have potential negative impacts on the lives of the residents. The study examined the risk factors in residential areas of two neighborhoods in Bosso Local Government Areas of Minna in Nigeria with a view to determining the level of their potential impacts. A sample of 378 households was drawn from the estimated population of 22,751 household heads. The questionnaire and direct observation were used as instruments for data collection. The data collected were analyzed using the Relative Importance Index (RII) rule to determine the level of the potential impact of the risk factors while ArcGIS was used for mapping the spatial distribution of the risks. The study established that the housing environment of Angwan Biri and El-Waziri areas of Bosso is poor and vulnerable as 26% of the houses were not habitable and 57% were only fairly habitable. The risks of epidemics, building collapse and rainstorms were evident in the area as 53% of the houses had poor ventilation; 20% of residents had no access to toilets; 47% practiced open waste dumping; 46% of the houses had cracked walls while 52% of the roofs were weak and sagging. The results of the analysis of the potential impact of the risk factors indicate a RII score of 0.528 for building collapse, 0.758 for rainstorms and 0.830 for epidemics, indicating a moderate to very high level of potential impacts. The mean RII score of 0.639 shows a significant potential impact of the risk factors. The study recommends the implementation of sanitation measures, provision of basic urban facilities and neighborhood revitalization through housing infrastructure retrofitting as measures to mitigate the risks of disasters and improve the living conditions of the residents of the study area.

Keywords: assessment, risk, residential, Nigeria

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: Usama Mohamed, Sam Booth, Aliysn J. Nedoma

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As part of the transition to electric vehicles, there has been a recent increase in demand for battery manufacturing. Cathodes typically account for approximately 50% of the total lithium-ion battery cell cost and are a pivotal factor in determining the viability of new industrial infrastructure. Cathodes which offer lower costs whilst maintaining or increasing performance, such as nickel-rich layered cathodes, have a significant competitive advantage when scaling up the manufacturing process. This project evaluates the techno-economic value proposition of an integrated industrial scale cathode active material (CAM) production process, closing the mass and energy balances, and optimizing the operation conditions using a sensitivity analysis. This is done by developing a process model of a co-precipitation synthesis route using Aspen Plus software and validated based on experimental data. The mechanism chemistry and equilibrium conditions were established based on previous literature and HSC-Chemistry software. This is then followed by integrating the energy streams, adding waste recovery and treatment processes, as well as testing the effect of key parameters (temperature, pH, reaction time, etc.) on CAM production yield and emissions. Finally, an economic analysis estimating the fixed and variable costs (including capital expenditure, labor costs, raw materials, etc.) to calculate the cost of CAM ($/kg and $/kWh), total plant cost ($) and net present value (NPV). This work sets the foundational blueprint for future research into sustainable industrial scale processes for CAM manufacturing.

Keywords: cathodes, industrial production, nickel-rich layered cathodes, process modelling, techno-economic analysis

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Authors: Guna Raj Dhungana, Roshan Nepal, Apshara Parajuli, , Archana Maharjan, Shyam K. Mishra, Pramod Aryal, Rajani Malla

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Introduction: Klebsiella pneumoniae is a well-known opportunistic human pathogen, primarily causing healthcare-associated infections. The global emergence of carbapenemase-producing K. pneumoniaeis a major public health burden, which is often extensively multidrug resistant.Thus, because of the difficulty to treat these ‘superbug’ and menace and some term as ‘apocalypse’ of post antibiotics era, an alternative approach to controlling this pathogen is prudent and one of the approaches is phage mediated control and/or treatment. Objective: In this study, we aimed to isolate novel bacteriophage against carbapenemase-producing K. pneumoniaeand characterize for potential use inphage therapy. Material and Methods: Twenty lytic phages were isolated from river water using double layer agar assay and purified. Biological features, physiochemical characters, burst size, host specificity and activity spectrum of phages were determined. One most potent phage: Phage TU_Kle10O was selected and characterized by electron microscopy. Whole genome sequences of the phage were analyzed for presence/absence of virulent factors, and other lysin genes. Results: Novel phage TU_Kle10O showed multiple host range within own genus and did not induce any BIM up to 5th generation of host’s life cycle. Electron microscopy confirmed that the phage was tailed and belonged to Caudovirales family. Next generation sequencing revealed its genome to be 166.2 Kb. bioinformatical analysis further confirmed that the phage genome ‘did not’ contain any ‘bacterial genes’ within phage genome, which ruled out the concern for transfer of virulent genes. Specific 'lysin’ enzyme was identified phages which could be used as 'antibiotics'. Conclusion: Extensively multidrug resistant bacteria like carbapenemase-producing K. pneumoniaecould be treated efficiently by phages.Absence of ‘virulent’ genes of bacterial origin and presence of lysin proteins within phage genome makes phages an excellent candidate for therapeutics.

Keywords: bacteriophage, Klebsiella pneumoniae, MDR, phage therapy, carbapenemase,

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Authors: Aawag Mohsen Al-Awag, Wesam Salah Alaloul, M. S. Liew

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Industrialized building system (IBS) is a method of construction with concentrated practices consisting of techniques, products, and a set of linked elements which operate collectively to accomplish objectives. The Industrialised Building System (IBS) has been recognised as a viable method for improving overall construction performance in terms of quality, cost, safety and health, waste reduction, and productivity. The Malaysian construction industry is considered one of the contributors to the development of the country. The acceptance level of IBS is still below government expectations. Thus, the Malaysian government has been continuously encouraging the industry to use and implement IBS. Conventional systems have several drawbacks, including project delays, low economic efficiency, excess inventory, and poor product quality. When it comes to implementing IBS, construction companies still face several obstacles and problems, notably in terms of contractual and procurement concerns, which leads to the low adoption of IBS in Malaysia. There are barriers to the acceptance of IBS technology, focused on awareness of historical failure and risks connected to IBS practices to provide enhanced performance. Therefore, the transformation from the existing conventional building systems to the industrialized building systems (IBS) is needed more than ever. The flexibility of IBS in Malaysia’s construction industry is very low due to numerous shortcomings and obstacles. Due to its environmental, economic, and social benefits, IBS could play a significant role in the Malaysian construction industry in the future. This paper concentrates on the potential role of IBS in sustainable construction practices in Malaysia. It also highlights the awareness, barriers, advantages, and disadvantages of IBS in the construction sector. The study concludes with recommendations for Malaysian construction stakeholders to encourage and increase the utilization of industrialised building systems.

Keywords: construction industry, industrialized building system, barriers, advantages and disadvantages, construction, sustainability, Malaysia

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Authors: Noah G. Akhimien, Eshrar Latif

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The natural environment is in need for an urgent rescue due to dilapidation and recession of resources. Passive design strategies have proven to be one of the effective ways to reduce CO₂ emissions and to improve building performance. On the other hand, there is a huge drop in material availability due to poor recycling culture. Consequently, building waste pose environmental hazard due to unrecycled building materials from construction and deconstruction. Buildings are seen to be material banks for a circular economy, therefore incorporating circular economy into passive housing will not only safe guide the climate but also improve resource efficiency. The study focuses on incorporating a circular economy in passive design strategies for an affordable energy and resource efficient residential building in Nigeria. Carbon dioxide (CO₂) concentration is still on the increase as buildings are responsible for a significant amount of this emission globally. Therefore, prompt measures need to be taken to combat the effect of global warming and associated threats. Nigeria is rapidly growing in human population, resources on the other hand have receded greatly, and there is an abrupt need for recycling even in the built environment. It is necessary that Nigeria responds to these challenges effectively and efficiently considering building resource and energy. Passive design strategies were assessed using simulations to obtain qualitative and quantitative data which were inferred to case studies as it relates to the Nigeria climate. Building materials were analysed using the ReSOLVE model in order to explore possible recycling phase. This provided relevant information and strategies to illustrate the possibility of circular economy in passive buildings. The study offers an alternative approach, as it is the general principle for the reworking of an economy on ecological lines in passive housing and by closing material loops in circular economy.

Keywords: building, circular, efficiency, environment, sustainability

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Authors: Ashmita Mukherjee, Yogesh Harishchandra Kabutare, Suritra Bandyopadhyay, Paulomi Ghosh

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Uncontrolled bleeding in the battlefield and the operation rooms can lead to serious injuries, trauma and even be lethal. Keratin was reported to be a haemostatic material which rapidly activates thrombin followed by activation of fibrinogen leading to the formation of insoluble fibrin. Also platelets, the main initiator of haemostasis are reported to adhere to keratin. However, the major limitation of pure keratin as a biomaterial is its poor physical property and corresponding low mechanical strength. To overcome this problem, keratin was cross-linked with alginate to increase its mechanical stability. In our study, Keratin extracted from feather waste showed yield of 80.5% and protein content of 8.05 ± 0.43 mg/mL (n=3). FTIR and CD spectroscopy confirmed the presence of the essential functional groups and preservation of the secondary structures of keratin. The keratin was then cross-linked with alginate to make a dope. The dope was used to draw fibers of desired diameters in a suitable coagulation bath using a customized wet spinning setup. The resultant morphology of keratin fibers was observed under a brightfield microscope. The FT-IR analysis implied that there was a presence of both keratin and alginate peaks in the fibers. The cross-linking was confirmed in the keratin alginate fibers by a shift of the amide A and amide B peaks towards the right and disappearance of the peak for N-H stretching (1534.68 cm-1). Blood was drawn in citrate vacutainers for whole blood clotting test and blood clotting kinetics, which showed that the keratin fibers could accelerate blood coagulation compared to that of alginate fibers and tissue culture plate. Additionally, cross-linked keratin-alginate fiber was found to have lower haemolytic potential compared to alginate fiber. Thus, keratin cross-linked fibers can have potential applications to combat unrestrained bleeding.

Keywords: biomaterial, biowaste, fiber, keratin

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Authors: Filiz Celik, Rachel Harrad, Rob Keasley, Paul Bennett

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The COVID-19 pandemic has posed a significant challenge to many, with some groups with particular vulnerability to adverse psychological impacts. These include those disadvantaged by mental ill health, either pre-existing or occurring during pregnancy or post-partum. Using a qualitative approach, the research aimed to identify the challenges posed by COVID-19 to women, their infants and families during the perinatal period and to suggest what further support can help alleviate the adverse mental health impact of COVID-19. 21 expectant and new mothers who were currently receiving support via a peri-natal mental health service participated in semi-structured interviews. In these interviews, participants explored the impact of changes in social circumstances and healthcare providers as a result of COVID-19 restrictions, with the resultant audio recordings transcribed and analyzed using Reflexive Thematic Analysis (RTA). Based on these accounts, it was concluded that women, their partners and potentially their infants experienced heightened peri-natal distress, and their experience at this time increased their risk for future mental health problems. Women described emerging as more vulnerable, owing to their role as primary caregivers during the perinatal period and also explained how social isolation and limited access to services meant protective buffers against mental health deterioration were reduced and the resources they needed in order to develop resilience were weakened. Although partners were invited to take part in the research, a sizeable volume of data could not be generated to fully assess the impact of the pandemic on a partner’s mental well-being. However, women expressed concerns about the paternal mental health of partners and husbands which invites us to be further vigilant to paternal mental health and associated experiences. Overall, these interviews serve to highlight and provide a voice to these women and their families who describe experiencing disadvantage at an already vulnerable time in their lives, as well as illustrating the need for services to prioritize the needs of this population when acute events strike, be those future pandemics or other disasters.

Keywords: patient experience, perinatal mental health, covid-19 pandemic, heightened anxiety, birth trauma, post-natal well-being

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Authors: Noorulaine Maqsood, Saeed Khan

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Background: Concern regarding incident reporting and bio-safety training in clinical laboratories in Pakistan has increased remarkably in the last few years due to rapid increase in diagnosis and research on infectious organisms. In order to ensure the safety of employees, this issue needs to be addressed immediately. Bio-safety training sessions and lectures are necessary for the protection of laboratory workers in order to ensure safe practices and minimize the count of incident reporting in the lab. Objective: To carry out an inter-departmental survey in lab regarding the awareness of bio-safety practices among lab employees before and after conducting bio-safety training sessions. Methodology: We conducted a 30 questions survey of laboratory workers in June 2013 (before training session) to gather information related to bio-safety awareness. Afterwards, we conducted another survey after training sessions and workshops related to bio-safety. Result: The survey regarding bio-safety level showed that before the training session 32% of the participants were aware of bio-safety level being used in their lab whereas after the session this percentage increased to 72%. 48% of the participants had information about the proper usage of PPE which increased to 76%. Awareness regarding proper management of hazardous waste increased from 32% to 64%. The incident reporting practice, sample handling and hand hygiene awareness was previously reported to be 40%, 65%, and 52% that increased to 80%, 85% and 88% respectively after the training session was completed. Conclusion: The first survey results showed lack of awareness that suggest nearly all senior scientists, faculty, medical technologist, lab attendant and housekeeping staff working in laboratories are required to have bio-safety training, and required inspection at least twice a year by a bio-safety officer and also required to renew their bio-safety training. After the training session, significant changes in awareness level and attitude of the participants regarding biosafety practices were observed. Therefore, such bio-safety sessions should be carried out regularly in clinical laboratories.

Keywords: biosafety practices, clinical laboratory, Pakistan, survey

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Authors: Michael D. Vinod, Hadi Khabbaz

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Construction of infrastructure above or adjacent to landfills is becoming more common to capitalize on the limited space available within urban areas. However, development above landfills is a challenging task due to large voids, the presence of organic matter, heterogeneous nature of waste and ambiguity surrounding landfill settlement prediction. Prior to construction of infrastructure above landfills, ground improvement techniques are being employed to improve the geotechnical properties of landfill material. Although the ground improvement techniques have little impact on long term biodegradation and creep related landfill settlement, they have shown some notable short term success with a variety of techniques, including methods for verifying the level of effectiveness of ground improvement techniques. This paper provides geotechnical and landfill engineers a guideline for selection of landfill ground improvement techniques and their suitability to project-specific sites. Ground improvement methods assessed and compared in this paper include concrete injected columns (CIC), dynamic compaction, rapid impact compaction (RIC), preloading, high energy impact compaction (HEIC), vibro compaction, vibro replacement, chemical stabilization and the inclusion of geosynthetics such as geocells. For each ground improvement technique a summary of the existing theory, benefits, limitations, suitable modern ground improvement monitoring methods, the applicability of ground improvement techniques for landfills and supporting case studies are provided. The authors highlight the importance of implementing cost-effective monitoring techniques to allow observation and necessary remediation of the subsidence effects associated with long term landfill settlement. These ground improvement techniques are primarily for the purpose of construction above closed landfills to cater for transport infrastructure loading.

Keywords: closed landfills, ground improvement, monitoring, settlement, transport infrastructure

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Authors: Nida Rizvi, Deeksha Katyal, Varun Joshi

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River Hindon is an important river catering the demand of highly populated rural and industrial cluster of western Uttar Pradesh, India. Water quality of river Hindon is deteriorating at an alarming rate due to various industrial, municipal and agricultural activities. The present study aimed at identifying the pollution sources and quantifying the degree to which these sources are responsible for the deteriorating water quality of the river. Various water quality parameters, like pH, temperature, electrical conductivity, total dissolved solids, total hardness, calcium, chloride, nitrate, sulphate, biological oxygen demand, chemical oxygen demand and total alkalinity were assessed. Water quality data obtained from eight study sites for one year has been subjected to the two multivariate techniques, namely, principal component analysis and cluster analysis. Principal component analysis was applied with the aim to find out spatial variability and to identify the sources responsible for the water quality of the river. Three Varifactors were obtained after varimax rotation of initial principal components using principal component analysis. Cluster analysis was carried out to classify sampling stations of certain similarity, which grouped eight different sites into two clusters. The study reveals that the anthropogenic influence (municipal, industrial, waste water and agricultural runoff) was the major source of river water pollution. Thus, this study illustrates the utility of multivariate statistical techniques for analysis and elucidation of multifaceted data sets, recognition of pollution sources/factors and understanding temporal/spatial variations in water quality for effective river water quality management.

Keywords: cluster analysis, multivariate statistical techniques, river Hindon, water quality

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Authors: Tsung Chin Wu, Yu Chen Tsai, Rhay Hung Weng, Weir Sen Lin

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In recent years, nursing staff’s lower job satisfaction has led to higher turnover rates, and high turnover rates not only cause medical institution costs to increase but also the quality of medical care to decrease. From the perspective of internal marketing, institution staffs are internal customers, and institutions should focus and meet the needs of staff, so that staff will strive to meet the needs of external customers and provide them with the required care. However, few previous studies have investigated the impact of internal staff satisfaction on external customers. Therefore, this study aimed to conduct job satisfaction surveys on internal staff to investigate the relationship between job satisfaction and quality of medical care through statistical analysis of the study results. The related study results may serve as a reference for healthcare managers. This study was conducted using a questionnaire and the subjects were nursing staff from four hospitals. A total of 600 questionnaires were distributed and 577 valid questionnaires were returned with a response rate of 96.1%. After collecting the data, the reliability and validity of the study variables were confirmed by confirmatory factor analysis. The impact of internal marketing and job satisfaction on turnover intention of nursing staff was analyzed using descriptive analysis, one-way ANOVA, Pearson correlation analysis and multiple regression analysis. The study results showed that there was a significant difference between nursing staff’s job title and ‘professional participation’ and ‘shifts’. There was a significant difference between salary and ‘shifts’ and ‘turnover intention’, as well as between marriage and ‘remuneration’ and ‘turnover intention’. A significant difference was found between professional advancement and ‘professional growth’ and ‘type of leave’, as well as between division of service and ‘shifts’ and ‘turnover intention’. Pearson correlation analysis revealed a significant negative correlation between turnover intention and ‘internal marketing’, ‘interaction’, ‘professional participation’, ‘grasp of environment’, ‘remuneration’ and ‘shifts’, meaning that the higher the satisfaction, the lower the turnover intention. It is recommended that hospitals establish a comprehensive internal marketing mechanism to enhance staff satisfaction and in turn, reduce intention to resign, and the key to increasing job satisfaction is by establishing effective methods of internal communication.

Keywords: internal marketing, job satisfaction, turnover intention, nursing staff

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Authors: Enes Caliskan, Hatice Camgoz Akdag

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There is no doubt that humanity needs to realize the sustainability problems in the world and take serious action regarding that. All members of the United Nations adopted the 2030 Agenda for Sustainable Development, the most comprehensive study on sustainability internationally, in 2015. The summary of the study is 17 sustainable development goals. It covers everything about sustainability, such as environment, society and governance. The use of Information and Communication Technology (ICT), such as the Internet, mobile phones, and satellites, is essential for tackling the main issues facing sustainable development. Hence, the contributions of 3 major ICT companies to the sustainable development goals are assessed in this study. Quality Function Deployment (QFD) is utilized as a methodology for this study. Since QFD is an excellent instrument for comparing businesses on relevant subjects, a House of Quality must be established to complete the QFD application. In order to develop a House of Quality, the demanded qualities (voice of the customer) and quality characteristics (technical requirements) must first be determined. UN SDGs are used as demanded qualities. Quality characteristics are derived from annual sustainability and corporate social responsibility reports of ICT companies. The companies' efforts, as indicated by the QFD results, are concentrated on the use of recycled raw materials and recycling, reducing GHG emissions through energy saving and improved connectivity, decarbonizing the value chain, protecting the environment and water resources by collaborating with businesses that have completed CDP water assessments and paying attention to reducing water consumption, ethical business practices, and reducing inequality. The evaluations of the three businesses are found to be very similar when they are compared. The small differences between the companies are usually about the region they serve. Efforts made by the companies mostly concentrate on responsible consumption and production, life below water, climate action, and sustainable cities and community goals. These efforts include improving connectivity in needed areas for providing access to information, education and healthcare.

Keywords: multi-criteria decision-making, sustainable supply chain risk, supply chain agility, quality function deployment, Sustainable development goals

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Authors: Anne Waithira Dormal

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Climate change is threatening pastoral livelihoods in Kajiado County, Kenya, through water shortages, livestock deaths, and increasing poverty. This study examines how these impacts differ for men and women within these communities. Limited access to resources, limited land and livestock rights, and limited decision-making power increase women's vulnerability, which is further burdened by traditional gender roles in water procurement. The research recognizes the complexity of climate change and emphasizes that factors such as wealth, family dynamics, and socioeconomic status also influence resilience. Effective adaptation strategies must address all genders. While livestock farming provides a safety net, socioeconomic empowerment through access to credit, healthcare, and education strengthens entire communities. An intersectional perspective that takes ethnicity, social status, and other factors into account is also crucial. This research, therefore, aims to examine how gender-specific adaptation strategies interact with gender and socioeconomic factors to determine the resilience of these Kenyan pastoralist communities. Such strategies, which address the specific needs and vulnerabilities of men and women, are expected to lead to increased resilience to climate change. The aim of the study is to identify effective, gender-specific adaptation strategies that can be integrated into climate change planning and implementation. Additionally, research awaits a deeper understanding of how socioeconomic factors interact with gender to influence vulnerability and resilience within these communities. The study uses a gender-sensitive qualitative approach with focus group discussions in four different pastoral and agropastoral communities. Both qualitative and demographic data are used to capture sources of income, education level, and household size of focus group respondents to increase the power of the analysis. While the research acknowledges the limitations of specific focus sites and potential biases in self-reporting, it offers valuable insights into gender and climate change in pastoral contexts. This study contributes to understanding gender-based vulnerabilities and building resilience in these communities.

Keywords: climate adaptation strategies, climate change, climate resilience, gendered vulnerability, pastoralism

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Authors: Adam Y. Sulaiman, Donal F. Cotter, Ming J. Huang, Neil J. Hewitt

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Suitable low global warming potential (GWP) refrigerants that conform to F-gas regulations are required to extend the operational envelope of high-temperature heat pumps (HTHPs) used for industrial waste heat recovery processes. The thermophysical properties and characteristics of these working fluids need to be assessed to provide a comprehensive understanding of operational effectiveness in HTHP applications. This paper presents the results of a theoretical simulation to investigate a range of low-GWP refrigerants and their suitability to supersede refrigerants HFC-245fa and HFC-365mfc. A steady-state thermodynamic model of a single-stage HTHP with an internal heat exchanger (IHX) was developed to assess system cycle characteristics at temperature ranges between 50 to 80 °C heat source and 90 to 150 °C heat sink. A practical approach to maximize the operational efficiency was examined to determine the effects of regulating minimum superheat within the process and subsequent influence on energetic and exergetic efficiencies. A comprehensive map of minimum superheat across the HTHP operating variables were used to assess specific tipping points in performance at 30 and 70 K temperature lifts. Based on initial results, the refrigerants HCFO-1233zd(E) and HFO-1336mzz(Z) were found to be closely aligned matches for refrigerants HFC-245fa and HFC-365mfc. The overall results show effective performance for HCFO-1233zd(E) occurs between 5-7 K minimum superheat, and HFO-1336mzz(Z) between 18-21 K dependant on temperature lift. This work provides a method to optimize refrigerant selection based on operational indicators to maximize overall HTHPs system performance.

Keywords: high-temperature heat pump, minimum superheat, energy & exergy efficiency, low GWP refrigerants

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Authors: Obinna Afamefuna Echi

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Background: The global increase in the elderly population is anticipated to reach significant levels by 2050, presenting extensive economic, social, and healthcare challenges. Age-related cognitive decline, alterations in brain anatomy, and systemic inflammation are profound concerns that diminish the quality of life and increase susceptibility to diseases like Alzheimer's and cardiovascular diseases. Resistance training is presently studied for its potential neuroprotective and anti-inflammatory benefits in older adults. Objectives: This study aimed to explore the effects of different resistance training modalities on neurotrophic factors, inflammatory markers, and cognitive functions in the elderly. Methods: A controlled trial was conducted with 60 male participants aged 60-75, assigned to either 12 weeks of high-intensity blood flow restriction training (BFRT), muscle damaging resistance training (MDRT), or a non-exercising control group. Cognitive function, neurotrophic factors such as BDNF, and inflammatory markers including IL-6 and TNF were measured before and after the intervention period. Setting: Participants were recruited from Kaunas, Lithuania, with sessions facilitated at the Lithuanian Sports University and health assessments conducted at the Lithuanian University of Health Sciences. Results: Preliminary data suggested did not show significant improvements in BDNF levels and cognitive functions in the BFRT and MDRT groups compared to controls. However, there was a notable reduction in inflammatory markers, indicating potential health benefits beyond cognitive enhancement. Conclusion: The incorporation of resistance training can be a strategic intervention to mitigate age-associated cognitive decline and systemic inflammation, thereby enhancing overall health and quality of life in older adults. The results advocate for wider adoption and further study of resistance training as a preventive measure in ageing populations. Funding: The Lithuanian Sports University, the Research Council of Lithuania and the Lithuanian University of Health Sciences.

Keywords: ageing, resistance training, BDNF, cognitive function

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Authors: Pablo Andres Flores Siguenza, Noe Rodrigo Guaman Guachichullca

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Sustainable practices have received increasing attention from academics and companies in recent decades due to, among many factors, the market advantages they generate, global commitments, and policies aimed at reducing greenhouse gas emissions, addressing resource scarcity, and rethinking waste management. The search for ways to promote sustainability leads industries to abandon classical methods and resort to the use of innovative strategies, which in turn are based on quantitative analysis methods and tools such as life cycle analysis (LCA), which is the basis for sustainable production and consumption, since it is a method that analyzes objectively, methodically, systematically, and scientifically the environmental impact caused by a process/product during its entire life cycle. The objective of this study is to develop an LCA of the antibacterial gel product throughout its entire supply chain (SC) under the methodology of ISO 14044 with the help of Gabi software and the Recipe 2016 method. The selection of the case study product was made based on its relevance in the current context of the COVID-19 pandemic and its exponential increase in production. For the development of the LCA, data from a Mexican company are used, and 3 scenarios are defined to obtain the midpoint and endpoint environmental impacts both by phases and globally. As part of the results, the most outstanding environmental impact categories are climate change, fossil fuel depletion, and terrestrial ecotoxicity, and the stage that generates the most pollution in the entire SC is the extraction of raw materials. The study serves as a basis for the development of different sustainability strategies, demonstrates the usefulness of an LCA, and agrees with different authors on the role and importance of this methodology in sustainable development.

Keywords: sustainability, sustainable development, life cycle analysis, environmental impact, antibacterial gel

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Authors: Narumon Jiwattanasuk, Phrakrupalad Pannavoravat, Pataraporn Sirikanchana

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Mindfulness has become a perspective addressing positive wellbeing these days. The aims of this paper are to analyze the problems of executive meditation practitioners at the Buddhamahametta Foundation in Thailand and to provide recommendations on the process to develop peaceful wellbeing in executive meditation practitioners by applying the principles of the four foundations of mindfulness. This study is particularly focused on executives because there is not much research focusing on the well-being development of executives, and the researcher recognizes that executives can be an example within their organizations. This would be a significant influence on their employees and their families to be interested in practicing mindfulness. This improvement will then grow from an individual to the surrounding community such as family, workplace, society, and the nation. This would lead to happiness at the national level, which is the expectation of this research. The paper highlights mindfulness practices that can be performed on a daily basis. This study is qualitative research, and there are 10 key participants who are executives from various sectors such as hospitality, healthcare, retail, power energy, and so on. Three mindfulness-based courses were conducted over a period of 8 months, and in-depth interviews were done before the first course as well as at the end of every course. In total, four in-depth interviews were conducted. The information collected from the interviews was analyzed in order to create the process to develop peaceful well-being. Focus group discussions with the mindfulness specialists were conducted to help develop the mindfulness program as well. As a result of this research, it is found that the executives faced the following problems: stress, negative thinking loops, losing temper, seeking acceptance, worry about uncontrollable external factors, unable to control their words, and weight gain. The cultivation of the four foundations of mindfulness can develop peaceful wellbeing. The results showed that after the key informant executives attended the mindfulness courses and practiced mindfulness regularly, they have developed peaceful well-being in all aspects such as physical, psychological, behavioral, and intellectual by applying 12 mindfulness-based activities. The development of wellbeing, in the conclusion of this study, also includes various tools to support the continuing practice, including the handout of guided mindfulness practice, VDO clips about mindfulness practice, the online dhamma channel, and mobile applications to support regular mindfulness-based practices.

Keywords: executive, mindfulness activities, stress, wellbeing

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Authors: Gurbanova Lamiya

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The Republic of Azerbaijan is considered a region with limited water resources, as up to 70% of surface water is formed outside the country's borders, and most of its territory is an arid (dry) climate zone. It is located at the lower limit of transboundary flows, which is the weakest source of natural water resources in the South Caucasus. It is essential to correctly assess the quality of natural, collector-drainage and groundwater of the area and their suitability for irrigation in order to properly carry out land reclamation measures, provide the normal water-salt regime, and prevent repeated salinization. Through the 141-km-long main Mil-Mugan collector, groundwater, household waste, and floodwaters generated during floods and landslides are poured into the Caspian Sea. The hydrochemical composition of the samples taken from the Sabir irrigation canal passing through the center of the Kura-Araz plain, the Main Mil-Mugan Collector, and the groundwater of the region, which we chose as our research object, were studied and the obtained results were compared by periods. A model is proposed that allows for a complete visualization of the primary materials collected for the study area. The practical use of the established digital model provides all possibilities. The practical use of the established digital model provides all possibilities. An extensive database was created with the ArcGis 10.8 package, using publicly available LandSat satellite images as primary data in addition to ground surveys to build the model. The principles of the construction of the geographic information system of modern GIS technology were developed, the boundary and initial condition of the research area were evaluated, and forecasts and recommendations were given.

Keywords: irrigation channel, groundwater, collector, meliorative measures

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Authors: Maria Bonolo Mathevula

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Background: Children are important members of communities playing major role in the future of any given country (Pera, Fails, Gelsomini, &Garzotto, 2018). Visual Perceptual Skills (VPSs) in children are important health aspect of early childhood development through the Foundation Phases in school. Subsequently, children should undergo visual screening before commencement of schooling for early diagnosis ofVPSs anomalies because the primary role of VPSs is to capacitate children with academic performance in general. Aim : The aim of this study was to determine the anomalies of visual VPSs amongst school children in Foundation Phase. The study’s objectives were to determine the prevalence of VPSs anomalies amongst school children in Foundation Phase; Determine the relationship between children’s academic and VPSs anomalies; and to investigate the relationship between VPSs anomalies and refractive error. Methodology: This study was a mixed method whereby triangulated qualitative (interviews) and quantitative (questionnaire and clinical data) was used. This was, therefore, descriptive by nature. The study’s target population was school children in Foundation Phase. The study followed purposive sampling method. School children in Foundation Phase were purposively sampled to form part of this study provided their parents have given a signed the consent. Data was collected by the use of standardized interviews; questionnaire; clinical data card, and TVPS standard data card. Results: Although the study is still ongoing, the preliminary study outcome based on data collected from one of the Foundation Phases have suggested the following:While VPSs anomalies is not prevalent, it, however, have indirect relationship with children’s academic performance in Foundation phase; Notably, VPSs anomalies and refractive error are directly related since majority of children with refractive error, specifically compound hyperopic astigmatism, failed most subtests of TVPS standard tests. Conclusion: Based on the study’s preliminary findings, it was clear that optometrists still have a lot to do in as far as researching on VPSs is concerned. Furthermore, the researcher recommends that optometrist, as the primary healthcare professionals, should also conduct the school-readiness pre-assessment on children before commencement of their grades in Foundation phase.

Keywords: foundation phase, visual perceptual skills, school children, refractive error

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Authors: Mateusz Szul, Tomasz Iluk, Aleksander Sobolewski

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Small-scale, distributed energy systems enabling cogeneration of heat and power based on gasification of sewage sludge, are considered as the most efficient and environmentally friendly ways of their treatment. However, economic aspects of such an investment are very demanding; therefore, for such a small scale sewage sludge gasification installation to be profitable, it needs to be efficient and simple at the same time. The article presents results of research on air gasification of sewage sludge in fixed bed GazEla reactor. Two of the most important aspects of the research considered the influence of the composition of sewage sludge blends with other feedstocks on properties of generated syngas and ash sintering problems occurring at the fixed bed. Different means of the fuel pretreatment and blending were proposed as a way of dealing with the above mentioned undesired characteristics. Influence of RDF (Refuse Derived Fuel) and biomasses in the fuel blends were evaluated. Ash properties were assessed based on proximate, ultimate, and ash composition analysis of the feedstock. The blends were specified based on complementary characteristics of such criteria as C content, moisture, volatile matter, Si, Al, Mg, and content of basic metals in the ash were analyzed, Obtained results were assessed with use of experimental gasification tests and laboratory ISO-procedure for analysis of ash characteristic melting temperatures. Optimal gasification process conditions were determined by energetic parameters of the generated syngas, its content of tars and lack of ash sinters within the reactor bed. Optimal results were obtained for co-gasification of herbaceous biomasses with sewage sludge where LHV (Lower Heating Value) of the obtained syngas reached a stable value of 4.0 MJ/Nm3 for air/steam gasification.

Keywords: ash fusibility, gasification, piston engine, sewage sludge

Procedia PDF Downloads 196

Authors: Haoyu Zhao, Qianshu Ma, Min Xie, Yunqi Huang, Yunjia Liu, Huan Song, Hongsheng Gui, Mingli Li, Qiang Wang

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Rationale: Bipolar disorder (BD) and major depressive disorder (MDD), as severe chronic illnesses that restrict patients’ psychosocial functioning and reduce their quality of life, are both categorized into mood disorders. Emerging evidence has suggested that the reliability of self-rated health (SRH) was wellvalidated and that the risk of various health outcomes, including mortality and health care costs, could be predicted by SRH. Compared with other lengthy multi-item patient-reported outcomes (PRO) measures, SRH was proven to have a comparable predictive ability to predict mortality and healthcare utilization. However, to our knowledge, no study has been conducted to assess the association between SRH and hospitalization among people with mental disorders. Therefore, our study aims to determine the association between SRH and subsequent all-cause hospitalizations in patients with BD and MDD. Methods: We conducted a prospective cohort study on people with BD or MDD in the UK from 2006 to 2010 using UK Biobank touchscreen questionnaire data and linked administrative health databases. The association between SRH and 2-year all-cause hospitalizations was assessed using proportional hazard regression after adjustment for sociodemographics, lifestyle behaviors, previous hospitalization use, the Elixhauser comorbidity index, and environmental factors. Results: A total of 29,966 participants were identified, experiencing 10,279 hospitalization events. Among the cohort, the average age was 55.88 (SD 8.01) years, 64.02% were female, and 3,029 (10.11%), 15,972 (53.30%), 8,313 (27.74%), and 2,652 (8.85%) reported excellent, good, fair, and poor SRH, respectively. Among patients reporting poor SRH, 54.19% had a hospitalization event within 2 years compared with 22.65% for those having excellent SRH. In the adjusted analysis, patients with good, fair, and poor SRH had 1.31 (95% CI 1.21-1.42), 1.82 (95% CI 1.68-1.98), and 2.45 (95% CI 2.22, 2.70) higher hazards of hospitalization, respectively, than those with excellent SRH. Conclusion: SRH was independently associated with subsequent all-cause hospitalizations in patients with BD or MDD. This large study facilitates rapid interpretation of SRH values and underscores the need for proactive SRH screening in this population, which might inform resource allocation and enhance high-risk population detection.

Keywords: severe mental illnesses, hospitalization, risk prediction, patient-reported outcomes

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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Authors: Dany I. Doughan, Nizam S. Najd

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Different governments in today’s global pandemic are approaching the challenging and complex issue of mitigating the spread of the SARS-CoV-2 virus differently while simultaneously considering their national economic and operational bottom lines. One of the most notable successes has been Taiwan's multifaceted virus containment approach, which resulted in a substantially lower incidence rate compared to Sweden’s chief mitigation tactic of herd immunity. From a classic Swiss Cheese Model perspective, integrating more fail-safe layers of defense against the virus in Taiwan’s approach compared to Sweden’s meant that in Taiwan, the government did not have to resort to extreme measures like the national lockdown Sweden is currently contemplating. From an optimized virus spread mitigation solution development standpoint using the Solutions Principle, the Taiwanese and Swedish solutions were desirable economically by businesses that remained open and non-economically or socially by individuals who enjoyed fewer disruptions from what they considered normal before the pandemic. Out of the two, the Taiwanese approach was more feasible long-term from a workforce management and quality control perspective for healthcare facilities and their professionals who were able to provide better, longer, more attentive care to the fewer new positive COVID-19 cases. Furthermore, the Taiwanese approach was more applicable as an overall model to emulate thanks in part to its short-term and long-term multilayered approach, which allows for the kind of flexibility needed by other governments to fully or partially adapt or adopt said, model. The Swedish approach, on the other hand, ignored the biochemical nature of the virus and relied heavily on short-term personal behavioral adjustments and conduct modifications, which are not as reliable as establishing required societal norms and awareness programs. The available international data on COVID-19 cases and the published governmental approaches to control the spread of the coronavirus support a better fit into the Solutions Principle of Taiwan’s Swiss Cheese Model success story compared to Sweden’s.

Keywords: coronavirus containment and mitigation, solutions principle, Swiss Cheese Model, viral mutation

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Authors: Samane Maroufi, Rasoul Khayyam Nekouei, Sajjad Mofarah

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Fabrication of the state-of-the-art portable pseudocapacitors with the desired transparency, mechanical flexibility, capacitance, and durability is challenging. In most cases, the fabrication of such devices requires critical elements which are either under the crisis of depletion or their extraction from virgin mineral ores have sever environmental impacts. This urges the use of secondary resources instead of virgin resources in fabrication of advanced devices. In this research, ultrathin films of defect-rich Mn1−x−y(CexLay)O2−δ with controllable thicknesses in the range between 5 nm to 627 nm and transmittance (≈29–100%) have been fabricated via an electrochemical chronoamperometric deposition technique using an aqueous precursor derived during the selective purification of rare earth oxide (REOs) isolated from end-of-life nickel-metal hydride (Ni-MH) batteries. Intercalation/de-intercalation of anionic O2− through the atomic tunnels of the stratified Mn1−x−y(CexLay)O2−δ crystallites was found to be responsible for outstanding areal capacitance of 3.4 mF cm−2 of films with 86% transmittance. The intervalence charge transfer among interstitial Ce/La cations and Mn oxidation states within the Mn1−x−y(CexLay)O2−δ structure resulted in excellent capacitance retention of ≈90% after 16 000 cycles. The synthesised transparent flexible Mn1−x−y(CexLay)O2−δ full-cell pseudocapacitor device possessed the energy and power densities of 0.088 μWh cm⁻² and 843 µW cm⁻², respectively. These values show insignificant changes under vigorous twisting and bending to 45–180° confirming these value-added materials are intriguing alternatives for size-sensitive energy storage devices. This research confirms the feasibility of utilisation of secondary waste resources for the fabrication of high-quality pseudocapacitors with engineered defects with the desired flexibility, transparency, and cycling stability suitable for size-sensitive portable electronic devices.

Keywords: pseudocapacitors, energy storage devices, flexible and transparent, sustainability

Procedia PDF Downloads 87

Authors: Tonya P. Bowers

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Background: The community/patient-focused quality improvement (QI) project has resolved a clinical problem using a quantitative design evaluating behavior change practices in a convenience sample from a multi-cultural congregation in a faith-based setting. AD is a legal document that speaks for the patient when they are unable to speak for themselves. The AD provides detailed information regarding critical medical decisions on behalf of the patient if they’re unable to make decisions themselves. The goal of an AD is to improve EOL care renderings that align with the patient’s desires. The AD diminishes anxiety and stress associated with making difficult EOL care decisions for patients and their families. Method: The project has two intervention strategies: pre-intervention and post-intervention formative surveys and a final summative survey. Most of the data collection takes place during implementation. The Let’s Talk About It Program utilized an online meeting platform for presentation. Participants were asked to complete informed consent and surveys via an online portal. Education included slide presentation, Advance Directive demonstration, video clips, discussions and 1:1 assistance with AD completion with a project manager. Results: Considering the overwhelming likelihood responses where 87.5% identified they “definitely would” hold an End-Of-Life conversation with their healthcare provider or family, and 81.25% indicated their likelihood that they “definitely would” complete an advance directive. In addition, the final summative post-intervention survey (n-14) also demonstrated an overwhelming 93% positive response. Which undoubtedly demonstrates favorable outcomes for the project. Conclusion: the Let’s Talk About It Program demonstrated effectiveness in improving participants' attitudes and acceptance towards Advance Directives and expanding End-of-Life care discussions. Emphasis on program sustainment within the church is imperative in fostering continued awareness and improved health outcomes for the local community with low health literacy.

Keywords: advance directive, end of life, advance care planning, palliative care, low health literacy, faith-based

Procedia PDF Downloads 211