Search results for: hospital waste
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4970

Search results for: hospital waste

4520 Admission C-Reactive Protein Serum Levels and In-Hospital Mortality in the Elderly Admitted to the Acute Geriatrics Department

Authors: Anjelika Kremer, Irina Nachimov, Dan Justo

Abstract:

Background: C-reactive protein (CRP) serum levels are commonly measured in hospitalized patients. Elevated admission CRP serum levels and in-hospital mortality has been seldom studied in the general population of elderly patients admitted to the acute Geriatrics department. Methods: A retrospective cross-sectional study was conducted at a tertiary medical center. Included were all elderly patients (age 65 years or more) admitted to a single acute Geriatrics department from the emergency room between April 2014 and January 2015. CRP serum levels were measured routinely in all patients upon the first 24 hours of admission. A logistic regression analysis was used to study if admission CRP serum levels were associated with in-hospital mortality independent of age, gender, functional status, and co-morbidities. Results: Overall, 498 elderly patients were included in the analysis: 306 (61.4%) female patients and 192 (38.6%) male patients. The mean age was 84.8±7.0 years (median: 85 years; IQR: 80-90 years). The mean admission CRP serum levels was 43.2±67.1 mg/l (median: 13.1 mg/l; IQR: 2.8-51.7 mg/l). Overall, 33 (6.6%) elderly patients died during the hospitalization. A logistic regression analysis showed that in-hospital mortality was independently associated with history of stroke (p < 0.0001), heart failure (p < 0.0001), and admission CRP serum levels (p < 0.0001) – and to a lesser extent with age (p = 0.042), collagen vascular disease (p=0.011), and recent venous thromboembolism (p=0.037). Receiver operating characteristic (ROC) curve showed that admission CRP serum levels predict in-hospital mortality fairly with an area under the curve (AUC) of 0.694 (p < 0.0001). Cut-off value with maximal sensitivity and specificity was 19.7 mg/L. Conclusions: Admission CRP serum levels may be used to predict in-hospital mortality in the general population of elderly patients admitted to the acute Geriatrics department.

Keywords: c-reactive protein, elderly, mortality, prediction

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4519 Urban Household Waste Disposal Modes and Their Determinants: Evidence from Bure Town, North-Western Ethiopia

Authors: Mastawal Melese, Yismaw Assefa

Abstract:

This study aims to identify household-level determinants of solid waste disposal (SWD) practices in Bure Town, north-western Ethiopia. Using a cross-sectional design and a mixed-methods approach, data were collected from 238 randomly selected households through structured interviews, focus group discussions, and field observations. Descriptive analysis revealed that 14.7% of households used composting as a primary SWD method, 37.4% practiced open dumping, 25.6% used burning, and 22.3% resorted to burial. Multinomial logistic regression showed that factors such as monthly income, age, family size, length of residence, sex, home ownership, solid waste sorting procedures, and education significantly influenced the choice of disposal method. Households with lower education, income, home ownership, and shorter residence times were more likely to use improper disposal methods. Females were found to be more likely to engage in better waste disposal practices than males. These findings underscore the need for context-specific interventions in newly developing towns to enhance household-level SWM systems by addressing key socio-economic factors.

Keywords: multinomial logistic regression, solid waste management, solid waste disposal, urban household

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4518 Knowledge and Practices on Waste Disposal Management Among Medical Technology Students at National University – Manila

Authors: John Peter Dacanay, Edison Ramos, Cristopher James Dicang

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Waste management is a global concern due to increasing waste production from changing consumption patterns and population growth. Proper waste disposal management is a critical aspect of public health and environmental protection. In the healthcare industry, medical waste is generated in large quantities, and if not disposed of properly, it poses a significant threat to human health and the environment. Efficient waste management conserves natural resources and prevents harm to human health, and implementing an effective waste management system can save human lives. The study aimed to assess the level of awareness and practices on waste disposal management, highlighting the understanding of proper disposal, potential hazards, and environmental implications among Medical Technology students. This would help to provide more recommendations for improving waste management practices in healthcare settings as well as for better waste management practices in educational institutions. From the collected data, a female of 21 years of age stands out among the respondents. With the frequency and percentage of medical technology students' knowledge of laboratory waste management being high, it indicates that all respondents demonstrated a solid understanding of proper disposal methods, regulations, risks, and handling procedures related to laboratory waste. That said, the findings emphasize the significance of education and awareness programs in equipping individuals involved in laboratory practices with the necessary knowledge to handle and dispose of hazardous and infectious waste properly. Most respondents demonstrate positive practices or are highly mannered in laboratory waste management, including proper segregation and disposal in designated containers. However, there are concerns about the occasional mixing of waste types, emphasizing the reiteration of proper waste segregation. Students show a strong commitment to using personal protective equipment and promptly cleaning up spills. Some students admit to improper disposal due to rushing, highlighting the importance of time management and safety prioritization. Overall, students follow protocols for hazardous waste disposal, indicating a responsible approach. The school's waste management system is perceived as adequate, but continuous assessment and improvement are necessary. Encouraging reporting of issues and concerns is crucial for ongoing improvement and risk mitigation. The analysis reveals a moderate positive relationship between the respondents' knowledge and practices regarding laboratory waste management. The statistically significant correlation with a p-value of 0.26 (p-value 0.05) suggests that individuals with higher levels of knowledge tend to exhibit better practices. These findings align with previous research emphasizing the pivotal role of knowledge in influencing individuals' behaviors and practices concerning laboratory waste management. When individuals possess a comprehensive understanding of proper procedures, regulations, and potential risks associated with laboratory waste, they are more inclined to adopt appropriate practices. Therefore, fostering knowledge through education and training is essential in promoting responsible and effective waste management in laboratory settings.

Keywords: waste disposal management, knowledge, attitude, practices

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4517 Hazardous Waste Management at Chemistry Section in Dubai Police Forensic Lab

Authors: Adnan Lanjawi

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This paper is carried out to investigate the management of hazardous waste in the chemistry section which belongs to Dubai Police forensic laboratory. The chemicals are the main contributor toward the accumulation of hazardous waste in the section. This is due to the requirement to use it in analysis, such as of explosives, drugs, inorganic and fire debris cases. This leads to negative effects on the environment and to the employees’ health and safety. The research investigates the quantity of chemicals there, the labels, the storage room and equipment used. The target is to reduce the need for disposal by looking at alternative options, such as elimination, substitution and recycling. The data was collected by interviewing the top managers there who have been working in the lab more than 20 years. Also, data was collected by observing employees and how they carry out experiments. Therefore, a survey was made to assess their knowledge about the hazardous waste. The management of hazardous chemicals in the chemistry section needs to be improved. The main findings illustrate that about 110 bottles of reference substances were going to be disposed of in 2014. These bottles were bought for about 100,000 UAE Dirhams (£17,600). This means that the management of substances purchase is not organised. There is no categorisation programme in place, which makes the waste control very difficult. In addition, the findings show that chemical are segregated according to alphabetical order, whereas the efficient way is to separate them according to their nature and property. In addition, the research suggested technology and experiments to follow to reduce the need for using solvents and chemicals in the sample preparation.

Keywords: control, hazard, laboratories, waste,

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4516 Sorption Properties of Biological Waste for Lead Ions from Aqueous Solutions

Authors: Lucia Rozumová, Ivo Šafařík, Jana Seidlerová, Pavel Kůs

Abstract:

Biosorption by biological waste materials from agriculture industry could be a cost-effective technique for removing metal ions from wastewater. The performance of new biosorbent systems, consisting of the waste matrixes which were magnetically modified by iron oxide nanoparticles, for the removal of lead ions from an aqueous solution was tested. The use of low-cost and eco-friendly adsorbents has been investigated as an ideal alternative to the current expensive methods. This article deals with the removal of metal ions from aqueous solutions by modified waste products - orange peels, sawdust, peanuts husks, used tea leaves and ground coffee sediment. Magnetically modified waste materials were suspended in methanol and then was added ferrofluid (magnetic iron oxide nanoparticles). This modification process gives the predictions for the formation of the smart materials with new properties. Prepared material was characterized by using scanning electron microscopy, specific surface area and pore size analyzer. Studies were focused on the sorption and desorption properties. The changes of iron content in magnetically modified materials after treatment were observed as well. Adsorption process has been modelled by adsorption isotherms. The results show that magnetically modified materials during the dynamic sorption and desorption are stable at the high adsorbed amount of lead ions. The results of this study indicate that the biological waste materials as sorbent with new properties are highly effective for the treatment of wastewater.

Keywords: biological waste, sorption, metal ions, ferrofluid

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4515 Effect on Surface Temperature Reduction of Asphalt Pavements with Cement–Based Materials Containing Ceramic Waste Powder

Authors: H. Higashiyama, M. Sano, F. Nakanishi, M. Sugiyama, O. Takahashi, S. Tsukuma

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The heat island phenomenon becomes one of the environmental problems. As countermeasures in the field of road engineering, cool pavements such as water retaining pavements and solar radiation reflective pavements have been developed to reduce the surface temperature of asphalt pavements in the hot summer climate in Japan. The authors have studied on the water retaining pavements with cement–based grouting materials. The cement–based grouting materials consist of cement, ceramic waste powder, and natural zeolite. The ceramic waste powder is collected through the recycling process of electric porcelain insulators. In this study, mixing ratio between the ceramic waste powder and the natural zeolite and a type of cement for the cement–based grouting materials is investigated to measure the surface temperature of asphalt pavements in the outdoor. All of the developed cement–based grouting materials were confirmed to effectively reduce the surface temperature of the asphalt pavements. Especially, the cement–based grouting material using the ultra–rapid hardening cement with the mixing ratio of 0.7:0.3 between the ceramic waste powder and the natural zeolite reduced mostly the surface temperature by 20 °C and more.

Keywords: ceramic waste powder, natural zeolite, road surface temperature, water retaining pavements

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4514 A Study on the Pressure Void Ratio Relationship for Waste Material

Authors: Aktan Ozsoy, Ali Fırat Cabalar, Eyyub Karakan

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Climate change is one of the biggest issues facing communities. Increasing population, growing economies, rapid industrialization are the main factors triggering it. On the other hand, the millions of tons of waste have generated by the period of rapid global growth not only harm to the environment but also lead to the use of valuable lands around the world as landfill sites. Moreover, it is rapidly consuming our resources and this forcing the human population and wildlife to share increasingly shrinking space. In this direction, it is vital to reuse waste materials with a sustainability philosophy. This study was carried out to contribute to the combat against climate change, conserve our natural resources and the environment. An oedometer (consolidation) test was performed on two waste materials combined in certain proportions to evaluate their sustainable usage. Crushed brick (BD) was mixed with rock powder (RP) in 0, 5, 10, 20, 30, 40, and 50% (dry weight of soil). The results obtained revealed the importance of the gradation of the material used in the consolidation test. It was found that there was a negligible difference between the initial and final void ratio of mixtures with brick dust added.

Keywords: waste material, oedometer test, environmental geotechnics, sustainability

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4513 Smart Card Technology Adaption in a Hospital Setting

Authors: H. K. V. Narayan

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This study was conducted at Tata Memorial Hospital (TMH), Mumbai, India. The study was to evaluate the impact of adapting Smart Card (SC) for clinical and business transactions in order to reduce Lead times and to enforce business rules of the hospital. The objective for implementing the Smart Card was to improve the patient perception of quality in terms of structures process and outcomes and also to improve the productivity of the Institution. The Smart Card was implemented in phases from 2011 and integrated with the Hospital Information System (HIS/EMR). The implementation was a learning curve for all the stake holders as software obviated the need to use hardcopies of transactions. The acceptability to the stake holders was challenge in change management. The study assessed the impact 3 years into the implementation and the observed trends have suggested that it has decreased the lead times for services and increased the no of transactions and thereby the productivity. Patients who used to complain of multiple queues and cumbersome transactions now compliment the administration for effective use of Information and Communication Technology.

Keywords: smart card, high availability of health care information, reduction in potential medical errors due to elimination of transcription errors, reduction in no of queues, increased transactions, augmentation of revenue

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4512 Patient Outcomes Following Out-of-Hospital Cardiac Arrest

Authors: Scott Ashby, Emily Granger, Mark Connellan

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Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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4511 Analysis of the Effect of Increased Self-Awareness on the Amount of Food Thrown Away

Authors: Agnieszka Dubiel, Artur Grabowski, Tomasz Przerywacz, Mateusz Roganowicz, Patrycja Zioty

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Food waste is one of the most significant challenges humanity is facing nowadays. Every year, reports from global organizations show the scale of the phenomenon, although society's awareness is still insufficient. One-third of the food produced in the world is wasted at various points in the food supply chain. Wastes are present from the delivery through the food preparation and distribution to the end of the sale and consumption. The first step in understanding and resisting the phenomenon is a thorough analysis of the everyday behaviors of humanity. This concept is understood as finding the correlation between the type of food and the reason for throwing it out and wasting it. Those actions were identified as a critical step in the start of work to develop technology to prevent food waste. In this paper, the problem mentioned above was analyzed by focusing on the inhabitants of Central Europe, especially Poland, aged 20-30. This paper provides an insight into collecting data through dedicated software and an organized database. The proposed database contains information on the amount, type, and reasons for wasting food in households. A literature review supported the work to answer research questions, compare the situation in Poland with the problem analyzed in other countries, and find research gaps. The proposed article examines the cause of food waste and its quantity in detail. This review complements previous reviews by emphasizing social and economic innovation in Poland's food waste management. The paper recommends a course of action for future research on food waste management and prevention related to the handling and disposal of food, emphasizing households, i.e., the last link in the supply chain.

Keywords: food waste, food waste reduction, consumer food waste, human-food interaction

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4510 Modelling a Hospital as a Queueing Network: Analysis for Improving Performance

Authors: Emad Alenany, M. Adel El-Baz

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In this paper, the flow of different classes of patients into a hospital is modelled and analyzed by using the queueing network analyzer (QNA) algorithm and discrete event simulation. Input data for QNA are the rate and variability parameters of the arrival and service times in addition to the number of servers in each facility. Patient flows mostly match real flow for a hospital in Egypt. Based on the analysis of the waiting times, two approaches are suggested for improving performance: Separating patients into service groups, and adopting different service policies for sequencing patients through hospital units. The separation of a specific group of patients, with higher performance target, to be served separately from the rest of patients requiring lower performance target, requires the same capacity while improves performance for the selected group of patients with higher target. Besides, it is shown that adopting the shortest processing time and shortest remaining processing time service policies among other tested policies would results in, respectively, 11.47% and 13.75% reduction in average waiting time relative to first come first served policy.

Keywords: queueing network, discrete-event simulation, health applications, SPT

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4509 An Overview of Sludge Utilization into Fired Clay Brick

Authors: Aeslina Binti Abdul Kadir, Ahmad Shayuti Bin Abdul Rahim

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Brick is one of the most common masonry units used as building material. Due to the demand, different types of waste have been investigated to be incorporated into the bricks. Many types of sludge have been incorporated in fired clay brick for example marble sludge, stone sludge, water sludge, sewage sludge, and ceramic sludge. The utilization of these waste materials in fired clay bricks usually has positive effects on the properties such as lightweight bricks with improved shrinkage, porosity, and strength. This paper reviews on utilization of different types of sludge wastes into fired clay bricks. Previous investigations have demonstrated positive effects on the physical and mechanical properties as well as less impact towards the environment. Thus, the utilizations of sludge waste could produce a good quality of brick and could be one of alternative disposal methods for the sludge wastes.

Keywords: fired clay brick, sludge waste, compressive strength, shrinkage, water absorption

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4508 Effect of Fortification of Expressed Human Breast Milk with Olive Oil and Skimmed Milk in Improving Weight Gain in Very Low Birth Weight Neonates and Shortening Their Length of Hospital Stay

Authors: Sumrina Kousar

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Objective: The aim of this study was to observe the effect of fortification of expressed human breast milk with olive oil and skimmed milk in improving weight gain in very low birth weight neonates and shortening their length of hospital stay. Study Design and place: A randomized controlled trial was carried out at the Combined Military Hospital Lahore from March 2018 to March 2019. Methods: Neonates admitted with very low birth weight and gestational age of < 34 weeks were included in the study. Sixty babies were enrolled using non-probability consecutive sampling; a random number table was used to allocate them into a fortification group and a control group. The control group received expressed milk alone, while olive oil 1 ml twice daily and skimmed milk 1 gram in every third feed were added to expressed milk in the fortification group. Data was analyzed on SPSS 20. Proportions were compared by applying the chi-square test. An independent sample t-test was applied for comparing means. A p-value of ≤ 0.05 was considered significant. Results: The study comprised of 60 neonates, with 30 in each of the groups. Weight gain was 24.83±5.63 in the fortification group and 11.72±3.95 in the control group (p =< 0.001). Mean hospital stay was 20.5716.511 in the fortification group and 27.678.89 in the control group (p =< 0.043). Conclusion: Olive oil and skimmed milk fortification of breast milk was effective for weight gain and reducing the length of hospital stay in very low birth weight neonates.

Keywords: fortification, olive oil, skimmed milk, weight gain

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4507 Waste Recovery: A Sustainable Way for Application of Solid Waste from WTP's in Building Materials

Authors: Flavio Araujo, Livia Dias, Fabiolla Lima, Paulo Scalize, Antonio Albuquerque

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Water treatment residues (WTR) are solid waste produced during drinking water treatment and have recently been seen as a reusable material. The aim of this research was show how to use the residue generated in a Water Treatment Plant, located in Goiania, Brazil, following the considerations of the law of solid waste to obtain normative parameters and consider sustainable alternatives for reincorporation of the residues in the productive chain for manufacturing various materials construction. In order to reduce the environmental liabilities generated by sanitation companies and discontinue unsustainable forms of disposal. The analyzes performed: Granulometry, Scanning Electron Microscopy and X-Ray Diffraction demonstrated the potential application of residues to replace the soil and sand, because it has characteristics compatible with small aggregate and can be used as feedstock for the manufacture of materials as ceramic and soil-cement bricks, mortars, interlocking floors and concrete artifacts.

Keywords: residue, sustainable, water treatment plants, WTR, WTP

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4506 Municipal Solid Waste Management in an Unplanned Hill Station in India

Authors: Moanaro Ao, Nzanthung Ngullie

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Municipal solid waste management (MSWM) has unique challenges in hilly urban settlements. Efforts have been taken by municipalities, private players, non-governmental organizations, etc. for managing solid waste by preventing its generation, reusing, and recovering them into useful products to the extent possible, thereby minimizing its impact on the environment and human health. However, there are many constraints that lead to inadequate management of solid waste. Kohima is an unplanned hill station city in the North Eastern Region of India. The city is facing numerous issues due to the mismanagement of the MSW generated. Kohima Municipal Council (KMC) is the Urban Local Body (ULB) responsible for providing municipal services. The present MSWM system in Kohima comprises of collection, transportation, and disposal of waste without any treatment. Several efforts and experimental projects on waste management have been implemented without any success. Waste management in Kohima city is challenging due to its remote location, difficult topography, dispersed settlements within the city, sensitive ecosystem, etc. Furthermore, the narrow road network in Kohima with limited scope for expansion, inadequate infrastructure facilities, and financial constraints of the ULB add up to the problems faced in managing solid waste. This hill station also has a unique system of traditional local self-governance. Thus, shifting from a traditional system to a modern system in implementing systematic and scientific waste management is also a challenge in itself. This study aims to analyse the existing situation of waste generation, evaluate the effectiveness of the existing management system of MSW, and evolve a strategic approach to achieve a sustainable and resilient MSWM system. The results from the study show that a holistic approach, including social aspects, technical aspects, environmental aspects, and financial aspects, is needed to reform the MSWM system. Stringent adherence to source segregation is required by encouraging public participation through awareness programs. Active involvement of community-based organizations (CBOs) has brought a positive change in sensitizing the public. A waste management model was designed to be adopted at a micro-level such as composting household biodegradable waste and incinerator plants at the community level for non-biodegradable waste. Suitable locations for small waste stations were identified using geographical information system (GIS) tools for waste recovery and recycling. Inculcating the sense of responsibility in every waste generator towards waste management by implementing incentive-based strategies at the Ward level was explored. Initiatives based on the ‘polluters pay principle’ were also explored to make the solid waste management model “self-sustaining”.

Keywords: municipal solid waste management, public participation, source segregation, sustainable

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4505 Investigation of the Mechanical Performance of Hot Mix Asphalt Modified with Crushed Waste Glass

Authors: Ayman Othman, Tallat Ali

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The successive increase of generated waste materials like glass has led to many environmental problems. Using crushed waste glass in hot mix asphalt paving has been though as an alternative to landfill disposal and recycling. This paper discusses the possibility of utilizing crushed waste glass, as a part of fine aggregate in hot mix asphalt in Egypt. This is done through evaluation of the mechanical properties of asphalt concrete mixtures mixed with waste glass and determining the appropriate glass content that can be adapted in asphalt pavement. Four asphalt concrete mixtures with various glass contents, namely; 0%, 4%, 8% and 12% by weight of total mixture were studied. Evaluation of the mechanical properties includes performing Marshall stability, indirect tensile strength, fracture energy and unconfined compressive strength tests. Laboratory testing had revealed the enhancement in both compressive strength and Marshall stability test parameters when the crushed glass was added to asphalt concrete mixtures. This enhancement was accompanied with a very slight reduction in both indirect tensile strength and fracture energy when glass content up to 8% was used. Adding more than 8% of glass causes a sharp reduction in both indirect tensile strength and fracture energy. Testing results had also shown a reduction in the optimum asphalt content when the waste glass was used. Measurements of the heat loss rate of asphalt concrete mixtures mixed with glass revealed their ability to hold heat longer than conventional mixtures. This can have useful application in asphalt paving during cold whether or when a long period of post-mix transportation is needed.

Keywords: waste glass, hot mix asphalt, mechanical performance, indirect tensile strength, fracture energy, compressive strength

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4504 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit

Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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4503 Recovery of Post-Consumer PET Bottles in a Composite Material Preparation

Authors: Rafenomananjara Tsinjo Nirina, Tomoo Sekito, Andrianaivoravelona Jaconnet Oliva

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Manufacturing a composite material from post-consumer bottles is an interesting outlet since Madagascar is still facing the challenges of managing plastic waste on the one hand and appropriate waste treatment facilities are not yet developed on the other hand. New waste management options are needed to divert End-Of-Life (EOL) soft plastic wastes from landfills and incineration. Waste polyethylene terephthalate (PET) bottles might be considered as a valuable resource and recovered into polymer concrete. The methodology is easy to implement and appropriate to the local context in Madagascar. This approach will contribute to the production of ecological building materials that might be profitable for the environment and the construction sector. This work aims to study the feasibility of using the post-consumer PET bottles as an alternative binding agent instead of the conventional Portland cement and water. Then, the mechanical and physical properties of the materials were evaluated.

Keywords: PET recycling, polymer concrete, ecological building materials, pollution mitigation

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4502 Evaluation of Radiological Health Danger Indices Arising from Diagnostic X-Ray Rooms

Authors: Jessica Chukwuyem Molua, Collins O Molua

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The effective dose of selected health care workers who are constantly exposed to X-ray radiation was measured using thermoluminescence dosimeters (TLD) placed over the lead apron at the chest region in all categories of medical personnel investigated. To measure radiation in all the selected hospitals to ascertain the exposure of x-ray machines at exactly 1m from the primary source. The work was carried out within a year in each of the selected centers. The personnel examination records containing the type of examination each day, peak tube voltage, tube current, and exposure time, including the actual number of films used, were obtained. A total of 40personel were examined in government hospital Agbor, 21 in central hospital Owa Alero and 18 in Okonye hospital The method used here has also been used by other researchers. Findings showed that the results obtained from the three hospitals investigated in this work were found to conform with the recommendations of the National Commission on radiological and protection {NCRP} 70 and 116 protocols. The Radiologist in the three study areas has the highest dose level, but of particular note is the dosage of the radiologist in Okonye hospital. This, as observed, is because the protective shielding parameters were inadequate and this could result in severe health consequences over time.

Keywords: radiology, health, Agbor, Owa

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4501 Development and Analysis of Waste Human Hair Fiber Reinforced Composite

Authors: Tesfaye Worku

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Human hair, chicken feathers, and hairs of other birds and animals are commonly described as waste products, and the currently available disposal methods, such as burying and burning these waste products, are contributing to environmental pollution. However, those waste products are used to develop fiber-reinforced textile composite material. In this research work, the composite was developed using human hair fiber and analysis of the mechanical and physical properties of the developed composite sample. A composite sample was made with different ratios of human hair and unsaturated polyester resin, and an analysis of the mechanical and physical properties of the developed composite sample was tested according to standards. The fabricated human hair fibers reinforced polymer matrix composite sample has given encouraging results in terms of high strength and rigidity for lightweight house ceiling board material.

Keywords: composite, human hair fiber, matrix, unsaturated polyester

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4500 Dewatering of Brewery Sludge through the Use of Biopolymers

Authors: Audrey Smith, M. Saifur Rahaman

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The waste crisis has become a global issue, forcing many industries to reconsider their disposal methods and environmental practices. Sludge is a form of waste created in many fields, which include water and wastewater, pulp and paper, as well as from breweries. The composition of this sludge differs between sources and can, therefore, have varying disposal methods or future applications. When looking at the brewery industry, it produces a significant amount of sludge with a high water content. In order to avoid landfilling, this waste can further be processed into a valuable material. Specifically, the sludge must undergo dewatering, a process which typically involves the addition of coagulants like aluminum sulfate or ferric chloride. These chemicals, however, limit the potential uses of the sludge since it will contain traces of metals. In this case, the desired outcome of the brewery sludge would be to produce animal feed; however, these conventional coagulants would add a toxic component to the sludge. The use of biopolymers like chitosan, which act as a coagulant, can be used to dewater brewery sludge while allowing it to be safe for animal consumption. Chitosan is also a by-product created by the shellfish processing industry and therefore reduces the environmental imprint since it involves using the waste from one industry to treat the waste from another. In order to prove the effectiveness of this biopolymer, experiments using jar-tests will be utilised to determine the optimal dosages and conditions, while variances of contaminants like ammonium will also be observed. The efficiency of chitosan can also be compared to other polysaccharides to determine which is best suited for this waste. Overall a significant separation has been achieved between the solid and liquid content of the waste during the coagulation-flocculation process when applying chitosan. This biopolymer can, therefore, be used to dewater brewery sludge such that it can be repurposed as animal feed. The use of biopolymers can also be applied to treat sludge from other industries, which can reduce the amount of waste produced and allow for more diverse options for reuse.

Keywords: animal feed, biopolymer, brewery sludge, chitosan

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4499 Investigating the Thermal Characteristics of Reclaimed Solid Waste from a Landfill Site Using Thermogravimetry

Authors: S. M. Al-Salem, G.A. Leeke, H. J. Karam, R. Al-Enzi, A. T. Al-Dhafeeri, J. Wang

Abstract:

Thermogravimetry has been popularized as a thermal characterization technique since the 1950s. It aims at investigating the weight loss against both reaction time and temperature, whilst being able to characterize the evolved gases from the volatile components of the organic material being tested using an appropriate hyphenated analytical technique. In an effort to characterize and identify the reclaimed waste from an unsanitary landfill site, this approach was initiated. Solid waste (SW) reclaimed from an active landfill site in the State of Kuwait was collected and prepared for characterization in accordance with international protocols. The SW was segregated and its major components were identified after washing and air drying. Shredding and cryomilling was conducted on the plastic solid waste (PSW) component to yield a material that is representative for further testing and characterization. The material was subjected to five heating rates (b) with minimal repeatable weight for high accuracy thermogravimetric analysis (TGA) following the recommendation of the International Confederation for Thermal Analysis and Calorimetry (ICTAC). The TGA yielded thermograms that showed an off-set from typical behavior of commercial grade resin which was attributed to contact of material with soil and thermal/photo-degradation.

Keywords: polymer, TGA, pollution, landfill, waste, plastic

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4498 The Composting Process from a Waste Management Method to a Remediation Procedure

Authors: G. Petruzzelli, F. Pedron, M. Grifoni, F. Gorini, I. Rosellini, B. Pezzarossa

Abstract:

Composting is a controlled technology to enhance the natural aerobic process of organic wastes degradation. The resulting product is a humified material that is principally recyclable for agricultural purpose. The composting process is one of the most important tools for waste management, by the European Community legislation. In recent years composting has been increasingly used as a remediation technology to remove biodegradable contaminants from soil, and to modulate heavy metals bioavailability in phytoremediation strategies. An optimization in the recovery of resources from wastes through composting could enhance soil fertility and promote its use in the remediation biotechnologies of contaminated soils.

Keywords: agriculture, biopile, compost, soil clean-up, waste recycling

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4497 Spatial Assessment of Soil Contamination from Informal E-Waste Recycling Site in Agbogbloshie, Ghana

Authors: Kyere Vincent Nartey, Klaus Greve, Atiemo Sampson

Abstract:

E-waste is discarded electrical electronic equipment inclusive of all components, sub-assemblies and consumables which are part of the product at the time of discarding and known to contain both hazardous and valuable fractions. E-waste is recycled within the proposed ecological restoration of the Agbogbloshie enclave using crude and rudimental recycling procedures such as open burning and manual dismantling which result in pollution and contamination of soil, water and air. Using GIS, this study was conducted to examine the spatial distribution and extent of soil contamination by heavy metals from the e-waste recycling site in Agbogbloshie. From the month of August to November 2013, 146 soil samples were collected in addition to their coordinates using GPS. Elemental analysis performed on the collected soil samples using X-Ray fluorescence revealed over 30 elements including, Ni, Cr, Zn, Cu, Pb and Mn. Using geostatistical techniques in ArcGIS 10.1 spatial assessment and distribution maps were generated. Mathematical models or equations were used to estimate the degree of contamination and pollution index. Results from soil analysis from the Agbogbloshie enclave showed that levels of measured or observed elements were significantly higher than the Canadian EPA and Dutch environmental standards.

Keywords: e-waste, geostatistics, soil contamination, spatial distribution

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4496 The Importance and Feasibility of Hospital Interventions for Patient Aggression and Violence Against Physicians in China: A Delphi Study

Authors: Yuhan Wu, CTB (Kees) Ahaus, Martina Buljac-Samardzic

Abstract:

Patient aggression and violence is a complex occupational hazards for physicians working in hospitals, and it can have multiple severe negative effects for physicians and hospitals. Although there is a range of interventions in the healthcare sector applied in various countries, China lacks a comprehensive set of interventions at the hospital level in this area. Therefore, due to cultural differences, this study investigates whether international interventions are important and feasible in the Chinese cultural context by conducting a Delphi study. Based on a literature search, a list of 47 hospital interventions to prevent and manage patient aggression and violence was constructed, including 8 categories: hospital environment design, access and entrance, staffing and work practice, training and education, leadership and culture, support, during/after-the-event actions, and hospital policy. The list of interventions will be refined, extended and brought back during a three-round Delphi study. The panel consists of 17 Chinese experts, including physicians experiencing patient aggression and violence, hospital management team members, scientists working in this research area, and policymakers in the healthcare sector. In each round, experts will receive the possible interventions with the instruction to indicate the importance and feasibility of each intervention for preventing and managing patient violence and aggression in Chinese hospitals. Experts will be asked about the importance and feasibility of interventions for patient violence and aggression at the same time. This study will exclude or include interventions based on the score of importance. More specifically, an intervention will be included after each round if >80% of the experts judged it as important or very important and excluded if >50% judged an intervention as not or moderately important. The three-round Delphi study will provide a list of included interventions and assess which of the 8 categories of interventions are considered as important. It is expected that this study can bring new ideas and inspiration to Chinese hospitals in the prevention and management of patient aggression and violence.

Keywords: patient aggression and violence, hospital interventions, feasibility, importance

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4495 Application of Non-Smoking Areas in Hospitals

Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

Abstract:

Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

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4494 Feedback of an Automated Hospital about the Performance of an Automated Drug Dispensing System’s Implementation

Authors: Bouami Hind, Millot Patrick

Abstract:

The implementation of automated devices in life-critical systems such as hospitals can bring a new set of challenges related to automation malfunctions. While automation has been identified as great leverage for the medication dispensing system’s security and efficiency, it also increases the complexity of the organization. In particular, the installation and operation stage of automated devices can be complex when malfunctions related to automated systems occur. This paper aims to document operators’ situation awareness about the malfunctions of automated drug delivery systems (ADCs) during their implementation through Saint Brieuc hospital’s feedback. Our evaluation approach has been deployed in Saint Brieuc hospital center’s pharmacy, which has been equipped with automated nominative drug dispensing systems since January of 2021. The analysis of Saint Brieuc hospital center pharmacy’s automation revealed numerous malfunctions related to the implementation of Automated Delivery Cabinets. It appears that the targeted performance is not reached in the first year of implementation in this case study. Also, errors have been collected in patients' automated treatments’ production such as lack of drugs in pill boxes or nominative carnets, excess of drugs, wrong location of the drug, drug blister damaged, non-compliant sachet, or ticket errors. Saint Brieuc hospital center’s pharmacy is doing a tremendous job of setting up and monitoring performance indicators from the beginning of automation and throughout ADC’s operation to control ADC’s malfunctions and meet the performance targeted by the hospital. Health professionals, including pharmacists, biomedical engineers and directors of work, technical services and safety, are heavily involved in an automation project. This study highlights the importance of the evaluation of ADCs’ performance throughout the implementation process and the hospital’s team involvement in automation supervision and management.

Keywords: life-critical systems, situation awareness, automated delivery cabinets, implementation, risks and malfunctions

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4493 Hospital Malnutrition and its Impact on 30-day Mortality in Hospitalized General Medicine Patients in a Tertiary Hospital in South India

Authors: Vineet Agrawal, Deepanjali S., Medha R., Subitha L.

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Background. Hospital malnutrition is a highly prevalent issue and is known to increase the morbidity, mortality, length of hospital stay, and cost of care. In India, studies on hospital malnutrition have been restricted to ICU, post-surgical, and cancer patients. We designed this study to assess the impact of hospital malnutrition on 30-day post-discharge and in-hospital mortality in patients admitted in the general medicine department, irrespective of diagnosis. Methodology. All patients aged above 18 years admitted in the medicine wards, excluding medico-legal cases, were enrolled in the study. Nutritional assessment was done within 72 h of admission, using Subjective Global Assessment (SGA), which classifies patients into three categories: Severely malnourished, Mildly/moderately malnourished, and Normal/well-nourished. Anthropometric measurements like Body Mass Index (BMI), Triceps skin-fold thickness (TSF), and Mid-upper arm circumference (MUAC) were also performed. Patients were followed-up during hospital stay and 30 days after discharge through telephonic interview, and their final diagnosis, comorbidities, and cause of death were noted. Multivariate logistic regression and cox regression model were used to determine if the nutritional status at admission independently impacted mortality at one month. Results. The prevalence of malnourishment by SGA in our study was 67.3% among 395 hospitalized patients, of which 155 patients (39.2%) were moderately malnourished, and 111 (28.1%) were severely malnourished. Of 395 patients, 61 patients (15.4%) expired, of which 30 died in the hospital, and 31 died within 1 month of discharge from hospital. On univariate analysis, malnourished patients had significantly higher morality (24.3% in 111 Cat C patients) than well-nourished patients (10.1% in 129 Cat A patients), with OR 9.17, p-value 0.007. On multivariate logistic regression, age and higher Charlson Comorbidity Index (CCI) were independently associated with mortality. Higher CCI indicates higher burden of comorbidities on admission, and the CCI in the expired patient group (mean=4.38) was significantly higher than that of the alive cohort (mean=2.85). Though malnutrition significantly contributed to higher mortality on univariate analysis, it was not an independent predictor of outcome on multivariate logistic regression. Length of hospitalisation was also longer in the malnourished group (mean= 9.4 d) compared to the well-nourished group (mean= 8.03 d) with a trend towards significance (p=0.061). None of the anthropometric measurements like BMI, MUAC, or TSF showed any association with mortality or length of hospitalisation. Inference. The results of our study highlight the issue of hospital malnutrition in medicine wards and reiterate that malnutrition contributes significantly to patient outcomes. We found that SGA performs better than anthropometric measurements in assessing under-nutrition. We are of the opinion that the heterogeneity of the study population by diagnosis was probably the primary reason why malnutrition by SGA was not found to be an independent risk factor for mortality. Strategies to identify high-risk patients at admission and treat malnutrition in the hospital and post-discharge are needed.

Keywords: hospitalization outcome, length of hospital stay, mortality, malnutrition, subjective global assessment (SGA)

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4492 Modelling of Organic Rankine Cycle for Waste Heat Recovery Process in Supercritical Condition

Authors: Jahedul Islam Chowdhury, Bao Kha Nguyen, David Thornhill, Roy Douglas, Stephen Glover

Abstract:

Organic Rankine Cycle (ORC) is the most commonly used method for recovering energy from small sources of heat. The investigation of the ORC in supercritical condition is a new research area as it has a potential to generate high power and thermal efficiency in a waste heat recovery system. This paper presents a steady state ORC model in supercritical condition and its simulations with a real engine’s exhaust data. The key component of ORC, evaporator, is modelled using finite volume method, modelling of all other components of the waste heat recovery system such as pump, expander and condenser are also presented. The aim of this paper is to investigate the effects of mass flow rate and evaporator outlet temperature on the efficiency of the waste heat recovery process. Additionally, the necessity of maintaining an optimum evaporator outlet temperature is also investigated. Simulation results show that modification of mass flow rate is the key to changing the operating temperature at the evaporator outlet.

Keywords: Organic Rankine cycle, supercritical condition, steady state model, waste heat recovery

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4491 GeoWeb at the Service of Household Waste Collection in Urban Areas

Authors: Abdessalam Hijab, Eric Henry, Hafida Boulekbache

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The complexity of the city makes sustainable management of the urban environment more difficult. Managers are required to make significant human and technical investments, particularly in household waste collection (focus of our research). The aim of this communication is to propose a collaborative geographic multi-actor device (MGCD) based on the link between information and communication technologies (ICT) and geo-web tools in order to involve urban residents in household waste collection processes. Our method is based on a collaborative/motivational concept between the city and its residents. It is a geographic collaboration dedicated to the general public (citizens, residents, and any other participant), based on real-time allocation and geographic location of topological, geographic, and multimedia data in the form of local geo-alerts (location-specific problems) related to household waste in an urban environment. This contribution allows us to understand the extent to which residents can assist and contribute to the development of household waste collection processes for a better protected urban environment. This suggestion provides a good idea of how residents can contribute to the data bank for future uses. Moreover, it will contribute to the transformation of the population into a smart inhabitant as an essential component of a smart city. The proposed model will be tested in the Lamkansa sampling district in Casablanca, Morocco.

Keywords: information and communication technologies, ICTs, GeoWeb, geo-collaboration, city, inhabitant, waste, collection, environment

Procedia PDF Downloads 128