Search results for: hospital waste management (HWM)

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

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Introduction: To improve early detection and mortality rate of In- Hospital Cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditions and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90mmHg, respiratory rate <8 or > 28 breaths per minute, O2 saturation < 90%, acute change in conscious state, acute chest pain or worried about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in In-Hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in In-Hospital cardiac arrest and overall hospital mortality rate. We conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed Chi -square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010 ,139 calls in 2011 and 245 calls in 2012.The number of ERT calls per 1000 admissions in year 2009-10 was 7.69, 5.61 in 2011 and 9.38 in 2013. The number of Code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, But we have not found difference in overall hospital mortality rate.

Keywords: emergency response team, ERT, cardiac arrest, emergency medicine

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Authors: Benmalek M. Larbi, R. Harbi, S. Boukor

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This paper reports an experimental work that aimed to investigate the effects of clay brick waste, as part of fine aggregate, on rendering mortar performance. The brick, in crushed form, was from a local brick manufacturer that was rejected due to being of-standard. It was used to replace 33.33 %, 50 %, 66.66 % and 100 % by weight of the quarry sand in mortar. Effects of the brick replacement on the mortar key properties intended for wall plastering were investigated; these are workability, compressive strength, flexural strength, linear shrinkage, water absorption by total immersion and by capillary suction. The results showed that as the brick replacement level increased, the mortar workability reduced. The linear shrinkage increases over time and decreases with the introduction of brick waste. The compressive and flexural strengths decrease with the increase of brick waste because of their great water absorption.

Keywords: clay brick waste, mortar, properties, quarry sand

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Authors: Lindiwe Ngcobo

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The aim of the study is to describe and understand the benefits and costs of having biogas digesters at both household and society level. On a household level, the purpose is to understand how rural households benefit from the biogas digesters, for example, by converting animal and human waste through biogas digesters, and at what costs the benefits are realized. At a societal level, the purpose is to understand the costs and benefits of biogas digesters relative to the situation of rural communities who do not have flush toilets and have no appropriate waste disposal services while they incur electricity costs. Multiple regression analysis was used to determine the effect of biogas digesters on electricity availability and waste management. The results showed that beneficiaries spent less on electricity using household waste, and also waste disposal costs were eliminated from household expenses. A move to biogas energy production can be beneficial to rural households. It is economically and environmentally friendly. Small-scale farmers need to be introduced to agricultural innovations that can assist them in producing nutritious crops at a low cost. This can be a good opportunity to start an agribusiness that focuses on organic crops. Extensions and training institutions have to play a part in supporting households to develop entrepreneurial skills. Cost-benefit analysis showed that the benefits of biogas exceed the costs of the biogas projects. This implies that this technology should be promoted in rural households. Government financial incentives must be put in place to motivate a generation of organic Agri-prenuers.

Keywords: Agri-prenuers, biogas digester, biogas energy, disposal costs

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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Authors: Harini Chakkera

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Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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Authors: Junzhang Wu, Yifeng Zou, Alessandro Manzardo, Antonio Scipioni

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Dynamic expiration dates (DEDs) play an essential role in reducing food waste in the context of the sustainable cold chain and food system. However, it is unknown for the trades-off in retail benefits when setting an expiration date on fresh food products. This study aims to develop a multi-dimensional decision-making model that integrates DEDs with food waste based on wireless sensor network technology. The model considers the initial quality of fresh food and the change rate of food quality with the storage temperature as cross-independent variables to identify the potential impacts of food waste in retail by applying s DEDs system. The results show that retail benefits from the DEDs system depend on each scenario despite its advanced technology. In the DEDs, the storage temperature of the retail shelf leads to the food waste rate, followed by the change rate of food quality and the initial quality of food products. We found that the DEDs system could reduce food waste when food products are stored at lower temperature areas. Besides, the potential of food savings in an extended replenishment cycle is significantly more advantageous than the fixed expiration dates (FEDs). On the other hand, the information-sharing approach of the DEDs system is relatively limited in improving sustainable assessment performance of food waste in retail and even misleads consumers’ choices. The research provides a comprehensive understanding to support the techno-economic choice of the DEDs associated with food waste in retail.

Keywords: dynamic expiry dates (DEDs), food waste, retail benefits, fixed expiration dates (FEDs)

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Authors: Gen Sakoda, Hideki Takayasu, Misako Takayasu

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Waste reduction is a fundamental problem for sustainability. Methods for waste reduction with point-of-sales (POS) data are proposed, utilizing the knowledge of a recent econophysics study on a statistical property of POS data. Concretely, the non-stationary time series analysis method based on the Particle Filter is developed, which considers abnormal fluctuation scaling known as Taylor's law. This method is extended for handling incomplete sales data because of stock-outs by introducing maximum likelihood estimation for censored data. The way for optimal stock determination with pricing the cost of waste reduction is also proposed. This study focuses on the examination of the methods for large sales numbers where Taylor's law is obvious. Numerical analysis using aggregated POS data shows the effectiveness of the methods to reduce food waste maintaining a high profit for large sales numbers. Moreover, the way of pricing the cost of waste reduction reveals that a small profit loss realizes substantial waste reduction, especially in the case that the proportionality constant  of Taylor’s law is small. Specifically, around 1% profit loss realizes half disposal at =0.12, which is the actual  value of processed food items used in this research. The methods provide practical and effective solutions for waste reduction keeping a high profit, especially with large sales numbers.

Keywords: food waste reduction, particle filter, point-of-sales, sustainable development goals, Taylor's law, time series analysis

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Authors: Ruth Green, Samantha Milton, Rinal Desai

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Background/Aims: Eye pain/swelling/redness is a common presentation to Barnet General Hospital (a district general hospital), pediatric emergency department, and is managed by both the pediatric and emergency teams. The management of each child differs dramatically depending on the healthcare professional who reviews them. There also appears to be confusion in diagnosis between periorbital cellulitis, pre-septal cellulitis, and orbital cellulitis. Pre septal cellulitis refers to an inflammation of the eyelids and soft tissue anterior to the orbital septum. In contrast, orbital cellulitis is a serious, rapidly progressive infection of soft tissues located posterior to the orbital septum. Pre-septal cellulitis is more prevalent and less serious than orbital cellulitis, although it may be part of a continuous spectrum if untreated. Pre-septal cellulitis should there be diagnosed and treated urgently to prevent spread to the septum. For the purpose of the audit, the term periorbital cellulitis has been used as an umbrella term for all spectrums of this infection. The audit aimed to look at, how as a whole, the department is diagnosing and managing orbital and pre-septal cellulitis. Gold Standard: Patients of the same age and diagnosis should be treated with the same medication, advice, and follow-up. Method: Data was collected retrospectively from pediatric patients ( < 18years) who attended the emergency department from June 2019 to February 2020 who had been coded as pre-septal cellulitis, periorbital cellulitis, orbital cellulitis, or eye pain/swelling/redness. Demographics, signs and symptoms, management, and follow-up were recorded for all patients with any of the diagnoses of pre-septal, periorbital, or orbital cellulitis. A Microsoft Excel spreadsheet was used to record the anonymised data. Results: There were vast discrepancies in the diagnosis, management, and follow-up of patients with periorbital cellulitis. Conclusion/Discussion: The audit concluded there is no uniform approach to managing periorbital cellulitis in Barnet General Hospital Paediatric Emergency Department. Healthcare professionals misdiagnosed conjunctivitis as periorbital cellulitis, and adequate steps did not appear to be documented on excluding red flag signs and symptoms of patients presenting. There was no consistency in follow-up, with some patients having timely phone reviews or clinical reviews for mild symptoms. Advice given by the staff was appropriate, and patients did return when symptoms got worse and were treated accordingly. Plan: Given the inconsistency, a gold standard care pathway or local easily accessible clinical guideline can be developed to help with the diagnosis and management of periorbital cellulitis. Along with this, a teaching session can be carried out for the staff of the pediatric team and emergency department to disseminate the teaching. Following the introduction of a guideline and teaching sessions, patients notes can be re-reviewed to check improvement in patient care.

Keywords: periorbital cellulitis, preseptal cellulitis, orbital cellulitis, erythematous eyelid

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Authors: Mehrnoosh Askarizadeh

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People, process and IT are the most important assets of any organization. Optimal utilization of these resources has been the question of research in business for many decades. The business world have responded by inventing various methodologies that can be used for addressing problems of quality improvement, efficiency of processes, continuous improvement, reduction of waste, automation, strategy alignments etc. Some of these methodologies can be commonly called as Business Process Quality Management methodologies (BPQM). In essence, the first references to the process management can be traced back to Frederick Taylor and scientific management. Time and motion study was addressed to improvement of manufacturing process efficiency. The ideas of scientific management were in use for quite a long period until more advanced quality management techniques were developed in Japan and USA. One of the first prominent methods had been Total Quality Management (TQM) which evolved during 1980’s. About the same time, Six Sigma (SS) originated at Motorola as a separate method. SS spread and evolved; and later joined with ideas of Lean manufacturing to form Lean Six Sigma. In 1990’s due to emerging IT technologies, beginning of globalization, and strengthening of competition, companies recognized the need for better process and quality management. Business Process Management (BPM) emerged as a novel methodology that has taken all this into account and helped to align IT technologies with business processes and quality management. In this article we will study various aspects of above mentioned methods and identified their relations.

Keywords: e-process, quality, TQM, BPM, lean, six sigma, CPI, information technology, management

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Authors: Moses Balina, Archbald Bahizi

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Introduction: Early onset neonatal sepsis is a systemic infection in a newborn baby during the first week after birth and contributes to 50% of neonatal deaths each year. Risk factors for early onset neonatal sepsis, which can be maternal, health care provider, or health care facility associated, can be prevented with access to quality antenatal care. Objective: The objective of the study was to assess early onset neonatal sepsis and antenatal factors associated with Fort Portal Regional Referral Hospital. Methodology: A cross sectional study design was used. The study involved 60 respondents who were mothers of breastfeeding neonates being treated for early onset neonatal sepsis at Fort Portal Regional Referral Hospital neonatal intensive care unit. Simple random sampling was used to select study participants. Data were collected using questionnaires, entered in Stata 16, and analysed using logistic regression. Results: The prevalence of early onset neonatal sepsis at Fort Portal Regional Referral Hospital was 25%. Multivariate analysis revealed that institutional factors were the only antenatal factors found to be significantly associated with early onset neonatal sepsis at Fort Portal Regional Referral Hospital (p < 0.01). Bivariate analysis revealed that attending antenatal care at a health centre III or IV instead of a hospital (p = 0.011) and attending antenatal care in health care facilities with no laboratory investigations (p = 0.048) were risk factors for early onset neonatal sepsis in the newborn at Fort Portal Regional Referral Hospital. Conclusion: Antenatal factors were associated with early onset neonatal sepsis, and health care facility factors like lower level health centre and unavailability of quality laboratory investigations to pregnant women contributed to early onset neonatal sepsis in the newborn. Mentorships, equipping/stocking laboratories, and improving staffing levels were necessary to reduce early onset neonatal sepsis.

Keywords: antenatal factors, early onset neonatal sepsis, neonates 0-7 days, fort portal regional referral hospital

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Authors: Farhan E Shafrin, Khandaker Shabbir Ahmed

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Natural ventilation strategies continue to be a key alternative to costly mechanical ventilation systems, especially in healthcare facilities, due to increasing energy issues in developing countries, including Bangladesh. Besides, overcrowding and insufficient ventilation strategies remain significant causes of thermal discomfort and hospital infection in Bangladesh. With the proper location of inlet and outlet windows, uniform flow is possible in the occupancy area to achieve thermal comfort. It also determines the airflow pattern of the ward that decreases the movement of the contaminated air. This paper aims to establish a relationship between the location of the windows and the thermal comfort of the occupants in a naturally ventilated hospital ward. It defines the openings and ventilation variables that are interrelated in a way that enhances or limits the health and thermal comfort of occupants. The study conducts a full-scale experiment in one of the naturally ventilated wards in a primary health care hospital in Manikganj, Dhaka. CFD simulation is used to explore the performance of various opening positions in ventilation efficiency and thermal comfort in the study area. The results indicate that the opening located in the hospital ward has a significant impact on the thermal comfort of the occupants and the airflow pattern inside the ward. The findings can contribute to design the naturally ventilated hospital wards by identifying and predicting future solutions when it comes to relationships with the occupants' thermal comforts.

Keywords: CFD simulation, hospital ward, natural ventilation, thermal comfort, window location

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Authors: Reza Mokhtari Malekabadi, Leila Jalalabadi, Zahra Kiyani Ghaleh No

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Today, systems of management and urban planning, attempt to reach more sustainable development through monitoring developments, urban development and development plans. Monitoring of changes in the urban places and sustainable urban development accounted a base for the realization of worthy goals urban sustainable development. The importance of women in environmental protection programs is high enough that in 21 agenda has been requested from all countries to allocate more shares to women in their policies. On the other hand, urban waste landfill has become one of the environmental concerns in modern cities. This research assumes that the impact of women on recycling, reduction and proper waste landfill is much more than men. For this reason, three districts; Yousef Abad, Heshmatieh and Nezam Abad are gauged through questionnaire and using the analytical research hypothesis model. This research will be categorized as functional research. The results have shown that noticing the power of women, their participation towards realization of the development objectives and programs can be used in solving their problems.

Keywords: citizens, urban, environmental, sustainability, solid waste, Tehran

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Authors: Adedayo Jeremiah Adeyekun, Samuel Oluwagbemiga Ishola

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This research paper focuses on the study of the master plan of rural Farrukhnagar, a town in Gurugram with an aim to proffer solutions to the problems associated with the planning of the town. The commercial zone has been selected for the case study. The findings from the case studies will reveal problems that will require a proposed design of a new ultra-modern market to position traders selling along the road in well-deserved stalls, waste disposal/incinerator system for proper management of waste and cleanliness within the market square, design of stormwater drainage to avoid flood during the rainy season and the design of car/auto – tricycle parks to create more space in the existing market cycle and thereby avoiding congestion. The research proposes urban and architectural solutions to improve the rural commercial service settings in Farrukhnagar which is a study area in Gurugram, Haryana, India.

Keywords: management, commercial, service, planning, congestion

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: weight management, weight control, health care providers, hospital

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Authors: Carolyn Cameron

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Stop Food Waste Australia is working with the industry to co-design sector action plans to prevent and reduce food waste across the supply chain. We are a public-private partnership, funded in 2021 by the Australian national government under the 2017 National Food Waste Strategy. Our partnership has representatives from all levels of government, industry associations from farm to fork, and food rescue groups. Like many countries, Australia has adopted the Sustainable Development Goal (SDG) target of 12.3 to halve food waste by 2030. A seminal 2021 study, the National Food Waste Feasibility Report, developed a robust national baseline, illustrating hotspots in commodities and across the supply chain. This research found that the consumption stages – households, food service, and institutions - account for over half of all food waste, and 22% of food produced never leaves the farm gate. Importantly the study found it is feasible for Australia to meet SDG 12.3, but it will require unprecedented action by governments, industry, and the community. Sector Action Plans (Plan) are one of the four main initiatives of Stop Food Waste Australia, including a voluntary commitment, a coordinated food waste communications hub, and robust monitoring and reporting framework. These plans provide a systems-based approach to reducing food loss and waste while realising multiple benefits for supply chain partners and other collaborators. Each plan is being co-designed with the key stakeholders most able to directly control or influence the root cause(s) of food waste hotspots and to take action to reduce or eliminate food waste in their value chain.  The initiatives in the Plans are fit-for-purpose, reflecting current knowledge and recognising priorities may refocus over time. To date, sector action plans have been developed with the Food Rescue, Cold Chain, Bread and Bakery, and Dairy Sectors. Work is currently underway on Meat and Horticulture, and we are also developing supply-chain stage plans for food services and institutions. The study will provide an overview of Australia’s food waste baseline and challenges, the important role of sector action plans in reducing food waste, and case studies of implementation outcomes.

Keywords: co-design, horticulture, sector action plans, voluntary

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Authors: A. Mavrikos, N. Petsas, E. Kaltsi, D. Kaliampakos

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The lignite-fired power plants in the Western Macedonia Lignite Center produce more than 8 106 t of fly ash per year. Approximately 90% of this quantity is used for restoration-reclamation of exhausted open-cast lignite mines and slope stabilization of the overburden. The purpose of this work is to evaluate the environmental behavior of the mixture of waste rock and fly ash that is being used in the external deposition site of the South Field lignite mine. For this reason, a borehole was made within the site and 86 samples were taken and subjected to chemical analyses and leaching tests. The results showed very limited leaching of trace elements and heavy metals from this mixture. Moreover, when compared to the limit values set for waste acceptable in inert waste landfills, only few excesses were observed, indicating only minor risk for groundwater pollution. However, due to the complexity of both the leaching process and the contaminant pathway, more boreholes and analyses should be made in nearby locations and a systematic groundwater monitoring program should be implemented both downstream and within the external deposition site.

Keywords: co-deposition, fly ash, leaching tests, lignite, waste rock

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Authors: H. Erbiyik, A. Bal, M. Sirakaya, Ö. Yesildal, E. Yolcu

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The emergence of many environmental issues began with the Industrial Revolution. The depletion of natural resources and emerging environmental challenges over time requires enterprises and managers to take into consideration environmental factors while managing business. If we take notice of these causes; the design and implementation of environmentally friendly green purchasing, production and waste management systems become very important at green logistics systems. Companies can adopt green supply chain with the awareness of these facts. The concept of green supply chain constitutes from green purchasing, green production, green logistics, waste management and reverse logistics. In this study, we wanted to identify the concept of green supply chain and why green supply chain should be applied. In the practice part of the study an analytic hierarchy process (AHP) study is conducted on an aluminum production company to evaluate suppliers.

Keywords: aluminum sector, analytic hierarchy process, decision making, green logistics

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Authors: H. Gonen, M. Dogan

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Meerschaum, which is found in the earth’s crust, is a white and clay like hydrous magnesium silicate. It has a wide area of use from production of carious ornaments to chemical industry. It has a white and irregular crystalline structure. It is wet and moist when extracted, which is a good form for processing. At drying phase, it gradually loses its moisture and becomes lighter and harder. In through-dry state, meerschaum is durable and floats on the water. After processing of meerschaum, A ratio between %15 to %40 of the amount becomes waste. This waste is usually kept in a dry-atmosphere which is isolated from environmental effects so that to be used right away when needed. In this study, use of meerschaum waste as aggregate in lightweight concrete is studied. Stress-strain diagrams for concrete with meerschaum aggregate are obtained. Then, stress-strain diagrams of lightweight concrete and concrete with regular aggregate are compared. It is concluded that meerschaum waste can be used in production of lightweight concrete.

Keywords: lightweight concrete, meerschaum, aggregate, sepiolite, stress-strain diagram

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Authors: Davidson E. Egirani, Nanfe R. Poyi, Napoleon Wessey

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This paper would report on the effect of solid waste on water resource quality in the Gbarain catchment of the Niger Delta Region of Nigeria. The Gbarain catchment presently hosts two waste-dump sites located along the flanks of a seasonal flow stream and perennially waterlogged terrain. The anthropogenic activity has significantly affected the quality of surface and groundwater in the Gbarain catchment. These wastes have made the water resource environment toxic leading to the poisoning of aquatic life. The contaminated water resources could lead to serious environmental and human health challenges such as low agricultural yields to loss of vital human organs. The contamination is via geological processes such as seepage and direct infiltration of contaminants into watercourses. The results obtained from field and experimental investigations followed by modeling, and graphical interpretation indicate heavy metal load and fecal pollution in some of the groundwater. The metal load, Escherichia coli, and total coliforms counts exceed the international and regional recommended limits. The contaminate values include Lead (> 0.01 mg/L), Mercury (> 0.006 mg/L), Manganese (> 0.4 mg/L and Escherichia coli (> 0 per 100ml) of the samples. Land use planning, enactment, and implementation of environmental laws are necessary for this region, for effective surface water and groundwater resource management.

Keywords: aquatic life, solid waste, environmental health, human health, waste-dump site, water-resource environment

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Authors: A. A. AlRasheed, A. Atkins, R. Campion

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This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: knowledge management, improvements, visualisation, workflow

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Authors: Yoseph Halala Handiso, Zewdi Gebregziabher

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Background: Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Despite the fact that malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical patients in Ethiopia, while nutritional assessment is also often a neglected component of the health service practice. Objective: This study aimed to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022. Methods: A facility-based prospective cohort study was conducted among 398 adult surgical patients admitted to the hospital. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 hours within 48 hours after admission (SGA). Data were collected using the open data kit (ODK) version 2022.3.3 software, while Stata version 14.1 software was employed for statistical analysis. The Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusting for several potential confounders taken at admission. Adjusted hazard ratio (HR) with a 95% confidence interval was used to show the effect of malnutrition. Results: The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59%-69%) according to the SGA classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11-13) as compared to well-nourished patients (8 days: 95% CI: 8-9), means adult surgical patients who were malnourished at admission were at higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29-0.47) as compared to well-nourished patients. Presence of comorbidity (AHR: 0.68, 95% CI: 0.50-90), poly medication (AHR: 0.69, 95% CI: 0.55-0.86), and history of admission (AHR: 0.70, 95% CI: 0.55-0.87) within the previous five years were found to be the significant covariates of the length of hospital stay (LOS). Conclusion: The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, polymedication, and history of admission were found to be the significant covariates of LOS. All stakeholders should give attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.

Keywords: effect of malnutrition, length of hospital stay, surgical patients, Ethiopia

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Authors: Trevor Malambo Simbayi, Diane Hildebrandt, Tonderayi Matambo

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The rapid growth of population in recent decades has resulted in an increased need for energy to meet human activities. As energy demands increase, the need for other sources of energy other than fossil fuels, increases in turn. Furthermore, environmental concerns such as global warming due to the use of fossil fuels, depleting fossil fuel reserves and the rising cost of oil have contributed to an increased interest in renewables sources of energy. Biogas is a renewable source of energy produced through the process of anaerobic digestion (AD) and it offers a two-fold solution; it provides an environmentally friendly source of energy and its production helps to reduce the amount of organic waste taken to landfills. This research seeks to address the waste management problem caused by an aquatic weed called water hyacinth (Eichhornia crassipes) at the Hartbeespoort (Harties) Dam in the North West Province of South Africa, through biogas production of the weed. Water hyacinth is a category 1 invasive species and it is deemed to be the most problematic aquatic weed. This weed is said to double its size in the space of five days. Eutrophication in the Hartbeespoort Dam has manifested itself through the excessive algae bloom and water hyacinth infestation. A large amount of biomass from water hyacinth and algae are generated per annum from the two hundred hectare surface area of the dam exposed to the sun. This biomass creates a waste management problem. Water hyacinth when in full bloom can cover nearly half of the surface of Hartbeespoort Dam. The presence of water hyacinth in the dam has caused economic and environmental problems. Economic activities such as fishing, boating, and recreation, are hampered by the water hyacinth’s prolific growth. This research proposes the use of water hyacinth as a feedstock or substrate for biogas production in order to find an economic and environmentally friendly means of waste management for the communities living around the Hartbeespoort Dam. In order to achieve this objective, water hyacinth will be collected from the dam and it will be mechanically pretreated before anaerobic digestion. Pretreatment is required for lignocellulosic materials like water hyacinth because such materials are called recalcitrant solid materials. Cow manure will be employed as a source of microorganisms needed for biogas production to occur. Once the water hyacinth and the cow dung are mixed, they will be placed in laboratory anaerobic reactors. Biogas production will be monitored daily through the downward displacement of water. Characterization of the substrates (cow manure and water hyacinth) to determine the nitrogen, sulfur, carbon and hydrogen, total solids (TS) and volatile solids (VS). Liquid samples from the anaerobic digesters will be collected and analyzed for volatile fatty acids (VFAs) composition by means of a liquid gas chromatography machine.

Keywords: anaerobic digestion, biogas, waste management, water hyacinth

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Authors: A. Sherif, A. El Zafarany, R. Arafa

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Hospitals, everywhere, are considered heavy energy consumers. Hospital Intensive Care Unit spaces pose a special challenge, where design guidelines requires the provision of external windows for day-lighting and external view. Window protection strategies could be employed to reduce energy loads without detriment effect on comfort or health care. This paper addresses the effectiveness of using various window strategies on the annual cooling, heating and lighting energy use of a typical Hospital Intensive Unit space. Series of experiments were performed using the EnergyPlus simulation software for a typical Intensive Care Unit (ICU) space in Cairo, located in the Egyptian desert. This study concluded that the use of shading systems is more effective in conserving energy in comparison with glazing of different types, in the Cairo ICUs. The highest energy savings in the West and South orientations were accomplished by external perforated solar screens, followed by overhangs positioned at a protection angle of 45°.

Keywords: energy, hospital, intensive care units, shading

Procedia PDF Downloads 272

Authors: Abrar R. Al-Hasan

Abstract:

Despite the widespread use of social media by consumers and marketers, empirical research investigating their economic value in the healthcare industry still lags. This study explores the impact of the use of social media marketing efforts on a hospital's brand equity and, ultimately, consumer response. Using social media data from Twitter and Facebook, along with an online and offline survey methodology, data is analyzed using logistic regression models. A random sample of (728) residents of the Kuwaiti population is used. The results of this study found that social media marketing efforts (SMME) in terms of use and validation lead to higher hospital brand equity and in turn, patient loyalty and patient visit. The study highlights the impact of SMME on hospital brand equity and patient response. Healthcare organizations should guide their marketing efforts to better manage this new way of marketing and communicating with patients to enhance their consumer loyalty and financial performance.

Keywords: brand equity, healthcare marketing, patient visit, social media, SMME

Procedia PDF Downloads 151

Authors: Y. Seki, A. Ç. Kılıç, M. Atagür, O. Özdemir, İ. Şen, K. Sever, Ö. Seydibeyoğlu, M. Sarikanat, N. Küçükdoğan

Abstract:

Cheap and abundant waste materials have been investigated as filler materials in thermoplastic polymers instead of wood- based materials because of deforestation. Vine stem, as an agricultural waste, was used as a filler material for a thermoplastic polymer, high-density polyethylene (HDPE) in this study. Agricultural waste of vine stem was collected from Manisa region, Turkey. Vine stem at different rations was used to reinforce HDPE. The effect of vine stem loading on tensile strength and Young’s modulus of composites were obtained. It was clearly observed that tensile strength and Young’s modulus of HDPE was increased by vine stem loading. Thermal stabilities of composites were obtained by using thermogravimetric analysis. Water absorption behavior of HDPE was improved by loading vine stem into HDPE. The crystallinity index values of neat HDPE and vine stem loaded HDPE composites were investigated byX-ray diffraction analysis. From this study, it was inferred that vine stem, as an agricultural waste, can be used as a filler material for HDPE.

Keywords: waste filler, high density polyethylene, composite, composite materials

Procedia PDF Downloads 501

Authors: Ashleigh Medina

Abstract:

Chronic conditions account for the majority of total health care spending both in the United States and globally. Encouraging self-management to improve chronic conditions, which in turn could decrease the strain placed on hospitals, requires resources to address the patient’s social concerns in addition to their medical concerns. Transitional care has been identified as a possible bridge between acutely managing conditions at the hospital to chronically managing conditions in a community setting. The aim of this integrative review was to examine the impact of transitional care on self-management outcomes of chronic conditions in un/underinsured populations. Both transitional care, by assisting with resources such as funding sources for healthcare and medications or identifying a healthcare provider for continued care, and self-management, by increasing responsibility for one’s care through goal setting and taking action, can impact health outcomes while providing health care cost-savings.

Keywords: chronic conditions, self-management, transitional care, uninsured

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Authors: Mohammed Abed, Rita Nemes, Salem Nehme

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The present study experimentally investigated the impact of incorporating unprocessed waste fly ash (UWFA) on the residual mechanical properties of self-compacting concrete (SCC) after exposure to elevated temperature. Three mixtures of SCC have been produced by replacing the cement mass by 0%, 15% and 30% of UWFA. Generally, the fire resistance of SCC has been enhanced by replacing the cement up to 15% of UWFA, especially in case of residual modulus of elasticity which considers more sensitive than other mechanical properties at elevated temperature. However, a strong linear relationship has been observed between the residual flexural strength and modulus of elasticity, where both of them affected significantly by the cracks appearance and propagation as a result of elevated temperature. Sustainable products could be produced by incorporating unprocessed waste powder materials in the production of concrete, where the waste materials, CO₂ emissions, and the energy needed for processing are reduced.

Keywords: self-compacting high-performance concrete, unprocessed waste fly ash, fire resistance, residual modulus of elasticity

Procedia PDF Downloads 121

Authors: Zhichao Li

Abstract:

This project has treated the waste-water that contains the nitrogen heterocyclic aromatic hydrocarbons, by using the phenol-induced microbial communities. The treatment of nitrogen heterocyclic aromatic hydrocarbons is a difficult problem for coking waste-water treatment. Pyridine, quinoline and indole are three kinds of most common nitrogen heterocyclic compounds in the f, and treating these refractory organics biologically has always been a research focus. The phenol-degrading bacteria can be used in the enhanced biological treatment effectively, and has a good treatment effect. Therefore, using the phenol-induced microbial communities to treat the coking waste-water can remove multiple pollutants concurrently, and improve the treating efficiency of coking waste-water. Experiments have proved that the phenol-induced microbial communities can degrade the nitrogen heterocyclic ring aromatic hydrocarbon efficiently.

Keywords: phenol, nitrogen heterocyclic aromatic hydrocarbons, phenol-degrading bacteria, microbial communities, biological treatment technology

Procedia PDF Downloads 184

Authors: Guillaume Richard, Sarra Zaied

Abstract:

Marine waste quantities increase more and more, 5 million tons of plastic waste enter the ocean every year. Their spatiotemporal distribution is never homogeneous and depends mainly on the hydrodynamic characteristics of the environment, as well as the size and location of the waste. As part of optimizing collect of marine plastic wastes, it is important to measure and monitor their evolution over time. In this context, diverse studies have been dedicated to describing waste behavior in order to identify its accumulation in ocean areas. None of the existing tools which track objects at sea had the objective of tracking down a slick of waste. Moreover, the applications related to marine waste are in the minority compared to rescue applications or oil slicks tracking applications. These approaches are able to accurately simulate an object's behavior over time but not during the collection mission of a waste sheet. This paper presents numerical modeling of a boat’s wake impact on the floating marine waste behavior during a collection mission. The aim is to predict the trajectory of a marine waste slick to optimize its collection using meteorological data of ocean currents, wind, and possibly waves. We have made the choice to use Ocean Parcels which is a Python library suitable for trajectoring particles in the ocean. The modeling results showed the important role of advection and diffusion processes in the spatiotemporal distribution of floating plastic litter. The performance of the proposed method was evaluated on real data collected from the Copernicus Marine Environment Monitoring Service (CMEMS). The results of the evaluation in Cape of Good Hope (South Africa) prove that the proposed approach can effectively predict the position and velocity of marine litter during collection, which allowed for optimizing time and more than $90\%$ of the amount of collected waste.

Keywords: marine litter, advection-diffusion equation, sea current, numerical model

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Authors: Samuele Abagnato, Lucia Rigamonti

Abstract:

Life-Cycle-Assessment (LCA) is an effective tool to quantify the environmental impacts of reuse models and recycling technologies for textiles. In this work, publications in the last ten years about LCA on textile waste are classified according to location, goal and scope, functional unit, waste composition, impact assessment method, impact categories, and sensitivity analysis. Twenty papers have been selected: 50% are focused only on recycling, 30% only on reuse, the 15% on both, while only one paper considers only the final disposal of the waste. It is found that reuse is generally the best way to decrease the environmental impacts of textiles waste management because of the avoided impacts of manufacturing a new item. In the comparison between a product made with recycled yarns and a product from virgin materials, in general, the first option is less impact, especially for the categories of climate change, water depletion, and land occupation, while for other categories, such as eutrophication or ecotoxicity, under certain conditions the impacts of the recycled fibres can be higher. Cultivation seems to have quite high impacts when natural fibres are involved, especially in the land use and water depletion categories, while manufacturing requires a remarkable amount of electricity, with its associated impact on climate change. In the analysis of the reuse processes, relevant importance is covered by the laundry phase, with water consumption and impacts related to the use of detergents. About the sensitivity analysis, it can be stated that one of the main variables that influence the LCA results and that needs to be further investigated in the modeling of the LCA system about this topic is the substitution rate between recycled and virgin fibres, that is the amount of recycled material that can be used in place of virgin one. Related to this, also the yield of the recycling processes has a strong influence on the results of the impact. The substitution rate is also important in the modeling of the reuse processes because it represents the number of avoided new items bought in place of the reused ones. Another aspect that appears to have a large influence on the impacts is consumer behaviour during the use phase (for example, the number of uses between two laundry cycles). In conclusion, to have a deeper knowledge of the impacts of a life-cycle approach of textile waste, further data and research are needed in the modeling of the substitution rate and of the use phase habits of the consumers.

Keywords: environmental impacts, life-cycle-assessment, textiles recycling, textiles reuse, textiles waste management

Procedia PDF Downloads 72