Search results for: hospital waste management (HWM)

Authors: Zhiyuan Jia, Xiuxiu Sun, Yong Chen, Liu Hai, Shuangqing Li

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The engine cooling water and exhaust gas contain a large amount of available energy. In order to improve energy efficiency, a steam injection technology based on waste heat recovery is proposed. The models of cooling water waste heat utilization, exhaust gas waste heat utilization, and exhaust gas-cooling water waste heat utilization were constructed, and the effects of the three modes on the performance of steam injection were analyzed, and then the feasibility of in-cylinder water injection steam technology based on waste heat recovery was verified. The research results show that when the injection water flow rate is 0.10 kg/s and the temperature is 298 K, at a cooling water temperature of 363 K, the maximum temperature of the injection water heated by the cooling water can reach 314.5 K; at an exhaust gas temperature of 973 K and an exhaust gas flow rate of 0.12 kg/s, the maximum temperature of the injection water heated by the exhaust gas can reach 430 K; Under the condition of cooling water temperature of 363 K, exhaust gas temperature of 973 K and exhaust gas flow rate of 0.12 kg/s, after cooling water and exhaust gas heating, the maximum temperature of the injection water can reach 463 K. When the engine is 1200 rpm, the water injection volume is 30 mg, and the water injection time is 36°CA, the engine power increases by 2% and the fuel consumption is reduced by 2.6%.

Keywords: cooling water, exhaust gas, extended range engine, steam injection, waste heat recovery

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Authors: Naseem M. Twaissi

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Medical professionals play an important role in society, and in general, they care more about their patients than about their personal well-being. They need to take a professional approach to maintain a work-life balance. Through a collection of primary data from 1020 medical professionals and the application of relevant statistical tools, this paper explores the pressures on medical professionals with reference to their work-life balance. This study highlights how hospital management, in addition to economic reasons, needs to identify variables to enhance the work-life balance of medical professionals so that quality healthcare facilities may be provided to the citizens of Jordan. Results indicate that formulation and implementation of policies for enhancing work-life balance together with career and retention plans for medical professionals would enhance the performance of hospitals and the quality of health care in Jordan, leading to greater societal well-being.

Keywords: work life balance, job environment, job satisfaction, employee well-being, stress, hospital industry

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Authors: Oscar Vega Camacho, Andrea Vargas, Ellery Ariza

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This paper presents the application of finite dynamic programming, specifically the "Markov Chain" model, as part of the decision making process of a company in the cosmetics sector located in the vicinity of Bogota DC. The objective of this process was to decide whether the company should completely reconstruct its waste water treatment plant or instead optimize the plant through the addition of equipment. The goal of both of these options was to make the required improvements in order to comply with parameters established by national legislation regarding the treatment of waste before it is released into the environment. This technique will allow the company to select the best option and implement a solution for the processing of waste to minimize environmental damage and the acquisition and implementation costs.

Keywords: decision making, markov chain, optimization, waste water

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Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

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Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

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Authors: Venkat S. Somayajula

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Ground surface temperature history prediction model plays a vital role in determining standards for international nuclear waste management. International standards for borehole based nuclear waste disposal require paleoclimate cycle predictions on scale of a million forward years for the place of waste disposal. This research focuses on developing a paleoclimate cycle prediction model using Bayesian long-short term memory (LSTM) neural architecture operated on accumulated borehole temperature history data. Bayesian models have been previously used for paleoclimate cycle prediction based on Monte-Carlo weight method, but due to limitations pertaining model coupling with certain other prediction networks, Bayesian models in past couldn’t accommodate prediction cycle’s over 1000 years. LSTM has provided frontier to couple developed models with other prediction networks with ease. Paleoclimate cycle developed using this process will be trained on existing borehole data and then will be coupled to surface temperature history prediction networks which give endpoints for backpropagation of LSTM network and optimize the cycle of prediction for larger prediction time scales. Trained LSTM will be tested on past data for validation and then propagated for forward prediction of temperatures at borehole locations. This research will be beneficial for study pertaining to nuclear waste management, anthropological cycle predictions and geophysical features

Keywords: Bayesian long-short term memory neural network, borehole temperature, ground surface temperature history, paleoclimate cycle

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Authors: Masoud Swalehe, Semra Günay

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Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.

Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest

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Authors: Krishmali N. Ekanayake, Brendan J. Holland, Colin J. Barrow, Rick Wood

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Globally, more than one-third of all food produced is lost or wasted, equating to 1.3 billion tonnes per year. Around 31.2 million tonnes of food waste are generated across the production, supply, and consumption chain in Australia. Generally, the food waste management processes adopt environmental-friendly and more sustainable approaches such as composting, anerobic digestion and energy implemented technologies. However, unavoidable, and non-recyclable food waste ends up as landfilling and incineration that involve many undesirable impacts and challenges on the environment. A biorefinery approach contributes to a waste-minimising circular economy by converting food and other organic biomass waste into valuable outputs, including feeds, nutrition, fertilisers, and biomaterials. As a solution, Green Eco Technologies has developed a food waste treatment process using WasteMaster system. The system uses charged oxygen and moderate temperatures to convert food waste, without bacteria, additives, or water, into a virtually odour-free, much reduced quantity of reusable residual material. In the context of a biorefinery, the WasteMaster dries and mills food waste into a form suitable for storage or downstream extraction/separation/concentration to create products. The focus of the study is to determine the nutritional composition of WasteMaster processed residue to potential develop aquafeed ingredients. The global aquafeed industry is projected to reach a high value market in future, which has shown high demand for the aquafeed products. Therefore, food waste can be utilized for aquaculture feed development by reducing landfill. This framework will lessen the requirement of raw crops cultivation for aquafeed development and reduce the aquaculture footprint. In the present study, the nutritional elements of processed residue are consistent with the input food waste type, which has shown that the WasteMaster is not affecting the expected nutritional distribution. The macronutrient retention values of protein, lipid, and nitrogen free extract (NFE) are detected >85%, >80%, and >95% respectively. The sensitive food components including omega 3 and omega 6 fatty acids, amino acids, and phenolic compounds have been found intact in each residue material. Preliminary analysis suggests a price comparability with current aquafeed ingredient cost making the economic feasibility. The results suggest high potentiality of aquafeed development as 5 to 10% of the ingredients to replace/partially substitute other less sustainable ingredients across biorefinery setting. Our aim is to improve the sustainability of aquaculture and reduce the environmental impacts of food waste.

Keywords: biorefinery, ffood waste residue, input, wasteMaster

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Authors: Kuladeep Kumar Sadevi

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The shift towards raising global urban population has intense implications on the sustainability of the urban livelihoods. Rapid urbanization has made governments, companies and civil societies recognize that they are barely equipped to deal with growing urban demands, especially water, waste and energy management. Effective management of land, water, energy and waste at a community level should be addressed well to attain greener cities. In pursuit of Green livelihoods; various norms, codes, and green rating programmes have been followed by stakeholders at various levels. While the sustainability is being adapted at smaller scale developments, greening the urban environment at community/city level is still finding its path to reality. This is due to lack of the sense of ownership in the citizens for their immediate neighborhoods and city as a whole. This phenomenon can be well connected to the theory of 'tragedy of commons' with respect to the community engagement to manage the common pool resources. The common pool resource management has been well addressed by Elinor Ostrom, who shared the Nobel Prize in Economics in 2009 for her lifetime of scholarly work investigating how communities succeed or fail at managing common pool (finite) resources. This paper examines the applicability of Elinor Ostrom's 8 Principles for Managing a Commons, to meet urban sustainability. The key objective of this paper is to come up with a model for effective urban common pool resource management, which ultimately leads to sustainability as a whole. The paper brings out a methodology to understand various parameters involved in urban sustainability, examine the synergies of all such parameters, and application of Ostrom’s principles to correlate these parameters in order to attain effective urban resource management.

Keywords: common pool resources, green cities, green communities, participatory management, sustainable development, urban resource management, urban sustainability

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Authors: Monika Gałwa-Widera, Anna Kwarciak–Kozłowska, Lucyna Sławik-Dembiczak

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Issues relating to management of sewage sludge from small and medium-sized wastewater treatment plants is a vital issue, which deal with such scholars as well as those directly involved in the issue of wastewater treatment and management of sedimentary. According to the Law on Waste generating waste is responsible for such processing to the product obtained impacted on the environment minimally. In small and medium-sized wastewater treatment plants have to deal with the technology of sludge management technology is far from drying and incineration of sewage sludge. So here you can use other technologies. One of them is the composting of sewage sludge. It is a process of processing and disposal of sewage sludge that effectively their disposal. By composting, we can obtain a product that contains significant amounts of organic matter to assess the fertilizing qualities. Modifications to the ongoing process in biological reactors allow for more rapid receipt of a wholesome product. The research presented and discussed in this publication relate to assist the composting process of sewage sludge and biomass structural material in the shares of rates: 35% biomass, 55% sludge, 10% structural material using a method which involves the re-spawning batch composting physical methods leachate from the composting process.

Keywords: biomass, composting, industry, sewage sludge

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Authors: Nor Azian Binti Aziz, Muhammad Afiq Bin Tambichik, Zamri Bin Hashim

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The rapid development of the construction industry has contributed to increased construction waste, with concrete waste being among the most abundant. This waste is generated from ready-mix batching plants after the concrete cube testing process is completed and disposed of in landfills, leading to increased solid waste management costs. This study aims to evaluate the engineering characteristics of foamed concrete with waste mixtures construction and agricultural waste to determine the usability of recycled materials in the construction of non-load-bearing walls. This study involves the collection of construction wastes, such as recycled aggregates (RCA) obtained from the remains of finished concrete cubes, which are then tested in the laboratory. Additionally, agricultural waste, such as rice husk ash, is mixed into foamed concrete interlock blocks to enhance their strength. The optimal density of foamed concrete for this study was determined by mixing mortar and foam-backed agents to achieve the minimum targeted compressive strength required for non-load-bearing walls. The tests conducted in this study involved two phases. In Phase 1, elemental analysis using an X-ray fluorescence spectrometer (XRF) was conducted on the materials used in the production of interlock blocks such as sand, recycled aggregate/recycled concrete aggregate (RCA), and husk ash paddy/rice husk ash (RHA), Phase 2 involved physical and thermal tests, such as compressive strength test, heat conductivity test, and fire resistance test, on foamed concrete mixtures. The results showed that foamed concrete can produce lightweight interlock blocks. X-ray fluorescence spectrometry plays a crucial role in the characterization, quality control, and optimization of foamed concrete mixes containing construction and agriculture waste. The unique composition mixer of foamed concrete and the resulting chemical and physical properties, as well as the nature of replacement (either as cement or fine aggregate replacement), the waste contributes differently to the performance of foamed concrete. Interlocking blocks made from foamed concrete can be advantageous due to their reduced weight, which makes them easier to handle and transport compared to traditional concrete blocks. Additionally, foamed concrete typically offers good thermal and acoustic insulation properties, making it suitable for a variety of building projects. Using foamed concrete to produce lightweight interlock blocks could contribute to more efficient and sustainable construction practices. Additionally, RCA derived from concrete cube waste can serve as a substitute for sand in producing lightweight interlock blocks.

Keywords: construction waste, recycled aggregates (RCA), sustainable concrete, structure material

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Authors: Siti Rajaah Binti Sayed Sultan

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Managing the code blue event is stressful for nurses, the patient, and the patient's families. The rapid response from the first and second responders in the code blue event will improve patient outcomes and prevent tissue hypoxia that leads to brain injury and other organ failures. Providing 1 minute for the cardiac massage and 2 minutes for defibrillation will significantly improve patient outcomes. As we know, the American Heart Association came out with guidelines for managing cardiac arrest patients. The hospital must provide competent staff to manage this situation. It can be achieved when the staff is well equipped with the skill, attitude, and knowledge to manage this situation with well-planned strategies, i.e., clear guidelines for managing the code blue event, competent staff, and functional equipment. The code blue simulation (CBS) was chosen in the training program for code blue management because it can mimic real scenarios. Having the code blue simulation module will allow the staff to appreciate what they will face during the code blue event, especially since it rarely happens in that area. This CBS module training will help the staff familiarize themselves with the activities that happened during actual events and be able to operate the equipment accordingly. Being challenged and independent in managing the code blue in the early phase gives the patient a better outcome. The CBS module will help the assessor and the hospital management team with the proper tools and guidelines for managing the code blue drill accordingly. As we know, prompt action will benefit the patient and their family. It also indirectly increases the confidence and job satisfaction among the nurses, increasing the standard of care, reducing the complication and hospital burden, and enhancing cost-effective care.

Keywords: code blue simulation module, development of code blue simulation module, code blue response time, code blue drill, cardiorespiratory arrest, managing code blue

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: anxiety, depression, sickle cell disease, socio-demographic quality of life, characteristics, Ghana

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Authors: Lucie Vodova, Radomir Sokolar, Jitka Hroudova

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Stoneware clay, fired clay (as a grog), calcite waste and class C fly ash in various mixing rations were the basic raw materials for the mixture for production of dry pressed ceramic tiles. Mechanical properties (water absorption, bulk density, apparent porosity, flexural strength) as well as mineralogical composition were studied on samples with different source of calcium oxide after firing at 900, 1000, 1100 and 1200°C. It was found that samples with addition of calcite waste contain dmisteinbergit and anorthite. This minerals help to improve the strength of the body and reduce porosity fired at lower temperatures. Class C fly ash has not significantly influence on properties of the fired body as calcite waste.

Keywords: ceramic tiles, class C fly ash, calcite waste, calcium oxide, anorthite

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Authors: Kgomotso Matobole, Natania De Wet, Tefo Mbambo, Hilary Rutto, Tumisang Seodigeng

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Nitrogen and phosphorus are nutrients which are required in the ecosystem, however, at high levels, these nutrients contribute to the process of eutrophication in the receiving water bodies, which threatens aquatic organisms. Hence it is vital that they are removed before the water is discharged. This phenomenon increases the cost related to wastewater treatment. This raises the need for the development of processes that are cheaper. Activated biocarbon was used in batch and filtration system to remove nitrates and phosphates. The batch system has higher nutrients removal capabilities than the filtration system. For phosphate removal, 93 % removal is achieved at the adsorbent of 300 g while for nitrates, 84 % removal is achieved when 200 g of activated carbon is loaded.

Keywords: waste water treatment, phosphates, nitrates, activated carbon, agricultural waste

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Authors: Abadou Yacine, Faid Hayette

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Significant investigations were performed on the use and impact on physical properties along with the mechanical strength of the recycled and reused E-glass waste powder. However, it has been modelled how recycled display e-waste glass may affect the characteristics and qualities of dune sand mortar. To be involved in this field, an investigation has been done with the substitution of dune sand for recycled E-glass waste and constant water-cement ratios. The linear relationship between the dune sand mortar and E-glass mortar mix % contributes to the model's reliability. The experimental data was exposed to regression analysis using JMP Statistics software. The regression model with one predictor presented the general form of the equation for the prediction of the five properties' characteristics of dune sand mortar from the substitution ratio of E-waste glass and curing age. The results illustrate that curing a long-term process produced an E-glass waste mortar specimen with the highest compressive strength of 68 MPa in the laboratory environment. Anova analysis indicated that the curing at long-term has the utmost importance on the sorptivity level and ultrasonic pulse velocity loss. Furthermore, the E-glass waste powder percentage has the utmost importance on the compressive strength and improvement in dynamic elasticity modulus. Besides, a significant enhancement of radiation-shielding applications.

Keywords: ANOVA analysis, E-glass waste, durability and sustainability, radiation-shielding

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Authors: Cameron Jones

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Emissions, produced by landfill waste from demolished obsolete buildings, have a damaging effect on both the Earth’s climate and human health. The philosophical theory of material vitalism - the potential for materials to react and emit harmful pollutants - therefore defines this construction and demolition waste (CDW) as having vitality. The European Union’s ‘Circular Economic Action Plan’ (CEAP) aims to mitigate the effects of CDW by prioritising the circularity of building materials. This dissertation examines how the philosophical theory of material vitalism can make an environmentally responsible contribution to CDW policy. The CEAP and Silvertown Quays development are used as case studies for the application of vitalism to policy revision. The study concludes that vitalism has a positive role to play in informing CDW policy, although its contribution is stronger in some areas. This is established by first appraising the aspects that relate to the obsolescence of buildings outlined in the EU’s existing CDW policies. Next, these policy directives are compared with the CE principles employed in the Silvertown Quays development. Subsequently, a keyword analysis model is used to categorise the language used in the CEAP, demonstrating how socio-political approaches to the CE and strategies to address resource scarcity could be strengthened to represent the EU’s policy aspirations more effectively. Recommendations are then made on how material vitalism could be utilised to strengthen legislation, arguing that a notable contribution can be made in most policy areas. Finally, theoretical testing of the impact of these revisions to policy on the case study development identified some practicalities for consideration in improving waste management outcomes.

Keywords: vitalism, construction waste, obsolescence, political ecology, exceptionalism

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Hafizan Junoh, Kumaran Palanisamy, Yip Chan Heng, Pua Fei Ling

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This study investigates the influence of low temperature thermo-chemical pretreatment of organic food waste on the performance of COD solubilisation. Both temperature and alkaline agent were reported to have an effect on solubilizing any possible biomass including organic food waste. The three independent variables considered in this pretreatment were temperature (50-90oC), pretreatment time (30-120 minutes) and alkaline concentration, sodium hydroxide, NaOH (0.7-15 g/L). The optimal condition obtained were 90oC, 15 g/L NaOH for 2 hours. Solubilisation has potential in enhancing methane production by providing a high amount of soluble components at an early stage during anaerobic digestion.

Keywords: food waste, pretreatments, respond surface methodology, ANOVA, anaerobic digestion

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Authors: Sung Hee Ahn, Ju Rang Han

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Background: With increasing importance in healthcare organization on patient satisfaction and nurses’ job satisfaction, many studies have been conducted. But no research has been administered how nurses’ satisfaction with healthcare organization influence patient satisfaction and loyalty. Purpose: This study aims to conceptualize nurses‘ satisfaction, patient satisfaction with and patient loyalty to hospitals using a hypothetical linear structural equation model, and to identify the significance of path coefficients and goodness of fit index of the structural equation model as well. Method: A total of 2,079 nurses and 6,776 patients recruited from 5 university hospitals in South Korea participated in this study. The data on nurses, including ward nurses and outpatient nurses, were collected from June 24th to July 12th, at the 204 departments of the 5 hospitals through an on-line survey. The data on the patients, including both inpatients and outpatients, were collected from September 30th to October 24th, 2013 at the 5 hospitals using a structured questionnaire. The variable of nurses’ satisfaction was measured using a scale evaluating internal client satisfaction, which is used in SSM Health Care System in the US. Patient satisfaction with the hospital and nurses and patient loyalty were measured by assessing the patient’s intention to revisit and to recommending the hospital to others using a visual analogue scale. The data were analyzed using SPSS version 21.0 and AMOS version 21.0. Result: The hypothetical model was fairly good in terms of goodness of fit (χ2= 64.897 (df=24, p <. 001), GFI=. 906, AGFI=.823, CFI=.921, NFI=.951, NNFI=.952. RMSEA=.114). The significance of path coefficients includes followings 1)The nurses’ satisfaction has significant influence on the patient satisfaction with nurses. 2)The patient satisfaction with nurses has significant influence on the patient satisfaction with the hospital. 3)The patient satisfaction with the hospital has significant influence on the patients’ revisit intention. 4)The patient satisfaction with the hospital has significant influence on the patients’ intention to the recommendations of the hospital. Conclusion: These results provide several practical implications to hospital administrators, who should incorporate ways of improving nurses' and patients' satisfaction with the hospital into their health care marketing strategies.

Keywords: linear structural equation model, loyalty, nurse, patient satisfaction

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Authors: Osuagwu Justine Ugochukwu

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Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought brand-new knowledge to leadership literature.

Keywords: workers performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership

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Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

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Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

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Authors: Jing Jiang, Yuguang Gao, Yang Yu

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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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Authors: Dalia Almaghaslah

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Design thinking approach; empathize, define, ideate prototype, test, implement, was used to assess outpatient experiences in two hospital pharmacies in the Asir region, Saudi Arabia. Semi-structured interviews were conducted with 40 patients. The data were analyzed using thematic analysis. The findings suggested that patients were generally satisfied with pharmaceutical services provided in both pharmacies. Pharmacists were found to have enough knowledge, good attitude, and efficient communication and counselling skills. Non-pharmacy-related factors such as cultural factors (gender segregation), long waiting times, uncomfortable waiting areas, lack of electronic prescribing, number waiting system were found to have a negative impact on patients' experiences and satisfaction. Prototypes will be used to test the effects of implementing the electronic system in Al -mahal hospital and to test changing the physical layout of the waiting area in Asir hospital.

Keywords: design thinking, hospital pharmacy, patient satisfaction, Saudi Arabia

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Authors: Mourad Morsli, Mohamed Tahiri, Azzedine Samdi

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The Cities are the urbanized territories most favorable to the consumption of resources (materials, energy). In Morocco, the economic capital Casablanca is one of them, with its 4M inhabitants and its 60% share in the economic and industrial activity of the kingdom. In the absence of legal status in force, urban development has favored the generation of millions of tons of demolition and construction waste scattered in open spaces causing a significant nuisance to the environment and citizens. Hence the main objective of our work is to valorize concrete waste. The representative wastes are mainly concrete, concrete, and fired clay bricks, ceramic tiles, marble panels, gypsum, and scrap metal. The work carried out includes: geolocation with a combination of artificial intelligence, GIS, and Google Earth, which allowed the estimation of the quantity of these wastes per site; then the sorting, crushing, grinding, and physicochemical characterization of the collected samples allowed the definition of the exploitation ways for each extracted fraction for integrated management of the said wastes. In the present work, we proceeded to the exploitation of the fractions obtained after sieving the representative samples to incorporate them in the manufacture of new ecological materials for construction. These formulations prepared studies have been tested and characterized: physical criteria (specific surface, resistance to flexion and compression) and appearance (cracks, deformation). We will present in detail the main results of our research work and also describe the specific properties of each material developed.

Keywords: demolition and construction waste, GIS combination software, inert waste recovery, ecological materials, Casablanca, Morocco

Procedia PDF Downloads 118

Authors: Luisa Maria Arrechea Fajardo, Luz Stella Cadavid Rodriguez

Abstract:

Fish is one of the most commercialized foods worldwide. However, this industry only takes advantage of about 55% of the product's weight, the rest is converted into waste, which is mainly composed of viscera, gills, scales and spines. Consequently, if these wastes are not used or disposed of properly, they cause serious environmental impacts. This is the case of Tumaco (Colombia), the second largest producer of marine fisheries on the Colombian Pacific coast, where artisanal fishermen process more than 50% of the commercialized volume. There, fishing waste is disposed primarily in the ocean, causing negative impacts on the environment and society. Therefore, in the present research, a proposal was made to take advantage of fishing waste through anaerobic treatments, through which it is possible to obtain products with high added value from organic waste. The research was carried out in four stages. First, the production of volatile fatty acids (VFA) in semi-continuous 4L reactors was studied, evaluating three hydraulic retention times (HRT) (10, 7 and 5 days) with four organic loading rates (OLR) (16, 14, 12 and 10 gVS/L/day), the experiment was carried out for 150 days. Subsequently, biogas production was evaluated from the solid digestate generated in the VFA production reactors, initially evaluating the biochemical methane potential (BMP) of 4 total solid concentrations (1, 2, 4 and 6% TS), for 40 days and then, with the optimum TS concentration (2 gVS/L/day), 2 HRT (15 and 20 days) in semi-continuous reactors, were evaluated for 100 days. Finally, the integration of the processes was carried out with the best conditions found, a first phase of VFA production from fishing waste and a second phase of biogas production from unrecovered VFAs and unprocessed material Additionally, an VFA membrane extraction system was included. In the first phase, a liquid digestate with a concentration and VFA production yield of 59.04 gVFA/L and 0.527 gVFA/gVS, respectively, was obtained, with the best condition found (HRT:7 days and OLR: 16 gVS/L/día), where acetic acid and isobutyric acid were the predominant acids. In the second phase of biogas production, a BMP of 0.349 Nm3CH4/KgVS was reached, and it was found as best HRT 20 days. In the integration, the isovaleric, butyric and isobutyric acid were the VFA with the highest percentage of extraction, additionally a 106.67% increase in biogas production was achieved. This research shows that anaerobic treatments are a promising technology for an environmentally safe management of fishing waste and presents the basis of a possible biorefinery.

Keywords: biogas production, fishing waste, VFA membrane extraction, VFA production

Procedia PDF Downloads 100

Authors: Rahimullah Habibzai

Abstract:

To achieve a sustainable concrete industry, reduce exploitation of the natural aggregate resources, and mitigate waste concrete environmental burden, one way is to use recycled concrete aggregate. The utilization of low-quality fine aggregate inclusively recycled concrete sand that is produced from crushing waste concrete recently has become a popular and challenging topic among researchers nowadays. This study provides a scientific base for promoting the application of concrete waste as fine aggregate in producing concrete by conducting a comprehensive laboratory program. The mechanical properties of mortar made from recycled concrete fine aggregate (RCFA), that is produced by pulse power crushing concrete waste are satisfactory and capable of being utilized in the construction industry. A better treatment of RCFA particles and enhancing its quality will make it possible to be utilized in producing structural concrete. Pulse power discharge technology is proposed in this research to produce RCFA, which is a more effective and promising technique compared to other recycling methods to generate medium to high-quality recycled concrete fine aggregate with a reduced amount of powder, mitigate the environmental burden, and save more space.

Keywords: construction and demolition waste, concrete waste recycle fine aggregate, pulse power discharge

Procedia PDF Downloads 130

Authors: Simran Kaur, Paul J. Van Geel

Abstract:

A coupled Thermal-Mechanical-Biological (TMB) model was developed for the analysis of impacts of temperatures on waste stabilization at a Municipal Solid Waste (MSW) landfill in Quebec, Canada using COMSOL Multiphysics, a finite element-based software. For waste placed in landfills in Northern climates during winter months, it can take months or even years before the waste approaches ideal temperatures for biodegradation to occur. Therefore, the proposed model links biodegradation induced strain in MSW to waste temperatures and corresponding heat generation rates as a result of anaerobic degradation. This provides a link between the thermal-biological and mechanical behavior of MSW. The thermal properties of MSW are further linked to density which is tracked and updated in the mechanical component of the model, providing a mechanical-thermal link. The settlement of MSW is modelled based on the concept of viscoelasticity. The specific viscoelastic model used is a single Kelvin – Voight viscoelastic body in which the finite element response is controlled by the elastic material parameters – Young’s Modulus and Poisson’s ratio. The numerical model was validated with 10 years of temperature and settlement data collected from a landfill in Ste. Sophie, Quebec. The coupled TMB modelling framework, which simulates placement of waste lifts as they are placed progressively in the landfill, allows for optimization of several thermal and mechanical parameters throughout the depth of the waste profile and helps in better understanding of temperature dependence of MSW stabilization. The model is able to illustrate how waste placed in the winter months can delay biodegradation-induced settlement and generation of landfill gas. A delay in waste stabilization will impact the utilization of the approved airspace prior to the placement of a final cover and impact post-closure maintenance. The model provides a valuable tool to assess different waste placement strategies in order to increase airspace utilization within landfills operating under different climates, in addition to understanding conditions for increased gas generation for recovery as a green and renewable energy source.

Keywords: coupled model, finite element modeling, landfill, municipal solid waste, waste stabilization

Procedia PDF Downloads 114

Authors: Elihasridas, Rusmana Wijaya Setia Ninggrat

Abstract:

This research aims to study the utilization of ammoniated corn waste complete ration for substitution basal ration of natural grass in Bali cattle. Four treatments (complete feed ration consisted of: R1=40% natural grass + 60% concentrate (control), R2= 50% natural grass+50% concentrate, R3=60% natural grass+40% concentrate and R4=40% ammoniated corn waste+60% concentrate) were employed in this experiment. This experiment was arranged in a latin square design. Observed variables included dry matter intake (DMI), average daily gain and feed conversion. Data were analyzed by using the Analysis of Variance following a 4 x 4 Latin Square Design. The DMI for R1was 7,15kg/day which was significantly (P < 0,05) higher than R2 (6,32 kg/day) and R3(6,07 kg/day), but was not significantly different (P < 0,05) from R4 (7,01 kg/day). Average daily gain for R1(0,75 kg/day) which was significantly (P < 0,05) higher than R2(0,66 kg/day) and R3 (0,61 kg/day),but was not significantly different (P > 0,05) from R4(0,74 kg/day). Feed conversion was not significantly affected (P > 0,05) by ration. It was concluded that ammoniated corn waste complete ration (40% ammoniated corn waste + 60% concentrate) could be utilized for substitution natural grass basal ration.

Keywords: ammoniated corn waste, bali cattle, complete feed, daily gain

Procedia PDF Downloads 189

Authors: Sarina Sulaiman, N.Khairudin , P.Jamal, M.Z. Alam, Zaki Zainudin, S. Azmi

Abstract:

In this study, fish bone waste was used as a new catalyst for biodiesel production. Instead of discarding the fish bone waste, it will be utilized as a source for catalyst that can provide significant benefit to the environment. Also, it can be substitute as a calcium oxide source instead of using eggshell, crab shell and snail shell. The XRD and SEM analysis proved that calcined fish bone contains calcium oxide, calcium phosphate and hydroxyapatite. The catalyst was characterized using Scanning Electron Microscope (SEM) and X-ray Diffraction (XRD).

Keywords: calcinations, fish bone, transesterification, waste catalyst

Procedia PDF Downloads 279

Authors: Kun-Ping Cheng, Dong-Shang Chang, Rou-Wen Wang

Abstract:

Pre-treatment of automobile paint-shop procedures are the preparation of warm water rinsing tank, hot water rinsing tank, degreasing tank, phosphate tank. The conventional boiler steam fuel is natural gas, producing steam to supply the heat exchange of each tank sink. In this study, the high-frequency soldering economizer is developed for recovering waste heat in the automotive paint-shop (RTO, Regenerative Thermal Oxidation). The heat recovery rate of the new economizer is 20% to 30% higher than the conventional embedded heat pipe. The adaptive control system responded to both RTO furnace exhaust gas and heat demands. In order to maintain the temperature range of the tanks, pre-treatment tanks are directly heated by waste heat recovery device (gas-to-water heat exchanger) through the hot water cycle of heat transfer. The performance of developed waste heat recovery system shows the annual recovery achieved to 1,226,411,483 Kcal of heat (137.8 thousand cubic meters of natural gas). Boiler can reduce fuel consumption by 20 to 30 percent compared to without waste heat recovery. In order to alleviate environmental impacts, the temperature at the end of the flue is further reduced from 160 to 110°C. The innovative waste heat recovery is helpful to energy savings and sustainable environment.

Keywords: waste heat recovery system, sustainability, RTO (Regenerative Thermal Oxidation), economizer, automotive industry

Procedia PDF Downloads 243