Search results for: hospital waste management (HWM)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12861

Search results for: hospital waste management (HWM)

12261 Factors Influencing Infection Prevention and Control Practices in the Emergency Department of Mbarara Regional Referral Hospital in Mbarara District- Uganda

Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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12260 Factors Influencing Infection Prevention and Control Practices in the Emergency Department of Mbarara Regional Referral Hospital in Mbarara District-Uganda

Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients, and attendants. It is, therefore important for all emergency medical technicians (EMTs) and patients to strictly adhere to them. It is also imperative for administrators to ensure the implementation of the infection control programme for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other factors influencing infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, the majority 16 (50%) always used protective gear when doing clinical work, 14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. About disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5 (15.6%) in yellow buckets, and only 5(15.6%) in black buckets, and 12(37.5%) didn’t respond, however, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17 (53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms, 15(46.9%) said they have never had quality assurance monitoring events, 14(43.8%) said monitoring was continuous while 15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: emergency medical technician, infection prevention, influencing factors, infection control

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12259 Reasons for Food Losses and Waste in Basic Production of Meat Sector in Poland

Authors: Sylwia Laba, Robert Laba, Krystian Szczepanski, Mikolaj Niedek, Anna Kaminska-Dworznicka

Abstract:

Meat and its products are considered food products, having the most unfavorable effect on the environment that requires rational management of these products and waste, originating throughout the whole chain of manufacture, processing, transport, and trade of meat. From the economic and environmental viewpoints, it is important to limit the losses and food wastage and the food waste in the whole meat sector. The link to basic production includes obtaining raw meat, i.e., animal breeding, management, and transport of animals to the slaughterhouse. Food is any substance or product, intended to be consumed by humans. It was determined (for the needs of the present studies) when the raw material is considered as a food. It is the moment when the animals are prepared to loading with the aim to be transported to a slaughterhouse and utilized for food purposes. The aim of the studies was to determine the reasons for loss generation in the basic production of the meat sector in Poland during the years 2017 – 2018. The studies on food losses and waste in the meat sector in basic production were carried out in two areas: red meat i.e., pork and beef and poultry meat. The studies of basic production were conducted in the period of March-May 2019 at the territory of the whole country on a representative trial of 278 farms, including 102 pork production, 55–beef production, and 121 poultry meat production. The surveys were carried out with the utilization of questionnaires by the PAPI (Paper & Pen Personal Interview) method; the pollsters conducted direct questionnaire interviews. Research results indicate that it is followed that any losses were not recorded during the preparation, loading, and transport of the animals to the slaughterhouse in 33% of the visited farms. In the farms where the losses were indicated, the crushing and suffocations, occurring during the production of pigs, beef cattle and poultry, were the main reasons for these losses. They constituted ca. 40% of the reported reasons. The stress generated by loading and transport caused 16 – 17% (depending on the season of the year) of the loss reasons. In the case of poultry production, in 2017, additionally, 10.7% of losses were caused by inappropriate conditions of loading and transportation, while in 2018 – 11.8%. The diseases were one of the reasons for the losses in pork and beef production (7% of the losses). The losses and waste, generated during livestock production and in meat processing and trade cannot be managed or recovered. They have to be disposed of. It is, therefore, important to prevent and minimize the losses throughout the whole production chain. It is possible to introduce the appropriate measures, connected mainly with the appropriate conditions and methods of animal loading and transport.

Keywords: food losses, food waste, livestock production, meat sector

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12258 A Reference Framework Integrating Lean and Green Principles within Supply Chain Management

Authors: M. Bortolini, E. Ferrari, F. G. Galizia, C. Mora

Abstract:

In the last decades, an increasing set of companies adopted lean philosophy to improve their productivity and efficiency promoting the so-called continuous improvement concept, reducing waste of time and cutting off no-value added activities. In parallel, increasing attention rises toward green practice and management through the spread of the green supply chain pattern, to minimise landfilled waste, drained wastewater and pollutant emissions. Starting from a review on contributions deepening lean and green principles applied to supply chain management, the most relevant drivers to measure the performance of industrial processes are pointed out. Specific attention is paid on the role of cost because it is of key importance and it crosses both lean and green principles. This analysis leads to figure out an original reference framework for integrating lean and green principles in designing and managing supply chains. The proposed framework supports the application, to the whole value chain or to parts of it, e.g. distribution network, assembly system, job-shop, storage system etc., of the lean-green integrated perspective. Evidences show that the combination of the lean and green practices lead to great results, higher than the sum of the performances from their separate application. Lean thinking has beneficial effects on green practices and, at the same time, methods allowing environmental savings generate positive effects on time reduction and process quality increase.

Keywords: environmental sustainability, green supply chain, integrated framework, lean thinking, supply chain management

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12257 Liquid Fuel Production via Catalytic Pyrolysis of Waste Oil

Authors: Malee Santikunaporn, Neera Wongtyanuwat, Channarong Asavatesanupap

Abstract:

Pyrolysis of waste oil is an effective process to produce high quality liquid fuels. In this work, pyrolysis experiments of waste oil over Y zeolite were carried out in a semi-batch reactor under a flow of nitrogen at atmospheric pressure and at different reaction temperatures (350-450 oC). The products were gas, liquid fuel, and residue. Only liquid fuel was further characterized for its composition and properties by using gas chromatography, thermogravimetric analyzer, and bomb calorimeter. Experimental results indicated that the pyrolysis reaction temperature significantly affected both yield and composition distribution of pyrolysis oil. An increase in reaction temperature resulted in increased fuel yield, especially gasoline fraction. To obtain high amount of fuel, the optimal reaction temperature should be higher than 350 oC. A presence of Y zeolite in the system enhanced the cracking activity. In addition, the pyrolysis oil yield is proportional to the catalyst quantity.

Keywords: gasoline, diesel, pyrolysis, waste oil, Y zeolite

Procedia PDF Downloads 180
12256 Turn Organic Waste to Green Fuels with Zero Landfill

Authors: Xu Fei (Philip) WU

Abstract:

As waste recycling concept been accepted more and more in modern societies, the organic portion of the municipal waste become a sires issue in today’s life. Depend on location and season, the organic waste can bee anywhere between 40-65% of total municipal solid waste. Also composting and anaerobic digestion technologies been applied in this field for years, however both process have difficulties been selected by economical and environmental factors. Beside environmental pollution and risk of virus spread, the compost is not a product been welcomed by people even the waste management has to give up them at no cost. The anaerobic digester has to have 70% of water and keep at 35 degree C or above; base on above conditions, the retention time only can be up to two weeks and remain solid has to be dewater and composting again. The enhancive waste water treatment has to be added after. Because these reasons, the voice of suggesting cancelling recycling program and turning all waste to mass burn incinerations have been raised-A process has already been proved has least energy efficiency and most air pollution problem associated process. A newly developed WXF Bio-energy process employs recently developed and patented pre-designed separation, multi-layer and multi-cavity successive bioreactor landfill technology. It features an improved leachate recycling technology, technologies to maximize the biogas generation rate and a reduced overall turnaround period on the land. A single properly designed and operated site can be used indefinitely. In this process, all collected biogas will be processed to eliminate H2S and other hazardous gases. The methane, carbon dioxide and hydrogen will be utilized in a proprietary process to manufacture methanol which can be sold to mitigate operating costs of the landfill. This integration of new processes offers a more advanced alternative to current sanitary landfill, incineration and compost technology. Xu Fei (Philip) Wu Xu Fei Wu is founder and Chief Scientist of W&Y Environmental International Inc. (W & Y), a Canadian environmental and sustainable energy technology company with patented landfill processes and proprietary waste to energy technologies. He has worked in environmental and sustainable energy fields over the last 25 years. Before W&Y, he worked for Conestoga-Rovers & Associates Limited, Microbe Environmental Science and Technology Inc. of Canada and The Ministry of Nuclear Industry and Ministry of Space Flight Industry of China. Xu Fei Wu holds a Master of Engineering Science degree from The University of Western Ontario. I wish present this paper as an oral presentation only Selected Conference Presentations: • “Removal of Phenolic Compounds with Algae” Presented at 25th Canadian Symposium on Water Pollution Research (CAWPRC Conference), Burlington, Ontario Canada. February, 1990 • “Removal of Phenolic Compounds with Algae” Presented at Annual Conference of Pollution Control Association of Ontario, London, Ontario, Canada. April, 1990 • “Removal of Organochlorine Compounds in a Flocculated Algae Photo-Bioreactor” Presented at International Symposium on Low Cost and Energy Saving Wastewater Treatment Technologies (IAWPRC Conference), Kiyoto, Japan, August, 1990 • “Maximizing Production and Utilization of Landfill Gas” 2009 Wuhan International Conference on Environment(CAWPRC Conference, sponsored by US EPA) Wuhan, China. October, 2009. • “WXF Bio-Energy-A Green, Sustainable Waste to Energy Process” Presented at 9Th International Conference Cooperation for Waste Issues, Kharkiv, Ukraine March, 2012 • “A Lannfill Site Can Be Recycled Indefinitely” Presented at 28th International Conference on solid Waste Technology and Management, Philadelphia, Pennsylvania, USA. March, 2013. Hosted by The Journal of Solid Waste Technology and Management.

Keywords: green fuel, waste management, bio-energy, sustainable development, methanol

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12255 Experimental Investigation of Bituminous Roads with Waste Plastic

Authors: Arjita Biswas, Sandeep Potnis

Abstract:

Plastic roads (bituminous roads using waste plastic in the wearing course ) have now become familiar in the Road Construction Sector in India. With the Indian Road Congress Code (IRC SP: 98 -2013), many agencies are coming forward to implement Plastic Roads in India. This paper discuss and compare about the various properties of bituminous mix with 8% waste plastic and normal bituminous mix. This paper also signifies the performance of both the types of roads after 4 months of age under loading conditions. Experiments were carried out to evaluate its performance. The result shows improved performance of plastic roads.

Keywords: bituminous roads, experiments, performance, plastic roads

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12254 Food Bolus Obstruction: A Rural Hospital’s Experience

Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

Abstract:

Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

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12253 Patient Reported Experience of in-Patient Orthognathic Care in an NHS Hospital, in Comparison to a Private Hospital

Authors: R. Litt, A. Kana, K. House

Abstract:

The primary aim of this patient-related experience questionnaire was to gain a better understanding of our patients' experience as inpatients when they undergo orthognathic surgery. The secondary aim of this study was to identify ways in which we can improve the orthognathic inpatient experience and to share this with other units. All patients who received orthognathic surgery at an NHS hospital - Bristol Royal Infirmary, England, over the course of 6 months were asked to complete a questionnaire regarding their care. This data was then analysed and compared to the same questionnaire given to patients treated in a private hospital where orthognathic surgery was completed. All treatment was completed by the same surgeon. The design of the questions took into account NICE (National Institute for Health and Care Excellence) guidance on improving the experience of patient care. Particularly taking into account patients' essential requirements of care, for example, assessing and managing pain, ensuring adequate and appropriate nutrition, and ensuring the patients' personal needs are regularly reviewed and addressed. Overall the patient-related experience after orthognathic surgery was comparable in both the NHS and private hospitals. However, the questionnaire highlighted aspects of inpatient care after orthognathic surgery that can easily be improved in order to provide our patients with the best possible care.

Keywords: orthognathic surgery, patient feedback, jaw surgery, inpatient experience

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12252 Testing Plastic-Sand Construction Blocks Made from Recycled Polyethylene Terephthalate (rPET)

Authors: Cassi Henderson, Lucia Corsini, Shiv Kapila, Egle Augustaityte, Tsemaye Uwejamomere Zinzan Gurney, Aleyna Yildirim

Abstract:

Plastic pollution is a major threat to human and planetary health. In Low- and Middle-Income Countries, plastic waste poses a major problem for marginalized populations who lack access to formal waste management systems. This study explores the potential for converting waste plastic into construction blocks. It is the first study to analyze the use of polyethylene terephthalate (PET) as a binder in plastic-sand bricks. Unlike previous studies of plastic sand-bricks, this research tests the properties of bricks that were made using a low-cost kiln technology that was co-designed with a rural, coastal community in Kenya.  The mechanical strength, resistance to fire and water absorption properties of the bricks are tested in this study. The findings show that the bricks meet structural standards for mechanical performance, fire resistance and water absorption. It was found that 30:70 PET to sand demonstrated the best overall performance.

Keywords: recycling, PET, plastic, sustainable construction, sustainable development

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12251 The Characteristics of Withhold Resuscitation in Out-Of-Hospital Cardiac Arrest

Authors: An-Yi Wang, Wei-Fong Kao, Shin-Han Tsai

Abstract:

Introduction: Information as patient characteristics, resuscitation scene, resuscitation provider perspectives and families wish affects on resuscitation decision-making for out-of-hospital cardiac arrest (OHCA). There is no consistency consensus on how families and emergency physicians approach this decision. The main purpose of our study is to evaluate the characteristics of withholding resuscitation efforts arrival at the hospital. Methods: We retrospectively analyzed patients with OHCA without pre-hospital return-of-spontaneous circulation (ROSC) who was sent to our emergency department (ED) between January 2014 and December 2015. Baseline characteristics, pre-hospital course, and causes of the cardiopulmonary arrest among patients were compared. Results: In 2 years, total 155 arrest patients without pre-hospital ROSC was included. 33(21.3%) patients withhold the resuscitation efforts in ED with mean resuscitation duration 4.45 ± 7.04 minutes after ED arrival. In withholding group, the initial rhythm of arrests was all non-shockable. 9 of them received endotracheal intubation before decision-making. None of the patients in withhold resuscitation group survived to discharge. There was no significant difference among gender, underlying cardiovascular disease, malignancy, chronic renal disease, nor witness collapse between withhold and continue resuscitation groups. Univariate analysis showed there was lower percentage of bystander resuscitation (32.3% vs. 50.4%, p=0.071), and the lower percentage of transport via emergency medical service (EMS) (78.8% vs. 91.8%, p=0.054) in withholding group. Multivariate analysis showed old age (adjusted odds ratio=1.06, 95% C.I.=[1.02-1.11], p<0.05), with underlying respiratory insufficiency (adjusted odds ratio=12.16, 95% C.I.=[3.34-44.29], p<0.05), living at home compared with nursing home (adjusted odds ratio=37.75, 95% C.I.=[1.09-1110.70], p<0.05) were more likely to withhold resuscitation. Transport via EMS was more likely to continue resuscitation (adjusted odds ratio=0.11, 95% C.I.=[0.02-0.71], p<0.05). Conclusion: The decision-making for families and emergency physicians to withhold or continue resuscitation for out-of-hospital cardiac arrest is complex and multi-factorial. Continue resuscitation efforts in nursing home residents is high, and further study among this population is warranted.

Keywords: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, termination resuscitation, withhold resuscitation

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12250 Are SMS Reminders an Precursor to Outpatient Show-Ups?

Authors: Shankar M. Bakkannavar, Smitha Nayak, Vinod C. Nayak, Ravi Bagali

Abstract:

Attendance rate for hospital outpatient appointments plays a pivotal role in operational efficiency of a hospital. Strategic interventions like ‘reminder systems’ prior to the scheduled appointment has proved to be an effective strategy for outpatient appointment ‘show-ups’. This study is designed with an objective to assess the effectiveness of SMS reminders as an intervention to enhance the effectiveness of hospital outpatient attendance. Method: The survey was conducted at Columbia Asia Hosiptal, Bangalore. We surveyed 60 patients who had a scheduled outpatient appointment in Department of General Medicine, Department of Obstetrics and Gynecology and the Orthopedics department, as these departments had a heavy patient flow and had higher contributions to the top line of the hospital. Results: Majority (64%) of the patients preferred to be sent an SMS reminder on the outpatient appointment schedule. 37 (61%) respondents stated that the ideally, reminders could be effective only if they are sent 24-48 hours prior to the appointment schedule. 41(68%) respondents were of the opinion that a minimum of two reminders would be necessary to ensure patients show up for the appointment. 1% level of significance. It also observed that there is strong association between age and preference on mode of reminder (P=0.002).

Keywords: reminder systems, appointment show-ups, SMS reminders, health Information

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12249 Development of an Automatic Sequential Extraction Device for Pu and Am Isotopes in Radioactive Waste Samples

Authors: Myung Ho Lee, Hee Seung Lim, Young Jae Maeng, Chang Hoon Lee

Abstract:

This study presents an automatic sequential extraction device for Pu and Am isotopes in radioactive waste samples from the nuclear power plant with anion exchange resin and TRU resin. After radionuclides were leached from the radioactive waste samples with concentrated HCl and HNO₃, the sample was allowed to evaporate to dryness after filtering the leaching solution with 0.45 micron filter. The Pu isotopes were separated in HNO₃ medium with anion exchange resin. For leaching solution passed through the anion exchange column, the Am isotopes were sequentially separated with TRU resin. Automatic sequential extraction device built-in software information of separation for Pu and Am isotopes was developed. The purified Pu and Am isotopes were measured by alpha spectrometer, respectively, after the micro-precipitation of neodymium. The data of Pu and Am isotopes in radioactive waste with an automatic sequential extraction device developed in this study were validated with the ICP-MS system.

Keywords: automatic sequential extraction device, Pu isotopes, Am isotopes, alpha spectrometer, radioactive waste samples, ICP-MS system

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12248 WHO Surgical Safety Checklist in a Rural Ugandan Hospital, Barriers and Drivers to Implementation

Authors: Lucie Litvack, Malaz Elsaddig, Kevin Jones

Abstract:

There is strong evidence to support the efficacy of the World Health Organization (WHO) Surgical Safety Checklist in improving patient safety; however, its use can be associated with difficulties. This study uses qualitative data collected in Kitovu Healthcare Complex, a rural Ugandan hospital, to identify factors that may influence the use of the checklist in a low-income setting. Potential barriers to and motivators for the hospital’s use of this checklist are identified and explored through observations of current patient safety practices; semi-structured interviews with theatre staff; a focus group with doctors; and trial implementation of the checklist. Barriers identified include the institutional context; knowledge and understanding; patient safety culture; resources and checklist contents. Motivators for correct use include prior knowledge; team attitudes; and a hospital advocate. Challenges are complex and unique to this socioeconomic context. Stepwise change to improve patient safety practices, local champions, whole team training, and checklist modification may assist the implementation and sustainable use of the checklist in an effective way.

Keywords: anaesthesia, patient safety, Uganda, WHO surgical safety checklist

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12247 Determinants of Hospital Obstetric Unit Closures in the United States 2002-2013: Loss of Hospital Obstetric Care 2002-2013

Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

Abstract:

Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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12246 Development of Environmentally Clean Construction Materials Using Industrial Waste from Kazakhstan

Authors: Galiya Zhanzakovna Alzhanova, Yelaman Kanatovich Aibuldinov, Zhanar Baktybaevna Iskakova, Gaziz Galymovich Abdiyussupov, Madi Toktasynuly Omirzak, Aizhan Doldashevna Gazizova

Abstract:

The sustainable use of industrial waste has recently increased due to increased environmental problems in landfills. One of the best ways to utilise waste is as a road base material. Industrial waste is a less costly and more efficient way to strengthen local soils than by introducing new additive materials. This study explored the feasibility of utilising red mud, blast furnace slag, and lime production waste to develop environmentally friendly construction materials for stabilising natural loam. Four different ratios of red mud (20, 30, and 40%), blast furnace slag (25, 30, and 35%), lime production waste (4, 6, and 8%), and varied amounts of natural loam were combined to produce nine different mixtures. The results showed that the sample with 40% red mud, 35% blast furnace slag, and 8% lime production waste had the highest strength. The sample's measured compressive strength for 90 days was 7.38 MPa, its water resistance for the same period was 7.12 MPa, and its frost resistance for the same period was 7.35 MP; low linear expansion met the requirements of the Kazakh regulations for first-class building materials. The study of mineral composition showed that there was no contamination with heavy metals or dangerous substances. Road base materials made of red mud, blast furnace slag, lime production waste, and natural loam mix can be employed because of their durability and environmental performance. The chemical and mineral composition of raw materials was determined using X-ray diffraction, X-ray fluorescence, scanning electron microscopy, energy dispersive spectroscopy, atomic absorption spectroscopy, and axial compressive strength were examined.

Keywords: blast furnace slag, lime production waste, natural loam stabilizing, red mud, road base material

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12245 A Review on Application of Waste Tire in Concrete

Authors: M. A. Yazdi, J. Yang, L. Yihui, H. Su

Abstract:

The application of recycle waste tires into civil engineering practices, namely asphalt paving mixtures and cementbased materials has been gaining ground across the world. This review summarizes and compares the recent achievements in the area of plain rubberized concrete (PRC), in details. Different treatment methods have been discussed to improve the performance of rubberized Portland cement concrete. The review also includes the effects of size and amount of tire rubbers on mechanical and durability properties of PRC. The microstructure behaviour of the rubberized concrete was detailed.

Keywords: waste rubber aggregates, microstructure, treatment methods, size and content effects

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12244 Anaerobic Fermentation Process for Production of Biohydrogen from Pretreated Fruit Wastes

Authors: A. K. R. Gobinath, He Jianzhong, Kun-Lin Yang

Abstract:

Fruit waste was used as a feedstock to produce biohydrogen in this study. Fruit waste used in this study was collected from several fruit juice stalls in Singapore. Based on our observation, the fruit waste contained 35-40% orange, 10-20% watermelon, 10-15% apple, 10-15% pineapple, 1-5% mango. They were mixed with water (1:1 ratio based on wet biomass) and blended to attain homogenous mixtures. Later, fruit waste was subjected to one of the following pretreatments: autoclave (121 °C for 20min), microwave (20min) or both. After pretreatment, the total sugar concentration in the hydrolysate was high (>12g/l) when both autoclave and microwave were applied. In contrast, samples without pretreatment measured only less than 2g/l of sugar. While using these hydrolysates as carbon sources, Clostridium strain BOH3 produces 2526-3126 ml/l of hydrogen after 72h of anaerobic fermentation. The hydrogen yield was 295-300 ml/g of sugar which is close to the hydrogen yields from glucose (338 ml/gm) and xylose (330 ml/gm). Our HPLC analysis showed that fruit waste hydrolysate contained oligosugars (25-27%), sucrose (18-23%), fructose (25-30%), glucose (10-15%) and mannose (2-5%). Additionally, pretreatment led to the release of free amino acids (160-512 mg/l), calcium (7.8-12.9 ppm), magnesium (4.32-6.55 ppm), potassium (5.4-65.1 ppm) and sodium (0.4-0.5 ppm) into the hydrolysate. These nutrients were able to support strain-BOH3 to grow and produce high level of hydrogen. Notably, unlike other pretreatment methods (with strong acids and bases), these pretreatment techniques did not generate any inhibitors (e.g. furfural and phenolic acids) to suppress the hydrogen production. Interestingly, strain BOH3 can also ferment pretreated fruit waste slurry and produce hydrogen with a high yield (156-343 ml/gm fruit waste). While fermenting pretreated fruit waste slurry, strain-BOH3 excreted several saccharolytic enzymes majorly xylanase (1.84U/ml), amylase (1.10U/ml), pectinase (0.36U/ml) and cellulase (0.43U/ml). Due to expressions of these enzymes, strain BOH3 was able to directly utilize pretreated fruit waste hydrolysate and produces high-level of hydrogen.

Keywords: autoclave pretreatment, biohydrogen production, clostridial fermentation, fruit waste, and microwave pretreatment

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12243 Introducing a Video-Based E-Learning Module to Improve Disaster Preparedness at a Tertiary Hospital in Oman

Authors: Ahmed Al Khamisi

Abstract:

The Disaster Preparedness Standard (DPS) is one of the elements that is evaluated by the Accreditation Canada International (ACI). ACI emphasizes to train and educate all staff, including service providers and senior leaders, on emergency and disaster preparedness upon the orientation and annually thereafter. Lack of awareness and deficit of knowledge among the healthcare providers about DPS have been noticed in a tertiary hospital where ACI standards were implemented. Therefore, this paper aims to introduce a video-based e-learning (VB-EL) module that explains the hospital’s disaster plan in a simple language which will be easily accessible to all healthcare providers through the hospital’s website. The healthcare disaster preparedness coordinator in the targeted hospital will be responsible to ensure that VB-EL is ready by 25 April 2019. This module will be developed based on the Kirkpatrick evaluation method. In fact, VB-EL combines different data forms such as images, motion, sounds, text in a complementary fashion which will suit diverse learning styles and individual learning pace of healthcare providers. Moreover, the module can be adjusted easily than other tools to control the information that healthcare providers receive. It will enable healthcare providers to stop, rewind, fast-forward, and replay content as many times as needed. Some anticipated limitations in the development of this module include challenges of preparing VB-EL content and resistance from healthcare providers.

Keywords: Accreditation Canada International, Disaster Preparedness Standard, Kirkpatrick evaluation method, video-based e-learning

Procedia PDF Downloads 135
12242 Aliens in Space: Reflections on an Applied Theatre Project in a Medium Secure Hospital

Authors: Ashley Barnes

Abstract:

This paper will consider the ways in which varied notions of Space played a central role in a 12-week drama project with patients in a Medium Secure Hospital in the UK. In the project, the patients devised and performed a series of sketches, inspired by Science Fiction films, which echoed their own experience of alienation. During the project, the familiar and rigorously regulated Activity Room became a site of imagination, adventure and laughter; transforming the atmosphere of the hospital and allowing the patients to be transported to another space entirely. A space that was as much in their heads as in the physical domain. It will be argued that, although work created in an institution such as a Medium Secure Hospital is infused with hegemonic associations and meanings, the starting point for such work should be to seek an empty space in which the participants can allow their imaginations to be released. This work sits within a range of contexts and will be consciously interdisciplinary. It will draw from Human Geography and Criminology, as well as Performance and Applied Theatre Literature. It is hoped that this paper will build upon the literature that relates to the very particular environment of Secure Hospitals and to provide a starting point for further practical exploration.

Keywords: criminal justice, mental health, science fiction films, space and place

Procedia PDF Downloads 199
12241 Prevalence of Malocclusion and Assessment of Orthodontic Treatment Needs in Malay Transfusion-Dependent Thalassemia Patients

Authors: Mohamed H. Kosba, Heba A. Ibrahim, H. Rozita

Abstract:

Statement of the Problem: The life expectancy for transfusion-dependent thalassemia patients has increased dramatically with iron-chelation therapy and other modern management modalities. In these patients, the most dominant maxillofacial manifestations are protrusion of zygomatic bones and premaxilla due to the hyperplasia of bone marrow. The purpose of this study is to determine the prevalence of malocclusion and orthodontic treatment needs according to the Dental Aesthetic Index (DAI) among Malay transfusion-dependent thalassemia patients. Orientation: This is a cross-sectional study consist of 43 Malay transfusion-dependent thalassemia patients, 22 males, and 19 females with the mean age of 15.9 years old (SD 3.58). The subjects were selected randomly from patients attending Paediatrics and Internal Medicine Clinic at Hospital USM and Hospital Sultana Bahiyah. The subjects were assessed for malocclusion according to Angle’s classification, and orthodontic treatment needs using DAI. The results show that 22 of the subjects (51.1%) have class II malocclusion, 12 subjects (28%) have class І, while 9 subjects (20.9%) have class Ⅲ. The assessment of orthodontic treatment needs to reveal 22 cases (51.1%) fall in the normal/minor needs category, 12 subjects (28%) fall in the severe and very severe category, while 9 subjects (20.9%) fall in the definite category. Conclusion & Significance: Half of Malay transfusion-dependent thalassemia patients have Class Ⅱmalocclusion. About 28% had malocclusion and required orthodontic treatment. This research shows that Malay transfusion-dependent thalassemia may require orthodontic management; earlier intervention to reduce the complexity of the treatment later, suggesting functional appliance as a suitable treatment option for them, a twin block appliance together with headgear to restrict maxillary growth suggested for management. The current protocol implemented by the Malaysian Ministry of Health for the management of these patients seems to be sufficient since the result shows that about 28% require orthodontic treatment need, according to DAI.

Keywords: prevalence, DAI, thalassaemia, angle classification

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12240 An Overview of Electronic Waste as Aggregate in Concrete

Authors: S. R. Shamili, C. Natarajan, J. Karthikeyan

Abstract:

Rapid growth of world population and widespread urbanization has remarkably increased the development of the construction industry which caused a huge demand for sand and gravels. Environmental problems occur when the rate of extraction of sand, gravels, and other materials exceeds the rate of generation of natural resources; therefore, an alternative source is essential to replace the materials used in concrete. Now-a-days, electronic products have become an integral part of daily life which provides more comfort, security, and ease of exchange of information. These electronic waste (E-Waste) materials have serious human health concerns and require extreme care in its disposal to avoid any adverse impacts. Disposal or dumping of these E-Wastes also causes major issues because it is highly complex to handle and often contains highly toxic chemicals such as lead, cadmium, mercury, beryllium, brominates flame retardants (BFRs), polyvinyl chloride (PVC), and phosphorus compounds. Hence, E-Waste can be incorporated in concrete to make a sustainable environment. This paper deals with the composition, preparation, properties, classification of E-Waste. All these processes avoid dumping to landfills whilst conserving natural aggregate resources, and providing a better environmental option. This paper also provides a detailed literature review on the behaviour of concrete with incorporation of E-Wastes. Many research shows the strong possibility of using E-Waste as a substitute of aggregates eventually it reduces the use of natural aggregates in concrete.

Keywords: dumping, electronic waste, landfill, toxic chemicals

Procedia PDF Downloads 156
12239 Drying Kinetics of Okara (Soy Pulp) Using the Multi-Commodity Heat Pump Dryer (MCHPD)

Authors: Lorcelie B. Taclan, Jolly S. Balila, Maribel Balagtas, Eunice M. Aclan, Myrtle C. Orbon, Emson Y. Taclan, Irenea A. Centeno

Abstract:

Okara (soy pulp), a by-product and waste from the production of soymilk, tufo and tokwa and soybean-based vegan food products is readily available in the university thrice a week. The Food Factory owned and managed by AUP produces these food products weekly. Generally the study was conducted to determine the drying kinetics of soya pulp using the MCHPD. Specifically, it aimed to establish the time of drying; moisture loss per hour and percent moisture content of soya pulp and to establish the dried okara as an ingredient to other foods. The MCHPD is drying equipment that has an ideal drying condition of 50.00C and 10.0% relative humidity. Fresh and wet soya pulp were weighed at 1.0 kg per tray (21 drying trays), laid on the trays lined with cheese cloth. The MCHPD was set to desired drying conditions. Weight loss was monitored every hour and calculated using standard formulas. Research results indicated that the drying time for soya pulp was 19.0 hours; the % moisture content was reduced from 87.6.0% to 9.7.0% at an average moisture loss of 3.0 g/hr. The nutritional values of okara were favorably maintained with enhanced color. The dried okara was added as an ingredient to other healthy bakery products produced by the AUP Food Factory. Making use of okara would add nutritional values to other food products and would also help waste management concerns inside the university.

Keywords: okara, MCHPD, drying kinetics, nutritional values, waste management

Procedia PDF Downloads 381
12238 Recycled Aggregates from Construction and Demolition Waste in the Production of Concrete Blocks

Authors: Juan A. Ferriz-Papi, Simon Thomas

Abstract:

The construction industry generates large amounts of waste, usually mixed, which can be composed of different origin materials, most of them catalogued as non-hazardous. The European Union targets for this waste for 2020 have been already achieved by the UK, but it is mainly developed in downcycling processes (backfilling) whereas upcycling (such as recycle in new concrete batches) still keeps at a low percentage. The aim of this paper is to explore further in the use of recycled aggregates from construction and demolition waste (CDW) in concrete mixes so as to improve upcycling. A review of most recent research and legislation applied in the UK is developed regarding the production of concrete blocks. As a case study, initial tests were developed with a CDW recycled aggregate sample from a CDW plant in Swansea. Composition by visual inspection and sieving tests of two samples were developed and compared to original aggregates. More than 70% was formed by soil waste from excavation, and the rest was a mix of waste from mortar, concrete, and ceramics with small traces of plaster, glass and organic matter. Two concrete mixes were made with 80% replacement of recycled aggregates and different water/cement ratio. Tests were carried out for slump, absorption, density and compression strength. The results were compared to a reference sample and showed a substantial reduction of quality in both mixes. Despite that, the discussion brings to identify different aspects to solve, such as heterogeneity or composition, and analyze them for the successful use of these recycled aggregates in the production of concrete blocks. The conclusions obtained can help increase upcycling processes ratio with mixed CDW as recycled aggregates in concrete mixes.

Keywords: aggregates, concrete, concrete block, construction and demolition waste, recycling

Procedia PDF Downloads 282
12237 The Use of Rice Husk Ash as a Stabilizing Agent in Lateritic Clay Soil

Authors: J. O. Akinyele, R. W. Salim, K. O. Oikelome, O. T. Olateju

Abstract:

Rice Husk (RH) is the major byproduct in the processing of paddy rice. The management of this waste has become a big challenge to some of the rice producers, some of these wastes are left in open dumps while some are burn in the open space, and these two actions have been contributing to environmental pollution. This study evaluates an alternative waste management of this agricultural product for use as a civil engineering material. The RH was burn in a controlled environment to form Rice Husk Ash (RHA). The RHA was mix with lateritic clay at 0, 2, 4, 6, 8, and 10% proportion by weight. Chemical test was conducted on the open burn and controlled burn RHA with the lateritic clay. Physical test such as particle size distribution, Atterberg limits test, and density test were carried out on the mix material. The chemical composition obtained for the RHA showed that the total percentage compositions of Fe2O3, SiO2 and Al2O3 were found to be above 70% (class “F” pozzolan) which qualifies it as a very good pozzolan. The coefficient of uniformity (Cu) was 8 and coefficient of curvature (Cc) was 2 for the soil sample. The Plasticity Index (PI) for the 0, 2, 4, 6, 8. 10% was 21.0, 18.8, 16.7, 14.4, 12.4 and 10.7 respectively. The work concluded that RHA can be effectively used in hydraulic barriers and as a stabilizing agent in soil stabilization.

Keywords: rice husk ash, pozzolans, paddy rice, lateritic clay

Procedia PDF Downloads 311
12236 The Effect of Treated Waste-Water on Compaction and Compression of Fine Soil

Authors: M. Attom, F. Abed, M. Elemam, M. Nazal, N. ElMessalami

Abstract:

—The main objective of this paper is to study the effect of treated waste-water (TWW) on the compaction and compressibility properties of fine soil. Two types of fine soils (clayey soils) were selected for this study and classified as CH soil and Cl type of soil. Compaction and compressibility properties such as optimum water content, maximum dry unit weight, consolidation index and swell index, maximum past pressure and volume change were evaluated using both tap and treated waste water. It was found that the use of treated waste water affects all of these properties. The maximum dry unit weight increased for both soils and the optimum water content decreased as much as 13.6% for highly plastic soil. The significant effect was observed in swell index and swelling pressure of the soils. The swell indexed decreased by as much as 42% and 33% for highly plastic and low plastic soils, respectively, when TWW is used. Additionally, the swelling pressure decreased by as much as 16% for both soil types. The result of this research pointed out that the use of treated waste water has a positive effect on compaction and compression properties of clay soil and promise for potential use of this water in engineering applications. Keywords—Consolidation, proctor compaction, swell index, treated waste-water, volume change.

Keywords: consolidation, proctor compaction, swell index, treated waste-water, volume change

Procedia PDF Downloads 245
12235 Res2ValHUM: Creation of Resource Management Tool and Microbial Consortia Isolation and Identification

Authors: A. Ribeiro, N. Valério, C. Vilarinho, J. Araujo, J. Carvalho

Abstract:

Res2ValHUM project involves institutions from the Spanish Autonomous Region of Galicia and the north of Portugal (districts of Porto and Braga) and has as overall objectives of promotion of composting as an process for the correct managing of organic waste, valorization of compost in different fields or applications for the constitution of products with high added value, reducing of raw materials losses, and reduction of the amount of waste throw in landfills. Three main actions were designed to achieve the objectives: development of a management tool to improve collection and residue channeling for composting, sensibilization of the population for composting and characterization of the chemical and biological properties of compost and humic and fulvic substances to envisage high-value applications of compost. Here we present the cooperative activity of Galician and northern Portuguese institutions to valorize organic waste in both regions with common socio-economic characteristics and residue management problems. Results from the creation of the resource manage tool proved the existence of a large number of agricultural wastes that could be valorized. In the North of Portugal, the wastes from maize, oats, potato, apple, grape pomace, rye, and olive pomace can be highlighted. In the Autonomous Region of Galicia the wastes from maize, wheat, potato, apple, and chestnuts can be emphasized. Regarding the isolation and identification of microbial consortia from compost samples, results proved microorganisms belong mainly to the genus Bacillus spp. Among all the species identified in compost samples, Bacillus licheniformis can be highlighted in the production of humic and fulvic acids.

Keywords: agricultural wastes, Bacillus licheniformis, Bacillus spp., humic-acids, fulvic-acids

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12234 Pre-Eliminary Design Adjustable Workstation for Piston Assembly Line Considering Anthropometric for Indonesian People

Authors: T. Yuri M. Zagloel, Inaki M. Hakim, Syarafi A. M.

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Manufacturing process has been considered as one of the most important activity in business process. It correlates with productivity and quality of the product so industries could fulfill customer’s demand. With the increasing demand from customer, industries must improve their manufacturing ability such as shorten lead time and reduce wastes on their process. Lean manufacturing has been considered as one of the tools to waste elimination in manufacturing or service industri. Workforce development is one practice in lean manufacturing that can reduce waste generated from operator such as waste of unnecessary motion. Anthropometric approach is proposed to determine the recommended measurement in operator’s work area. The method will get some dimensions from Indonesia people that related to piston workstation. The result from this research can be obtained new design for the workarea considering ergonomic aspect.

Keywords: adjustable, anthropometric, ergonomic, waste

Procedia PDF Downloads 392
12233 An Investigation about the Health-Promoting Lifestyle of 1389 Emergency Nurses in China

Authors: Lei Ye, Min Liu, Yong-Li Gao, Jun Zhang

Abstract:

Purpose: The aims of the study are to investigate the status of health-promoting lifestyle and to compare the healthy lifestyle of emergency nurses in different levels of hospitals in Sichuan province, China. The investigation is mainly about the health-promoting lifestyle, including spiritual growth, health responsibility, physical activity, nutrition, interpersonal relations, stress management. Then the factors were analyzed influencing the health-promoting lifestyle of emergency nurses in hospitals of Sichuan province in order to find the relevant models to provide reference evidence for intervention. Study Design: A cross-sectional research method was adopted. Stratified cluster sampling, based on geographical location, was used to select the health facilities of 1389 emergency nurses in 54 hospitals from Sichuan province in China. Method: The 52-item, six-factor structure Health-Promoting Lifestyle Profile II (HPLP- II) instrument was used to explore participants’ self-reported health-promoting behaviors and measure the dimensions of health responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management. Demographic characteristics, education, work duration, emergency nursing work duration and self-rated health status were documented. Analysis: Data were analyzed through SPSS software ver. 17.0. Frequency, percentage, mean ± standard deviation were used to describe the general information, while the Nonparametric Test was used to compare the constituent ratio of general data of different hospitals. One-way ANOVA was used to compare the scores of health-promoting lifestyle in different levels hospital. A multiple linear regression model was established. P values which were less than 0.05 determined statistical significance in all analyses. Result: The survey showed that the total score of health-promoting lifestyle of nurses at emergency departments in Sichuan Province was 120.49 ± 21.280. The relevant dimensions are ranked by scores in descending order: interpersonal relations, nutrition, health responsibility, physical activity, stress management, spiritual growth. The total scores of the three-A hospital were the highest (121.63 ± 0.724), followed by the senior class hospital (119.7 ± 1.362) and three-B hospital (117.80 ± 1.255). The difference was statistically significant (P=0.024). The general data of nurses was used as the independent variable which includes age, gender, marital status, living conditions, nursing income, hospital level, Length of Service in nursing, Length of Service in emergency, Professional Title, education background, and the average number of night shifts. The total score of health-promoting lifestyle was used as dependent variable; Multiple linear regression analysis method was adopted to establish the regression model. The regression equation F = 20.728, R2 = 0.061, P < 0.05, the age, gender, nursing income, turnover intention and status of coping stress affect the health-promoting lifestyle of nurses in emergency department, the result was statistically significant (P < 0.05 ). Conclusion: The results of the investigation indicate that it will help to develop health promoting interventions for emergency nurses in all levels of hospital in Sichuan Province through further research. Managers need to pay more attention to emergency nurses’ exercise, stress management, self-realization, and conduct intervention in nurse training programs.

Keywords: emergency nurse, health-promoting lifestyle profile II, health behaviors, lifestyle

Procedia PDF Downloads 268
12232 The Impact of Covid-19 Pandemic on Acute Urology Admissions in a Busy District General Hospital in the UK

Authors: D. Bheenick, M. Young, M.Elmussareh, A.Ali

Abstract:

Objective: Coronavirus disease 2019 (COVID-19) has had unprecedented effects on the healthcare system in the UK. The pandemic has impacted every service within secondary care, including urology. Our objective is to determine how COVID-19 has influenced acute urology admissions in a busy district general hospital in the UK. Patient and methods: Retrospective data of patients presenting acutely to the urology department was collected between 13th January to 22nd March 2020 (pre-lockdown period) and 23rd March to 31st May 2020 (lockdown period). The nature of referrals, types of admission encountered, and management required in accordance with the new set of protocols established during the lockdown period were analysed and compared to the same data prior to UK lockdown. Results: 1092 patients were included in the study. An overall reduction of 32.5% was seen in the total number of admissions. A marked decrease was seen in non-urological pathology as compared to other categories. Urolithiasis showed the highest proportional increase. Treatment varied proportionately to the diagnosis, with conservative management accounting for the most likely treatment during lockdown. However, the proportion of patients requiring interventions during the lockdown period increased overall. No comparative differences were observed during the two periods in terms of source of referral, length of stay and patient age. Conclusion: The admission rate showed a decrease, with no significant difference in the nature and timing of presentation. Our department was able to continue providing effective management to patients presenting acutely during the COVID-19 outbreak.

Keywords: COVID-19, lockdown, admissions, urology

Procedia PDF Downloads 148