Search results for: hospital waste
4340 Evaluation of Medication Errors in Outpatient Pharmacies: Electronic Prescription System vs. Paper System
Authors: Mera Ababneh, Sayer Al-Azzam, Karem Alzoubi, Abeer Rababa'h
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Background: Medication errors are among the most common medical errors. Their occurrences result in patient’s mortality, morbidity, and additional healthcare costs. Continuous monitoring and detection is required. Objectives: The aim of this study was to compare medication errors in outpatient’s prescriptions in two different hospitals (paper system vs. electronic system). Methods: This was a cross sectional observational study conducted in two major hospitals; King Abdullah University Hospital (KAUH) and Princess Bassma Teaching Hospital (PBTH) over three months period. Data collection was conducted by two trained pharmacists at each site. During the study period, medication prescriptions and dispensing procedures were screened for medication errors in both participating centers by two trained pharmacist. Results: In the electronic prescription hospital, 2500 prescriptions were screened in which 631 medication errors were detected. Prescription errors were 231 (36.6%), and dispensing errors were 400 (63.4%) of all errors. On the other side, analysis of 2500 prescriptions in paper-based hospital revealed 3714 medication errors, of which 288 (7.8%) were prescription errors, and 3426 (92.2%) were dispensing errors. A significant number of 2496 (67.2%) were inadequately and/or inappropriately labeled. Conclusion: This study provides insight for healthcare policy makers, professionals, and administrators to invest in advanced technology systems, education, and epidemiological surveillance programs to minimize medication errors.Keywords: medication errors, prescription errors, dispensing errors, electronic prescription, handwritten prescription
Procedia PDF Downloads 2804339 Impact of Physiotherapy on COVID-19 and Post COVID-19 Patients, (Expert Physiotherapy and American Hospital, Case Study)
Authors: Jonida Hasanaj
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Abstract: Four years after the pandemic, numerous studies discuss the long-term effects of COVID-19 on patients, with chronic fatigue syndrome being a prominent concern. Understanding the mechanisms behind this syndrome is crucial for developing prevention, treatment, and rehabilitation strategies. The appropriateness of physiotherapeutic treatment in covid 19 and post-COVID-19 patients has remained uncertain due to inconsistent diagnostic criteria, highlighting the need for further research. This paper intends to offer guidelines and specific suggestions for hospital-based physical therapists managing COVID-19 hospitalized patients at ‘’Expert Physiotherapy’ and ’American Hospital’ in Albania using a national approach in accordance with worldwide initiatives. Several studies indicate that chronic tiredness syndrome and high intracranial pressure could result from failure of the post-Covid-19 lymphatic system. Enabling the patient to intensify their physical activity and enhance their ability to move, exercise, and even resume a regular life cycle is the aim of physiotherapy treatment.Keywords: mobility, physiotherapy, post-covid 19, rehabilitation, results
Procedia PDF Downloads 634338 Value Generation of Construction and Demolition Waste Originated in the Building Rehabilitation to Improve Energy Efficiency; From Waste to Resources
Authors: Mercedes Del Rio Merino, Jaime Santacruz Astorqui, Paola Villoria Saez, Carmen Viñas Arrebola
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The lack of treatment of the waste from construction and demolition waste (CDW) is a problem that must be solved immediately. It is estimated that in the world not to use CDW generates an increase in the use of new materials close to 20% of the total value of the materials used. The problem is even greater in case these wastes are considered hazardous because the final deposition of them may also generate significant contamination. Therefore, the possibility of including CDW in the manufacturing of building materials, represents an interesting alternative to ensure their use and to reduce their possible risk. In this context and in the last years, many researches are being carried out in order to analyze the viability of using CDW as a substitute for the traditional raw material of high environmental impact. Even though it is true, much remains to be done, because these works generally characterize materials but not specific applications that allow the agents of the construction to have the guarantees required by the projects. Therefore, it is necessary the involvement of all the actors included in the life cycle of these new construction materials, and also to promote its use for, for example, definition of standards, tax advantages or market intervention is necessary. This paper presents the main findings reached in "Waste to resources (W2R)" project since it began in October 2014. The main goal of the project is to develop new materials, elements and construction systems, manufactured from CDW, to be used in improving the energy efficiency of buildings. Other objectives of the project are: to quantify the CDW generated in the energy rehabilitation works, specifically wastes from the building envelope; and to study the traceability of CDW generated and promote CDW reuse and recycle in order to get close to the life cycle of buildings, generating zero waste and reducing the ecological footprint of the construction sector. This paper determines the most important aspects to consider during the design of new constructive solutions, which improve the energy efficiency of buildings and what materials made with CDW would be the most suitable for that. Also, a survey to select best practices for reducing "close to zero waste" in refurbishment was done. Finally, several pilot rehabilitation works conform the parameters analyzed in the project were selected, in order to apply the results and thus compare the theoretical with reality. Acknowledgements: This research was supported by the Spanish State Secretariat for Research, Development and Innovation of the Ministry of Economy and Competitiveness under "Waste 2 Resources" Project (BIA2013-43061-R).Keywords: building waste, construction and demolition waste, recycling, resources
Procedia PDF Downloads 2504337 Ambivalence in Embracing Artificial Intelligence in the Units of a Public Hospital in South Africa
Authors: Sanele E. Nene L., Lia M. Hewitt
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Background: Artificial intelligence (AI) has a high value in healthcare, various applications have been developed for the efficiency of clinical operations, such as appointment/surgery scheduling, diagnostic image analysis, prognosis, prediction and management of specific ailments. Purpose: The purpose of this study was to explore, describe, contrast, evaluate, and develop the various leadership strategies as a conceptual framework, applied by public health Operational Managers (OMs) to embrace AI benefits, with the aim to improve the healthcare system in a public hospital. Design and Method: A qualitative, exploratory, descriptive and contextual research design was followed and a descriptive phenomenological approach. Five phases were followed to conduct this study. Phenomenological individual interviews and focus groups were used to collect data and a phenomenological thematic data analysis method was used. Findings and conclusion: Three themes surfaced as the experiences of AI by the OMs; Positive experiences related to AI, Management and leadership processes in AI facilitation, and Challenges related to AI.Keywords: ambivalence, embracing, Artificial intelligence, public hospital
Procedia PDF Downloads 794336 Establishing a Communication Framework in Response to the COVID-19 Pandemic in a Tertiary Government Hospital in the Philippines
Authors: Nicole Marella G. Tan, Al Joseph R. Molina, Raisa Celine R. Rosete, Soraya Elisse E. Escandor, Blythe N. Ke, Veronica Marie E. Ramos, Apolinario Ericson B. Berberabe, Jose Jonas D. del Rosario, Regina Pascua-Berba, Eileen Liesl A. Cubillan, Winlove P. Mojica
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Emergency risk and health communications play a vital role in any pandemic response. However, the Philippine General Hospital (PGH) lacked a system of information delivery that could effectively fulfill the hospital’s communication needs as a COVID-19 referral hospital. This study aimed to describe the establishment of a communication framework for information dissemination within a tertiary government hospital during the COVID-19 pandemic and evaluated the perceived usefulness of its outputs. This is a mixed quantitative-qualitative study with two phases. Phase 1 documented the formation and responsibilities of the Information Education Communication (IEC) Committee. Phase 2 evaluated its output and outcomes through a hospital-wide survey of 528 healthcare workers (HCWs) using a pre-tested questionnaire. In-depth explanations were obtained from five focused group discussions (FGD) amongst various HCW subgroups. Descriptive analysis was done using STATA 16 while qualitative data were synthesized thematically. Communication practices in PGH were loosely structured at the beginning of the pandemic until the establishment of the IEC Committee. The IEC Committee was well-represented by concerned stakeholders. Nine types of infographics tackled different aspects of the hospital’s health operations after thorough inputs from concerned offices. Internal and external feedback mechanisms ensured accurate infographics. Majority of the survey respondents (98.67%) perceived these as useful in their work or daily lives. FGD participants cited the relevance of infographics to their occupations, suggested improvements, and hoped that these efforts would be continued in the future. Sustainability and comprehensive reach were the main concerns in this undertaking. The PGH COVID-19 IEC framework was developed through trial and testing as there were no existing formal structures to communicate health risks and to properly direct the HCWs in the chaotic time of a pandemic. It is a continuously evolving framework which is perceived as useful by HCWs and is hoped to be sustained in the future.Keywords: COVID-19, pandemic, health communication, infographics, social media
Procedia PDF Downloads 1234335 Mechanical, Physical and Durability Properties of Cement Mortars Added with Recycled PP/PE-Based Food Packaging Waste Material
Authors: Livia Guerini, Christian Paglia
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In Switzerland, only a fraction of plastic waste from food packaging is collected and recycled for further use in the food industry. Therefore, reusing these waste plastics for building applications can be an attractive alternative to disposal in order to reduce the problem of waste management and to make up for the depletion of raw materials needed for construction. In this study, experiments were conducted on the mechanical properties (compressive and flexural strength, elastic modulus), physical properties (density, workability, porosity, and water permeability) and durability (freeze/thaw resistance) of cementitious mortars with additions of recycled low-/high-density polyethylene (LDPE/HDPE)/ polypropylene (PP) regrind (addition of 5% and 10% by weight) and LDPE sheets (addition of 0.5% and 1.5% by weight) coming from food packaging. The results show that as the addition of plastic material increases, the density and mechanical properties of the mortars decrease compared to conventional ones. Porosity is similar in all the mixtures made, while the workability and the permeability are affected not only by the amount added but also by the shape of the plastic aggregate. Freeze/thaw resistance, on the other hand, is significantly higher in mortars with plastic aggregates than in traditional mortar. This feature may be interesting for the realization of outdoor mortars in cold environments.Keywords: food packaging waste, durability properties, mechanical properties, mortar, recycled PE, recycled PP
Procedia PDF Downloads 1454334 Assessing the Potential of a Waste Material for Cement Replacement and the Effect of Its Fineness in Soft Soil Stabilisation
Authors: Hassnen M. Jafer, W. Atherton, F. Ruddock
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This paper represents the results of experimental work to investigate the suitability of a waste material (WM) for soft soil stabilisation. In addition, the effect of particle size distribution (PSD) of the waste material on its performance as a soil stabiliser was investigated. The WM used in this study is produced from the incineration processes in domestic energy power plant and it is available in two different grades of fineness (coarse waste material (CWM) and fine waste material (FWM)). An intermediate plasticity silty clayey soil with medium organic matter content has been used in this study. The suitability of the CWM and FWM to improve the physical and engineering properties of the selected soil was evaluated dependant on the results obtained from the consistency limits, compaction characteristics (optimum moisture content (OMC) and maximum dry density (MDD)); along with the unconfined compressive strength test (UCS). Different percentages of CWM were added to the soft soil (3, 6, 9, 12 and 15%) to produce various admixtures. Then the UCS test was carried out on specimens under different curing periods (zero, 7, 14, and 28 days) to find the optimum percentage of CWM. The optimum and other two percentages (either side of the optimum content) were used for FWM to evaluate the effect of the fineness of the WM on UCS of the stabilised soil. Results indicated that both types of the WM used in this study improved the physical properties of the soft soil where the index of plasticity (IP) was decreased significantly. IP was decreased from 21 to 13.64 and 13.10 with 12% of CWM and 15% of FWM respectively. The results of the unconfined compressive strength test indicated that 12% of CWM was the optimum and this percentage developed the UCS value from 202kPa to 500kPa for 28 days cured samples, which is equal, approximately 2.5 times the UCS value for untreated soil. Moreover, this percentage provided 1.4 times the value of UCS for stabilized soil-CWA by using FWM which recorded just under 700kPa after 28 days curing.Keywords: soft soil stabilisation, waste materials, fineness, unconfined compressive strength
Procedia PDF Downloads 2694333 Recycling Motivations and Barriers in Kota Kinabalu, Malaysia
Authors: Jasmine Adela Mutang, Rosnah Ismail, Chua Bee Seok, Ferlis Bahari, Lailawati Madlan, Walton Wider, Rickless Das
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Waste projection is increasing and most landfills in Malaysia are running out of space. Due to that, waste management is now becoming a major challenge. The most sustainable solution is by practicing sustainable practices such as recycling. Since 1993 the government has launched several recycling campaigns and implemented the National Recycling Policy. However, public participation is still very low. Only 10.5% of solid waste was recycled up to now which is far below than of in developed countries. Nevertheless the government is optimistic that the target of 22% recycling by 2020 will be achieved if there is a positive flow pattern in sustainable practices in particular recycling behavior among Malaysian. Understanding public motivations towards recycling domestic waste are important to improve current recycling rate. Thus this study attempts to identify what are the possible motivations and hindrances for the public to recycle. Open-ended questions format were administered to 484 people in Kota Kinabalu, Sabah, Malaysia. Two specific questions we asked to explore their general determinants and barriers in practicing recycling: “What motivates you to recycle?” and “What are the barriers you encountered in doing recycling activities?” Thematic analysis was conducted on the open-ended questions in which themes were created with the raw comments. It was found that the underlying recycling motivations are awareness’ towards the environment, benefits to the society and individual, and social influence. Non participations are influence by attitudes, commitment, facilities, knowledge, inconvenience, and enforcement.Keywords: recycling motivation, recycling barrier, sustainable, household waste
Procedia PDF Downloads 5534332 Timing of Ileostomy Closure Following Rectal Cancer Surgery at an Australian Regional Hospital
Authors: Tedman Cheuk-Yiu Chau, Xavier Harvey, Hung Nguyen
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Defunctioning ileostomies are frequently used as an adjunct to low anterior resection in the surgical treatment of rectal cancer. Despite reducing the rate of clinically relevant anastomotic leak, the burden of defunctioning ileostomy is significant, with up to two-thirds of patients reporting stoma-related morbidity. International data have demonstrated an increased risk of bowel dysfunction and lower quality of life in patients with delayed closure (greater than six months post-surgery). While timely reversal is safe and cost-effective, the time to the reversal in Australian and New Zealand public hospitals is not described in the published literature. Thus, it is important to assess the current timeliness of ileostomy closure in the Australian regional context and examine the reasons for the delay. A retrospective analysis of ileostomy closure in Launceston General Hospital (LGH) patients treated with low/ultra low anterior resection for rectal cancer between 2012 and 2019 was undertaken. 94 cases of rectal adenocarcinoma undergoing ultralow anterior resection were examined over the years between 2012-2019. Amongst these, 21 cases (22.3%) were not reversed due to disease progress, death prior to reversal, or surgical complication. Demographics, disease status, surgical technique, and hospital inpatient events of these cases were examined. An average waiting time of 213.2 days was noted. Reasons for the delay include non-specified/prolonged hospital waiting time (54%), delayed or complicated chemotherapy course (13%), surgical complication (11%), advanced age, and frailty(5%). Complication of a delayed ileostomy reversal includes post-operation ileus and the development of an incisional hernia. We conclude that a delayed reversal of ileostomy can contribute to a higher incidence of stoma-related co-morbidities and contribute to a longer hospital stay and therefore use of public hospital resources.Keywords: anterior resection, colorectal surgery, ileostomy reversal, rectal cancer
Procedia PDF Downloads 954331 Kinetics of Cu(II) Transport through Bulk Liquid Membrane with Different Membrane Materials
Authors: Siu Hua Chang, Ayub Md Som, Jagannathan Krishnan
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The kinetics of Cu(II) transport through a bulk liquid membrane with different membrane materials was investigated in this work. Three types of membrane materials were used: Fresh cooking oil, waste cooking oil, and kerosene each of which was mixed with di-2-ethylhexylphosphoric acid (carrier) and tributylphosphate (modifier). Kinetic models derived from the kinetic laws of two consecutive irreversible first-order reactions were used to study the facilitated transport of Cu(II) across the source, membrane, and receiving phases of bulk liquid membrane. It was found that the transport kinetics of Cu(II) across the source phase was not affected by different types of membrane materials but decreased considerably when the membrane materials changed from kerosene, waste cooking oil to fresh cooking oil. The rate constants of Cu(II) removal and recovery processes through the bulk liquid membrane were also determined.Keywords: transport kinetics, Cu(II), bulk liquid membrane, waste cooking oil
Procedia PDF Downloads 4264330 Combustion and Emissions Performance of Syngas Fuels Derived from Palm Kernel Shell and Polyethylene (PE) Waste via Catalytic Steam Gasification
Authors: Chaouki Ghenai
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Computational fluid dynamics analysis of the burning of syngas fuels derived from biomass and plastic solid waste mixture through gasification process is presented in this paper. The syngas fuel is burned in gas turbine can combustor. Gas turbine can combustor with swirl is designed to burn the fuel efficiently and reduce the emissions. The main objective is to test the impact of the alternative syngas fuel compositions and lower heating value on the combustion performance and emissions. The syngas fuel is produced by blending Palm Kernel Shell (PKS) with Polyethylene (PE) waste via catalytic steam gasification (fluidized bed reactor). High hydrogen content syngas fuel was obtained by mixing 30% PE waste with PKS. The syngas composition obtained through the gasification process is 76.2% H2, 8.53% CO, 4.39% CO2 and 10.90% CH4. The lower heating value of the syngas fuel is LHV = 15.98 MJ/m3. Three fuels were tested in this study natural gas (100%CH4), syngas fuel and pure hydrogen (100% H2). The power from the combustor was kept constant for all the fuels tested in this study. The effect of syngas fuel composition and lower heating value on the flame shape, gas temperature, mass of carbon dioxide (CO2) and nitrogen oxides (NOX) per unit of energy generation is presented in this paper. The results show an increase of the peak flame temperature and NO mass fractions for the syngas and hydrogen fuels compared to natural gas fuel combustion. Lower average CO2 emissions at the exit of the combustor are obtained for the syngas compared to the natural gas fuel.Keywords: CFD, combustion, emissions, gas turbine combustor, gasification, solid waste, syngas, waste to energy
Procedia PDF Downloads 5934329 Investigation on Strength Properties of Concrete Using Industrial Waste as Supplementary Cementitious Material
Authors: Ravi Prasad Darapureddi
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The use of industrial waste in making concrete reduce the consumption of natural resources and pollution of the environment. These materials possess problems of disposal and health hazards. An attempt has been made to use paper and thermal industrial wastes such as lime sludge and flyash. Present investigation is aimed at the utilization of Lime Sludge and Flyash as Supplementary Cementitious Materials (SCM) and influence of these materials on strength properties of concrete. Thermal industry waste fly ash is mixed with lime sludge and used as a replacement to cement at different proportions to obtain the strength properties and compared with ordinary concrete prepared without any additives. Grade of concrete prepared was M₂₅ designed according to Indian standard method. Cement has been replaced by paper industry waste and fly ash in different proportions such as 0% (normal concrete), 10%, 20%, and 30% by weight. Mechanical properties such as compressive strength, splitting tensile strength and flexural strength were assessed. Test results indicated that the use of lime sludge and Fly ash in concrete had improved the properties of concrete. Better results were observed at 20% replacement of cement with these additives.Keywords: supplementary cementitious materials, lime sludge, fly ash, strength properties
Procedia PDF Downloads 1964328 Biogas Production Improve From Waste Activated Sludge Using Fenton Oxidation
Authors: A. Hassiba Zemmouri, B. Nabil Mameri, C. Hakim Lounici
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In this study, the effect of Fenton technology pretreatment on the anaerobic digestion of excess waste activated sludge (WAS) was investigated. The variation of physicochemical characteristics (TOC, DS, VSS, VS) and biogas volume (as form of value added products) were also evaluated. The preselected operator conditions of Fenton pretreatment were 0.01ml H2O2/g SS, 150 [H2O2]/[Fe2+], 25g/l TS, at 25 °C and 30, 60 and120 min as treatment duration. The main results show a Maximum solubilization and biodegradability (70%) obtained at 120 min of Fenton pretreatment duration. An increasing of TOC in soluble phase related obviously by releasing organic substances of sludge flocs was contested. Improving in biogas volume was also, increased. Fenton oxidation pretreatment may be a promising chemical pre-treatment for a benefic digestion, stabilization and volume reduction.Keywords: waste activated sludge, fenton pre-treatment, biodegradability, biogas
Procedia PDF Downloads 6404327 Optimization of Bio-Based Lightweight Mortars Containing Wood Waste
Authors: Valeria Corinaldesi, Nicola Generosi, Daniele Berdini
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In this study, wood waste from processing by-products was used by replacing natural sand for producing bio-based lightweight mortars. Manufacturers of wood products and furniture usually generate sawdust and pieces of side-cuts. These are produced by cutting, drilling, and milling operations as well. Three different percentages of substitution of quartz sand were tried: 2.5%, 5%, and 10% by volume. Wood by-products were pre-soaked in calcium hydroxide aqueous solution in order to obtain wood mineralization to avoid undesirable effects on the bio-based building materials. Bio-based mortars were characterized by means of compression and bending tests, free drying shrinkage tests, resistance to water vapour permeability, water capillary absorption, and, finally, thermal conductivity measurements. Results obtained showed that a maximum dosage of 5% wood by-products should be used in order to avoid an excessive loss of bio-based mortar mechanical strength. On the other hand, by adding the proper dosage of water-reducing admixture, adequate mechanical performance can be achieved even with 10% wood waste addition.Keywords: bio-based mortar, energy efficiency, lightweight mortar, thermal insulation, wood waste
Procedia PDF Downloads 54326 A Comparative Study on the Positive and Negative of Electronic Word-of-Mouth on the SERVQUAL Scale-Take A Certain Armed Forces General Hospital in Taiwan As An Example
Authors: Po-Chun Lee, Li-Lin Liang, Ching-Yuan Huang
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Purpose: Research on electronic word-of-mouth (eWOM)& online review has been widely used in service industry management research in recent years. The SERVQUAL scale is the most commonly used method to measure service quality. Therefore, the purpose of this research is to combine electronic word of mouth & online review with the SERVQUAL scale. To explore the comparative study of positive and negative electronic word-of-mouth reviews of a certain armed force general hospital in Taiwan. Data sources: This research obtained online word-of-mouth comment data on google maps from a military hospital in Taiwan in the past ten years through Internet data mining technology. Research methods: This study uses the semantic content analysis method to classify word-of-mouth reviews according to the revised PZB SERVQUAL scale. Then carry out statistical analysis. Results of data synthesis: The results of this study disclosed that the negative reviews of this military hospital in Taiwan have been increasing year by year. Under the COVID-19 epidemic, positive word-of-mouth has a downward trend. Among the five determiners of SERVQUAL of PZB, positive word-of-mouth reviews performed best in “Assurance,” with a positive review rate of 58.89%, Followed by 43.33% of “Responsiveness.” In negative word-of-mouth reviews, “Assurance” performed the worst, with a positive rate of 70.99%, followed by responsive 29.01%. Conclusions: The important conclusions of this study disclosed that the total number of electronic word-of-mouth reviews of the military hospital has revealed positive growth in recent years, and the positive word-of-mouth growth has revealed negative growth after the epidemic of COVID-19, while the negative word-of-mouth has grown substantially. Regardless of the positive and negative comments, what patients care most about is “Assurance” of the professional attitude and skills of the medical staff, which needs to be strengthened most urgently. In addition, good “Reliability” will help build positive word-of-mouth. However, poor “Responsiveness” can easily lead to the spread of negative word-of-mouth. This study suggests that the hospital should focus on these few service-oriented quality management and audits.Keywords: quality of medical service, electronic word-of-mouth, armed forces general hospital
Procedia PDF Downloads 1774325 Study for Utilization of Industrial Solid Waste, Generated by the Discharge of Casting Sand Agglomeration with Clay, Blast Furnace Slag and Sugar Cane Bagasse Ash in Concrete Composition
Authors: Mario Sergio de Andrade Zago, Javier Mazariegos Pablos, Eduvaldo Paulo Sichieri
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This research project accomplished a study on the technical feasibility of recycling industrial solid waste generated by the discharge of casting sand agglomeration with clay, blast furnace slag and sugar cane bagasse ash. For this, the plan proposed a methodology that initially establishes a process of solid waste encapsulation, by using solidification/stabilization technique on Portland cement matrices, in which the residuals act as small and large aggregates on the composition of concrete, and later it presents the possibility of using this concrete in the manufacture of concrete pieces (concrete blocks) for paving. The results obtained in this research achieved the objective set with great success, regarding the manufacturing of concrete pieces (blocks) for paving urban roads, whenever there is special vehicle traffic or demands capable of producing accentuated abrasion effects (surpassing the 50 MPa required by the regulation), which probes the technical practicability of using waste from sand casting agglomeration with clay and blast furnace slag used in this study, unlocking usage possibilities for construction.Keywords: industrial solid waste, solidification/stabilization, Portland cement, reuse, bagasse ash in the sugar cane, concrete
Procedia PDF Downloads 3024324 Effect of Serum Electrolytes on a QTc Interval and Mortality in Patients admitted to Coronary Care Unit
Authors: Thoetchai Peeraphatdit, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham, Niyada Naksuk
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Background: Serum electrolyte abnormalities are a common cause of an acquired prolonged QT syndrome, especially, in the coronary care unit (CCU) setting. Optimal electrolyte ranges among the CCU patients have not been sufficiently investigated. Methods: We identified 8,498 consecutive CCU patients who were admitted to the CCU at Mayo Clinic, Rochester, the USA, from 2004 through 2013. Association between first serum electrolytes and baseline corrected QT intervals (QTc), as well as in-hospital mortality, was tested using multivariate linear regression and logistic regression, respectively. Serum potassium 4.0- < 4.5 mEq/L, ionized calcium (iCa) 4.6-4.8 mg/dL, and magnesium 2.0- < 2.2 mg/dL were used as the reference levels. Results: There was a modest level-dependent relationship between hypokalemia ( < 4.0 mEq/L), hypocalcemia ( < 4.4 mg/dL), and a prolonged QTc interval; serum magnesium did not affect the QTc interval. Association between the serum electrolytes and in-hospital mortality included a U-shaped relationship for serum potassium (adjusted odds ratio (OR) 1.53 and OR 1.91for serum potassium 4.5- < 5.0 and ≥ 5.0 mEq/L, respectively) and an inverted J-shaped relationship for iCa (adjusted OR 2.79 and OR 2.03 for calcium < 4.4 and 4.4- < 4.6 mg/dL, respectively). For serum magnesium, the mortality was greater only among patients with levels ≥ 2.4 mg/dL (adjusted OR 1.40), compared to the reference level. Findings were similar in sensitivity analyses examining the association between mean serum electrolytes and mean QTc intervals, as well as in-hospital mortality. Conclusions: Serum potassium 4.0- < 4.5 mEq/L, iCa ≥ 4.6 mg/dL, and magnesium < 2.4 mg/dL had a neutral effect on QTc intervals and were associated with the lowest in-hospital mortality among the CCU patients.Keywords: calcium, electrocardiography, long-QT syndrome, magnesium, mortality, potassium
Procedia PDF Downloads 3944323 Nurse's Professional Space: Psychiatric Outpatient Clinic of Ottawa's Montfort Hospital 1976-2002
Authors: Silvia Maria Moya
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After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.Keywords: mental health, nursing, deinstitutionalization, professional space
Procedia PDF Downloads 3634322 Effects of Palm Waste Ash Residues on Acidic Soil in Relation to Physiological Responses of Habanero Chili Pepper (Capsicum chinense jacq.)
Authors: Kalu Samuel Ukanwa, Kumar Patchigolla, Ruben Sakrabani
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The use of biosolids from thermal conversion of palm waste for soil fertility enhancement was tested in acidic soil of Southern Nigeria for the growing of Habanero chili pepper (Capsicum chinense jacq.). Soil samples from the two sites, showed pH 4.8 and 4.8 for site A and B respectively, below 5.6-6.8 optimum range and other fertility parameters indicating a low threshold for pepper growth. Nursery planting was done at different weeks to determine the optimum planting period. Ash analysis showed that it contains 26% of total K, 20% of total Ca, 0.27% of total P, and pH 11. The two sites were laid for an experiment in randomized complete block design and setup with three replications side by side. Each plot measured 3 x 2 m and a total of 15 plots for each site, four treatments, and one control. Outlined as control, 2, 4, 6 and 8 tonnes/hectare of palm waste ash, the combined average for both sites with correspondent yield after six harvests in one season are; 0, 5.8, 6, 6, 14.5 tonnes/hectare respectively to treatments. Optimum nursery survival rate was high in July; the crop yield was linear to the ash application. Site A had 6% yield higher than site B. Fruit development, weight, and total yield in relation to the control plot showed that palm waste ash is effective for soil amendment, nutrient delivery, and exchange.Keywords: ash, palm waste, pepper, soil amendment
Procedia PDF Downloads 1334321 Influence of the Flow Rate Ratio in a Jet Pump on the Size of Air Bubbles
Authors: L. Grinis, N. Lubashevsky, Y. Ostrovski
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In waste water treatment processes, aeration introduces air into a liquid. In these systems, air is introduced by different devices submerged in the waste water. Smaller bubbles result in more bubble surface area per unit of volume and higher oxygen transfer efficiency. Jet pumps are devices that use air bubbles and are widely used in waste water treatment processes. The principle of jet pumps is their ability to transfer energy of one fluid, called primary or motive, into a secondary fluid or gas. These pumps have no moving parts and are able to work in remote areas under extreme conditions. The objective of this work is to study experimentally the characteristics of the jet pump and the size of air bubbles in the laboratory water tank. The effect of flow rate ratio on pump performance is investigated in order to have a better understanding about pump behavior under various conditions, in order to determine the efficiency of receiving air bubbles different sizes. The experiments show that we should take care when increasing the flow rate ratio while seeking to decrease bubble size in the outlet flow. This study will help improve and extend the use of the jet pump in many practical applications.Keywords: jet pump, air bubbles size, retention time, waste water
Procedia PDF Downloads 3074320 Anaerobic Co-Digestion of Pressmud with Bagasse and Animal Waste for Biogas Production Potential
Authors: Samita Sondhi, Sachin Kumar, Chirag Chopra
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The increase in population has resulted in an excessive feedstock production, which has in return lead to the accumulation of a large amount of waste from different resources as crop residues, industrial waste and solid municipal waste. This situation has raised the problem of waste disposal in present days. A parallel problem of depletion of natural fossil fuel resources has led to the formation of alternative sources of energy from the waste of different industries to concurrently resolve the two issues. The biogas is a carbon neutral fuel which has applications in transportation, heating and power generation. India is a nation that has an agriculture-based economy and agro-residues are a significant source of organic waste. Taking into account, the second largest agro-based industry that is sugarcane industry producing a high quantity of sugar and sugarcane waste byproducts such as Bagasse, Press Mud, Vinasse and Wastewater. Currently, there are not such efficient disposal methods adopted at large scales. According to manageability objectives, anaerobic digestion can be considered as a method to treat organic wastes. Press mud is lignocellulosic biomass and cannot be accumulated for Mono digestion because of its complexity. Prior investigations indicated that it has a potential for production of biogas. But because of its biological and elemental complexity, Mono-digestion was not successful. Due to the imbalance in the C/N ratio and presence of wax in it can be utilized with any other fibrous material hence will be digested properly under suitable conditions. In the first batch of Mono-digestion of Pressmud biogas production was low. Now, co-digestion of Pressmud with Bagasse which has desired C/N ratio will be performed to optimize the ratio for maximum biogas from Press mud. In addition, with respect to supportability, the main considerations are the monetary estimation of item result and ecological concerns. The work is designed in such a way that the waste from the sugar industry will be digested for maximum biogas generation and digestive after digestion will be characterized for its use as a bio-fertilizer for soil conditioning. Due to effectiveness demonstrated by studied setups of Mono-digestion and Co-digestion, this approach can be considered as a viable alternative for lignocellulosic waste disposal and in agricultural applications. Biogas produced from the Pressmud either can be used for Powerhouses or transportation. In addition, the work initiated towards the development of waste disposal for energy production will demonstrate balanced economy sustainability of the process development.Keywords: anaerobic digestion, carbon neutral fuel, press mud, lignocellulosic biomass
Procedia PDF Downloads 1694319 Use of Cassava Waste and Its Energy Potential
Authors: I. Inuaeyen, L. Phil, O. Eni
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Fossil fuels have been the main source of global energy for many decades, accounting for about 80% of global energy need. This is beginning to change however with increasing concern about greenhouse gas emissions which comes mostly from fossil fuel combustion. Greenhouse gases such as carbon dioxide are responsible for stimulating climate change. As a result, there has been shift towards more clean and renewable energy sources of energy as a strategy for stemming greenhouse gas emission into the atmosphere. The production of bio-products such as bio-fuel, bio-electricity, bio-chemicals, and bio-heat etc. using biomass materials in accordance with the bio-refinery concept holds a great potential for reducing high dependence on fossil fuel and their resources. The bio-refinery concept promotes efficient utilisation of biomass material for the simultaneous production of a variety of products in order to minimize or eliminate waste materials. This will ultimately reduce greenhouse gas emissions into the environment. In Nigeria, cassava solid waste from cassava processing facilities has been identified as a vital feedstock for bio-refinery process. Cassava is generally a staple food in Nigeria and one of the most widely cultivated foodstuff by farmers across Nigeria. As a result, there is an abundant supply of cassava waste in Nigeria. In this study, the aim is to explore opportunities for converting cassava waste to a range of bio-products such as butanol, ethanol, electricity, heat, methanol, furfural etc. using a combination of biochemical, thermochemical and chemical conversion routes. . The best process scenario will be identified through the evaluation of economic analysis, energy efficiency, life cycle analysis and social impact. The study will be carried out by developing a model representing different process options for cassava waste conversion to useful products. The model will be developed using Aspen Plus process simulation software. Process economic analysis will be done using Aspen Icarus software. So far, comprehensive survey of literature has been conducted. This includes studies on conversion of cassava solid waste to a variety of bio-products using different conversion techniques, cassava waste production in Nigeria, modelling and simulation of waste conversion to useful products among others. Also, statistical distribution of cassava solid waste production in Nigeria has been established and key literatures with useful parameters for developing different cassava waste conversion process has been identified. In the future work, detailed modelling of the different process scenarios will be carried out and the models validated using data from literature and demonstration plants. A techno-economic comparison of the various process scenarios will be carried out to identify the best scenario using process economics, life cycle analysis, energy efficiency and social impact as the performance indexes.Keywords: bio-refinery, cassava waste, energy, process modelling
Procedia PDF Downloads 3734318 Role of NaOH in the Synthesis of Waste-derived Solid Hydroxy Sodalite Catalyst for the Transesterification of Waste Animal Fat to Biodiesel
Authors: Thomas Chinedu Aniokete, Gordian Onyebuchukwu Mbah, Michael Daramola
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A sustainable NaOH integrated hydrothermal protocol was developed for the synthesis of waste-derived hydroxy sodalite catalysts for transesterification of waste animal fat (WAF) with a high per cent free fatty acid (FFA) to biodiesel. In this work, hydroxy sodalite catalyst was synthesized from two complex waste materials namely coal fly ash (CFA) and waste industrial brine (WIB). Measured amounts of South African CFA and WIB obtained from a coal mine field were mixed with NaOH solution at different concentrations contained in secured glass vessels equipped with magnetic stirrers and formed consistent slurries after aging condition at 47 oC for 48 h. The slurries were then subjected to hydrothermal treatments at 140 oC for 48 h, washed thoroughly and separated by the action of a centrifuge on the mixture. The resulting catalysts were calcined in a muffle furnace for 2 h at 200 oC and subsequently characterized for different effects using X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared (FT-IR), and Bennett Emmet Teller (BET) adsorption-desorption techniques. The produced animal fat methyl ester (AFME) was analyzed using the gas chromatography-mass spectrometry (GC-MS) method. Results of the investigation indicate profoundly an enhanced catalyst purity, textural property and desired morphology due to the action of NaOH. Similarly, the performance evaluation with respect to catalyst activity reveals a high catalytic conversion efficiency of 98 % of the high FFA WAF to biodiesel under the following reaction conditions; a methanol-to-WAF ratio of 15:1, amount of SOD catalyst of 3 wt % with a stirring speed of 300-500 rpm, a reaction temperature of 60 oC and a reaction time of 8 h. There was a recovered 96 % stable catalyst after reactions and potentially recyclable, thus contributing to the economic savings to the process that had been a major bottleneck to the production of biodiesel. This NaOH route for synthesizing waste-derived hydroxy sodalite (SOD) catalyst is a sustainable and eco-friendly technology that speaks directly to the global quest for renewable-fossil fuel controversy enforcing sustainable development goal 7.Keywords: coal fly ash, waste industrial brine, waste-derived hydroxy sodalite catalyst, sodium hydroxide, biodiesel, transesterification, biomass conversion
Procedia PDF Downloads 344317 Processing and Characterization of Glass-Epoxy Composites Filled with Linz-Donawitz (LD) Slag
Authors: Pravat Ranjan Pati, Alok Satapathy
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Linz-Donawitz (LD) slag a major solid waste generated in huge quantities during steel making. It comes from slag formers such as burned lime/dolomite and from oxidizing of silica, iron etc. while refining the iron into steel in the LD furnace. Although a number of ways for its utilization have been suggested, its potential as a filler material in polymeric matrices has not yet been explored. The present work reports the possible use of this waste in glass fiber reinforced epoxy composites as a filler material. Hybrid composites consisting of bi-directional e-glass-fiber reinforced epoxy filled with different LD slag content (0, 7.5, 15, 22.5 wt%) are prepared by simple hand lay-up technique. The composites are characterized in regard to their density, porosity, micro-hardness and strength properties. X-ray diffractography is carried out in order to ascertain the various phases present in LDS. This work shows that LD slag, in spite of being a waste, possesses fairly good filler characteristics as it modifies the strength properties and improves the composite micro-hardness of the polymeric resin.Keywords: characterization, glass-epoxy composites, LD slag, waste utilization
Procedia PDF Downloads 3924316 An Investigation of Foam Glass Production from Sheet Glass Waste and SiC Foaming Agent
Authors: Aylin Sahin, Recep Artir, Mustafa Kara
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Foam glass is a remarkable material with having incomparable properties like low weight, rigidity, high thermal insulation capacity and porous structure. In this study, foam glass production was investigated with using glass powder from sheet glass waste and SiC powder as foaming agent. Effects of SiC powders and sintering temperatures on foaming process were examined. It was seen that volume expansions (%), cellular structures and pore diameters of obtained foam glass samples were highly depending on composition ratios and sintering temperature. The study showed that various foam glass samples having with homogenous closed porosity, low weight and low thermal conductivity were achieved by optimizing composition ratios and sintering temperatures.Keywords: foam glass, foaming, waste glass, silicon carbide
Procedia PDF Downloads 3854315 Quantification of the Non-Registered Electrical and Electronic Equipment for Domestic Consumption and Enhancing E-Waste Estimation: A Case Study on TVs in Vietnam
Authors: Ha Phuong Tran, Feng Wang, Jo Dewulf, Hai Trung Huynh, Thomas Schaubroeck
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The fast increase and complex components have made waste of electrical and electronic equipment (or e-waste) one of the most problematic waste streams worldwide. Precise information on its size on national, regional and global level has therefore been highlighted as prerequisite to obtain a proper management system. However, this is a very challenging task, especially in developing countries where both formal e-waste management system and necessary statistical data for e-waste estimation, i.e. data on the production, sale and trade of electrical and electronic equipment (EEE), are often lacking. Moreover, there is an inflow of non-registered electronic and electric equipment, which ‘invisibly’ enters the EEE domestic market and then is used for domestic consumption. The non-registration/invisibility and (in most of the case) illicit nature of this flow make it difficult or even impossible to be captured in any statistical system. The e-waste generated from it is thus often uncounted in current e-waste estimation based on statistical market data. Therefore, this study focuses on enhancing e-waste estimation in developing countries and proposing a calculation pathway to quantify the magnitude of the non-registered EEE inflow. An advanced Input-Out Analysis model (i.e. the Sale–Stock–Lifespan model) has been integrated in the calculation procedure. In general, Sale-Stock-Lifespan model assists to improve the quality of input data for modeling (i.e. perform data consolidation to create more accurate lifespan profile, model dynamic lifespan to take into account its changes over time), via which the quality of e-waste estimation can be improved. To demonstrate the above objectives, a case study on televisions (TVs) in Vietnam has been employed. The results show that the amount of waste TVs in Vietnam has increased four times since 2000 till now. This upward trend is expected to continue in the future. In 2035, a total of 9.51 million TVs are predicted to be discarded. Moreover, estimation of non-registered TV inflow shows that it might on average contribute about 15% to the total TVs sold on the Vietnamese market during the whole period of 2002 to 2013. To tackle potential uncertainties associated with estimation models and input data, sensitivity analysis has been applied. The results show that both estimations of waste and non-registered inflow depend on two parameters i.e. number of TVs used in household and the lifespan. Particularly, with a 1% increase in the TV in-use rate, the average market share of non-register inflow in the period 2002-2013 increases 0.95%. However, it decreases from 27% to 15% when the constant unadjusted lifespan is replaced by the dynamic adjusted lifespan. The effect of these two parameters on the amount of waste TV generation for each year is more complex and non-linear over time. To conclude, despite of remaining uncertainty, this study is the first attempt to apply the Sale-Stock-Lifespan model to improve the e-waste estimation in developing countries and to quantify the non-registered EEE inflow to domestic consumption. It therefore can be further improved in future with more knowledge and data.Keywords: e-waste, non-registered electrical and electronic equipment, TVs, Vietnam
Procedia PDF Downloads 2464314 Greywater Treatment Using Activated Biochar Produced from Agricultural Waste
Authors: Pascal Mwenge, Tumisang Seodigeng
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The increase in urbanisation in South Africa has led to an increase in water demand and a decline in freshwater supply. Despite this, poor water usage is still a major challenge in South Africa, for instance, freshwater is still used for non-drinking applications. The freshwater shortage can be alleviated by using other sources of water for non-portable purposes such as greywater treated with activated biochar produced from agricultural waste. The success of activated biochar produced from agricultural waste to treat greywater can be both economically and environmentally beneficial. Greywater treated with activated biochar produced from agricultural waste is considered a cost-effective wastewater treatment. This work was aimed at determining the ability of activated biochar to remove Total Suspended Solids (TSS), Ammonium (NH4-N), Nitrate (NO3-N), and Chemical Oxygen Demand (COD) from greywater. The experiments were carried out in 800 ml laboratory plastic cylinders used as filter columns. 2.5 cm layer of gravel was used at the bottom and top of the column to sandwich the activated biochar material. Activated biochar (200 g and 400 g) was loaded in a column and used as a filter medium for greywater. Samples were collected after a week and sent for analysis. Four types of greywater were treated: Kitchen, floor cleaning water, shower and laundry water. The findings showed: 95% removal of TSS, 76% of NO3-N and 63% of COD on kitchen greywater and 85% removal of NH4-N on bathroom greywater, as highest removal of efficiency of the studied pollutants. The results showed that activated biochar produced from agricultural waste reduces a certain amount of pollutants from greywater. The results also indicated the ability of activated biochar to treat greywater for onsite non-potable reuse purposes.Keywords: activated biochar produced from agriculture waste, ammonium, NH₄-N, chemical oxygen demand, COD, greywater, nitrate, NO₃-N, total suspended solids, TSS
Procedia PDF Downloads 2024313 Experimental Studies on Flexural Behaviour on Beam Using Lathe Waste in SIFCON
Authors: R. Saravanakumar, A. Siva, R. Banupriya, K. Balasubramanian
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Slurry infiltrated fibrous concrete (SIFCON) is one of the recently developed construction material that can be considered as a special type of high performance fibre reinforced concrete (HPFRC) with higher fibre content. Fibre reinforced concrete is essentially a composite material in which fibres out of waste having higher modulus of elasticity. SIFCON is a special type of high fibrous concrete and it is having a high cementious content and sand. The matrix usually consists of cement-sand slurry or fluent mortar. The construction industry is in need of finding cost effective materials for increasing the strength of concrete structures hence an endeavour has been made in the present investigations to study the influence of addition of waste material like Lathe waste from workshop at different dosages to the total weight of concrete. The waste of steel scrap material which is available from the lathe is used as a steel fibre for innovative construction industry. To get sustainable and environmental benefits, lathe scrap as recycled fibres with concrete are likely to be used. An experimental program was carried out to investigate the flexural behavior of Slurry infiltrated fibrous concrete (SIFCON) in which the fibres having an aspect ratio of 100 is used. The investigations were done using M25 mix and tests were carried out as per recommended procedures by appropriate codes. SIFCON specimens with 8%, 10% and 12% volume of fraction fibres are used in this study. Test results were presented in comparison of SIFCON with and without conventional steel reinforcement. The load carrying capacity of SIFCON specimen is higher than conventional concrete and it also reduced crack width. In the SIFCON specimen less number of cracks as compared with conventional concrete.Keywords: SIFCON, lathe waste, RCC, fibre volume, flexural behaviour
Procedia PDF Downloads 3164312 Managing the Baltic Sea Region Resilience: Prevention, Treatment Actions and Circular Economy
Authors: J. Burlakovs, Y. Jani, L. Grinberga, M. Kriipsalu, O. Anne, I. Grinfelde, W. Hogland
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The worldwide future sustainable economies are oriented towards the sea: the maritime economy is becoming one of the strongest driving forces in many regions as population growth is the highest in coastal areas. For hundreds of years sea resources were depleted unsustainably by fishing, mining, transportation, tourism, and waste. European Sustainable Development Strategy is identifying and developing actions to enable the EU to achieve a continuous, long-term improvement of the quality of life through the creation of sustainable communities. The aim of this paper is to provide insight in Baltic Sea Region case studies on implemented actions on tourism industry waste and beach wrack management in coastal areas, hazardous contaminants and plastic flow treatment from waste, wastewaters and stormwaters. These projects mentioned in study promote successful prevention of contaminant flows to the sea environments and provide perspectives for creation of valuable new products from residuals for future circular economy are the step forward to green innovation winning streak.Keywords: resilience, hazardous waste, phytoremediation, water management, circular economy
Procedia PDF Downloads 1744311 Decision Support System for Hospital Selection in Emergency Medical Services: A Discrete Event Simulation Approach
Authors: D. Tedesco, G. Feletti, P. Trucco
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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection
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