Search results for: health facility

Authors: Antoaneta Stefanova, Rositsa Gencheva, Pavlin Groudev

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This paper presents an application of the ASTEC V2r3p3 computer code for simulation of QUENCH-12 experiment. The test has been performed to investigate the behavior of VVER type of fuel assemblies during severe accident conditions. In the performed analyses it has been assessed the mass of generated hydrogen during the experiment flooding of overheated core. The comparison of ASTECv2r3p3 calculated results with measured test data shows good agreement.

Keywords: hydrogen production, VVER, QUENCH facility, severe accident, reactor core

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Salam Alzubaidi, G. Fantoni, F. Failli, M. Frosolini

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The dynamic facility layout problem is a really critical issue in the competitive industrial market; thus, solving this problem requires robust design and effective simulation systems. The sustainable simulation requires inputting reliable and accurate data into the system. So this paper describes an automated system integrated into the real environment to measure the duration of the material handling operations, collect the data in real-time, and determine the variances between the actual and estimated time schedule of the operations in order to update the simulation software and redesign the facility layout periodically. The automated method- time measurement system collects the real data through using Radio Frequency-Identification (RFID) and Internet of Things (IoT) technologies. Hence, attaching RFID- antenna reader and RFID tags enables the system to identify the location of the objects and gathering the time data. The real duration gathered will be manipulated by calculating the moving average duration of the material handling operations, choosing the shortest material handling path, and then updating the simulation software to redesign the facility layout accommodating with the shortest/real operation schedule. The periodic simulation in real-time is more sustainable and reliable than the simulation system relying on an analysis of historical data. The case study of this methodology is in cooperation with a workshop team for producing mechanical parts. Although there are some technical limitations, this methodology is promising, and it can be significantly useful in the redesigning of the manufacturing layout.

Keywords: dynamic facility layout problem, internet of things, method time measurement, radio frequency identification, simulation

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Authors: Tanja Salary

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This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

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Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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Authors: Soumen Mitra, Aparna Saha

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The perceived link between the city and the countryside is evolving rapidly and is getting shifted away from the assumptions of mainstream paradigms to new conceptual networks where rural-urban links are being redefined. In this conceptual field, the fringe interface is still considered as a transitional zone between city and countryside, and is defined as a diffused area rather than a discrete territory. In developing countries fringe areas are said to have both rural and urban characteristics but are devoid of basic municipal facilities. Again, when the urban core areas envelopes the fringe areas along with it the character of fringe changes but services are not well facilitated which in turn results to uneven growth, rapid and haphazard development. One of the major services present in fringe areas is inter-linkages in terms of transit corridors. Planning for the appropriate and sustainable future of fringe areas requires a sheer focus on these corridors pertaining to transit facility, for better accessibility and mobility. Inducing a transit facility plan enhances the various facilities and also increases their proximity for user groups. The study focuses on the western fringe region of Kolkata metropolis which is a major source of industrial hub and housing sector, thus converting the agricultural lands into non-agricultural use. The study emphasizes on providing transit facilities both physical (stops, sheds, terminals, etc.) and operational (ticketing system, route prioritization, integration of transit modes, etc.), to facilitate the region as well as accelerate the growth pattern systematically. Hence, the scope of this work is on the basis of prevailing conditions in fringe areas and attempts for an effective transit facility plan. The strategies and recommendations are in terms of road widening, service coverage, feeder route prioritization, bus stops facilitation, pedestrian facilities, etc, which in turn enhances the region’s growth pattern. Thus, this context of transit facility planning acts as a catalytic agent to avoid the future unplanned growth and accelerates it towards an integrated development.

Keywords: feeder route, fringe, municipal planning, transit facility

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Authors: J. Byimana, I. A. Muhire, J. E. Nzabahimana, A. Nyombayire

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Introduction: A successful cardiopulmonary resuscitation during a sudden cardiac arrest can be delayed by different components including new hospital setting, lack of adequate training, lack of pre-established resuscitation team and ineffective communication and lead to an unexpected outcome which is death. The main objective of the study was to assess the readiness of resuscitation teams during cardiac arrest and the organizational approaches that would best support their functioning in a new hospital facility, and to detect any factor that may have contributed to responses. This study analyses the readiness of Resuscitation Team (RT) during cardiac arrest. —Material and methods: A prospective Analytic design was carried out at a newly established United Nations level 2 hospital facility, on four RTM (resuscitation team member). A semi structured questionnaire was used to collect data. —Results: This study highlights indicate that the response time during cardiac arrest simulation meet both American heart association (AHA) and European resuscitation council guidelines. The study offers useful evidence about the impact of a new facility on RTM performance and provides an exposure of staff to emergency events within the Work setting.

Keywords: cardiac arrest, code blue, simulation, resuscitation team member

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Authors: Sunghoon Park, Hank Kim, Jinwon An, Sungzoon Cho

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Internet of Things allows one to collect data from facilities which are then used to monitor them and even predict malfunctions in advance. Conventional quality control methods focus on setting a normal range on a sensor value defined between a lower control limit and an upper control limit, and declaring as an anomaly anything falling outside it. However, interactions among sensor values are ignored, thus leading to suboptimal performance. We propose a multivariate approach which takes into account many sensor values at the same time. In particular Gaussian Mixture Model is used which is trained to maximize likelihood value using Expectation-Maximization algorithm. The number of Gaussian component distributions is determined by Bayesian Information Criterion. The negative Log likelihood value is used as an anomaly score. The actual usage scenario goes like a following. For each instance of sensor values from a facility, an anomaly score is computed. If it is larger than a threshold, an alarm will go off and a human expert intervenes and checks the system. A real world data from Building energy system was used to test the model.

Keywords: facility anomaly detection, gaussian mixture model, anomaly score, expectation maximization algorithm

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Authors: Moses Balina, Archbald Bahizi

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

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

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Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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Authors: Maria Vueba, Tchilissila A. Simoes

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Angola has a deficient health system characterized by reduced human and material resources. Nurses are the main actors combating different types of diseases simultaneously dealing with a lack of essentials tools and means. In this study, we aimed to assess the organizational commitment and job satisfaction of 51 health professionals from a maternity ward in Lubango, Angola. Participants completed the Organizational Commitment Questionnaire and the Job Satisfaction Scale and demonstrated a strong commitment towards the maternal facility, despite the majority of them were not satisfied with their work. Moreover, the gender and years of service seemed to not influence the level of commitment and satisfaction among the professionals. These results show the need for organizational restructuration (i.e., wages, career progression, supervision) to increase job satisfaction in this institution.

Keywords: Africa, health professionals, organizational commitment, work satisfaction

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Authors: Ruquan You, Haiwang Li, Zhi Tao

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A time-resolved particle image velocimetry (PIV) system is developed to investigate the boundary layer flow with the effect of rotating Coriolis and buoyancy force. This time-resolved PIV system consists of a 10 Watts continuous laser diode and a high-speed camera. The laser diode is able to provide a less than 1mm thickness sheet light, and the high-speed camera can capture the 6400 frames per second with 1024×1024 pixels. The whole laser and the camera are fixed on the rotating facility with 1 radius meters and up to 500 revolutions per minute, which can measure the boundary flow velocity in the rotating channel with and without ribs directly at rotating conditions. To investigate the effect of buoyancy force, transparent heater glasses are used to provide the constant thermal heat flux, and then the density differences are generated near the channel wall, and the buoyancy force can be simulated when the channel is rotating. Due to the high temporal and spatial resolution of the system, the proper orthogonal decomposition (POD) can be developed to analyze the characteristic of the turbulent boundary layer flow at rotating conditions. With this rotating facility and PIV system, the velocity profile, Reynolds shear stress, spatial and temporal correlation, and the POD modes of the turbulent boundary layer flow can be discussed.

Keywords: rotating facility, PIV, boundary layer flow, spatial and temporal resolution

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Authors: Humaira Maheen, Elizabeth Hoban, Catherine Bennette

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Background: Globally, role of Community Health Workers (CHW) as front line disaster health work force is underutilized. Developing countries which are at risk of natural disasters or humanitarian emergencies should lay down effective strategies especially to ensure adequate access to maternity care during crisis situation by using CHW as they are local, trained, and most of them possess a good relationship with the community. The Minimum Initial Service Package (MISP) is a set of universal guidelines that addresses women’s reproductive health needs during the first phase of an emergency. According to the MISP, pregnant women should have access to a skilled birth attendant and adequate transportation arrangements so they can access a maternity care facility. Pakistan is one of the few countries which has been severely affected by a number of natural disaster as well as humanitarian emergencies in last decade. Pakistan has a young and structured National Disaster Management System in place, where District Authorities play a vital role in disaster management. The District Health Department develops the contingency health plan for an emergency situation and implements it under the existing district health human resources (health workers and medical staff at the health facility) and infrastructure (health care facilities). Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. The district health department didn’t make transportation arrangement for labouring women from relief camp to the nearest health care facility. As a result 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth. Of the 332 women who were pregnant at the time of the floods, 26 had adverse birth outcomes; 10 had miscarriages, 14 had stillbirths and there were four neonatal deaths. Conclusion: The district health department was not able to provide access to adequate maternity care during according to the international standard during the floods in 2011. We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps. Methods: A mixed methods study was conducted in rural villages of Sindh adjacent to the river Indus, and included in-depth interviews with 15 women who gave birth during the floods, structured interviews with 668 women who were pregnant during 2010-2014, and in-depth interviews with 25 community health workers (CHW) and 30 key informants. Results: Women said that giving birth in the relief camps during the floods was one of the most challenging times of their life. Nearly 91.2% women gave birth in temporary shelters with the help of a traditional birth attendant (Dai) with no clean physical space available to birth, and the health camp was mostly accessed by men and always overcrowded. There was no obstetric trained medical staff in the health camps or transportation provided to take women with complications to the nearest health facility. The rate of adverse outcome following disaster was 22.2% (95% CI: 8.62% – 42.2%) amongst 27 women who did not evacuate as compare to 7.91% (95% CI: 5.03% – 11.8%) among 278 women who lived in relief camp study participants. There were 27 women who evacuated on pre-flood warning and had 0% rate of adverse outcome. Conclusion: We propose a model where CHWs will be used as frontline maternity care providers during any emergency or disaster situations in Pakistan. A separate "birthing station" should be mandatory in all district relief camps, managed by CHWs. Community midwives (CMW) would and the Lady Health Workers (LHW) would provide antenatal and postnatal care alongside, vaccination for pregnant women, neonates and children under five. There must be an ambulance facility for emergency obstetric cases and all district health facilities should have at least two medical staff identified and trained for emergency obstetric management. The District Health Department must provide clean birthing kits and regular and emergency contraceptives in the relief camps.

Keywords: natural disaster, maternity care model, rural, Pakistan, community health workers

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Authors: Asma Ahmed, Farah Khalid, Sahlah Sohail, Saira Banusokwalla, Sabiha Banu, Inaara Akbar, Safia Awan, Syed Iqbal Azam

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Background and Objectives: The level of knowledge regarding obesity as a disease condition and health-seeking behavior regarding its management is grossly lacking. We present data from our multidisciplinary obesity clinic at the large tertiary care facility in Karachi, Pakistan, to provide baseline profiles and outcomes of patients attending these clinics. Methods: 260 who attended the obesity clinic between June 2018 to March 2020 were enrolled in this study. The analysis included descriptive and ROC analysis to identify the best cut-offs of theanthropometric measurements to diagnose obesity-related comorbid conditions. Results: The majority of the studied population were women (72.3%) and employed(43.7%) with a mean age of 35.5 years. Mean BMIwas 37.4, waist circumference was 112.4 cm, visceral fat was 11.7%, and HbA1C was 6.9%. The most common comorbidities were HTN & D.M (33 &31%, respectively). The prevalence of MetS was 16.3% in patients and was slightly higher in males. Visceral fat was the main factor in predicting D.M (0.750; 95% CI: 0.665, 0.836) and MetS (0.709; 95% CI: 0.590, 0.838) compared to total body fat, waist circumference, and BMI. The risk of predicting DM &MetS for the visceral fat above 9.5% in women had the highest sensitivity (80% for D.M & 79% for MetS) and an NPV (92.75% for D.M & 95% for MetS). Conclusions: This study describes and establishes characteristics of these obese individuals, which can help inform clinical practices. These practices may involve using visceral fat for earlier identification and counseling-based interventions to prevent more severe surgical interventions down the line.

Keywords: obesity, metabolic syndrome, tertiary care facility, BMI, waist circumference, visceral fat

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Authors: Carlos G. Santos, Frederico A. Genezini, A. P. Dos Santos, H. Yorivaz, P. T. D. Siqueira

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The Prompt-Gamma Activation Analysis (PGAA) is a valuable technique for investigating the elemental composition of various samples. However, the installation of a PGAA system entails specific conditions such as filtering the neutron beam according to the target and providing adequate shielding for both users and detectors. These requirements incur substantial costs, exceeding $100,000, including manpower. Nevertheless, a cost-effective approach involves leveraging an existing neutron beam facility to create a hybrid system integrating PGAA and Neutron Tomography (NT). The IEA-R1 nuclear reactor at IPEN/USP possesses an NT facility with suitable conditions for adapting and implementing a PGAA device. The NT facility offers a thermal flux slightly colder and provides shielding for user protection. The key additional requirement involves designing detector shielding to mitigate high gamma ray background and safeguard the HPGe detector from neutron-induced damage. This study employs Monte Carlo simulations with the MCNP6 code to optimize the collimator plug for PGAA within the IEA-R1 NT facility. Three collimator models are proposed and simulated to assess their effectiveness in shielding gamma and neutron radiation from nucleon fission. The aim is to achieve a focused prompt-gamma signal while shielding ambient gamma radiation. The simulation results indicate that one of the proposed designs is particularly suitable for the PGAA-NT hybrid system.

Keywords: MCNP6.1, neutron, prompt-gamma ray, prompt-gamma activation analysis

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Authors: Prasenjit Singha, Ajay Kumar Shukla

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To produce high-quality steel in larger volumes, dynamic control of composition and temperature throughout the process is essential. In this paper, we developed a mass transfer model based on thermodynamics to simulate the ladle metallurgy steel-making process using FactSage and its macro facility. The overall heat and mass transfer processes consist of one equilibrium chamber, two non-equilibrium chambers, and one adiabatic reactor. The flow of material, as well as heat transfer, occurs across four interconnected unit chambers and a reactor. We used the macro programming facility of FactSage™ software to understand the thermochemical model of the secondary steel making process. In our model, we varied the oxygen content during the process and studied their effect on the composition of the final hot metal and slag. The model has been validated with respect to the plant data for the steel composition, which is similar to the ladle metallurgy steel-making process in the industry. The resulting composition profile serves as a guiding tool to optimize the process of ladle metallurgy in steel-making industries.

Keywords: desulphurization, degassing, factsage, reactor

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Authors: Piotr Ciuman, Barbara Lipska

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The aim of presented research was to improve numerical predictions of air parameters distribution in the actual natatorium by the selection of calculation formula of mass flux of moisture emitted from the pool. Selected correlation should ensure the best compliance of numerical results with the measurements' results of these parameters in the facility. The numerical model of the natatorium was developed, for which boundary conditions were prepared on the basis of measurements' results carried out in the actual facility. Numerical calculations were carried out with the use of ANSYS CFX software, with six formulas being implemented, which in various ways made the moisture emission dependent on water surface temperature and air parameters in the natatorium. The results of calculations with the use of these formulas were compared for air parameters' distributions: Specific humidity, velocity and temperature in the facility. For the selection of the best formula, numerical results of these parameters in occupied zone were validated by comparison with the measurements' results carried out at selected points of this zone.

Keywords: experimental validation, indoor swimming pool, moisture emission, natatorium, numerical calculations CFD, thermal and humidity conditions, ventilation

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Authors: Bezhan Ghvaberidze

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A fuzzy multi-objective facility location-selection problem (FLSP) under uncertain and extreme environments based on possibility theory is developed. The model’s uncertain parameters in the q-rung orthopair fuzzy values are presented and transformed in the Dempster-Shaper’s belief structure environment. An objective function – distribution centers’ selection ranking index as an extension of Dempster’s extremal expectations under discrimination q-rung orthopair fuzzy information is constructed. Experts evaluate each humanitarian aid from distribution centers (HADC) against each of the uncertain factors. HADCs location problem is reduced to the bicriteria problem of partitioning the set of customers by the set of centers: (1) – Minimization of transportation costs; (2) – Maximization of centers’ selection ranking indexes. Partitioning type constraints are also constructed. For an illustration of the obtained results, a numerical example is created from the facility location-selection problem.

Keywords: FLSP, multi-objective combinatorial optimization problem, evidence theory, HADC, q-rung orthopair fuzzy set, possibility theory

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Authors: Mehdi Seifbarghy, Zahra Nasiri

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Competitive location problem deals with locating new facilities to provide a service (or goods) to the customers of a given geographical area where other facilities (competitors) offering the same service are already present. The new facilities will have to compete with the existing facilities for capturing the market share. This paper proposes a new model to maximize the market share in which customers choose the facilities based on traveling time, waiting time and attractiveness. The attractiveness of a facility is considered as a parameter in the model. A heuristic is proposed to solve the problem.

Keywords: competitive location, market share, facility attractiveness, heuristic

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Authors: Sung Jong Lee, Hong Joo Ha, Chun Sang Hong

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In recent years, the interests on the impacts of industrial wastewater on aquatic ecosystem have increased with concern about ecosystem protection and human health. Whole effluent toxicity tests are used to monitor toxicity by unknown toxic chemicals as well as conventional pollutants from industrial effluent discharges. This study describes the application of TIE (toxicity identification evaluation) procedures to an acutely toxic effluent from a Seawater desalination facility in industrial complex which was toxic to Daphnia magna. In TIE phase I (characterization step), the toxic effects by heavy metals, organic compounds, oxidants, volatile organic compounds, suspended solids and ammonia were screened and revealed that the source of toxicity is far from these toxicants group. Chemical analysis (TIE phase II) on TDS showed that the concentration of chloride ion (24,215 ~ 29,562 mg/L) was substantially higher than that predicted from EC50 for D. magna. In confirmation step (TIE phase III), chloride ion was demonstrated to be main toxicant in this effluent by the spiking approach, species sensitivity approach, and deletion approach. Calcium, potassium, magnesium, sodium, fluorine, sulfate ion concentration was not shown toxicity from D. magna. Finally, we concluded that chloride was the most contributing toxicant in the waste water treatment plant. Further research activities are needed for technical support of toxicity identification and evaluation on the various types of wastewater treatment plant discharge in Korea. Acknowledgement: This research was supported by a grant (16IFIP-B089911-03) from Plant Research Program funded by Ministry of Land, Infrastructure and Transport of Korean government.

Keywords: TIE, D. magna, V. fischeri, seawater desalination facility

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Authors: Paul Kenneth D. Luzon, Maria Antonia N. Tanchuling

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The Quezon City Controlled Dumping facility also known as Payatas produces leachate which can contaminate soil and water environment in the area. The goal of this study is to quantify the leachate produced by the QCCDF using the Hydrologic Evaluation of Landfill Performance (HELP) model. Results could be used as input for groundwater contaminant transport studies. The HELP model is based on a simple water budget and is an essential “model requirement” used by the US Environmental Protection Agency (EPA). Annual waste profile of the QCCDF was calculated. Based on topographical maps and estimation of settlement due to overburden pressure and degradation, a total of 10M m^3 of waste is contained in the landfill. The input necessary for the HELP model are weather data, soil properties, and landfill design. Results showed that from 1988 to 2011, an average of 50% of the total precipitation percolates through the bottom layer. Validation of the results is still needed due to the assumptions made in the study. The decrease in porosity of the top soil cover showed the best mitigation for minimizing percolation rate. This study concludes that there is a need for better leachate management system in the QCCDF.

Keywords: help model, landfill, payatas trash slide, quezon city controlled dumping facility

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Authors: Ebenezer Kwesi Armah-Ansah, Kenneth Fosu Oteng, Esther Selasi Avinu, Eugene Budu, Edward Kwabena Ameyaw

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Background: Maternal mortality, particularly in Benin, is a major public health concern in Sub-Saharan Africa. To provide a positive pregnancy experience and reduce maternal morbidities, all pregnant women must get appropriate and timely prenatal support. However, many pregnant women in developing countries, including Benin, begin antenatal care late. There is a paucity of empirical literature on the prevalence and predictors of early antenatal care visits in Benin. As a result, the purpose of this study is to investigate the prevalence and predictors of early antenatal care visits among women of productive age in Benin. Methods: This is a secondary analysis of the 2017/2018 Benin Demographic and Health Survey (BDHS) data. The study involved 6,919 eligible women. Data analysis was conducted using Stata version 14.2 for Mac OS. We adopted a multilevel logistic regression to examine the predictors of early ANC visits in Benin. The results were presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and p-value <0.05 to determine the significant associations. Results: The prevalence of early ANC visits among pregnant women in Benin was 57.03% [95% CI: 55.41-58.64]. In the final multilevel logistic regression, early ANC visit was higher among women aged 30-34 [aOR=1.60, 95% CI=1.17-2.18] compared to those aged 15-19, women with primary education [aOR=1.22, 95% CI=1.06-142] compared to the non-educated women, women who were covered by health insurance [aOR=3.03, 95% CI=1.35-6.76], women without a big problem in getting the money needed for treatment [aOR=1.31, 95% CI=1.16-1.49], distance to the health facility, not a big problem [aOR=1.23, 95% CI=1.08-1.41], and women whose partners had secondary/higher education [aOR=1.35, 95% CI=1.15-1.57] compared with those who were not covered by health insurance, had big problem in getting money needed for treatment, distance to health facility is a big problem and whose partners had no education respectively. However, women who had four or more births [aOR=0.60, 95% CI=0.48-0.74] and those in Atacora Region [aOR=0.50, 95% CI=0.37-0.68] had lower odds of early ANC visit. Conclusion: This study revealed a relatively high prevalence of early ANC visits among women of reproductive age in Benin. Women's age, educational status of women and their partners, parity, health insurance coverage, distance to health facilities, and region were all associated with early ANC visits among women of reproductive in Benin. These factors ought to be taken into account when developing ANC policies and strategies in order to boost early ANC visits among women in Benin. This will significantly reduce maternal and newborn mortality and help achieve the World Health Organization’s recommendation that all pregnant women should initiate early ANC visits within the first three months of pregnancy.

Keywords: antenatal care, Benin, maternal health, pregnancy, DHS, public health

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Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

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In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

Procedia PDF Downloads 426

Authors: Zainal Abidin Akasah, Maizam Alias, Azuin Ramli

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The safety and health performances aspects of a building are the most challenging aspect of facility management. It requires a deep understanding by the building managers on the factors that contribute to health and safety performances. This study attempted to develop an explanatory architectural safety performance model for stratified low-cost housing in Malaysia. The proposed Building Safety and Health Performance (BSHP) model was tested empirically through a survey on 308 construction practitioners using Partial Least Squares (PLS) and Structural Equation Modelling (SEM) tool. Statistical analysis results supports the conclusion that architecture, building services, external environment, management approaches and maintenance management have positive influence on safety and health performance of stratified low-cost housing in Malaysia. The findings provide valuable insights for construction industry to introduce BSHP model in the future where the model could be used as a guideline for training purposes of managers and better planning and implementation of building management.

Keywords: building management, stratified low-cost housing, safety, health model

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Authors: Fatemah Al-Baroud, Sudharani Shreenivas Kshatriya

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Kuwait Oil Company (KOC) is one of the companies for gas & oil production in Kuwait. The oil and gas industry is truly global; with operations conducted in every corner of the globe, the global community will rely heavily on oil and gas supplies. KOC has made many commitments to protect all due to KOC’s operations and operational releases. As per KOC’s strategy, the substantial increase in production activities will bring many challenges in managing various environmental hazards and stresses in the company. In order to handle those environmental challenges, the need of implementing effectively the health, safety, and environmental management system (HSEMS) is significant. And by implementing the HSEMS system properly, the environmental aspects of the activities, products, and services were identified, evaluated, and controlled in order to (i) Comply with local regulatory and other obligatory requirements; (ii) Comply with company policy and business requirements; and (iii) Reduce adverse environmental impact, including adverse impact to company reputation. Assessments for the Jurassic Production Facilities are being carried out as a part of the KOC HSEMS procedural requirement and monitoring the implementation of the relevant HSEMS procedures in the facilities. The assessments have been done by conducting series of theme audits using KOC’s audit protocol at JPFs. The objectives of the audits are to evaluate the compliance of the facilities towards the implementation of environmental procedures and the status of the KEPA requirement at all JPFs. The list of the facilities that were covered during the theme audit program are the following: (1) Jurassic Production Facility (JPF) – Sabriya (2) Jurassic Production Facility (JPF) – East Raudhatian (3) Jurassic Production Facility (JPF) – West Raudhatian (4)Early Production Facility (EPF 50). The auditing process comprehensively focuses on the application of KOC HSE MS procedures at JPFs and their ability to reduce the resultant negative impacts on the environment from the operations. Number of findings and observations were noted and highlighted in the audit reports and sent to all concerned controlling teams. The results of these audits indicated that the facilities, in general view, were in line with KOC HSE Procedures, and there were commitments in documenting all the HSE issues in the right records and plans. Further, implemented several control measures at JPFs that minimized/reduced the environmental impact, such as SRU were installed for sulphur recovery. Future scope and monitoring audit after a sufficient period of time will be carried out in conjunction with the controlling teams in order to verify the current status of the recommendations and evaluate the contractors' performance towards the required actions in preserving the environment.

Keywords: assessment of the environmental compliance, environmental and social impact assessment, kuwait environment public authority regulations, health, safety and environment management procedures, jurassic production facilities

Procedia PDF Downloads 162

Authors: David Holton, Michelle Dickinson, Giovanni Carta

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The principle of geological disposal is to isolate higher-activity radioactive wastes deep inside a suitable rock formation to ensure that no harmful quantities of radioactivity reach the surface environment. To achieve this, wastes will be placed in an engineered underground containment facility – the geological disposal facility (GDF) – which will be designed so that natural and man-made barriers work together to minimise the escape of radioactivity. Internationally, various multi-barrier concepts have been developed for the disposal of higher-activity radioactive wastes. High-heat-generating wastes (HLW, spent fuel and Pu) provide a number of different technical challenges to those associated with the disposal of low-heat-generating waste. Thermal management of the disposal system must be taken into consideration in GDF design; temperature constraints might apply to the wasteform, container, buffer and host rock. Of these, the temperature limit placed on the buffer component of the engineered barrier system (EBS) can be the most constraining factor. The heat must therefore be managed such that the properties of the buffer are not compromised to the extent that it cannot deliver the required level of safety. The maximum temperature of a buffer surrounding a container at the centre of a fixed array of heat-generating sources, arises due to heat diffusing from neighbouring heat-generating wastes, incrementally contributing to the temperature of the EBS. A range of strategies can be employed for managing heat in a GDF, including the spatial arrangements or patterns of those containers; different geometrical configurations can influence the overall thermal density in a disposal facility (or area within a facility) and therefore the maximum buffer temperature. A semi-analytical thermal dimensioning tool and methodology have been applied at a generic stage to explore a range of strategies to manage the disposal of high-heat-generating waste. A number of examples, including different geometrical layouts and chequer-boarding, have been illustrated to demonstrate how these tools can be used to consider safety margins and inform strategic disposal options when faced with uncertainty, at a generic stage of the development of a GDF.

Keywords: buffer, geological disposal facility, high-heat-generating waste, spent fuel

Procedia PDF Downloads 251

Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

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After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

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Authors: Avram Irina, Coiciu Eugenia-Mihaela, Popovici Mara-Georgiana, Mitu Iani Octavian

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ELI-NP stands as a cutting-edge facility globally, hosting unique radiological setups. It conducts experiments leveraging high-power lasers capable of producing extremely brief 10 PW pulses on two fronts. Moreover, it houses an exceptional gamma beam system with distinctive spectral characteristics. The facility hosts various experiments across designated experimental areas, encompassing ultra-short high-power laser tests, high-intensity gamma beam trials, and combined experiments utilizing both setups. The facility hosts a dosimetry laboratory, which recently obtained accreditation, where the radiation safety group employs a host of different types of detectors for monitoring the personnel, environment, and public exposure to ionizing radiation generated in experiments performed. ELI-NP's design was shaped by radiological protection assessments conducted through Monte Carlo simulations. The poster exemplifies an assessment conducted using the FLUKA code in an experimental area where a high-power laser system is implemented, and the future diagnostic system for variable energy gamma beams will soon be operational.

Keywords: radiation protection, Monte Carlo simulation, FLUKA, dosimetry

Procedia PDF Downloads 39

Authors: Suhib A. Abu-Seini, Kyung-Doo Kim

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A heat loss model for ATLAS facility was introduced using SPACE code predefined correlations and various dialing factors. As all previous simulations were carried out using a heat loss free input; the facility was considered to be completely insulated and the core power was reduced by the experimentally measured values of heat loss to compensate to the account for the loss of heat, this study will consider heat loss throughout the simulation. The new heat loss model will be affecting SPACE code simulation as heat being leaked out of the system throughout a transient will alter many parameters corresponding to temperature and temperature difference. For that, a Station Blackout followed by a multiple Steam Generator Tube Rupture accident will be simulated using both the insulated system approach and the newly introduced heat loss input of the steady state. Major parameters such as system temperatures, pressure values, and flow rates to be put into comparison and various analysis will be suggested upon it as the experimental values will not be the reference to validate the expected outcome. This study will not only show the significance of heat loss consideration in the processes of prevention and mitigation of various incidents, design basis and beyond accidents as it will give a detailed behavior of ATLAS facility during both processes of steady state and major transient, but will also present a verification of how credible the data acquired of ATLAS are; since heat loss values for steady state were already mismatched between SPACE simulation results and ATLAS data acquiring system. Acknowledgement- This work was supported by the Korean institute of Energy Technology Evaluation and Planning (KETEP) and the Ministry of Trade, Industry & Energy (MOTIE) of the Republic of Korea.

Keywords: ATLAS, heat loss, simulation, SPACE, station blackout, steam generator tube rupture, verification

Procedia PDF Downloads 204

Authors: Aditya Jayadas

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During a pandemic like the one we are in with COVID-19, older adults, especially those who live in a senior retirement facility, experience even bigger challenges as they are often dependent on other individuals for care. Many older adults are dependent on caregivers to assist with their instrumented activities of daily living (IADL). With travel restrictions imposed during a pandemic, there is a critical need to ensure that older adults who are homebound continue to be able to participate in physical exercise, cognitive exercise, and social interaction programs. The objective of this study was to better understand the challenges that older adults faced during the pandemic and what they were doing specifically to cope with the pandemic physically, mentally, and through social interaction. A focus group was conducted with ten older adults (age: 82.70 ± 7.81 years; nine female and one male) who resided in a senior retirement facility. During the course of one hour, seven open-ended questions were posed to the participants: a) What has changed in your life since the start of the pandemic, b) What has been most challenging for you, c) What are you doing to take care of yourself, d) Are you doing anything specifically as it relates to your physical health, e) Are you doing anything specifically as it relates to your mental health, f) What did you do for social interaction during the pandemic, g) Is there anything else you would like to share as it relates to your experience during the pandemic. The focus group session was audio-taped, and verbatim transcripts were created to evaluate the responses of the participants. The transcript consisted of 4,698 words and 293 lines of text. The data was analyzed using content analysis. The unit of analysis was the text from the audio recordings that were transcribed. From the review of the transcribed text, themes and sub-themes were identified, along with salient quotes under each sub-theme. The major themes that emerged from the data were: having a routine, engaging in activities, attending exercise classes, use of technology, family, community, and prayer. The quotes under the sub-themes provided compelling evidence of how older adults coped during the pandemic while addressing the challenges they faced and developing strategies to address their physical and mental health while interacting with others. Lessons learned from this focus group can be used to develop specific physical exercise, cognitive exercise, and social interaction programs that benefit the health and well-being of older adults.

Keywords: cognitive exercise, pandemic, physical exercise, social interaction

Procedia PDF Downloads 47