Search results for: hospital waste management (HWM)

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

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Authors: Soad Abubakr Abdelgalil, Gaber Attia Abo-Zaid, Mohamed Mohamed Yousri Kaddah

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Background: The Environmental Protection Agency has listed eggshell waste as the 15th most significant food industry pollution hazard. The utilization of eggshell waste as a source of renewable energy has been a hot topic in recent years. Therefore, finding a sustainable solution for the recycling and valorization of eggshell waste by investigating its potential to produce acid phosphatase (ACP) and organic acids by the newly-discovered B. sonorensis was the target of the current investigation. Results: The most potent ACP-producing B. sonorensis strain ACP2 was identified as a local bacterial strain obtained from the effluent of paper and pulp industries on basis of molecular and morphological characterization. The use of consecutive statistical experimental approaches of Plackett-Burman Design (PBD), and Orthogonal Central Composite Design (OCCD), followed by pH-uncontrolled cultivation conditions in a 7 L bench-top bioreactor, revealed an innovative medium formulation that substantially improved ACP production, reaching 216 U L⁻¹ with ACP yield coefficient Yp/x of 18.2 and a specific growth rate (µ) of 0.1 h⁻¹. The metals Ag+, Sn+, and Cr+ were the most efficiently released from eggshells during the solubilization process by B. sonorensis. The uncontrolled pH culture condition is the most suited and favored setting for improving the ACP and organic acids production simultaneously. Quantitative and qualitative analyses of produced organic acids were carried out using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Lactic acid, citric acid, and hydroxybenzoic acid isomer were the most common organic acids produced throughout the cultivation process. The findings of thermogravimetric analysis (TGA), differential scan calorimeter (DSC), scanning electron microscope (SEM), energy-dispersive spectroscopy (EDS), Fourier-Transform Infrared Spectroscopy (FTIR), and X-Ray Diffraction (XRD) analysis emphasize the significant influence of organic acids and ACP activity on the solubilization of eggshells particles. Conclusions: This study emphasized robust microbial engineering approaches for the large-scale production of a newly discovered acid phosphatase accompanied by organic acids production from B. sonorensis. The biovalorization of the eggshell waste and the production of cost-effective ACP and organic acids were integrated into the current study, and this was done through the implementation of a unique and innovative medium formulation design for eggshell waste management, as well as scaling up ACP production on a bench-top scale.

Keywords: chicken eggshells waste, bioremediation, statistical experimental design, batch fermentation

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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

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Authors: Minhui Chiu

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According to relevant studies, clinical nurses have high work pressure and relatively high job adaptation needs. The nurses who work in oncology wards have more adaptation needs when they face repeating hospitalization patients. The aims of this study were to investigate the job stress adaptation and related factors of nurses in oncology wards and to understand the predictors of job stress adaptation needs. Convenience sampling was used in this study. The nurses in the oncology specialist ward of a regional teaching hospital in southern Taiwan were selected as the research objects. A cross-sectional survey was conducted using a structured questionnaire, random sampling, and the questionnaires were filled out by the participating nurses. A total of 68 people were tested, and 65 valid questionnaires (95.6%). One basic data questionnaire and nurses’ job stress adaptation needs questionnaire were used. The data was archived with Microsoft Excel, and statistical analysis was performed with JMP12.0. The results showed that the average age was 28.8 (±6.7) years old, most of them were women, 62 (95.38%), and the average clinical experience in the hospital was 5.7 years (±5.9), and 62 (95.38%) were university graduates. 39 people (60.0%) had no work experience. 39 people (60.0%) liked nursing work very much, and 23 people (35.3%) just “liked”. 47 (72.3%) people were supported to be oncology nurses by their families. The nurses' job stress adaptation needs were 119.75 points (±17.24). The t-test and variance analysis of the impact of nurses' job pressure adaptation needs were carried out. The results showed that the score of college graduates was 121.10 (±16.39), which was significantly higher than that of master graduates 96.67 (±22.81), and the degree of liking for nursing work also reached a Significant difference. These two variables are important predictors of job adaptation needs, and the R Square is 24.15%. Conclusion: Increasing the love of clinical nurses in nursing and encouraging university graduation to have positive effects on job pressure adaptation needs and can be used as a reference for the management of human resources hospitals for oncology nurses.

Keywords: oncology nurse, job stress, job stress adaptation needs, manpower

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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

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Authors: Boularas El-Alia, Arbi Raja, Bachir Bouiadjra Sara, Rezk-Kallah Haciba, Rezkkallah Baghdad

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Objectives : To determine the handling practices of cytotoxic drugs and to describe clinical manifestations expressed by hospital personnel of Sidi Bel Abbes during the year 2014. Methods: Sectional descriptive study conducted in 3 center university hospital units (Hematology, Oncology and Urology) and Gynecology of EHS Sidi Bel Abbes. A questionnaire was administered to hospital workers regulary exposed to cytotoxic drugs. A work-place visit was performed to have an overview about working conditions. The Cytotoxic Contact Index (CCI) was calculated for each nurse on a period of 15 working days. Treatment of the results was done using SPSS software. Results: The survey reveals that 22 men and 58 women are exposed to cytotoxic drugs for an average of 7 years. Many symptoms such as ocular irritation (38,75%), throat irritation (56,25%), headache (68,75%), dizziness (43,75%), nausea (37,5%), metallic taste (30%), were reported with high frequency. Are noted in the offspring, 3 congenital anomalies,2 diaphragmatic hernia and a cleft palate. The Cytotoxic Contact Index (CCI) was higher than 3 among Oncology nurses and higher than 1 for most of the nurses of Hematology and Gynecology service. The wearing of personal protective clothing was not respected by all workers: (22/23) wear gloves and (20/23) wear a mask,(5/23) wear a cap, (2/23) wear glasses. Only 3 nurses have benefited from continuous training on handling cytotoxic drugs. Conclusion: This study shows a high occupational exposure risk to cytotoxic drugs among persons handling these drugs and the necessity to apply rigorously all measures related to personal protection awareness and training of personnel to minimize these exposure.

Keywords: cytotoxic drugs, handling, clinical manifestations, hospital staff

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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

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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: 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

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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

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Authors: Ji Wen Sun, Nan Ping Shen, Yi Bei Wu

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This study used Nursing Interventions Classification (NIC-6th) to identify the interventions performed in a pediatric cardiology unit, and then to analysis its frequency, time and difficulty, so as to give a brief review on what our nurses have done. The research team selected a 35 beds pediatric cardiology unit, and drawn all the nursing interventions in the nursing record from our hospital information system (HIS) from 1 October 2015 to 30 November 2015, using NIC-6th to do the matching and then counting their frequencies. Then giving each intervention its own time and difficulty code according to NIC-6th. The results showed that nurses in pediatric cardiology unit performed totally 43 interventions from 5394 statements, and most of them were in RN(basic) education level needed and less than 15 minutes time needed. There still had some interventions just needed by a nursing assistant but done by nurses, which should call for nurse managers to think about the suitable staffing. Thus, counting the summary of the product of frequency, time and difficulty for each intervention of each nurse can know one's performance. Acknowledgement Clinical Management Optimization Project of Shanghai Shen Kang Hospital Development Center (SHDC2014615); Hundred-Talent Program of Construction of Nursing Plateau Discipline (hlgy16073qnhb).

Keywords: nursing interventions, nursing interventions classification, nursing record, pediatric cardiology

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Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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Authors: Jonghoon Chun, Insung Kim, Jonghyun Lim, Gun Ro

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We believe that it is possible to provide a solution to reduce patient safety accidents by displaying correct medical records and prescription information through interactive patient identification. Our system is based on the use of smart bands worn by patients and these bands communicate with the hybrid gateways which understand both BLE and Wifi communication protocols. Through the convergence of low-power Bluetooth (BLE) and hybrid gateway technology, which is one of short-range wireless communication technologies, we implement ‘Intelligent Patient Identification and Location Tracking System’ to prevent medical malfunction frequently occurring in medical institutions. Based on big data and IOT technology using MongoDB, smart band (BLE, NFC function) and hybrid gateway, we develop a system to enable two-way communication between medical staff and hospitalized patients as well as to store locational information of the patients in minutes. Based on the precise information provided using big data systems, such as location tracking and movement of in-hospital patients wearing smart bands, our findings include the fact that a patient-specific location tracking algorithm can more efficiently operate HIS (Hospital Information System) and other related systems. Through the system, we can always correctly identify patients using identification tags. In addition, the system automatically determines whether the patient is a scheduled for medical service by the system in use at the medical institution, and displays the appropriateness of the medical treatment and the medical information (medical record and prescription information) on the screen and voice. This work was supported in part by the Korea Technology and Information Promotion Agency for SMEs (TIPA) grant funded by the Korean Small and Medium Business Administration (No. S2410390).

Keywords: BLE, hybrid gateway, patient identification, IoT, safety management, smart band

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Authors: Degineh Belachew Andarge, Tariku Lambiyo Anticho, Getamesay Mulatu Jara, Musa Mohammed Ali

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Introduction: Tuberculosis (TB) is a communicable chronic disease causedby Mycobacterium tuberculosis (MTB). About one-third of the world’s population is latently infected with MTB. TB is among the top 10 causes of mortality throughout the globe from a single pathogen. Objective: The aim of this study was to determine the prevalence of tuberculosis,rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis, and associated factors among presumptive tuberculosis cases attending the tuberculosis clinic of Adare General Hospital located in Hawassa city. Methods: A hospital-based cross-sectional study was conducted among 321 tuberculosis suspected patients from April toJuly 2018. Socio-demographic, environmental, and behavioral data were collected using a structured questionnaire. Sputumspecimens were analyzed using GeneXpert. Data entry was made using Epi info version 7 and analyzed by SPSS version 20. Logistic regression models were used to determine the risk factors. A p-value less than 0.05 was taken as a cut point. Results: In this study, the prevalence of Mycobacterium tuberculosis was 98 (30.5%) with 95% confidence interval (25.5–35.8), and the prevalence of rifampicin-resistant/multidrug-resistantMycobacterium tuberculosis among the 98 Mycobacteriumtuberculosis confirmed cases was 4 (4.1%). The prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosisamong the tuberculosis suspected patients was 1.24%. Participants who had a history of treatment with anti-tuberculosisdrugs were more likely to develop rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis. Conclusions: This study identified relatively high rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis amongtuberculosis suspected patients in the study area. Early detection of drug-resistant Mycobacterium tuberculosis should be givenenough attention to strengthen the management of tuberculosis cases and improve direct observation therapy short-course and eventually minimize the spread of rifampicin-resistant tuberculosis strain in the community.

Keywords: rifampicin resistance, mycobacterium tuberculosis, risk factors, prevalence of TB

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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

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Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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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

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Authors: J. Silva, P. Arezes, R. Schierl, N. Costa

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In order to study environmental contamination by cytostatic drugs in Portugal hospitals, sampling campaigns were conducted in three hospitals in 2015 (112 samples). Platinum containing drugs and fluorouracil were chosen because both were administered in high amounts. The detection limit was 0.01 pg/cm² for platinum and 0.1 pg/cm² for fluorouracil. The results show that spills occur mainly on the patient`s chair, while the most referenced occurrence is due to an inadequately closed wrapper. Day hospitals facilities were detected as having the largest number of contaminated samples and with higher levels of contamination.

Keywords: cytostatic, contamination, hospital, procedures, handling

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Authors: Marcelus U. Ajonina, Deodata B. Ngonga, Kenric B. Ware, Carine K. Nfor

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Background: Lack of knowledge of rational use of antimalarial drugs among dispensers is a serious problem, especially in areas of intense transmission, thus increasing the risk of resistance and adverse drug reactions. This study was aimed at assessing the knowledge of malaria as well as perception and dispensing practices of antimalarials among vendors in Buea community. Methods: A community-based cross-sectional survey of a random sample of 140 drug vendors living within the Buea community was conducted between March and June 2017. A questionnaire was designed to obtain information from drug vendors on the general knowledge of malaria as well as dispensing practices. Data were analyzed using SPSS Statistics 20.0 and were considered significant at p ≤ 0.05. Results: Knowledge of malaria symptoms, transmission, and prevention was reasonable among 55.8% (77) of the respondents. Only 33.6% (47) of the respondents could attribute the cause of malaria to protozoan of genus Plasmodium species. Of the 140 vendors, 115 (82.7%) prescribe antimalarial drugs. The knowledge of the national protocol was malaria case management among dispensers was 35.0%. Vendors in hospital/community pharmacies were 2.4 times (OR = 3.14, 95% CI: 4.14 - 8.74, p < 0.001) more knowledgeable about malaria treatment protocol than those of in drugstores. The prevalence of self-prescription of antimalarials was 39.3%. Self-prescription was significantly higher in drugstores than hospital/community pharmacies (p=0.004). In all, 56 (40.6%) of vendors showed good practices regarding antimalarial drug dispensing with the majority (51.7%) from community pharmacies (OR=2.27,95% CI: 1.13-4.56). Conclusion: Findings reveal moderate knowledge of malaria but poor prescription and dispensing practices of antimalarial drugs among vendors, thus indicating a need for routine monitoring and evaluation to prevent the emergence of resistant strains to current efficacious antimalarials.

Keywords: antimalarials, drug retail outlets, dispensing, drug resistance, prescription

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Authors: Hana A. Jameel Alsaeed, Rayyan Ibrahim Khaleel, Hanaa Hussein Mukhlif

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Background: Contamination in Iraq's hospitals is a localized problem with high rates of disease And deaths that mainly affect poor areas. Thus, this study aims to evaluate hospital infections in the city of Mosul and to identify the etiology. So to assess environmental infection prevention in pediatric wards and newborn critical care units in Mosul city. Methods: The present study is a cross-sectional hospital based in Mosul-Iraq between (10th February to 1st April 2022). Purposive sample of 60 nurses from neonatal intensive care units and pediatric wards in three pediatric teaching hospitals in Mosul city; Data was gathered using a questionnaire created by the researchers after reviewing previous studies. Results: The study showed that the majority of the study infection prevention and control policy isn't available in 46.7% of departments, and 45% of hospital workers in Iraq don't know if there is an Iraqi version of it. 70% of the study group had participated in an infection control training program. Conclusions: In the majority of samples 55% of respondents to the study claimed not to be aware of these rules. 60% of the study's participants had never attended a course on infection prevention and control, according to the study's findings on education and training programs. In the neonatal and critical care unit, nurses' skill levels, years of experience, and actual duties varied by wide statistically significant differences.

Keywords: pediatric, infection control, assessment, mosul city

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Authors: Soheil Heydari, Ailar Hajimohammadi, Nasser Khalili

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The application of plastic waste for asphalt modification is a sustainable strategy to deal with the enormous plastic waste generated each year and enhance the properties of asphalt. The modification is either practiced by the dry process or the wet process. In the dry process, plastics are added straight into the asphalt mixture, and in the wet process, they are mixed and digested into bitumen. In this article, the effects of plastic inclusion in asphalt mixture, through the dry process, on the permanent deformation of the asphalt are investigated. The main waste plastics that are usually used in asphalt modification are taken into account, which is linear, low-density polyethylene, low-density polyethylene, high-density polyethylene, and polypropylene. Also, to simulate a plastic waste stream, different grades of each virgin plastic are mixed and used. For instance, four different grades of polypropylene are mixed and used as representative of polypropylene. A precisely designed mixing condition is considered to dry-mix the plastics into the mixture such that the polymer was melted and modified by the later introduced binder. In this mixing process, plastics are first added to the hot aggregates and mixed three times in different time intervals, then bitumen is introduced, and the whole mixture is mixed three times in fifteen minutes intervals. Marshall specimens were manufactured, and dynamic creep tests were conducted to evaluate the effects of modification on the permanent deformation of the asphalt mixture. Dynamic creep is a common repeated loading test conducted at different stress levels and temperatures. Loading cycles are applied to the AC specimen until failure occurs; with the amount of deformation constantly recorded, the cumulative, permanent strain is determined and reported as a function of the number of cycles. The results of this study showed that the dry inclusion of the waste plastics is very effective in enhancing the resistance against permanent deformation of the mixture. However, the mixing process must be precisely engineered to melt the plastics, and a homogenous mixture is achieved.

Keywords: permanent deformation, waste plastics, low-density polyethene, high-density polyethene, polypropylene, linear low-density polyethene, dry process

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Authors: Osagbai Joshua Eriki, Ngozi Agunwamba, Alice Hill, Lorna Almond, Maniya Duffy, Devashini Naidoo, David Ho, Raman Deo

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Aims: To evaluate the baseline eating pattern in a psychiatric hospital through quantifying purchases of food and drink items at the hospital shop and to implement a traffic light healthy eating labeling system. Method: A electronic till with reporting capabilities was purchased. A two-week period of baseline data collection was conducted. Thereafter, a system for labeling items based on the nutritional value of the food items at the hospital shop was implemented. Green labeling represented the items with the lowest calories and red the most. Further data was collated on the number and types of items purchased by patients according to the category, and the initial effectiveness of the system was evaluated. Result: Despite the implementation of the traffic light system, the red category had the highest number of items purchased by patients, highlighting the importance of promoting healthy eating choices. However, the study also showed that the system was effective in promoting healthy options, as the number of items purchased from the green category increased during the study period. Conclusion: The implementation of a traffic light labeling system for items sold at the hospital shop offers a promising approach to promoting healthy eating habits and choices. This is likely to contribute to a toolkit of measures when considering the multifactorial challenges that obesity and weight issues pose for long-stay psychiatric inpatients

Keywords: mental health, nutrition, food, healthy

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Authors: S. Southamirajan, D. Dhavashankaran

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Fly ash is one of the major residues generated during combustion of coal in thermal power plants. Fly ash brick technology is the process of converting industrial waste materials into quality building material. Another issue in earth is dumping of the Bagasse ash, rice husk ash and copper slag waste. In a growing country like India a huge amount of fly ash waste materials are polluting the environment. The necessity of recycling the materials play a big role in the development of the safe and non- polluted earth. Fly ash, lime, gypsum and quarry dust are used as a replacement material for fly ash. The fly ash was replaced by the Bagasse ash and rice husk ash in the proportion of 2.5%, 5%, 7.5%, 10%, 12.5%, 15%, 17.5%, 20%, 22.5%, 25%27.5% and 30%. Two types of fly ash bricks were casted. One type is Bagasse ash replaced fly ash and another type is rice husk ash replaced fly ash bricks then copper slag are partially replaced in quarry dust. The prepared bricks are cured for 7 days and 28 days and dried in regular temperature. The mechanical and durability properties of optimum percentages of Bagasse ash and rice husk ash replaced fly ash bricks. The use of Bagasse ash and rice husk ash provides for considerable value – added utilization of Bagasse and rice husk in bricks and significant reductions in the production of greenhouse gases by the cement industry.

Keywords: Bagasse Ash, Fly ash, bricks, mechanical & durability properties, Rice husk ash

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Authors: S. N. Turkmen Koc, A. S. Kipcak, M. B. Piskin, E. Moroydor Derun, N. Tugrul

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Active carbon can be obtained from agricultural sources. Due to the high surface area, the production of activated carbon from cheap resources is very important. Since the surface area of 1 g activated carbon is approximately between 300 and 2000 m², it can be used to remove both organic and inorganic impurities. In this study, the adsorption of Zn metal was studied with the product of activated carbon, which is obtained from pomegranate peel by microwave and chemical activation methods. The microwave process of pomegranate peel was carried out under constant microwave power of 800 W and 1 to 4 minutes. After the microwave process, samples were treated with H₂SO₄ for 3 h. Then prepared product was used in synthetic waste water including 40 ppm Zn metal. As a result, removal of waste Zn in waste water ranged from 91% to 93%.

Keywords: activated carbon, chemical activation, H₂SO₄, microwave, pomegranate peel

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Authors: Savvas Varitis, Panagiotis Kavouras, George Kaimakamis, Eleni Pavlidou, George Vourlias, Konstantinos Chrysafis, Philomela Komninou, Theodoros Karakostas

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Tannery industry produces high quantities of chromium containing waste which also have high organic content. Processing of this waste is important since the organic content is above the disposal limits and the containing trivalent chromium could be potentially oxidized to hexavalent in the environment. This work aims to fabricate new vitreous and glass ceramic materials which could incorporate the tannery waste in stabilized form either for safe disposal or for the production of useful materials. Tannery waste was incinerated at 500oC in anoxic conditions so most of the organic content would be removed and the chromium remained trivalent. Glass forming agents SiO2, Na2O and CaO were mixed with the resulting ash in different proportions with decreasing ash content. Considering the low solubility of Cr in silicate melts, the mixtures were melted at 1400oC and/or 1500oC for 2h and then casted on a refractory steel plate. The resulting vitreous products were characterized by X-Ray Diffraction (XRD), Differential Thermal Analysis (DTA), Scanning and Transmission Electron Microscopy (SEM and TEM). XRD reveals the existence of Cr2O3 (eskolaite) crystallites embedded in a glassy amorphous matrix. Such crystallites are not formed under a certain proportion of the waste in the ash-vitrified material. Reduction of the ash proportion increases chromium content in the silicate matrix. From these glassy products, glass-ceramics were produced via different regimes of thermal treatment.

Keywords: chromium containing tannery ash, glass ceramic materials, thermal processing, vitrification

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Authors: David Oluwole Moses, Odeyemi Adebowale Toba, Olawale Adetunji Kola

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Candida auris, an emerging fungus, has been reported in more than 30 countries around the world since its first detection in 2009. Due to its several virulence factors, resistance to antifungals, and persistence in hospital settings, Candida auris has been reported to cause treatment-failure infections. This study was therefore carried out to determine the incidence of Candida auris in a tertiary hospital in Ekiti State, Nigeria. In this study, a total of 115 samples were screened for Candida species using cultural and molecular methods. The carriage of virulence factors and antifungal resistance among C. auris was detected using standard microbiological methods. Candida species isolated from the samples were 15 (30.0%) in clinical samples and 22 (33.85%) in hospital equipment screened. Non-albicans Candida accounted for 3 (20%) and 8 (36.36%) among the isolates from the clinical samples and equipment, respectively. Only five of the non-albicans Candida isolates were C. auris. All the isolates produced biofilm, gelatinase, and hemolysin, while none produced germ tubes. Two of the isolates were resistant to all the antifungals tested. Also, all the isolates were resistant to fluconazole and itraconazole. Nystatin appeared to be the most effective among the tested antifungals. The isolation of Candida auris is being reported for the second time in Nigeria, further confirming that the fungus has spread beyond Lagos and Ibadan, where it was first reported. The extent of the spread of the nosocomial fungus needed to be further investigated and curtailed in Nigeria before its outbreak in healthcare facilities.

Keywords: candida auris, virulence factors, antifungals, pathogen, hospital, infection

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Authors: Ayoub Bouazza, Ali Faddouli, Said Amal, Rachid Benhida, Khaoula Khaless

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Brine waste generated from reverse osmosis (RO) desalination plants contains various valuable compounds, mainly salts, trace elements, and organic matter. These wastes are up to two times saltier than standard seawater. Therefore, there is a strong economic interest in recovering these salts. The current practice in desalination plants is to reject the brine back to the sea, which affects the marine ecosystem and the environment. Our study aims to bring forth a reliable management solution for the valorisation of waste brines. Natural evaporation, isothermal evaporation at 25°C and 50°C, and evaporation using continuous heating were used to crystallize valuable salts from a reverse osmosis desalination plant brine located on the Moroccan Atlantic coast. The crystallization sequence of the brine was studied in comparison with standard seawater. The X-Ray Diffraction (XRD) of the precipitated solid phases showed similar results, where halite was the main solid phase precipitated from both the brine and seawater. However, Jänecke diagram prediction, along with FREZCHEM simulations, showed that Kainite should crystallize before Epsomite and Carnallite. As the absence of kainite formation in many experiments in the literature has been related to the metastability of kainite and the critical relative humidity conditions, and the precipitation of K–Mg salts is very sensitive to climatic conditions. An evaporation process is proposed as a solution to achieve the predicted crystallization path and to affirm the recovery of Kainite.

Keywords: salts crystallization, reverse osmosis, solar evaporation, frezchem, ZLD

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Authors: Jacob Nortey

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Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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Authors: Yi-Hao Pai, Wen-Feng Chen

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The planting area of Pomelo in Hualien, Taiwan amounts to thousands of hectares. Especially in the blooming season of Pomelo, it is an important producing area for Pomelo honey, and it is also a good test field for promoting the "Under-forest Economy". However, in the current Pomelo garden planting and management operations, the large amount of agricultural waste generated by the pruning of the branches causes environmental sanitation concerns, which can lead to the hiding of pests or the infection of the Pomelo tree, and indirectly increase the health risks of bees. Therefore, how to deal with the pruning of the branches and avoid open burning is a topic of social concern in recent years. In this research, afeasibility study evaluating energy conversion efficiency through agricultural waste gasification from the Pomelo garden, Taiwan, is demonstrated. we used a high-temperature gasifier to convert the pruning of the branches into syngas and biochar. In terms of syngas composition and calorific value assessment, we use the biogas monitoring system for analysis. Then, we used Raman spectroscopy and electron microscopy (EM) to diagnose the microstructure and surface morphology of biochar. The results indicate that the 1 ton of pruning of the branches can produce 1797.03m3 of syngas, corresponding to a calorific value of 9.1MJ/m3. The main components of the gas include CH4, H2, CO, and CO2, and the corresponding gas composition ratio is 16.8%, 7.1%, 13.7%, and 24.5%. Through the biomass syngas generator with a conversion efficiency of 30% for power generation, a total of 1,358kWh can be obtained per ton of pruning of the branches. In the research of biochar, its main characteristics in Raman spectroscopy are G bands and D bands. The first-order G and D bands are at 1580 and 1350 cm⁻¹, respectively. The G bands originates from the in-plane tangential stretching of the C−C bonds in the graphitic structure, and theD band corresponds to scattering from local defects or disorders present in carbon. The area ratio of D and G peaks (D/G) increases with the decrease of reaction temperature. The larger the D/G, the higher the defect concentration and the higher the porosity. This result is consistent with the microstructure displayed by SEM. The study is expected to be able to reuse agricultural waste and promote the development of agricultural and green energy circular economy.

Keywords: agricultural waste, gasification, energy conversion, pomelo garden

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Authors: Mahmoud Karimi, Golmohammad Khoobbakht

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This study focuses on the exergy flow analysis in the transesterification of waste cooking oil with methanol to decrease the consumption of materials and energy and promote the use of renewable resources. The exergy analysis performed is based on the thermodynamic performance parameters namely exergy destruction and exergy efficiency to investigate the effects of variable parameters on renewability of transesterification. The experiment variables were methanol to WCO ratio, catalyst concentration and reaction temperature in the transesterification reaction. The optimum condition with yield of 90.2% and exergy efficiency of 95.2% was obtained at methanol to oil molar ratio of 8:1, 1 wt.% of KOH, at 55 °C. In this condition, the total waste exergy was found to be 45.4 MJ for 1 kg biodiesel production. However high yield in the optimal condition resulted high exergy efficiency in the transesterification of WCO with methanol.

Keywords: biodiesel, exergy, thermodynamic analysis, transesterification, waste cooking oil

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