Search results for: healthcare waste management

Authors: Vidya Pratap, Seena Biju, Keshavdev A.

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In the educational town of Manipal (located in southern India) households dispose their wastes without segregation. Mixed wastes (organic, inorganic and hazardous items) are collected either by private collectors or by the local municipal body in trucks and taken to dump yards. These collectors select certain recyclables from the collected trash and sell them to scrap merchants to earn some extra money. Rag pickers play a major role in picking up card board boxes, glass bottles and milk sachets from dump yards and public areas and scrap iron from construction sites for recycling. In keeping with the Indian Prime Minister’s mission of Swachh Bharat (A Clean India), the local municipal administration is taking efforts to ensure segregation of domestic waste at source. With this in mind, each household in a residential area in Manipal was given two buckets – for wet and dry wastes (wet waste referred to organic waste while dry waste included recyclable and hazardous items). A study was conducted in this locality covering a cluster of 145 households to assess the residents’ knowledge of recyclable, organic and hazardous items commonly disposed by households. Another objective of this research was to evaluate the extent to which the residents actually dispose their wastes appropriately. Questionnaires were self-administered to a member of each household with the assistance of individuals speaking the local language whenever needed. Respondents’ knowledge of whether an item was organic, inorganic or hazardous was captured through a questionnaire containing a list of 50 common items. Their behaviour was captured by asking how they disposed these items. Results show that more than 70% of respondents are aware that banana and orange peels, potato skin, egg shells and dried leaves are organic; similarly, more than 70% of them consider newspapers, notebook and printed paper are recyclable. Less than 65% of respondents are aware that plastic bags and covers and plastic bottles are recyclable. However, the results of the respondents’ recycling behaviour is less impressive. Fewer than 35% of respondents recycle card board boxes, milk sachets and glass bottles. Unfortunately, since plastic items like plastic bags and covers and plastic bottles are not accepted by scrap merchants, they are not recycled. This study shows that the local municipal authorities must find ways to recycle plastic into products, alternate fuel etc.

Keywords: behaviour, knowledge, plastic waste management, recyclables

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Authors: Wameed Alghazali, Shawn Kenny, Paul J. Van Geel

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Settlement of municipal solid waste (MSW) in landfills can be represented by mechanical settlement, which is instantaneous and time-dependent creep components, and biodegradation-induced settlement. Mechanical settlement is governed by the physical characteristics of MSW and the applied overburden pressure. Several research studies used oedometers and different size compression cells to evaluate the primary and mechanical creep compression indices/ratios. However, MSW is known for its heterogeneity, which means data obtained from laboratory testing are not necessary to be a good representation of the mechanical response observed in the field. Furthermore, most of the laboratory tests found in the literature were conducted on shredded samples of MSW to obtain specimens that are suitable for the testing setup. It is believed that shredding MSW samples changes the physical and mechanical properties of the waste. In this study, settlement field data was collected during the filling stage of Ste. Sophie landfill was used to estimate the primary and mechanical creep compression ratios. The field results from Ste. Sophie landfill indicated that both the primary and mechanical creep compression ratios of MSW are not constants but decrease with the increase in the applied vertical stress.

Keywords: mechanical creep compression ratio, municipal solid waste, primary compression ratio, stress level

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Authors: Floyd Misheck Mwanza, Paul Boniface Majura

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The paper looked at highways/ roadside waste generation, disposal and the consequent environmental impacts. The dramatic increase in vehicular and paved roads in the recent past in Zambia, has given rise to the indiscriminate disposal of litter that now poses a threat to health and the environment. Primary data was generated by carrying out oral interviews and field observations for holistic and in–depth assessment of the environment and the secondary data was obtained from desk review method, information on effects of roadside wastes on environment were obtained from relevant literatures. The interviews were semi structured and a purposive sampling method was adopted and analyzed descriptively. The results of the findings showed that population growth and unplanned road expansion has exceeded the expected limit in recent time with resultant poor system of roadside wastes disposal. Roadside wastes which contain both biodegradable and non-biodegradable roadside wastes are disposed at the shoulders of major highways in temporary dumpsites and are never collected by a road development agency (RDA). There is no organized highway to highway or street to street collection of the wastes in Zambia by the key organization the RDA. The study revealed that roadside disposal of roadside wastes has serious impacts on the environment. Some of these impacts include physical nuisance of the wastes to the environment, the waste dumps also serve as hideouts for rodents and snakes which are dangerous. Waste are blown around by wind making the environment filthy, most of the wastes are also been washed by overland flow during heavy downpour to block drainage channels and subsequently lead to flooding of the environment. Most of the non- biodegradable wastes contain toxic chemicals which have serious implications on the environmental sustainability and human health. The paper therefore recommends that Government/ RDA should come up with proper orientation and environmental laws should be put in place for the general public and also to provide necessary facilities and arrange for better methods of collection of wastes.

Keywords: biodegradable, disposal, environment, impacts

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Authors: I. Djefour, M. Saidi, I. Tlemsani, S. Toubal

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Lignin is a molecule derived from wood and also generated as waste from the paper industry. With a view to its valorization and protection of the environment, we are interested in its use as a superplasticizer-type adjuvant in mortars and concretes to improve their mechanical strengths. The additives of the concrete have a very strong influence on the properties of the fresh and / or hardened concrete. This study examines the development and use of industrial waste and lignin extracted from a renewable natural source (wood) in cementitious materials. The use of these resources is known at present as a definite resurgence of interest in the development of building materials. Physicomechanical characteristics of mortars are determined by optimization quantity of the natural superplasticizer. The results show that the mechanical strengths of mortars based on natural adjuvant have improved by 20% (64 MPa) for a W/C ratio = 0.4, and the amount of natural adjuvant of dry extract needed is 40 times smaller than commercial adjuvant. This study has a scientific impact (improving the performance of the mortar with an increase in compactness and reduction of the quantity of water), ecological use of the lignin waste generated by the paper industry) and economic reduction of the cost price necessary to elaboration of self-compacting mortars and concretes).

Keywords: biopolymer (lignin), industrial waste, mechanical resistances, self compacting mortars (SCM)

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Authors: Larbi Belagraa, Miloud Beddar, Abderrazak Bouzid

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The needs of the construction sector still increasing for concrete. However, the shortage of natural resources of aggregate could be a problem for the concrete industry, in addition to the negative impact on the environment due to the demolition wastes. Recycling aggregate from construction and demolition (C&D) waste presents a major interest for users and researchers of concrete since this constituent can occupies more than 70% of concrete volume. The aim of the study here in is to assess the effect of sulfate resistant cement combined with the local mineral addition of marble waste fillers on the mechanical behavior of a recycled aggregate concrete (RAC). Physical and mechanical properties of RAC including the density, the flexural and the compressive strength were studied. The non destructive test methods (pulse-velocity, rebound hammer) were performed . The results obtained were compared to crushed aggregate concrete (CAC) using the normal compressive testing machine test method. The optimal content of 5% marble fillers showed an improvement for both used test methods (compression, flexion and NDT). Non-destructive methods (ultrasonic and rebound hammer test) can be used to assess the strength of RAC, but a correction coefficient is required to obtain a similar value to the compressive strength given by the compression tests. The study emphasizes that these waste materials can be successfully and economically utilized as additional inert filler in RAC formulation within similar performances compared to a conventional concrete.

Keywords: marble waste fillers, mechanical strength, natural aggregate, non-destructive testing (NDT), recycled aggregate concrete

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Authors: Usman Aliyu Jalam, Shuaibu Alolo Sumaila, Sa’adiya Iliyasu Muhammed

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Modern building industry lays much emphasis on sophisticated materials that have high embodied energy with intrinsic distinctiveness for damaging the environment. But today, advances in solid waste management have resulted in alternative building materials as partial or complete replacement of the conventional materials like cement, aggregate etc particularly for low cost housing. Investigations carried out revealed that an estimated 18.0 million tonnes of agricultural solid wastes are being generated in Nigeria annually. This constitutes a problem not only to the natural environment but also to the built environment more particularly with the way the wastes are being dispose of. The paper has discussed the present status on the generation and utilisation of agricultural solid wastes, their recycling potentials and environmental implications. It further discovered that although considerable quantity of these wastes were found to have the potentials of being recycled as building materials, the availability of the appropriate technology remains a big challenge in the country. Moreover, majority of the wastes type have gained popularity as fuel. As such, the economic and environmental benefits of recycling the wastes and the use of the wastes as fuel need further investigation.

Keywords: agricultural waste, building, environment, materials, Nigeria

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Authors: Vinay Singh, Chandra Deo, Asit Chakrabarti, Lopamudra Sahoo, Mahak Singh, Rakesh Kumar, Dinesh Kumar, H. Bharati, Biswajit Das, V. K. Mishra

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The most widely used feed resources in poultry feed, like maize and soybean, are expensive as well as in short supply. Hence, there is a need to utilize non-conventional feed ingredients to cut down feed costs. As an alternative, brewery by-products like brewers’ dried grains are potential non-conventional feed resources. North-East India is inhabited by many tribes, and most of these tribes prepare their indigenous local brew, mostly using rice grains as the primary substrate. Choak, a homemade rice beer waste, is an excellent and cheap source of protein and other nutrients. Fresh homemade rice beer waste (rice brewer’s grain) was collected locally. The proximate analysis indicated 28.53% crude protein, 92.76% dry matter, 5.02% ether extract, 7.83% crude fibre, 2.85% total ash, 0.67% acid insoluble ash, 0.91% calcium, and 0.55% total phosphorus. A feeding trial with 5 treatments (incorporating rice beer waste at the inclusion levels of 0,10,20,30 & 40% by replacing maize and soybean from basal diet) was conducted with 25 laying hens per treatment for 16 weeks under completely randomized design in order to study the production performance, blood-biochemical parameters, immunity, egg quality and cost economics of laying hens. The results showed substantial variations (P<0.01) in egg production, egg mass, FCR per dozen eggs, FCR per kg egg mass, and net FCR. However, there was not a substantial difference in either body weight or feed intake or in egg weight. Total serum cholesterol reduced significantly (P<0.01) at 40% inclusion of rice beer waste. Additionally, the egg haugh unit grew considerably (P<0.01) when the graded levels of rice beer waste increased. The inclusion of 20% rice brewers dried grain reduced feed cost per kg egg mass and per dozen egg production by Rs. 15.97 and 9.99, respectively. Choak (homemade rice beer waste) can thus be safely incorporated into the diet of laying hens at a 20% inclusion level for better production performance and cost-effectiveness.

Keywords: choak, rice beer waste, laying hen, production performance, cost economics

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Authors: Pabasara H. Gamage, Sisira K. Weliwegamage, Sameera R. Gunatilake, Hondamuni I. C De Silva, Parakrama Karunaratne

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Green diesel is an upcoming category of biofuels, which has more practical advantages than biodiesel. Production of green diesel involves production of hydrocarbons from various fatty acid sources. Though green diesel is chemically similar to fossil fuel hydrocarbons, it is more environmentally friendly. Decarboxylation of fatty acid sources is one of green diesel production methods and is less expensive and more energy efficient compared to hydrodeoxygenation. Free fatty acids (FFA), undergo decarboxylation readily than triglycerides. Waste coconut oil, which is a rich source of FFA, can be easily decarboxylated than other oils which have lower FFA contents. These free fatty acids can be converted to hydrocarbons by decarboxylation. Experiments were conducted to carry out decarboxylation of waste coconut oil in a high pressure hastealloy reactor (Toption Goup LTD), in the presence of soda lime and mixtures of soda lime and alumina. Acid value (AV) correlates to the amount of FFA available in a sample of oil. It can be shown that with the decreasing of AV, FFAs have converted to hydrocarbons. First, waste coconut oil was reacted with soda lime alone, at 150 °C, 200 °C, and 250 °C and 1.2 MPa pressure for 2 hours. AVs of products at different temperatures were compared. AV of products decreased with increasing temperature. Thereafter, different mixtures of soda lime and alumina (100% Soda lime, 1:1 soda lime and alumina and 100% alumina) were employed at temperatures 150 °C, 200 °C, and 250 °C and 1.2 MPa pressure. The lowest AV of 2.99±0.03 was obtained when 1:1 soda lime and alumina were employed at 250 °C. It can be concluded with respect to the AV that the amount of FFA decreased when decarboxylation temperature was increased. Soda lime:alumina 1:1 mixture showed the lowest AV among the compositions studied. These findings lead to formulate a method to successfully synthesize hydrocarbons by decarboxylating waste coconut oil in the presence of soda lime and alumina (1:1) at elevated tempertaures such as 250 °C.

Keywords: acid value, free fatty acids, green diesel, high pressure reactor, waste coconut oil

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Authors: Francis Chinweuba Eboh, Tobias Richards

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In this study, a waste-to-energy combined heat and power plant under construction was modelled and simulated with the Aspen Plus software. The base case process plant was evaluated and compared when integrated with flue gas condensation (FGC) in order to find out the impact of the exergy efficiency and economic feasibility as well as the effect of overall system exergy losses and revenue generated in the investigated plant. The economic evaluations were carried out using the vendor cost data from Aspen process economic analyser. The results indicate that 4 % increase in the exergy efficiency and 29 % reduction in the exergy loss in the flue gas were obtained when the flue gas condensation was incorporated. Furthermore, with the integrated FGC, the net present values (NPV) and income generated in the base process plant were increased by 29 % and 10 % respectively after 20 years of operation.

Keywords: economic feasibility, exergy efficiency, exergy losses, flue gas condensation, waste-to-energy

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Authors: Hasan Basri Jumin

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Application of crude palm oil waste combined to suitable concentration of benzyl-adenine give the significant effect to mean relative growth rate of vegetable plants and the same pattern in net assimilation rate crude palm oil waste has also significantly increased during 28 days old plants. Combination of treatment of suitable concentration of crude palm oil and benzyl adenine increased the growth and production of vegetable plants. The relative growth rate of vegetable plants was rapid 3 weeks after planting and gradually decreased at the end of the harvest time period. Combination of 400 mg.l-1 CPO with 1.0 mgl-1 till 10mgl-1 BA increased the Mean Relative Growth Rate (MRGR), Net assimilation rate (NAR), Leaf area and dry weight of Brassica juncea, Brassica oleraceae and Lactuca sativa.

Keywords: benzyladenine, crude-palm-oil, nutrient, vegetable, waste

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Authors: Mohammad Al-Mousawi

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This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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Authors: Manuel Rosales, Francisco Agrela, Julia Rosales

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The development of concrete pavements that include recycled waste with active and predictive safety features is a possible approach to mitigate the harmful impacts of the construction industry, such as CO2 emissions and the consumption of energy and natural resources during the construction and maintenance of road infrastructure. This study establishes the basis for formulating new smart materials for concrete pavements and carrying out the in-situ implementation of an experimental road section. To this end, a comprehensive recycled pavement solution is developed that combines eco-hybrid cement made with 25% mixed recycled aggregate powder (pMRA) and biomass bottom ash powder (pBBA) and a 30% substitution of natural aggregate by MRA and BBA. This work is grouped in three lines. 1) construction materials with high rates of use of recycled material, 2) production processes with efficient consumption of natural resources and use of cleaner energies, and 3) implementation and monitoring of road section with sustainable concrete made from waste. The objective of this study is to ensure satisfactory rheology, mechanical strength, durability, and CO2 capture of pavement concrete manufactured from waste and its subsequent application in real road section as well as its monitoring to establish the optimal range of recycled material. The concrete developed during this study are aimed at the reuse of waste, promoting the circular economy. For this purpose, and after having carried out different tests in the laboratory, three mixtures were established to be applied on the experimental road.

Keywords: biomass bottom ash, construction and demolition waste, recycled concrete pavements, full-scale experimental road, monitoring

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Authors: Ali Mohammed Yimer, Ayalew Assen, Youssef Belmabkhout

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Environmental remediation is a pressing global concern, necessitating innovative strategies to address the challenges posed by industrial waste and pollution. This study aims to advance environmental remediation by developing cutting-edge functional porous materials from phosphorite residue tailings. Phosphorite mining activities generate vast amounts of waste, which pose significant environmental risks due to their contaminants. The proposed approach involved transforming these phosphorite residue tailings into valuable porous materials through a series of physico-chemical processes including milling, acid-base leaching, designing or templating as well as formation processes. The key components of the tailings were extracted and processed to produce porous arrays with high surface area and porosity. These materials were engineered to possess specific properties suitable for environmental remediation applications, such as enhanced adsorption capacity and selectivity for target contaminants. The synthesized porous materials were thoroughly characterized using advanced analytical techniques (XRD, SEM-EDX, N2 sorption, TGA, FTIR) to assess their structural, morphological, and chemical properties. The performance of the materials in removing various pollutants, including heavy metals and organic compounds, were evaluated through batch adsorption experiments. Additionally, the potential for material regeneration and reusability was investigated to enhance the sustainability of the proposed remediation approach. The outdoors of this research holds significant promise for addressing the environmental challenges associated with phosphorite residue tailings. By valorizing these waste materials into porous materials with exceptional remediation capabilities, this study contributes to the development of sustainable and cost-effective solutions for environmental cleanup. Furthermore, the utilization of phosphorite residue tailings in this manner offers a potential avenue for the remediation of other contaminated sites, thereby fostering a circular economy approach to waste management.

Keywords: functional porous materials, phosphorite residue tailings, adsorption, environmental remediation, sustainable solutions

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Authors: John Pomerat, Aviv Segev

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Recently, deep learning has had many theoretical breakthroughs. For deep learning to be successful in the industry, however, there need to be practical algorithms capable of handling many real-world hiccups preventing the immediate application of a learning algorithm. Although AI promises to revolutionize the healthcare industry, getting access to patient data in order to train learning algorithms has not been easy. One proposed solution to this is data- sharing. In this paper, we propose an alternative protocol, based on multi-party computation, to train deep learning models while maintaining both the privacy and security of training data. We examine three methods of training neural networks in this way: Transfer learning, average ensemble learning, and series network learning. We compare these methods to the equivalent model obtained through data-sharing across two different experiments. Additionally, we address the security concerns of this protocol. While the motivating example is healthcare, our findings regarding multi-party computation of neural network training are purely theoretical and have use-cases outside the domain of healthcare.

Keywords: neural network aggregation, multi-party computation, transfer learning, average ensemble learning

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Authors: Johannes Full, Martin Reisinger, Alexander Sauer, Robert Miehe

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The use of biogenic residues for the biotechnological production of chemical energy carriers for electricity and heat generation as well as for mobile applications is an important lever for the shift away from fossil fuels towards a carbon dioxide neutral post-fossil future. A multitude of promising biotechnological processes needs, therefore, to be compared against each other. For this purpose, a multi-objective target system and a corresponding methodology for the evaluation of the underlying key figures are presented in this paper, which can serve as a basis for decisionmaking for companies and promotional policy measures. The methodology considers in this paper the economic and ecological potential of bio-hydrogen production using the example of hydrogen production from fruit and milk production waste with the purple bacterium R. rubrum (so-called dark photosynthesis process) for the first time. The substrate used in this cost-effective and scalable process is fructose from waste material and waste deposits. Based on an estimation of the biomass potential of such fructose residues, the new methodology is used to compare different scenarios for the production and usage of bio-hydrogen through the considered process. In conclusion, this paper presents, at the example of the promising dark photosynthesis process, a methodology to evaluate the ecological and economic potential of biotechnological production of bio-hydrogen from residues and waste.

Keywords: biofuel, hydrogen, R. rubrum, bioenergy

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Authors: Jozef Junak, Nadezda Stevulova

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This paper is aimed to the use of different types of industrial wastes in concrete production. From examined waste (crushed concrete waste) our tested concrete samples with dimension 150 mm were prepared. In these samples, fractions 4/8 mm and 8/16 mm by recycled concrete aggregate with a range of variation from 0 to 100% were replaced. Experiment samples were tested for compressive strength after 2, 7, 14 and 28 days of hardening. From obtained results it is evident that all samples prepared with washed recycled concrete aggregates met the requirement of standard for compressive strength of 20 MPa already after 14 days of hardening. Sample prepared with recycled concrete aggregates (4/8 mm: 100% and 8/16 mm: 60%) reached 101% of compressive strength value (34.7 MPa) after 28 days of hardening in comparison with the reference sample (34.4 MPa). The lowest strength after 28 days of hardening (27.42 MPa) was obtained for sample consisting of recycled concrete in proportion of 40% for 4/8 fraction and 100% for 8/16 fraction of recycled concrete.

Keywords: recycled concrete aggregate, re-use, workability, compressive strength

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Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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Authors: Bozena Dohnalkova, Jakub Hodul, Rostislav Drochytka, Jana Kosikova

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This paper deals with a proposal of a new methodology for durability assessment of solidification product for its safe further use. The new methodology is based on a review of the current state of assessment of treated waste in Czech Republic and abroad. The aim of the paper is to propose an optimal evaluation methodology for verifying properties of solidification product to ensure its safe further use in building industry.

Keywords: solidification, stabilization, durability, waste

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Authors: Vijayakumar Kunche

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Waste heat recovery from Pre Heater exhaust gases and Clinker cooler vent gases is now common place in Cement Industry. Most common practice is to use Steam Rankine cycle for heat to power conversion. In this process, waste heat from the flue gas is recovered through a Heat Recovery steam generator where steam is generated and fed to a conventional Steam turbine generator. However steam Rankine cycle tends to have lesser efficiency for smaller power plants with less than 5MW capacity and where the steam temperature at the inlet of the turbine is less than 350 deg C. further a steam Rankine cycle needs treated water and maintenance intensive. These problems can be overcome by using Thermodynamic cycle using Cyclopentane vapour in place of steam. This innovative cycle is best suited for Heat recovery in cement plants and results in best possible heat to power conversion efficiency. This paper discusses about Heat Recovery Power generation using innovative thermal cycle which uses Cyclopentane vapour in place of water- steam. And how this technology has been adopted for a Clinker cooler hot gas from mid-tap.

Keywords: clinker cooler, energy efficiency, organic rankine cycle, waste heat recovery

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Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Houmame Benbouali

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The risks, in general, exist in any project; one can hardly carry out a project without taking risks. The hydraulic works are rather complex projects in their design, realization and exploitation, and are often subjected at the multiple risks being able to influence with their good performance, and can have an negative impact on their environment. The present study was carried out to quote the impacts caused by purification plant STEP Chlef on the environment, it aims has studies the environmental impacts during construction and when designing this STEP, it is divided into two parts: The first part results from a research task bibliographer which contain three chapters (-cleansing of water worn-general information on water worn-proceed of purification of waste water). The second part is an experimental part which is divided into four chapters (detailed state initial-description of the station of purification-evaluation of the impacts of the project analyzes measurements and recommendations).

Keywords: treatment plant, waste water, waste water treatment, environmental impact

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Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: Rosine Angelique Uwacu

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Poor household sanitation is rife in Uganda, especially in Kampala. This study was carried out with he goal of establishing the main causes and effects of poor household sanitation in Kansanga parish. The study objectively sought to: To identify various ways through which wastes are generated and disposed of in Kansanga parish, identify different hygiene procedures/behaviors of waste handling in Kansanga parish and assess health effects of poor household sanitation and suggest the recommended appropriate measures of addressing cases of lack of hygiene in Kansanga parish. The study used a survey method where cluster sampling was employed. This is because there is no register of population or sufficient information, or geographic distribution of individuals is widely scattered. Data was collected through the use of interviews accompanied by observation and questionnaires. The study involved a sample of 100 households. The study revealed that; some households use wheeled bin collection, skip hire and roll on/off contained others take their wastes to refuse collection vehicles. Surprisingly, majority of the households submitted that they use polythene bags 'Kavera' and at times plastic sacs to dispose of their wastes which are dumped in drainage patterns or dustbins and other illegal dumping site. The study showed that washing hands with small jerrycans after using the toilet was being adopted by most households as there were no or few other alternatives. The study revealed that the common health effects that come as a result of poor household sanitation in Kansanga Parish are diseases outbreaks such as malaria, typhoid and diarrhea. Finally, the study gave a number of recommendations or suggestions on maintaining and achieving an adequate household sanitation in Kansanga Parish such as sensitization of community members by their leaders like Local Counselors could help to improve the situation, establishment of community sanitation days for people to collectively and voluntarily carry out good sanitation practices like digging trenches, burning garbage and proper waste management and disposal. Authorities like Kampala Capital City Authority should distribute dumping containers or allocate dumping sites where people can dispose of their wastes preferably at a minimum cost for proper management.

Keywords: household sanitation, kansanga parish, Uganda, waste

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Authors: Jiazhen Zhou, Youcai Zhao

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Waste tea is commonly generated in certain areas of China and its utilization has drawn a lot of concern nowadays. In this paper, highly microporous and mesoporous activated carbons were produced from waste tea by physical activation in the presence of water vapor in a tubular furnace. The effect of activation temperature on yield and pore properties of produced activated carbon are studied. The yield decreased with the increase of activation temperature. According to the Nitrogen adsorption isotherms, the micropore and mesopore are both developed in the activated carbon. The specific surface area and the mesopore volume fractions of the activated carbon increased with the raise of activation temperature. The maximum specific surface area attained 756 m²/g produced at activation temperature 900°C. The results showed that the activation temperature had a significant effect on the micro and mesopore volumes as well as the specific surface area.

Keywords: activated carbon, nitrogen adsorption isotherm, physical activation, waste tea

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Authors: Zhuang Ma, Zihan Zhang, Yu Li

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Environmental concerns from stakeholders (e.g., governments & customers) have pushed firms to integrate environmental management systems into business processes such as R&D, manufacturing, and marketing. Environmental systems include managing environmental risks and pollution control (e.g., air pollution control, waste-water treatment, noise control, energy recycling & solid waste treatment) through raw material management, the elimination and reduction of contaminants, recycling, and reuse in firms' operational processes. Despite increasing studies on firms' proactive adoption of environmental management, their focus is primarily on large corporations operating in developed economies. Investigations in the environmental management efforts of small and medium-sized enterprises (SMEs) are scarce. This is problematic for SMEs because, unlike large corporations, SMEs have limited awareness, resources, capabilities to adapt their operational routines to address environmental impacts. The purpose of this study is to explore how SMEs develop organizational capabilities through interactions with business partners (e.g., environmental management specialists & customers). Drawing on the resource-based view (RBV) and an organizational capabilities perspective, this study investigates the interactively developed capabilities that allow SMEs to adopt environmental management systems. Using an exploratory approach, the study includes 12 semi-structured interviews with senior managers from four SMEs, two environmental management specialists, and two customers in the pharmaceutical sector in Chongqing, China. Findings of this study include four key organizational capabilities: 1) ‘dynamic marketing’ capability, which allows SMEs to recoup the investments in environmental management systems by developing environmentally friendly products to address customers' ever-changing needs; 2) ‘process improvement’ capability, which allows SMEs to select and adopt the latest technologies from biology, chemistry, new material, and new energy sectors into the production system for improved environmental performance and cost-reductions; and 3) ‘relationship management’ capability which allows SMEs to improve corporate image among the public, social media, government agencies, and customers, who in turn help SMEs to overcome their competitive disadvantages. These interactively developed capabilities help SMEs to address larger competitors' foothold in the local market, reduce market constraints, and exploit competitive advantages in other regions (e.g., Guangdong & Jiangsu) of China. These findings extend the RBV and organizational capabilities perspective; that is, SMEs can develop the essential resources and capabilities required for environmental management through interactions with upstream and downstream business partners. While a limited number of studies did highlight the importance of interactions among SMEs, customers, suppliers, NGOs, industrial associations, and consulting firms, they failed to explore the specific capabilities developed through these interactions. Additionally, the findings can explain how a proactive adoption of environmental management systems could help some SMEs to overcome the institutional and market restraints on their products, thereby springboarding into larger, more environmentally demanding, yet more profitable markets compared with their existing market.

Keywords: capabilities, environmental management systems, interactions, SMEs

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Authors: Zipeng Zhang, Yat C. Wong, Arul Arulrajah

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Since automobiles became widely popular around the early 20th century, end-of-life tyres have been one of the major types of waste humans encounter. Every minute, there are considerable quantities of tyres being disposed of around the world. Most end-of-life tyres are simply landfilled or simply stockpiled, other than recycling. To address the potential issues caused by tyre waste, incorporating it into construction materials can be a possibility. This research investigated the viability of manufacturing bricks using mill waste and tyre crumb by alkali-activation at a relatively low temperature. The mill waste was extracted from a brick factory located in Melbourne, Australia, and the tyre crumbs were supplied by a local recycling company. As the main precursor, the mill waste was activated by the alkaline solution, which was comprised of sodium hydroxide (8m) and sodium silicate (liquid). The introduction ratio of alkaline solution (relative to the solid weight) and the weight ratio between sodium hydroxide and sodium silicate was fixed at 20 wt.% and 1:1, respectively. The tyre crumb was introduced to substitute part of the mill waste at four ratios by weight, namely 0, 5, 10 and 15%. The mixture of mill waste and tyre crumbs were firstly dry-mixed for 2 min to ensure the homogeneity, followed by a 2.5-min wet mixing after adding the solution. The ready mixture subsequently was press-moulded into blocks with the size of 109 mm in length, 112.5 mm in width and 76 mm in height. The blocks were cured at 50°C with 95% relative humidity for 2 days, followed by a 110°C oven-curing for 1 day. All the samples were then placed under the ambient environment until the age of 7 and 28 days for testing. A series of tests were conducted to evaluate the linear shrinkage, compressive strength and water absorption of the samples. In addition, the microstructure of the samples was examined via the scanning electron microscope (SEM) test. The results showed the highest compressive strength was 17.6 MPa, found in the 28-day-old group using 5 wt.% tyre crumbs. Such strength has been able to satisfy the requirement of ASTM C67. However, the increasing addition of tyre crumb weakened the compressive strength of samples. Apart from the strength, the linear shrinkage and water absorption of all the groups can meet the requirements of the standard. It is worth noting that the use of tyre crumbs tended to decrease the shrinkage and even caused expansion when the tyre content was over 15 wt.%. The research also found that there was a significant reduction in compressive strength for the samples after water absorption tests. In conclusion, the tyre crumbs have the potential to be used as a filler material in brick manufacturing, but more research needs to be done to tackle the durability problem in the future.

Keywords: bricks, mill waste, tyre crumbs, waste recycling

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Authors: Brenda Cecilia Ledesma, Andrea Beltramone

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This work deals with the bio-waste valorization approach for catalyst development, the use of products derived from biomass as raw material and the obtaining of biofuels. In this research, activated carbons were synthesized from the orange peel using different synthesis conditions. With the activated carbons obtained with the best structure and texture, PtIr bimetallic catalysts were prepared. Carbon activation was carried out through a chemical process with phosphoric acid as an activating agent, varying the acid concentration, the ratio substrate/activating agent and time of contact between them. The best support was obtained using a carbonization time of 1 h, the temperature of carbonization of 470oC, the phosphoric acid concentration of 50 wt.% and a BET area of 1429 m2/g. Subsequently, the metallic nanoparticles were deposited in the activated carbon to use the solid as a catalytic material for the hydrogenation of HMF to 2,5-DMF. The catalyst presented an excellent performance for biofuels generation.

Keywords: orange peel, bio-waste valorization, platinum, iridium, 5-hydroxymethylfurfural

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Authors: Olusegun Ayodeji Olagunju, Christine Tyreesa Pillay

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Biodiesel from waste sources is regarded as an economical and most viable fuel alternative to depleting fossil fuels. In this work, biodiesel was produced from three different sources of waste cooking oil; from cafeterias, which is vegetable-based using the transesterification method. The free fatty acids (% FFA) of the feedstocks were conducted successfully through the titration method. The results for sources 1, 2, and 3 were 0.86 %, 0.54 % and 0.20 %, respectively. The three variables considered in this process were temperature, reaction time, and catalyst concentration within the following range: 50 oC – 70 oC, 30 min – 90 min, and 0.5 % – 1.5 % catalyst. Produced biodiesel was characterized using ASTM standard methods for biodiesel property testing to determine the fuel properties, including kinematic viscosity, specific gravity, flash point, pour point, cloud point, and acid number. The results obtained indicate that the biodiesel yield from source 3 was greater than the other sources. All produced biodiesel fuel properties are within the standard biodiesel fuel specifications ASTM D6751. The optimum yield of biodiesel was obtained at 98.76%, 96.4%, and 94.53% from source 3, source 2, and source 1, respectively at optimum operating variables of 65 oC temperature, 90 minutes reaction time, and 0.5 wt% potassium hydroxide.

Keywords: waste cooking oil, biodiesel, free fatty acid content, potassium hydroxide catalyst, optimization analysis

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Authors: Maiya Smith, Tyler Thorne

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Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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Authors: Samuel Fekadu A., Esayas Alemayehu B., Bultum Oljira D., Seid Tiku D., Dessalegn Dadi D., Bart Van Der Bruggen A.

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The peroxi-photoelectrocoagulation process was evaluated for the removal of chemical oxygen demand (COD) and color from healthcare wastewater. A 2-level full factorial design with center points was created to investigate the effect of the process parameters, i.e., initial COD, H₂O₂, pH, reaction time and current density. Furthermore, the total energy consumption and average current efficiency in the system were evaluated. Predictive models for % COD, % color removal and energy consumption were obtained. The initial COD and pH were found to be the most significant variables in the reduction of COD and color in peroxi-photoelectrocoagulation process. Hydrogen peroxide only has a significant effect on the treated wastewater when combined with other input variables in the process like pH, reaction time and current density. In the peroxi-photoelectrocoagulation process, current density appears not as a single effect but rather as an interaction effect with H₂O₂ in reducing COD and color. Lower energy expenditure was observed at higher initial COD, shorter reaction time and lower current density. The average current efficiency was found as low as 13 % and as high as 777 %. Overall, the study showed that hybrid electrochemical oxidation can be applied effectively and efficiently for the removal of pollutants from healthcare wastewater.

Keywords: electrochemical oxidation, UV, healthcare pollutants removals, factorial design

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