Search results for: healthcare waste disposal

Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: Nasra Idilbi, Jalal Tarabeia, Layalleh Masalha, Heiam Shoufani Kassis, Gizell Green

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Background: Healthcare professionals working in underground facilities face unique challenges affecting their physical and mental health and team effectiveness. We aimed to examine how an underground work environment affects the physical and mental health and effectiveness of a multi-professional medical team in a medical center under continuous war threats and the contribution of various demographic and professional characteristics. Methods: A cross-sectional survey was disseminated electronically. The questionnaire assessed team effectiveness, the quality of the work, and the health symptoms reported by the team while working in the underground complex. Results: In total, 270 healthcare workers (mean age 40 years, 75.6% females, 88.4% nurses) completed the questionnaire. Women reported statistically significantly higher mean scores of physical strain, fatigue, and eye irritation associated with the work environment compared to men. Multiple regression analysis revealed that psychological distress, noise, and lighting in the underground compound significantly influenced team effectiveness. The qualitative analysis revealed two key themes: the mental health impact of working in an underground environment and the effects of noise and lighting on staff performance. Nurses reported feelings of suffocation, claustrophobia, and difficulty concentrating due to the enclosed space, with some expressing heightened stress levels that impaired their ability to work effectively and safely. Female staff reported more pronounced symptoms of physical strain, fatigue, and eye irritation. Additionally, the underground complex’s poor noise absorption created a highly disruptive work environment, while inadequate lighting hindered accurate patient assessments, leading to potential errors. These challenges were exacerbated by physical symptoms like headaches and nausea, which further impacted job performance. The findings underscore the significant role of environmental factors in influencing both mental health and operational effectiveness, aligning with quantitative data on the predictors of team performance. Conclusions: The underground work environment is crucial in influencing healthcare team effectiveness, with psychological distress, noise, and lighting as key factors. The study highlights the importance of creating a comfortable work environment to foster team efficiency. The findings provide valuable insights for managers in underground healthcare facilities to optimize team performance and well-being.

Keywords: team effectiveness, underground settings, healthcare, environmental factors, a mixed-methods study

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Authors: Lebogang L. R. Mphahlele, Bruce B. Sithole

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Chicken meat is the highest consumed meat in south Africa, with a per capita consumption of >33 kg yearly. Hence, South Africa produces over 250 million kg of waste chicken feathers each year, the majority of which is landfilled or incinerated. The discarded feathers have caused environmental pollution and natural protein resource waste. Therefore, the valorisation of waste chicken feathers is measured as a more environmentally friendly and cost-effective treatment. Feather contains 91% protein, the main component being beta-keratin, a fibrous and insoluble structural protein extensively cross linked by disulfide bonds. Keratin is usually converted it into nanofibers via electrospinning for a variety of applications. keratin nanofiber composites have many potential biomedical applications for their attractive features, such as high surface-to-volume ratio and very high porosity. The application of nanofibers in the biomedical wound dressing requires antimicrobial properties for materials. One approach is incorporating inorganic nanoparticles, among which silver nanoparticles played an important alternative antibacterial agent and have been studied against many types of microbes. The objective of this study is to combine synthetic polymer, chicken feather keratin, and antibacterial nanoparticles to develop novel electrospun antibacterial nanofibrous composites for possible wound dressing application. Furthermore, this study will converting a two-dimensional electrospun nanofiber membrane to three-dimensional fiber networks that resemble the structure of the extracellular matrix (ECM)

Keywords: chicken feather keratin, nanofibers, nanoparticles, nanocomposites, wound dressing

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Authors: Elakneswaran Yogarajah, Toyoharu Nawa, Eiji Owaki

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Cement-based materials have been using in various reinforced concrete structural components as well as in nuclear waste repositories. The sulfate attack has been an environmental issue for cement-based materials exposed to sulfate bearing groundwater or soils, and it plays an important role in the durability of concrete structures. The reaction between penetrating sulfate ions and cement hydrates can result in swelling, spalling and cracking of cement matrix in concrete. These processes induce a reduction of mechanical properties and a decrease of service life of an affected structure. It has been identified that the precipitation of secondary sulfate bearing phases such as ettringite, gypsum, and thaumasite can cause the damage. Furthermore, crystallization of soluble salts such as sodium sulfate crystals induces degradation due to formation and phase changes. Crystallization of mirabilite (Na₂SO₄:10H₂O) and thenardite (Na₂SO₄) or their phase changes (mirabilite to thenardite or vice versa) due to temperature or sodium sulfate concentration do not involve any chemical interaction with cement hydrates. Over the past couple of decades, an intensive work has been carried out on sulfate attack in cement-based materials. However, there are several uncertainties still exist regarding the mechanism for the damage of concrete in sulfate environments. In this study, modelling work has been conducted to investigate the chemical degradation of cementitious materials in various sulfate environments. Both internal and external sulfate attack are considered for the simulation. In the internal sulfate attack, hydrate assemblage and pore solution chemistry of co-hydrating Portland cement (PC) and slag mixing with sodium sulfate solution are calculated to determine the degradation of the PC and slag-blended cementitious materials. Pitzer interactions coefficients were used to calculate the activity coefficients of solution chemistry at high ionic strength. The deterioration mechanism of co-hydrating cementitious materials with 25% of Na₂SO₄ by weight is the formation of mirabilite crystals and ettringite. Their formation strongly depends on sodium sulfate concentration and temperature. For the external sulfate attack, the deterioration of various types of cementitious materials under external sulfate ingress is simulated through reactive transport model. The reactive transport model is verified with experimental data in terms of phase assemblage of various cementitious materials with spatial distribution for different sulfate solution. Finally, the reactive transport model is used to predict the long-term performance of cementitious materials exposed to 10% of Na₂SO₄ for 1000 years. The dissolution of cement hydrates and secondary formation of sulfate-bearing products mainly ettringite are the dominant degradation mechanisms, but not the sodium sulfate crystallization.

Keywords: thermodynamic calculations, reactive transport, radioactive waste disposal, PHREEQC

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Authors: Sema Kayapinar, Ismail Karaoglan, Turan Paksoy, Hadi Gokcen

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Green Supply Chain Management is gaining growing interest among researchers and supply chain management. The concept of Green Supply Chain Management is to integrate environmental thinking into the Supply Chain Management. It is the systematic concept emphasis on environmental problems such as reduction of greenhouse gas emissions, energy efficiency, recycling end of life products, generation of solid and hazardous waste. This study is to present a green supply chain network model integrated Internet of Things applications. Internet of Things provides to get precise and accurate information of end-of-life product with sensors and systems devices. The forward direction consists of suppliers, plants, distributions centres and sales and collect centres while, the reverse flow includes the sales and collects centres, disassembled centre, recycling and disposal centre. The sales and collection centre sells the new products are transhipped from factory via distribution centre and also receive the end-of life product according their value level. We describe green logistics activities by presenting specific examples including “recycling of the returned products and “reduction of CO2 gas emissions”. The different transportation choices are illustrated between echelons according to their CO2 gas emissions. This problem is formulated as a mixed integer linear programming model to solve the green supply chain problems which are emerged from the environmental awareness and responsibilities. This model is solved by using Gams package program. Numerical examples are suggested to illustrate the efficiency of the proposed model.

Keywords: green supply chain optimization, internet of things, greenhouse gas emission, recycling

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Authors: Farramae Francisco, Rhoda Mae Simora, Sharon Nunal

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Deproteination and demineralization efficiencies of shrimp waste using two Lactobacillus species treated with different carbohydrate sources for chitin production, its chemical conversion to chitosan and the quality of chitin and chitosan produced were determined. Using 5% glucose and 5% cassava starch as carbohydrate sources, pH slightly increased from the initial pH of 6.0 to 6.8 and 7.2, respectively after 24 h and maintained their pH at 6.7 to 7.3 throughout the treatment period. Demineralization (%) in 5 % glucose and 5 % cassava was highest during the first day of treatment which was 82% and 83%, respectively. Deproteination (%) was highest in 5% cassava starch on the 3rd day of treatment at 84.4%. The obtained chitin from 5% cassava and 5% glucose had a residual ash and protein below 1% and solubility of 59% and 44.3%, respectively. Chitosan produced from 5% cassava and 5% glucose had protein content below 0.05%; residual ash was 1.1% and 0.8%, respectively. Chitosan solubility and degree of deacetylation were 56% and 33% in 5% glucose and 48% and 29% in 5% cassava, respectively. The advantage this alternative technology offers over that of chemical extraction is large reduction in chemicals needed thus less effluent production and generation of a protein-rich liquor, although the demineralization process should be improved to achieve greater degree of deacetylation.

Keywords: alternative carbon source, bioprocessing, lactic acid bacteria, waste utilization

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Authors: Efil Yusrianto, Noraini Marsi, Noraniah Kassim, Izzati Abdul Manaf, Hafizuddin Hakim Shariff

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Today, municipal solid waste (MSW), noise pollution, and attack fire are three ongoing issues for inhabitants of urban including in Malaysia. To solve these issues, eco-friendly autoclaved aerated concrete (AAC) containing recycled ceramic and gypsum waste (CGW) as a partial replacement for sand with different ratios (0%, 5%, 10%, 15%, 20%, and 25% wt) has been prepared. The performance of samples, such as the physical, mechanical, sound absorption coefficient, and direct fire resistance, has been investigated. All samples showed normal color behavior, i.e., grey and free crack. The compressive strength was increased in the range of 6.10% to 29.88%. The maximum value of compressive strength was 2.13MPa for 15% wt of CGW. The positive effect of CGW on the compressive strength of AAC has also been confirmed by crystalline phase and microstructure analysis. The acoustic performances, such as sound absorption coefficients of samples at low frequencies (500Hz), are higher than the reference sample (RS). AAC-CGW samples are categorized as AAC material classes B and C. The fire resistance results showed the physical surface of the samples had a free crack and was not burned during the direct fire at 950ºC for 300s. The results showed that CGW succeeded in enhancing the performance of fresh AAC, such as compressive strength, crystalline phase, sound absorption coefficient, and fire resistance of samples.

Keywords: physical, mechanical, acoustic, direct fire resistance performance, autoclaved aerated concrete, recycled ceramic-gypsum waste

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Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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Authors: William Mahony, L. Jacqueline Hirth, Richard Rupp, Sandra Gonzalez, Roger Zoorob

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Background: The impact of the COVID-19 pandemic on physicians has been considered by many researchers, but less is known about non-physician healthcare workers. The aim of this study is to examine the association of COVID-19 safety training and communication with stress. Methods: A 91-item online survey was distributed, starting January 2, 2021, to non-physician healthcare workers, including physician assistants, nurse practitioners, and medical assistants (MAs) in the United States through email and social media. A $1 donation was made to the Red Cross for each completed survey. The survey consisted of demographics, occupational questions, and perceived stress (perceived stress scale, PSS). Items on the PSS were combined for an overall score and categorized according to the severity of perceived stress. Chi-square tests were performed for bivariate analyses of categorical variables. Results: Of the 284 participants consenting to complete the survey, 197 participants completed the full survey. MAs made up most of the sample at 79%. Among all respondents, 47% had moderate PSS scores (scored between 14 and 26), and 51% had severe PSS scores (scored between 27 and 40). Unvaccinated participants reported statistically significantly lower levels of perceived stress (p = 0.002). Performing tasks outside of typical job responsibilities was not associated with PSS scores (p = .667). Discussion: Non-physician healthcare workers demonstrated a high level of perceived stress overall. The association between vaccination status and perceived stress should be examined in order to evaluate whether vaccination levels could be improved with further education about the virus and associated risks.

Keywords: COVID-19, SARS-Cov-2, nursing, public health

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Authors: Chaouki Ghenai

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Computational Fluid Dynamic analysis of co-combustion of coal/biomass waste fuel blends is presented in this study. The main objective of this study is to investigate the effects of biomass portions (0%, 10%, 20%, 30%: weight percent) blended with coal and oxygen concentrations (21% for air, 35%, 50%, 75% and 100 % for pure oxygen) on the combustion performance and emissions. The goal is to reduce the air emissions from power plants coal combustion. Sub-bituminous Nigerian coal with calorific value of 32.51 MJ/kg and sawdust (biomass) with calorific value of 16.68 MJ/kg is used in this study. Coal/Biomass fuel blends co-combustion is modeled using mixture fraction/pdf approach for non-premixed combustion and Discrete Phase Modeling (DPM) to predict the trajectories and the heat/mass transfer of the fuel blend particles. The results show the effects of oxygen concentrations and biomass portions in the coal/biomass fuel blends on the gas and particles temperatures, the flow field, the devolitization and burnout rates inside the combustor and the CO2 and NOX emissions at the exit from the combustor. The results obtained in the course of this study show the benefits of enriching combustion air with oxygen and blending biomass waste with coal for reducing the harmful emissions from coal power plants.

Keywords: co-combustion, coal, biomass, fuel blends, CFD, air emissions

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Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto

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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.

Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice

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Authors: Firas Daghistani, Hossam Abuel Naga

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Waste tyres is a global problem that has a negative effect on the environment, where there are approximately one billion waste tyres discarded worldwide yearly. Waste tyres are discarded in stockpiles, where they provide harm to the environment in many ways. Finding applications to these materials can help in reducing this global problem. One of these applications is recycling these waste materials and using them in geotechnical engineering. Recycled waste tyre particulates can be mixed with sand to form a lightweight material with varying shear strength characteristics. Contradicting results were found in the literature on the inclusion of particulate rubber to sand, where some experiments found that the inclusion of particulate rubber can increase the shear strength of the mixture, while other experiments stated that the addition of particulate rubber decreases the shear strength of the mixture. This research further investigates the inclusion of particulate rubber to sand and whether it can increase or decrease the shear strength characteristics of the mixture. For the experiment, a series of direct shear tests were performed on a poorly graded sand with a mean particle size of 0.32 mm mixed with recycled poorly graded particulate rubber with a mean particle size of 0.51 mm. The shear tests were performedon four normal stresses 30, 55, 105, 200 kPa at a shear rate of 1 mm/minute. Different percentages ofparticulate rubber content were used in the mixture i.e., 10%, 20%, 30% and 50% of sand dry weight at three density states, namely loose, slight dense, and dense state. The size ratio of the mixture,which is the mean particle size of the particulate rubber divided by the mean particle size of the sand, was 1.59. The results identified multiple parameters that can influence the shear strength of the mixture. The parameters were: normal stress, particulate rubber content, mixture gradation, mixture size ratio, and the mixture’s density. The inclusion of particulate rubber tosand showed a decrease to the internal friction angle and an increase to the apparent cohesion. Overall, the inclusion of particulate rubber did not have a significant influenceon the shear strength of the mixture. For all the dense states at the low normal stresses 33 and 55 kPa, the inclusion of particulate rubber showed aslight increase in the shear strength where the peak was at 20% rubber content of the sand’s dry weight. On the other hand, at the high normal stresses 105, and 200 kPa, there was a slight decrease in the shear strength.

Keywords: shear strength, direct shear, sand-rubber mixture, waste material, granular material

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Authors: Amornchai Challcharoenwattana, Chanathip Pharino

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Rising amount of MSW every day, maximizing material diversions from landfills via recycling is a prefer method to land dumping. Characteristic of Thai MSW is classified as 40 -60 per cent compostable wastes while potentially recyclable materials in waste streams are composed of plastics, papers, glasses, and metals. However, rate of material recovery from MSW, excluding composting or biogas generation, in Thailand is still low. Thailand’s recycling rate in 2010 was only 20.5 per cent. Central government as well as local governments in Thailand have tried to curb this problem by charging some of MSW management fees at the users. However, the fee is often too low to promote MSW minimization. The objective of this paper is to identify levels of willingness-to-pay (WTP) for MSW recycling in different social structures with expected outcome of sustainable MSW managements for different town settlements to maximize MSW recycling pertaining to each town’s potential. The method of eliciting WTP is a payment card. The questionnaire was deployed using online survey during December 2012. Responses were categorized into respondents living in Bangkok, living in other municipality areas, or outside municipality area. The responses were analysed using descriptive statistics, and multiple linear regression analysis to identify relationships and factors that could influence high or low WTP. During the survey period, there were 168 filled questionnaires from total 689 visits. However, only 96 questionnaires could be usable. Among respondents in the usable questionnaires, 36 respondents lived in within the boundary of Bangkok Metropolitan Administration while 45 respondents lived in the chartered areas that were classified as other municipality but not in BMA. Most of respondents were well-off as 75 respondents reported positive monthly cash flow (77.32%), 15 respondents reported neutral monthly cash flow (15.46%) while 7 respondent reported negative monthly cash flow (7.22%). For WTP data including WTP of 0 baht with valid responses, ranking from the highest means of WTP to the lowest WTP of respondents by geographical locations for good MSW management were Bangkok (196 baht/month), municipalities (154 baht/month), and non-urbanized towns (111 baht/month). In-depth analysis was conducted to analyse whether there are additional room for further increase of MSW management fees from the current payment that each correspondent is currently paying. The result from multiple-regression analysis suggested that the following factors could impacts the increase or decrease of WTP: incomes, age, and gender. Overall, the outcome of this study suggests that survey respondents are likely to support improvement of MSW treatments that are not solely relying on landfilling technique. Recommendations for further studies are to obtain larger sample sizes in order to improve statistical powers and to provide better accuracy of WTP study.

Keywords: MSW, willingness to pay, payment card, waste seperation

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Authors: Michelle Zeyuan Ma, Hermann Heilmeier

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Recently, meat production ecosystem impacts initiated many hot discussions and researchers, and it is a difficult implementation to reduce such impacts due to the demand of meat products. It calls for better management and control of ecosystem impacts from every aspects of meat production. This article analyzes the ecosystem impacts of meat production based on meat products life cycle. The analysis shows that considerable ecosystem impacts are caused by different meat production steps: initial establishment phase, animal raising, slaughterhouse processing, meat consumption, and wastes management. Based on this analysis, the impacts are summarized as: leading factor for biodiversity loss; water waste, land use waste and land degradation; greenhouse gases emissions; pollution to air, water, and soil; related major diseases. The article also provides a discussion on a solution-sustainable food system, which could help in reducing ecosystem impacts. The analysis method is based on the life cycle level, it provides a concept of the whole meat industry ecosystem impacts, and the analysis result could be useful to manage or control meat production ecosystem impacts from investor, producer and consumer sides.

Keywords: eutrophication, life cycle based analysis, sustainable food, waste management

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Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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Authors: Jamie Lee Harder

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In the context of rapidly changing social and economic circumstances in the developing world, this paper analyses access to public healthcare for poor people with disabilities in Cambodia. Like other countries of South East Asia, Cambodia is developing at rapid pace. The historical past of Cambodia, however, has set former social policy structures to zero. This past forces Cambodia and its citizens to implement new public health policies to align with the needs of social care, healthcare, and urban planning. In this context, the role of people with disabilities (PwDs) is crucial as new developments should and can take into consideration their specific needs from the beginning onwards. This paper is based on qualitative research with expert interviews and focus group discussions in Cambodia. During the field work it became clear that the identification tool for the poorest households (HHs) does not count disability as a financial risk to fall into poverty neither when becoming sick nor because of higher health expenditures and/or lower income because of the disability. The social risk group of poor PwDs faces several barriers in accessing public healthcare. The urbanization, the socio-economic health status, and opportunities for education; all influence social status and have an impact on the health situation of these individuals. Cambodia has various difficulties with providing access to people with disabilities, mostly due to barriers regarding finances, geography, quality of care, poor knowledge about their rights and negative social and cultural beliefs. Shortened budgets and the lack of prioritizations lead to the need for reorientation of local communities, international and national non-governmental organizations and social policy. The poorest HHs are identified with a questionnaire, the IDPoor program, for which the Ministry of Planning is responsible. The identified HHs receive an ‘Equity Card’ which provides access free of charge to public healthcare centers and hospitals among other benefits. The dataset usually does not include information about the disability status. Four focus group discussions (FGD) with 28 participants showed various barriers in accessing public healthcare. These barriers go far beyond a missing ramp to access the healthcare center. The contents of the FGDs were ratified and repeated during the expert interviews with the local Ministries, NGOs, international organizations and private persons working in the field. The participants of the FGDs faced and continue to face high discrimination, low capacity to work and earn an own income, dependency on others and less social competence in their lives. When discussing their health situation, we identified, a huge difference between those who are identified and hold an Equity Card and those who do not. Participants reported high costs without IDPoor identification, positive experiences when going to the health center in terms of attitude and treatment, low satisfaction with specific capacities for treatments, negative rumors, and discrimination with the consequence of fear to seek treatment in many cases. The problem of accessing public healthcare by risk groups can be adapted to situations in other countries.

Keywords: access, disability, health, inequality, Cambodia

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Authors: Kristina Rosengren, Petra Brannefors, Eric Carlstrom

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Background: Implementation and use of person-centered care (PCC) is increasing worldwide, and why the current study intends to increase knowledge regarding how PCC is used in different European countries. Purpose: To describe the extent of person-centred care in 23 European countries in relation to use specific countries healthcare system (Beveridge, Bismarck, Mixed/OOP). Methods: The study was conducted by literature review inspired by Spice, both scientific empirical studies (Cinahl, Medline, Scopus) as well as grey literature (Google) were used. Totally 1194 documents were included divided into Cinahl n=139, Medline n=245, Scopus n=493 and Google n=317. Data were analysed with descriptive (percentage, range) regarding content and scope of PCC/country according to content and scope of PCC in each country, grouped into the healthcare system (Beveridge, Bismarck, Mixed/OOP) and geographic placement. Results: PCC were most common in UK (England, Scotland, Wales, North Ireland), n=481, 40.3%, Sweden (n=231, 19.3%), The Netherlands (n=80, 6.7%), Ireland (n=79, 6.6%) and Norway (n=61, 5.1%); and less common in Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Beveridge healthcare system (12/23=0.5217, 52.2%) show 85 percent of documents with advantage of scientific literature valued 2.92 (n=999, 0.55-4.07), compare to advantage of grey literature in Bismarck (10/23=0.4347, 43.5%) with 15 percentage valued 2.35 (n=190, 0-3.27) followed by Mixed/OOP (1/23=4%) with 0.4 valued 2.25. Conclusions: Seven out of 10 countries with Beveridge health system used PCC compare to less-used PCC in countries with the Bismarck system. Research, as well as national regulations regarding PCC, are important tools to motivate the advantage of PCC in clinical practice. Moreover, implementation of PCC needs a systematic approach, from national (politicians), regional (guideline) and local (specific healthcare settings) levels visualized by decision-making as law, mission, policies, and routines in clinical practice to establish a well-integrated phenomenon in Europe.

Keywords: Beveridge, Bismarck, Europe, evidence-based, literature review, person-centered care

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Authors: Quinn Au, Amedeo Carmine, Tauheed Khan Mohd

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The Internet of Things (IoT) is emerging as a new development in information technology in recent years, with the potential to improve convenience and efficiency in life. Following the rise of IoT, the Social Internet of Things (SIoT) is another new development in which the benefits of connectivity and user-friendliness from social network services (SNS) are its main features. With the introduction of IoT, the world will be much more modernized, convenient, and industrialized. This paper will discuss the applications of IoT in different sectors such as healthcare services, education, and lifestyle. The privacy challenges that IoT still poses to user data will also be discussed. Finally, an empirical study to evaluate the number of active installed IoT connections in recent years demonstrates the increase in usage of IoT regardless of the privacy challenges. The study also examines some types of IoT devices that are being preferred in the market and predictions from researchers about IoT in the upcoming years.

Keywords: IoT, health care, robotics, social Internet of Things

Procedia PDF Downloads 151

Authors: Nourmalita Safitri Ningsih, Ridwan, Iqri Puspa Yunanda

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The aim of this study was to utilize the waste from slaughterhouses for chicken feed ingredients is probiotic. Livestock waste produced by livestock activities such as feces, urine, food remains, as well as water from livestock and cage cleaning. The process starts with the isolation of bacteria. Rumen fluid is taken at Slaughterhouse Giwangan, Yogyakarta. Isolation of Lactobacillus ruminus is done by using de Mann Rogosa Sharpe (MRS) medium. In the sample showed a rod-shaped bacteria are streaked onto an agar plates. After it was incubated at 37ºC for 48 hours, after which it is observed. The observation of these lactic acid bacteria it will show a clear zone at about the colony. These bacterial colonies are white, round, small, shiny on the agar plate mikroenkapsul In the manufacturing process carried out by the method of freeze dried using skim milk in addition capsulated material. Then the results of these capsulated bacteria are mixed with feed for livestock. The results from the mixing of capsulated bacteria in feed are to increase the quality of animal feed so as to provide a good effect on livestock. Scanning electron microscope testing we have done show the results of bacteria have been shrouded in skim milk. It can protect the bacteria so it is more durable in use. The observation of the bacteria showed a sheath on Lactobacillus sp. Preservation of bacteria in this way makes the bacteria more durable for use. As well as skim milk can protect bacteria that are resistant to the outside environment. Results of probiotics in chicken feed showed significant weight gain in chickens. Calculation Anova (P <0.005) shows the average chicken given probiotics her weight increased.

Keywords: chicken, probiotics, waste, Lactobacillus sp, bacteria

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Authors: V. E. Messerle, A. B. Ustimenko, O. A. Lavrichshev

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A large amount of manure and its irrational use negatively affect the environment. As compared with biomass fermentation, plasma processing of manure enhances makes it possible to intensify the process of obtaining fuel gas, which consists mainly of synthesis gas (CO + H₂), and increase plant productivity by 150–200 times. This is achieved due to the high temperature in the plasma reactor and a multiple reduction in waste processing time. This paper examines the plasma processing of biomass using the example of dried mixed animal manure (dung with a moisture content of 30%). Characteristic composition of dung, wt.%: Н₂О – 30, С – 29.07, Н – 4.06, О – 32.08, S – 0.26, N – 1.22, P₂O₅ – 0.61, K₂O – 1.47, СаО – 0.86, MgO – 0.37. The thermodynamic code TERRA was used to numerically analyze dung plasma gasification and pyrolysis. Plasma gasification and pyrolysis of dung were analyzed in the temperature range 300–3,000 K and pressure 0.1 MPa for the following thermodynamic systems: 100% dung + 25% air (plasma gasification) and 100% dung + 25% nitrogen (plasma pyrolysis). Calculations were conducted to determine the composition of the gas phase, the degree of carbon gasification, and the specific energy consumption of the processes. At an optimum temperature of 1,500 K, which provides both complete gasification of dung carbon and the maximum yield of combustible components (99.4 vol.% during dung gasification and 99.5 vol.% during pyrolysis), and decomposition of toxic compounds of furan, dioxin, and benz(a)pyrene, the following composition of combustible gas was obtained, vol.%: СО – 29.6, Н₂ – 35.6, СО₂ – 5.7, N₂ – 10.6, H₂O – 17.9 (gasification) and СО – 30.2, Н₂ – 38.3, СО₂ – 4.1, N₂ – 13.3, H₂O – 13.6 (pyrolysis). The specific energy consumption of gasification and pyrolysis of dung at 1,500 K is 1.28 and 1.33 kWh/kg, respectively. An installation with a DC plasma torch with a rated power of 100 kW and a plasma reactor with a dung capacity of 50 kg/h was used for dung processing experiments. The dung was gasified in an air (or nitrogen during pyrolysis) plasma jet, which provided a mass-average temperature in the reactor volume of at least 1,600 K. The organic part of the dung was gasified, and the inorganic part of the waste was melted. For pyrolysis and gasification of dung, the specific energy consumption was 1.5 kWh/kg and 1.4 kWh/kg, respectively. The maximum temperature in the reactor reached 1,887 K. At the outlet of the reactor, a gas of the following composition was obtained, vol.%: СO – 25.9, H₂ – 32.9, СO₂ – 3.5, N₂ – 37.3 (pyrolysis in nitrogen plasma); СO – 32.6, H₂ – 24.1, СO₂ – 5.7, N₂ – 35.8 (air plasma gasification). The specific heat of combustion of the combustible gas formed during pyrolysis and plasma-air gasification of agricultural waste is 10,500 and 10,340 kJ/kg, respectively. Comparison of the integral indicators of dung plasma processing showed satisfactory agreement between the calculation and experiment.

Keywords: agricultural waste, experiment, plasma gasification, thermodynamic calculation

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Authors: R. Sharma, S. Kumar, C. Sharma

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A number of toxic chlorophenolic compounds are formed during pulp bleaching. The nature and concentration of these chlorophenolic compounds largely depends upon the amount and nature of bleaching chemicals used. These compounds are highly recalcitrant and difficult to remove but are partially removed by the biochemical treatment processes adopted by the paper industry. Identification and estimation of these chlorophenolic compounds has been carried out in the primary and secondary clarified effluents from the paper mill by GCMS. Twenty-six chorophenolic compounds have been identified and estimated in paper mill waste waters. Electrochemical treatment is an efficient method for oxidation of pollutants and has successfully been used to treat textile and oil waste water. Electrochemical treatment using less expensive anode material, stainless steel electrodes has been tried to study their removal. The electrochemical assembly comprised a DC power supply, a magnetic stirrer and stainless steel (316 L) electrode. The optimization of operating conditions has been carried out and treatment has been performed under optimized treatment conditions. Results indicate that 68.7% and 83.8% of cholorphenolic compounds are removed during 2 h of electrochemical treatment from primary and secondary clarified effluent respectively. Further, there is a reduction of 65.1, 60 and 92.6% of COD, AOX and color, respectively for primary clarified and 83.8%, 75.9% and 96.8% of COD, AOX and color, respectively for secondary clarified effluent. EC treatment has also been found to increase significantly the biodegradability index of wastewater because of conversion of non- biodegradable fraction into biodegradable fraction. Thus, electrochemical treatment is an efficient method for the degradation of cholorophenolic compounds, removal of color, AOX and other recalcitrant organic matter present in paper mill waste water.

Keywords: chlorophenolics, effluent, electrochemical treatment, wastewater

Procedia PDF Downloads 387

Authors: Xu Qian

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This abstract examines the concept of resilience in adolescents from both adolescent medicine and child psychology perspectives. It discusses the role of healthcare providers in fostering resilience among adolescents, encompassing physical, psychological, and social aspects. The paper highlights evidence-based interventions and practical strategies for promoting resilience in this population. Introduction: Resilience plays a crucial role in the healthy development of adolescents, enabling them to navigate through the challenges of this transitional period. This abstract explores the concept of resilience from the perspectives of adolescent medicine and child psychology, shedding light on the collective efforts of healthcare providers in fostering resilience. By integrating the principles and practices of these two disciplines, this abstract emphasizes the multidimensional nature of resilience and its significance in the overall well-being of adolescents. Methods: A comprehensive literature review was conducted, encompassing research articles, empirical studies, and expert opinions from both adolescent medicine and child psychology fields. The search included databases such as PubMed, PsycINFO, and Google Scholar, focusing on publications from the past decade. The review aimed to identify evidence-based interventions and practical strategies employed by healthcare providers to promote resilience among adolescents. Results: The review revealed several key findings regarding the promotion of resilience in adolescents. Firstly, resilience is a dynamic process influenced by individual characteristics, environmental factors, and the interaction between the two. Secondly, healthcare providers play a critical role in fostering resilience by addressing the physical, psychological, and social needs of adolescents. This entails comprehensive healthcare services that integrate medical care, mental health support, and social interventions. Thirdly, evidence-based interventions such as cognitive-behavioral therapy, social skills training, and positive youth development programs have shown promising outcomes in enhancing resilience. Discussion: The integration of adolescent medicine and child psychology perspectives provides a comprehensive framework for promoting resilience in adolescents. By acknowledging the interplay between physical health, psychological well-being, and social functioning, healthcare providers can tailor interventions to address the specific needs and challenges faced by adolescents. Collaborative efforts between medical professionals, psychologists, educators, and families are vital in creating a supportive environment that fosters resilience. Additionally, the findings highlight the importance of early identification and intervention, emphasizing the need for routine screening and assessment to identify adolescents at risk and provide timely support. Conclusion: Promoting resilience in adolescents requires a holistic approach that integrates adolescent medicine and child psychology perspectives. By recognizing the multifaceted nature of resilience, healthcare providers can implement evidence-based interventions and practical strategies to enhance the well-being of adolescents. The collaboration between healthcare professionals from different disciplines, alongside the involvement of families and communities, is crucial for creating a resilient support system. By investing in the promotion of resilience during adolescence, we can empower young individuals to overcome adversity and thrive in their journey toward adulthood.

Keywords: psychology, clinical psychology, child psychology, adolescent psychology, adolescent

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Authors: Louise Ödlund, Danica Djuric Ilic

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From a system perspective, there are several benefits of DH. A possibility to utilize the excess heat from waste incineration and biomass-based combined heat and power (CHP) production (e.g. possibility to utilize the excess heat from electricity production) are two examples. However, in a future sustainable society, the benefits of DH may be less obvious. Due to the climate changes and increased energy efficiency of buildings, the demand for space heating is expected to decrease. Due to the society´s development towards circular economy, a larger amount of the waste will be material recycled, and the possibility for DH production by the energy recovery through waste incineration will be reduced. Furthermore, the benefits of biomass-based CHP production will be less obvious since the marginal electricity production will no longer be linked to high greenhouse gas emissions due to an increased share of renewable electricity capacity in the electricity system. The purpose of the study is (1) to provide an overview of the possible development of other sectors which may influence the DH in the future and (2) to detect new business strategies which would enable for DH to adapt to the future conditions and remain competitive to alternative heat production in the future. A system approach was applied where DH is seen as a part of an integrated system which consists of other sectors as well. The possible future development of other sectors and the possible business strategies for DH producers were searched through a systematic literature review In order to remain competitive to the alternative heat production in the future, DH producers need to develop new business strategies. While the demand for space heating is expected to decrease, the space cooling demand will probably increase due to the climate changes, but also due to the better insulation of buildings in the cases where the home appliances are the heat sources. This opens up a possibility for applying DH-driven absorption cooling, which would increase the annual capacity utilization of the DH plants. The benefits of the DH related to the energy recovery from the waste incineration will exist in the future since there will always be a need to take care of materials and waste that cannot be recycled (e.g. waste containing organic toxins, bacteria, such as diapers and hospital waste). Furthermore, by operating central controlled heat pumps, CHP plants, and heat storage depending on the intermittent electricity production variation, the DH companies may enable an increased share of intermittent electricity production in the national electricity grid. DH producers can also enable development of local biofuel supply chains and reduce biofuel production costs by integrating biofuel and DH production in local DH systems.

Keywords: district heating, sustainable business strategies, sustainable development, system approach

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Authors: Hadi Rouhi Belvirdi, Davoud Beheshtizadeh

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The increasing demand for sustainable construction materials has led to a growing interest in high-strength recycled concrete (HSRC). Utilizing recycled materials not only reduces waste but also minimizes the depletion of natural resources. This study explores the application of artificial intelligence (AI) techniques to model and predict the properties of HSRC. In the past two decades, the production levels in various industries and, consequently, the amount of waste have increased significantly. Continuing this trend will undoubtedly cause irreparable damage to the environment. For this reason, engineers have been constantly seeking practical solutions for recycling industrial waste in recent years. This research utilized the results of the compressive strength of 90-day high-strength recycled concrete. The method for creating recycled concrete involved replacing sand with crushed glass and using glass powder instead of cement. Subsequently, a feedforward artificial neural network was employed to model the compressive strength results for 90 days. The regression and error values obtained indicate that this network is suitable for modeling the compressive strength data.

Keywords: high-strength recycled concrete, feedforward artificial neural network, regression, construction materials

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Authors: Jonathan Kissi, Baozhen Dai, Wisdom W. K. Pomegbe, Abdul-Basit Kassim

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Protecting patient’s digital information is a growing concern for healthcare institutions as people nowadays perpetually live their lives through telemedicine services. These telemedicine services have been confronted with several determinants that hinder their successful implementations, especially in developing countries. Identifying such determinants that influence the acceptance of telemedicine services is also a problem for healthcare professionals. Despite the tremendous increase in telemedicine services, its adoption, and use has been quite slow in some healthcare settings. Generally, it is accepted in today’s globalizing world that the success of telemedicine services relies on users’ satisfaction. Satisfying health professionals and patients are one of the crucial objectives of telemedicine success. This study seeks to investigate the determinants that influence health professionals’ intention to utilize telemedicine services in clinical activities in a sub-Saharan African country in West Africa (Ghana). A hybridized model comprising of health adoption models, including technology acceptance theory, diffusion of innovation theory, and protection of motivation theory, were used to investigate these quandaries. The study was carried out in four government health institutions that apply and regulate telemedicine services in their clinical activities. A structured questionnaire was developed and used for data collection. Purposive and convenience sampling methods were used in the selection of healthcare professionals from different medical fields for the study. The collected data were analyzed based on structural equation modeling (SEM) approach. All selected constructs showed a significant relationship with health professional’s behavioral intention in the direction expected from prior literature including perceived usefulness, perceived ease of use, management strategies, financial sustainability, communication channels, patients security threat, patients privacy risk, self efficacy, actual service use, user satisfaction, and telemedicine services systems securities threat. Surprisingly, user characteristics and response efficacy of health professionals were not significant in the hybridized model. The findings and insights from this research show that health professionals are pragmatic when making choices for technology applications and also their willingness to use telemedicine services. They are, however, anxious about its threats and coping appraisals. The identified significant constructs in the study may help to increase efficiency, quality of services, quality patient care delivery, and satisfactory user satisfaction among healthcare professionals. The implantation and effective utilization of telemedicine services in the selected hospitals will aid as a strategy to eradicate hardships in healthcare services delivery. The service will help attain universal health access coverage to all populace. This study contributes to empirical knowledge by identifying the vital factors influencing health professionals’ behavioral intentions to adopt telemedicine services. The study will also help stakeholders of healthcare to formulate better policies towards telemedicine service usage.

Keywords: telemedicine service, perceived usefulness, perceived ease of use, management strategies, security threats

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Authors: Hecson Christian, Joel Macwan

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Landfill site selection in an urban area is a critical issue in the planning process. With the growth of the urbanization, it has a mammoth impact on the economy, ecology, and environmental health of the region. Outsized amount of wastes are produced and the problem gets soared every day. Hence, selection of ideal site for sanitary landfill is a challenge for urban planners and solid waste managers. Disposal site is a function of many parameters. Among all, Geotechnical parameters are very vital as the same is related to surrounding open land. Moreover, the accessible safe and acceptable land is also scarce. Therefore, in this paper geotechnical parameters are used to develop a GIS model to identify an ideal location for landfill purpose. Metropolitan city of Surat is highly populated and fastest growing urban area in India. The research objectives are to conduct field experiments to collect data and to transfer the facts in GIS platform to evolve a model, to find ideal location. Planners’ preferences were obtained to use analytical hierarchical process (AHP) to find weights of each parameter. Integration of GIS and Multi-Criteria Decision Analysis (MCDA) techniques are applied to improve decision-making. It augments an environment for transformation and combination of geographical data and planners’ preferences. GIS performs deterministic overlay and buffer operations. MCDA methods evaluate alternatives based on the decision makers’ subjective values and priorities. Research results have shown many alternative locations. Economic analysis of selected site from actual operations point of view is not included in this research.

Keywords: GIS, AHP, MCDA, Geo-technical

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Authors: Jocelyne Uwibambe, Ange Thaina Ndizeye, Dinah Ishimwe, Emmanuel Mugabo Byakagaba

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Background: In low- and middle-income countries (LMICs), the use of modern contraceptive methods among women, including adolescents, is still low despite the desire to avoid pregnancy. In addition, countries have set a minimum age for marriage, which is 21 years for most countries, including Rwanda. The Rwandan culture, to a certain extent, and religion, to a greater extent, however, limit the freedom of young women to use contraceptive services because it is wrongly perceived as an encouragement for premarital sexual intercourse. In the end, what doesn’t change is that denying access to contraceptives to either male or female adolescents does not translate into preventing them from sexual activities, hence leading to an ever-increasing number of unwanted pregnancies, possible STIs, HIV, Human Papilloma Virus, and subsequent unsafe abortion followed by avoidable expensive complications. The purpose of this study is to evaluate the perception of healthcare providers regarding contraceptive use among adolescents. Methodology: This was a qualitative study. Interviews were done with different healthcare providers, including doctors, nurses, midwives, and pharmacists, through focused group discussions and in-depth interviews, then the audio was transcribed, translated and thematic coding was done. Results: This study explored the perceptions of healthcare workers regarding the provision of modern contraception to adolescents in Rwanda. The findings revealed that while healthcare providers had a good understanding of family planning and contraception, they were hesitant to provide contraception to adolescents. Sociocultural beliefs played a significant role in shaping their attitudes, as many healthcare workers believed that providing contraception to adolescents would encourage promiscuous behavior and go against cultural norms. Religious beliefs also influenced their reluctance, with some healthcare providers considering premarital sex and contraception as sinful. Lack of knowledge among parents and adolescents themselves was identified as a contributing factor to unwanted pregnancies, as inaccurate information from peers and social media influenced risky sexual behavior. Conditional policies, such as the requirement for parental consent, further hindered adolescents' access to contraception. The study suggested several solutions, including comprehensive sexual and reproductive health education, involving multiple stakeholders, ensuring easy access to contraception, and involving adolescents in policymaking. Overall, this research highlights the need for addressing sociocultural beliefs, improving healthcare providers' knowledge, and revisiting policies to ensure adolescents' reproductive health rights are met in Rwanda. Conclusion: The study highlights the importance of enhancing healthcare provider training, expanding access to modern contraception, implementing community-based interventions, and strengthening policy and programmatic support for adolescent contraception. Addressing these challenges is crucial for improving the provision of family planning services to adolescents in Rwanda and achieving the Sustainable Development Goals related to sexual and reproductive health. Collaborative efforts involving various stakeholders and organizations can contribute to overcoming these barriers and promoting the well-being of adolescents in Rwanda.

Keywords: adolescent, health care providers, contraception, reproductive health

Procedia PDF Downloads 50

Authors: Bei Shan Lin, Chun Mei Lu, Ya Ping Chen, Li Chen Lu

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This study explores the ethical issues concerning the use of physical restraint in geriatric care. Physical restraint use in a medical care setting is seen as a controversial form of treatment that has occurred over decades. There is no doubt that people nowadays are living longer than previous generations. The ageing process is inevitable. Common disease such as impaired comprehension, memory loss, and trouble expressing one’s self contribute to the difficulty that these older patients have in adapting to medical institution. For these reasons, physical restraint is often used in reducing the risk of falling, managing wandering behaviour, preventing agitation, and promoting patient compliance in geriatric care. It can mean that physical restraints are considered as a common practice that is used in the care of older patients. It is most commonly used for three specific purposes, including procedural restraint, restraint to prevent falls, and behavioural restraints. Although there have been well documented instances of morbidity and mortality recognised as being potential risks associated with physical restraint use, it continues to be permitted and used in healthcare, often in the name of safety. However, there is insufficient evidence supporting the effectiveness of physical restraint use reducing injuries from falls and controlling challenging behaviour in geriatric care settings. There is barely any empirical evidence of either a scientific basis or clinical trials have evaluated the improvement in patient safety following physical restraint. In difficult clinical situations, guidelines and practical suggestions for Healthcare professionals to comply requirements can help those making appropriate decisions and to facilitate better judgement regarding physical restraint use. The following recommendations are given for physical restraint use in long-term care settings: an interdisciplinary team approach to assess, evaluate, and treat underlying diseases to determine if treatment can ease issues precipitating physical restraint use; a clearly stated purpose of treatment plan should be made after weighing up the risk of physical restraint use against the risk of without physical restraint use; a care plan for physical restraint has to include individualised treatment planning, informed consent, identification and remedial action to avoid negative consequences, regular assessment and modification, reduction and removal of risks; patients and their families must have the opportunity to consider and give voluntary informed consent prior to physical restraint utilisation; patients, family members, and Healthcare professionals should be educated on use and adverse consequences of physical restraints in order to make raise awareness of potential risks and to take appropriate steps to prevent unnecessary harm; after physical restraint removal, Healthcare professionals should discuss with patients and family members about their experience, feelings, and any anxieties regarding the treatment. Physical restraint should always be considered a last resort as deprive patient’s freedom, control, and individuality. Healthcare professionals should emphasise on providing individualized care, interdisciplinary decision-making process, and creative and collaborative alternatives to promote older patient’s rights, dignity and overall well-being as much as possible.

Keywords: ethics healthcare, geriatric care, healthcare, physical restraint

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Authors: Stanislav Perepechko

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Industrial companies - one of the major sources of harmful substances to the atmosphere. The main cause of pollution on the concrete plants are cement dust emissions. All the cement silos, pneumatic transport, and ventilation systems equipped with filters, to avoid this. Today, many Russian companies have to decide on replacement morally and physically outdated filters and guided back to the electrostatic filters as usual equipment. The offered way of a cleaning of waste-free filtering of air differs in the fact that a filtering medium of the filter is used in concrete manufacture. Basalt is widespread and pollution-free material. In the course of cleaning, one part of basalt fiber and cement immediately goes to the mixer through flow-control units of initial basalt fiber and cement. Another part of basalt fiber goes to filters for purification of the air used in systems of an air lift, and ventilating emissions passes through them, and with trapped particles also goes to the mixer through flow-control units of the basalt fiber fulfilled in filters. At the same time, regulators are adjusted in such a way that total supply of basalt fiber and cement into the mixer remains invariable and corresponds to a given technological mode.

Keywords: waste-free air filtration, concrete, basalt fiber, building automation

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Authors: Shailender Kumar

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Current health policy pronouncements in India advocate for insurance-based financing mechanism to achieve universal health coverage (UHC), while undermine the role of comprehensive healthcare provision system. UHC is achieved when all people receive the health services they need without suffering financial hardship. This study, using 68th & 71st NSS rounds data, examines their relative and combined strength in achieving the above objective. Health-insurance has been unsuccessful in reducing prevalence and catastrophic effects of out-of-pocket payment and even dismantle the effectiveness of traditional way of health financing system. Healthcare provision is the best way forward to enhance health and well-being of households in condition if India removes existing inadequacies and inequalities in service provision across districts/states and ensure free/low cost medicines/diagnostics to the citizens.

Keywords: health policy, demand-side financing, supply-side financing, incidence of health payment

Procedia PDF Downloads 259