Search results for: healthcare pollutants removals
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2421

Search results for: healthcare pollutants removals

1011 Revisiting the Donning and Doffing Procedure: Ensuring a Coordinated Practice

Authors: Deanna Ruano-Meas, Laura Shenkman

Abstract:

Variances are seen in the way healthcare personnel (HCP) don and doff PPE risking contamination to self and others. By standardizing practice, variances in technique decrease, and so does the risk of contamination. To implement this change, the Model for Improvement will be used. A system change will be developed that will outline the role of the organizational leader’s support of HCP in the proper donning and doffing of PPE. Interventions will include environmental surveys to assess the safety and work situation ensuring a permissible environment, plan audits to confirm consistency, and the assessment of PPE wear for standardization. The change will also include an educational plan that will involve instruction of the current guidelines recommended by the Centers for Disease Control and Prevention (CDC) to all pertinent HCP, and the incorporation of PPE education in yearly educational training. The goal is a standardized practice and a reduced risk of contamination through education and organizational support. Personal protective equipment has had recent attention with the coming of the SARS-CoV-2. The realization that proper technique is important to decreasing contamination of pathogens has led to the revising of current processes.

Keywords: donning and doffing, HAI, infection control, PPE

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1010 Developing Urban Design and Planning Approach to Enhance the Efficiency of Infrastructure and Public Transportation in Order to Reduce GHG Emissions

Authors: A. Rostampouryasouri, A. Maghoul, S. Tahersima

Abstract:

The rapid growth of urbanization and the subsequent increase in population in cities have resulted in the destruction of the environment to cater to the needs of citizens. The industrialization of urban life has led to the production of pollutants, which has significantly contributed to the rise of air pollution. Infrastructure can have both positive and negative effects on air pollution. The effects of infrastructure on air pollution are complex and depend on various factors such as the type of infrastructure, location, and context. This study examines the effects of infrastructure on air pollution, drawing on a range of empirical evidence from Iran and China. Our paper focus for analyzing the data is on the following concepts: 1. Urban design and planning principles and practices 2. Infrastructure efficiency and optimization strategies 3. Public transportation systems and their environmental impact 4. GHG emissions reduction strategies in urban areas 5. Case studies and best practices in sustainable urban development This paper employs a mixed methodology approach with a focus on developmental and applicative purposes. The mixed methods approach combines both quantitative and qualitative research methods to provide a more comprehensive understanding of the research topic. A group of 20 architectural specialists and experts who are proficient in the field of research, design, and implementation of green architecture projects were interviewed in a systematic and purposeful manner. The research method was based on content analysis using MAXQDA2020 software. The findings suggest that policymakers and urban planners should consider the potential impacts of infrastructure on air pollution and take measures to mitigate negative effects while maximizing positive ones. This includes adopting a nature-based approach to urban planning and infrastructure development, investing in information infrastructure, and promoting modern logistic transport infrastructure.

Keywords: GHG emissions, infrastructure efficiency, urban development, urban design

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1009 Introducing Design Principles for Clinical Decision Support Systems

Authors: Luca Martignoni

Abstract:

The increasing usage of clinical decision support systems in healthcare and the demand for software that enables doctors to take informed decisions is changing everyday clinical practice. However, as technology advances not only are the benefits of technology growing, but so are the potential risks. A growing danger is the doctors’ over-reliance on the proposed decision of the clinical decision support system, leading towards deskilling and rash decisions by doctors. In that regard, identifying doctors' requirements for software and developing approaches to prevent technological over-reliance is of utmost importance. In this paper, we report the results of a design science research study, focusing on the requirements and design principles of ultrasound software. We conducted a total of 15 interviews with experts about poten-tial ultrasound software functions. Subsequently, we developed meta-requirements and design principles to design future clinical decision support systems efficiently and as free from the occur-rence of technological over-reliance as possible.

Keywords: clinical decision support systems, technological over-reliance, design principles, design science research

Procedia PDF Downloads 101
1008 Evaluation of Rehabilitation in Ischemic Stroke

Authors: Amirmohammad Dahouri

Abstract:

Each year, more than 795,000 individuals in the United States grieve a stroke, and by 2030, it is predictable that 4% of the U.S. people will have had a stroke. Ischemic stroke, accounting for about 80% of all strokes, is one of the main causes of disability. The goal of stroke rehabilitation is to help patients return to physical and mental functions and relearn the required aids to living everyday life. This flagging has an adverse effect on patients’ quality of life and affects their daily living activities. In recent years, the rehabilitation of ischemic stroke attractions more attention in the world. A review of the rudimentary perceptions of stroke rehabilitation that are price stressing to all specialists who delicacy patients with stroke. Ideas are made for patients on how to functionally manage daily activities after they have qualified for a stroke. It is vital for home healthcare clinicians to understand the process from acute events to medical equilibrium and rehabilitation to adaptation. Different sources such as Pub Med Google Scholar and science direct have been used and various contemporary articles in this era have been analyzed. The care plan must also foundation actual actions to protect against recurrent stroke, as stroke patients are generally at significant risk for further ischemic or hemorrhagic attacks. Here, we review evidence of rehabilitation in treating post-stroke impairment.

Keywords: rehabilitation, stroke, ischemic, hemorrhagic, brain

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1007 Impact of Ventilation Systems on Indoor Air Quality in Swedish Primary School Classrooms

Authors: Sarka Langer, Despoina Teli, Blanka Cabovska, Jan-Olof Dalenbäck, Lars Ekberg, Gabriel Bekö, Pawel Wargocki, Natalia Giraldo Vasquez

Abstract:

The aim of the study was to investigate the impact of various ventilation systems on indoor climate, air pollution, chemistry, and perception. Measurements of thermal environment and indoor air quality were performed in 45 primary school classrooms in Gothenburg, Sweden. The classrooms were grouped into three categories according to their ventilation system: category A) natural or exhaust ventilation or automated window opening; category B) balanced mechanical ventilation systems with constant air volume (CAV); and category C) balanced mechanical ventilation systems with variable air volume (VAV). A questionnaire survey about indoor air quality, perception of temperature, odour, noise and light, and sensation of well-being, alertness focus, etc., was distributed among the 10-12 years old children attending the classrooms. The results (medians) showed statistically significant differences between ventilation category A and categories B and C, but not between categories B and C in air change rates, median concentrations of carbon dioxide, individual volatile organic compounds formaldehyde and isoprene, in-door-to-outdoor ozone ratios and products of ozonolysis of squalene, a constituent of human skin oils, 6-methyl-5-hepten-2-one and decanal. Median ozone concentration, ozone loss -a difference between outdoor and indoor ozone concentrations- were different only between categories A and C. Median concentration of total VOCs and a perception index based on survey responses on perceptions and sensations indoors were not significantly different. In conclusion, ventilation systems have an impact on air change rates, indoor air quality, and chemistry, but the Swedish primary school children’s perception did not differ with the ventilation systems of the classrooms.

Keywords: indoor air pollutants, indoor climate, indoor chemistry, air change rate, perception

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1006 Steady and Spatio-Temporal Monitoring of Water Quality Feeding Area Southwest of Great Casablanca (Morocco)

Authors: Hicham Maklache, Rajae Delhi, Fatiha Benzha, Mohamed Tahiri

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In Morocco, where semi-arid climate is dominant, the supply of industrial and drink water is provided primarily by surface water. Morocco has currently 118 multi-purpose dams. If the construction of these works was a necessity to ensure in all seasons, the water essential to our country, it is impartial to control and protect the quality of running water. -Most dam reservoir used are threatened by eutrophication due to increased terrigenous and anthropogenic pollutants, coming from an over-fertilization of water by phosphorus and nitrogen nutrients and accelerated by uncontrolled development of microalgae aging. It should also be noted that the daily practices of citizens with respect to the resource, an essential component involved in almost all human activities (agriculture, agro-industries, hydropower, ...), has contributed significantly to the deterioration of water quality despite its treatment in several plants. Therefore, the treated water, provides a legacy of bad tastes and odors unacceptable to the consumer. -The present work exhibits results of water quality watershed Oum Erbia used to supply drinking water to the whole terraced area connecting the city of Khenifra to the city of Azemmour. The area south west of Great Casablanca (metropolis of the kingdom with about 4 million inhabitants) supplied 50% of its water needs by sourcing Dam Sidi Said Maachou located, last anchor point of the watershed before the spill in the Atlantic Ocean. The results were performed in a spatio-temporal scale and helped to establish a history of monitoring water quality during the 2009-2011 cycles, the study also presents the development of quality according to the seasonal rhythmicity and rainfall. It gives also an overview on the concept of watershed stewardship.

Keywords: crude surface water quality, Oum Er Rbia hydraulic basin, spatio-temporal monitoring, Great Casablanca drink water quality, Morocco

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1005 A Comparative Study of Black Carbon Emission Characteristics from Marine Diesel Engines Using Light Absorption Method

Authors: Dongguk Im, Gunfeel Moon, Younwoo Nam, Kangwoo Chun

Abstract:

Recognition of the needs about protecting environment throughout worldwide is widespread. In the shipping industry, International Maritime Organization (IMO) has been regulating pollutants emitted from ships by MARPOL 73/78. Recently, the Marine Environment Protection Committee (MEPC) of IMO, at its 68th session, approved the definition of Black Carbon (BC) specified by the following physical properties (light absorption, refractory, insolubility and morphology). The committee also agreed to the need for a protocol for any voluntary measurement studies to identify the most appropriate measurement methods. Filter Smoke Number (FSN) based on light absorption is categorized as one of the IMO relevant BC measurement methods. EUROMOT provided a FSN measurement data (measured by smoke meter) of 31 different engines (low, medium and high speed marine engines) of member companies at the 3rd International Council on Clean Transportation (ICCT) workshop on marine BC. From the comparison of FSN, the results indicated that BC emission from low speed marine diesel engines was ranged from 0.009 to 0.179 FSN and it from medium and high speed marine diesel engine was ranged 0.012 to 3.2 FSN. In consideration of measured the low FSN from low speed engine, an experimental study was conducted using both a low speed marine diesel engine (2 stroke, power of 7,400 kW at 129 rpm) and a high speed marine diesel engine (4 stroke, power of 403 kW at 1,800 rpm) under E3 test cycle. The results revealed that FSN was ranged from 0.01 to 0.16 and 1.09 to 1.35 for low and high speed engines, respectively. The measurement equipment (smoke meter) ranges from 0 to 10 FSN. Considering measurement range of it, FSN values from low speed engines are near the detection limit (0.002 FSN or ~0.02 mg/m3). From these results, it seems to be modulated the measurement range of the measurement equipment (smoke meter) for enhancing measurement accuracy of marine BC and evaluation on performance of BC abatement technologies.

Keywords: black carbon, filter smoke number, international maritime organization, marine diesel engine (two and four stroke), particulate matter

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1004 Pharmaceutical Evaluation of Five Different Generic Brands of Prednisolone

Authors: Asma A. Ben Ahmed, Hajer M. Alborawy, Alaa A. Mashina, Pradeep K. Velautham, Abdulmonem Gobassa, Emhemmed Elgallal, Mohamed N. El Attug

Abstract:

Generic medicines are those where patent protection has expired, and which may be produced by manufacturers other than the innovator company. Use of generic medicines has been increasing in recent years, primarily as a cost saving measure in healthcare provision. Generic medicines are typically 20 – 90 % cheaper than originator equivalents. Physicians often continue to prescribe brand-name drugs to their patients even when less expensive pharmacologically equivalent generic drugs are available. Because generics are less expensive than their brand-name counterparts, the cost-savings to the patient is not the only factor that physicians consider when choosing between generic and brand-name drugs. Unfortunately Physicians in general and Libyan Physicians in particular tend to prescribe brand-name drugs, even without evidence of their therapeutic superiority, because neither they nor their insured patients bear these drugs’ increased cost with respect to generic substitutes. This study is to compare the quality of five different prednisolone tablets of the same strength from different companies under different trade names: Julphar, October pharma, Akums, Actavis, Pfizer compared them with pure prednisolone reference (BPCRS).

Keywords: quality control, pharmaceutical analysis, generic medicines, prednisolone

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1003 Dissolved Black Carbon Accelerates the Photo-Degradation of Polystyrene Microplastics

Authors: Qin Ou, Yanghui Xu, Xintu Wang, Kim Maren Lompe, Gang Liu, Jan Peter Van Der Hoek

Abstract:

Microplastics (MPs) can undergo the photooxidation process under ultraviolet (UV) exposure, which determines their transformation and fate in environments. The presence of dissolved organic matter (DOM) can interact with MPs and take participate in the photo-degradation of MPs. As an important DOM component, dissolved black carbon (DBC), widely distributed in aquatic environments, can accelerate or inhibit the sunlight-driven photo-transformation of environmental pollutants. However, the role and underlying mechanism of DBC in the photooxidation of MPs are not clear. Herein, the DBC (< 0.45 µm) was extracted from wood biochar and fractionated by molecular weight (i.e., <3 KDa, 3 KDa−30 KDa, 30 KDa−0.45 µm). The effects of DBC chemical composition (i.e., molecular weight and chemical structure) in DBC-mediated photo-transformation of polystyrene (PS) MPs were investigated. The results showed that DBC initially inhibited the photo-degradation of MPs due to light shielding. Under UV exposure for 6−24 h, the presence of 5 mg/L DBC decreased the carbonyl index of MPs compared to the control. This inhibitory effect of DBC was found to decrease with increasing irradiation time. Notably, DBC initially decreased but then increased the hydroxyl index with aging time, suggesting that the role of DBC may shift from inhibition to acceleration. In terms of the different DBC fractions, the results showed that the smallest fraction of DBC (<3 KDa) significantly accelerated the photooxidation of PS MPs since it acted as reactive oxygen species (ROS) generators, especially in promoting the production of ¹O₂ and ³DBC* and •OH. With the increase in molecular weight, the acceleration effect of DBC on the degradation of MPs was decreased due to the increase of light shielding and possible decrease of photosensitization ability. This study thoroughly investigated the critical role of DBC chemical composition in the photooxidation process, which helps to assess the duration of aging and transformation of MPs during long-term weathering in natural waters.

Keywords: microplastics, photo-degradation, dissolved black carbon, molecular weight, photosensitization

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1002 Practical Experiences in the Development of a Lab-Scale Process for the Production and Recovery of Fucoxanthin

Authors: Alma Gómez-Loredo, José González-Valdez, Jorge Benavides, Marco Rito-Palomares

Abstract:

Fucoxanthin is a carotenoid that exerts multiple beneficial effects on human health, including antioxidant, anti-cancer, antidiabetic and anti-obesity activity; making the development of a whole process for its production and recovery an important contribution. In this work, the lab-scale production and purification of fucoxanthin in Isocrhysis galbana have been studied. In batch cultures, low light intensities (13.5 μmol/m2s) and bubble agitation were the best conditions for production of the carotenoid with product yields of up to 0.143 mg/g. After fucoxanthin ethanolic extraction from biomass and hexane partition, further recovery and purification of the carotenoid has been accomplished by means of alcohol – salt Aqueous Two-Phase System (ATPS) extraction followed by an ultrafiltration (UF) step. An ATPS comprised of ethanol and potassium phosphate (Volume Ratio (VR) =3; Tie-line Length (TLL) 60% w/w) presented a fucoxanthin recovery yield of 76.24 ± 1.60% among the studied systems and was able to remove 64.89 ± 2.64% of the carotenoid and chlorophyll pollutants. For UF, the addition of ethanol to the original recovered ethanolic ATPS stream to a final relation of 74.15% (w/w) resulted in a reduction of approximately 16% of the protein contents, increasing product purity with a recovery yield of about 63% of the compound in the permeate stream. Considering the production, extraction and primary recovery (ATPS and UF) steps, around a 45% global fucoxanthin recovery should be expected. Although other purification technologies, such as Centrifugal Partition Chromatography are able to obtain fucoxanthin recoveries of up to 83%, the process developed in the present work does not require large volumes of solvents or expensive equipment. Moreover, it has a potential for scale up to commercial scale and represents a cost-effective strategy when compared to traditional separation techniques like chromatography.

Keywords: aqueous two-phase systems, fucoxanthin, Isochrysis galbana, microalgae, ultrafiltration

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1001 The Impacts of Green Logistics Management Practices on Sustainability Performance in Nigeria

Authors: Ozoemelam Ikechukwu Lazarus, Nizamuddin B. Zainuddin, Abdul Kafi

Abstract:

Numerous studies have been carried out on Green Logistics Management Practices (GLMPs) across the globe. The study on the practices and performance of green chain practices in Africa in particular has not gained enough scholarly attention. Again, the majority of supply chain sustainability research being conducted focus on environmental sustainability. Logistics has been a major cause of supply chain resource waste and environmental damage. Many sectors of the economy that engage in logistical operations significantly rely on vehicles, which emit pollutants into the environment. Due to urbanization and industrialization, the logistical operations of manufacturing companies represent a serious hazard to the society and human life, making the sector one of the fastest expanding in the world today. Logistics companies are faced with numerous difficulties when attempting to implement logistics practices along their supply chains. In Nigeria, manufacturing companies aspire to implement reverse logistics in response to stakeholders’ requirements to reduce negative environmental consequences. However, implementing this is impeded by a criteria framework, and necessitates the careful analysis of how such criteria interact with each other in the presence of uncertainty. This study integrates most of the green logistics management practices (GLMPs) into the Nigerian firms to improve generalizability, and credibility. It examines the effect of Green Logistics Management Practices on environmental performance, social performance, market performance, and financial performance in the logistics industries. It seeks to identify the critical success factors in order to develop a model that incorporates different factors from the perspectives of the technology, organization, human and environment to inform the adoption and use of technologies for logistics supply chain social sustainability in Nigeria. It uses exploratory research approach to collect and analyse the data.

Keywords: logistics, managemernt, suatainability, environment, operations

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1000 Exposure Assessment to Heavy Metals and Flame Retardants Among Moroccan Children and Their Impact on the Epigenetic Profile

Authors: Kaoutar Chbihi, Aziza Menouni, Emilie Hardy, Matteo Creta, Nathalie Grova, An Van Nieuwenhuyse, Lode Godderis, Samir El Jaafari, Radu-Corneliu Duca

Abstract:

Industrial products and materials are often treated with additional compounds like brominated flame retardants (BFRs) and heavy metals in order to prevent their ignition, increase their functionality and improve their performance like electrical conductivity. Consequently, this could potentially expose children to harmful chemicals through indoor dust and through hand-to-mouth or toy-chewing behaviors. The aim of this study was to assess the exposure of Moroccan children aged 5-11 years to BFRs and heavy metal elements and investigate their impacts on the epigenetic profile, namely through global DNA methylation modifications. First, parents were asked to answer a questionnaire on children’s lifestyle, then blood and urine samples were collected from (n= 93) children, following the ethical guidelines, for biomonitoring and DNA methylation analysis, using a set of solid phase extraction (SPE), LC-MS/MS, GC-MS/MS and ICP/MS techniques. BFRs were detected in 54.84% of samples with a median concentration of 0.01 nmol/mL (range: 0.004-0.051 nmol/mL), while metal elements were detected in more than 90% of samples. No association was found between BFRs and global DNA methylation, unlike metal element levels that showed significant variations with global DNA methylation biomarkers, namely 5-mdC, 5-OH-mdC and N⁶-mA levels. To conclude, Moroccan children could be significantly exposed to flame retardant compounds and heavy metal elements through several routes, such as dust or equipment usage and are therefore susceptible to the adverse health effects that could be linked with such chemicals. Further research is required to assess the exposure to environmental pollutants among the Moroccan population in order to protect Moroccan health and prevent the incidence of diseases.

Keywords: biomonitoring, children, DNA methylation, epigenetics, flame retardants, heavy metals, Morocco

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999 Barriers and Drivers Towards the Use of Childhood Vaccination Services by Undocumented Migrant Caregivers in Sabah, Malaysia: A Qualitative Analysis

Authors: Michal Christina Steven, Mohd. Yusof Hj Ibrahim, Haryati Abdul Karim, Prabakaran Dhanaraj, Kelly Alexius Mansin

Abstract:

After 27 years, Malaysia reported polio cases in 2019 involving the children of the undocumented migrants living in Sabah. These undocumented migrants present a significant challenge in achieving the elimination of vaccine-preventable diseases (VPD). Due to the recent polio outbreak among the undocumented migrant children in Sabah, an in-depth interview was conducted among the caregivers of undocumented migrant children to identify the barriers and drivers towards vaccinating their children. Financial barriers, legal citizenship status, language barrier, the COVID-19 pandemic, and physical barriers have been the barriers to access vaccination services by undocumented migrants. Five significant drivers for undocumented migrants to vaccinate their children are social influence, fear of disease, parental trust in healthcare providers, good support, and vaccine availability. Necessary action should be taken immediately to address the problems of vaccinating the children of undocumented migrants to prevent the re-emergence of VPD.

Keywords: Malaysia, polio, Sabah, undocumented migrants

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998 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

Abstract:

The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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997 Assessment of Waste Management Practices in Bahrain

Authors: T. Radu, R. Sreenivas, H. Albuflasa, A. Mustafa Khan, W. Aloqab

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The Kingdom of Bahrain, a small island country in the Gulf region, is experiencing fast economic growth resulting in a sharp increase in population and greater than ever amounts of waste being produced. However, waste management in the country is still very basic, with landfilling being the most popular option. Recycling is still a scarce practice, with small recycling businesses and initiatives emerging in recent years. This scenario is typical for other countries in the region, with similar amounts of per capita waste being produced. In this paper, we are reviewing current waste management practices in Bahrain by collecting data published by the Government and various authors, and by visiting the country’s only landfill site, Askar. In addition, we have performed a survey of the residents to learn more about the awareness and attitudes towards sustainable waste management strategies. A review of the available data on waste management indicates that the Askar landfill site is nearing its capacity. The site uses open tipping as the method of disposal. The highest percentage of disposed waste comes from the building sector (38.4%), followed by domestic (27.5%) and commercial waste (17.9%). Disposal monitoring and recording are often based on estimates of weight and without proper characterization/classification of received waste. Besides, there is a need for assessment of the environmental impact of the site with systematic monitoring of pollutants in the area and their potential spreading to the surrounding land, groundwater, and air. The results of the survey indicate low awareness of what happens with the collected waste in the country. However, the respondents have shown support for future waste reduction and recycling initiatives. This implies that the education of local communities would be very beneficial for such governmental initiatives, securing greater participation. Raising awareness of issues surrounding recycling and waste management and systematic effort to divert waste from landfills are the first steps towards securing sustainable waste management in the Kingdom of Bahrain.

Keywords: landfill, municipal solid waste, survey, waste management

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996 Carbon-Based Electrochemical Detection of Pharmaceuticals from Water

Authors: M. Ardelean, F. Manea, A. Pop, J. Schoonman

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The presence of pharmaceuticals in the environment and especially in water has gained increasing attention. They are included in emerging class of pollutants, and for most of them, legal limits have not been set-up due to their impact on human health and ecosystem was not determined and/or there is not the advanced analytical method for their quantification. In this context, the development of various advanced analytical methods for the quantification of pharmaceuticals in water is required. The electrochemical methods are known to exhibit the great potential for high-performance analytical methods but their performance is in direct relation to the electrode material and the operating techniques. In this study, two types of carbon-based electrodes materials, i.e., boron-doped diamond (BDD) and carbon nanofiber (CNF)-epoxy composite electrodes have been investigated through voltammetric techniques for the detection of naproxen in water. The comparative electrochemical behavior of naproxen (NPX) on both BDD and CNF electrodes was studied by cyclic voltammetry, and the well-defined peak corresponding to NPX oxidation was found for each electrode. NPX oxidation occurred on BDD electrode at the potential value of about +1.4 V/SCE (saturated calomel electrode) and at about +1.2 V/SCE for CNF electrode. The sensitivities for NPX detection were similar for both carbon-based electrode and thus, CNF electrode exhibited superiority in relation to the detection potential. Differential-pulsed voltammetry (DPV) and square-wave voltammetry (SWV) techniques were exploited to improve the electroanalytical performance for the NPX detection, and the best results related to the sensitivity of 9.959 µA·µM-1 were achieved using DPV. In addition, the simultaneous detection of NPX and fluoxetine -a very common antidepressive drug, also present in water, was studied using CNF electrode and very good results were obtained. The detection potential values that allowed a good separation of the detection signals together with the good sensitivities were appropriate for the simultaneous detection of both tested pharmaceuticals. These results reclaim CNF electrode as a valuable tool for the individual/simultaneous detection of pharmaceuticals in water.

Keywords: boron-doped diamond electrode, carbon nanofiber-epoxy composite electrode, emerging pollutans, pharmaceuticals

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995 Effects of pH, Load Capacity and Contact Time in the Sulphate Sorption onto a Functionalized Mesoporous Structure

Authors: Jaime Pizarro, Ximena Castillo

Abstract:

The intensive use of water in agriculture, industry, human consumption and increasing pollution are factors that reduce the availability of water for future generations; the challenge is to advance in sustainable and low-cost solutions to reuse water and to facilitate the availability of the resource in quality and quantity. The use of new low-cost materials with sorbent capacity for pollutants is a solution that contributes to the improvement and expansion of water treatment and reuse systems. Fly ash, a residue from the combustion of coal in power plants that is produced in large quantities in newly industrialized countries, contains a high amount of silicon oxides and aluminum oxides, whose properties can be used for the synthesis of mesoporous materials. Properly functionalized, this material allows obtaining matrixes with high sorption capacity. The mesoporous materials have a large surface area, thermal and mechanical stability, uniform porous structure, and high sorption and functionalization capacities. The goal of this study was to develop hexagonal mesoporous siliceous material (HMS) for the adsorption of sulphate from industrial and mining waters. The silica was extracted from fly ash after calcination at 850 ° C, followed by the addition of water. The mesoporous structure has a surface area of 282 m2 g-1 and a size of 5.7 nm and was functionalized with ethylene diamine through of a self-assembly method. The material was characterized by Diffuse Reflectance Infrared Fourier Transform Spectroscopy (DRIFTS). The capacity of sulphate sorption was evaluated according to pH, maximum load capacity and contact time. The sulphate maximum adsorption capacity was 146.1 mg g-1, which is three times higher than commercial sorbents. The kinetic data were fitted according to a pseudo-second order model with a high coefficient of linear regression at different initial concentrations. The adsorption isotherm that best fitted the experimental data was the Freundlich model.

Keywords: fly ash, mesoporous siliceous, sorption, sulphate

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994 A Hybrid Digital Watermarking Scheme

Authors: Nazish Saleem Abbas, Muhammad Haris Jamil, Hamid Sharif

Abstract:

Digital watermarking is a technique that allows an individual to add and hide secret information, copyright notice, or other verification message inside a digital audio, video, or image. Today, with the advancement of technology, modern healthcare systems manage patients’ diagnostic information in a digital way in many countries. When transmitted between hospitals through the internet, the medical data becomes vulnerable to attacks and requires security and confidentiality. Digital watermarking techniques are used in order to ensure the authenticity, security and management of medical images and related information. This paper proposes a watermarking technique that embeds a watermark in medical images imperceptibly and securely. In this work, digital watermarking on medical images is carried out using the Least Significant Bit (LSB) with the Discrete Cosine Transform (DCT). The proposed methods of embedding and extraction of a watermark in a watermarked image are performed in the frequency domain using LSB by XOR operation. The quality of the watermarked medical image is measured by the Peak signal-to-noise ratio (PSNR). It was observed that the watermarked medical image obtained performing XOR operation between DCT and LSB survived compression attack having a PSNR up to 38.98.

Keywords: watermarking, image processing, DCT, LSB, PSNR

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993 Rule of Natural Synthetic Chemical on Lead Immobilization in Polluted Sandy Soils

Authors: Saud S. AL Oud

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Soil contamination can have dire consequences, such as loss of ecosystem and agricultural productivity, diminished food chain quality, tainted water resources, economic loss, and human and animal illness. In recent years, attention has focused on the development of in situ immobilization methods that are generally less expensive and disruptive to the natural landscape, hydrology, and ecosystems than are conventional excavation treatments, and disposal methods. Soft, inexpensive, and efficient agents were used in the present research to immobilize Pb in polluted sandy soil. Five agents, either naturally occurring or chemically prepared, were used for this purpose. These agents include; iron ore (72% Fe2O3), cement, a mixture of calcite and shale rich in aluminum (CASH), and two chemically prepared amorphous materials of Al- and Fe-gel. These agents were selected due to their ability to specifically adsorb heavy metals onto their surface OH functional groups, which provide permanent immobilization of metal pollutants and reduce the fraction that is potentially mobile or bioavailable. The efficiency of these agents in immobilizing Pb were examined in a laboratory experiment, in which two rates (0.5 and 1.0 %) of tested agents were added to the polluted soils containing total contents of Pb ranging from 17.4-49.8 mg/kg. The results show that all immobilizing agents were succeed in minimizing the mobile form of Pb as extracted by 0.5 N HNO3. The extracted Pb decreased with increasing addition rate of immobilizing agents. At addition rate of 0.5%, HNO3 extractable-Pb varied widely depending on the agents type and were found to represent 21-67% of the initial values. All agents were able to reduce mobile Pb to levels lower than that (2.0 mg/kg) reported for non polluted soil, particularly for soils had initials of mobile Pb less than 10 mg/kg. Both iron oxide and CASH had the highest efficiency in immobilizing Pb, followed by cement, then amorphous materials of Fe and Al hydroxides.

Keywords: soil, synthetic chemical, lead, immobilization, polluted

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992 Multi-Functional Metal Oxides as Gas Sensors, Photo-Catalysts and Bactericides

Authors: Koyar Rane

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Nano- to submicron size particles of narrow particle size distribution of semi-conducting TiO₂, ZnO, NiO, CuO, Fe₂O₃ have been synthesized by novel hydrazine method and tested for their gas sensing, photocatalytic and bactericidal activities and the behavior found to be enhanced when the oxides in the thin film forms, that obtained in a specially built spray pyrolysis reactor. Hydrazine method is novel in the sense, say, the UV absorption edge of the white pigment grade wide band gap (~3.2eV) TiO₂ and ZnO shifted to the visible region turning into yellowish particles, indicating modification occurring the band structure. The absorption in the visible region makes these oxides visible light sensitive photocatalysis in degrading pollutants, especially the organic dyes which otherwise increase the chemical oxygen demand of the drinking water, enabling the process feasible not under the harsh energetic UV radiation regime. The electromagnetic radiations on irradiation produce electron-hole pairs Semiconductor + hν → e⁻ + h⁺ The electron-hole pairs thus produced form Reactive Oxygen Species, ROS, on the surface of the semiconductors, O₂(adsorbed)+e⁻ → O₂• - superoxide ion OH-(surface)+h⁺ →•OH - Hydroxyl radical The ROS attack the organic material and micro-organisms. Our antibacterial studies indicate the metal oxides control the Biological Oxygen Demand (BOD) of drinking water which had beyond the safe level normally found in the municipal supply. Metal oxides in the thin film form show overall enhanced properties and the films are reusable. The results of the photodegradation and antibactericidal studies are discussed. Gas sensing studies too have been done to find the versatility of the multifunctional metal oxides.

Keywords: hydrazine method, visible light sensitive, photo-degradation of dyes, water/airborne pollutant

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991 Optimizing Telehealth Internet of Things Integration: A Sustainable Approach through Fog and Cloud Computing Platforms for Energy Efficiency

Authors: Yunyong Guo, Sudhakar Ganti, Bryan Guo

Abstract:

The swift proliferation of telehealth Internet of Things (IoT) devices has sparked concerns regarding energy consumption and the need for streamlined data processing. This paper presents an energy-efficient model that integrates telehealth IoT devices into a platform based on fog and cloud computing. This integrated system provides a sustainable and robust solution to address the challenges. Our model strategically utilizes fog computing as a localized data processing layer and leverages cloud computing for resource-intensive tasks, resulting in a significant reduction in overall energy consumption. The incorporation of adaptive energy-saving strategies further enhances the efficiency of our approach. Simulation analysis validates the effectiveness of our model in improving energy efficiency for telehealth IoT systems, particularly when integrated with localized fog nodes and both private and public cloud infrastructures. Subsequent research endeavors will concentrate on refining the energy-saving model, exploring additional functional enhancements, and assessing its broader applicability across various healthcare and industry sectors.

Keywords: energy-efficient, fog computing, IoT, telehealth

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990 Seismic Vulnerability Mitigation of Non-Engineered Buildings

Authors: Muhammad Tariq A. Chaudhary

Abstract:

The tremendous loss of life that resulted in the aftermath of recent earthquakes in developing countries is mostly due to the collapse of non-engineered and semi-engineered building structures. Such structures are used as houses, schools, primary healthcare centres and government offices. These building are classified structurally into two categories viz. non-engineered and semi-engineered. Non-engineered structures include: adobe, Unreinforced Masonry (URM) and wood buildings. Semi-engineered buildings are mostly low-rise (up to 3 story) light concrete frame structures or masonry bearing walls with reinforced concrete slab. This paper presents an overview of the typical damage observed in non-engineered structures and their most likely causes in the past earthquakes with specific emphasis on the performance of such structures in the 2005 Kashmir earthquake. It is demonstrated that seismic performance of these structures can be improved from life-safety viewpoint by adopting simple low-cost modifications to the existing construction practices. Incorporation of some of these practices in the reconstruction efforts after the 2005 Kashmir earthquake are examined in the last section for mitigating seismic risk hazard.

Keywords: Kashmir earthquake, non-engineered buildings, seismic hazard, structural details, structural strengthening

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989 Natural and Construction/Demolition Waste Aggregates: A Comparative Study

Authors: Debora C. Mendes, Matthias Eckert, Claudia S. Moço, Helio Martins, Jean-Pierre Gonçalves, Miguel Oliveira, Jose P. Da Silva

Abstract:

Disposal of construction and demolition waste (C&DW) in embankments in the periphery of cities causes both environmental and social problems. To achieve the management of C&DW, a detailed analysis of the properties of these materials should be done. In this work we report a comparative study of the physical, chemical and environmental properties of natural and C&DW aggregates from 25 different origins. Assays were performed according to European Standards. Analysis of heavy metals and organic compounds, namely polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs), were performed. Finally, properties of concrete prepared with C&DW aggregates are reported. Physical analyses of C&DW aggregates indicated lower quality properties than natural aggregates, particularly for concrete preparation and unbound layers of road pavements. Chemical properties showed that most samples (80%) meet the values required by European regulations for concrete and unbound layers of road pavements. Analyses of heavy metals Cd, Cr, Cu, Pb, Ni, Mo and Zn in the C&DW leachates showed levels below the limits established by the Council Decision of 19 December 2002. Identification and quantification of PCBs and PAHs indicated that few samples shows the presence of these compounds. The measured levels of PCBs and PAHs are also below the limits. Other compounds identified in the C&DW leachates include phthalates and diphenylmethanol. The characterized C&DW aggregates show lower quality properties than natural aggregates but most samples showed to be environmentally safe. A continuous monitoring of the presence of heavy metals and organic compounds should be made to trial safe C&DW aggregates. C&DW aggregates provide a good economic and environmental alternative to natural aggregates.

Keywords: concrete preparation, construction and demolition waste, heavy metals, organic pollutants

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988 Observations of Conformity in the Health Professions

Authors: Tanya Beran, Michelle Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

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Although research shows that interprofessional practice has desirable effects on patient care, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists were developed to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A new method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal.

Keywords: conformity, decision-making, inter-professional teams, simulation

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987 Analysis of Patient No-Shows According to Health Conditions

Authors: Sangbok Lee

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There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

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986 Action Plans to Prevent Negative Attitudes Towards Gay and Lesbian Parents: A Systemic Analysis of Health-Care Interventions in Belgium

Authors: Therese Scali

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Over the years, the European Union has continued to extend its action on lesbian, gay men, bisexual and transgender (LGBT) rights to a range of areas including access to justice, asylum, freedom of expression and assembly, parenting, and mutual recognition of civil status within the EU. The European Parliament has been a driving force behind such action adopting a range of resolutions calling for continued progress in this field. In particular, Belgium has been one of the first countries to legalize same-sex parenting and to create a general framework for action against negative attitudes towards gay and lesbian parents. The present paper aims at highlighting public healthcare workers’ attitudes towards different types of same-sex headed families in Belgium, and the content of their interventions in schools. Results revealed that attitudes can go from supportive to unsupportive, and participants do not show the same degree of support towards the different types of same-sex parenting. This contribution highlights work’s implication for public policy by understanding the resources and challenges that health-care professionals face in their work.

Keywords: attitudes, gay and lesbian parents, health-care workers, homophobia, prevention

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985 Revealing the Urban Heat Island: Investigating its Spatial and Temporal Changes and Relationship with Air Quality

Authors: Aneesh Mathew, Arunab K. S., Atul Kumar Sharma

Abstract:

The uncontrolled rise in population has led to unplanned, swift, and unsustainable urban expansion, causing detrimental environmental impacts on both local and global ecosystems. This research delves into a comprehensive examination of the Urban Heat Island (UHI) phenomenon in Bengaluru and Hyderabad, India. It centers on the spatial and temporal distribution of UHI and its correlation with air pollutants. Conducted across summer and winter seasons from 2001 to 2021 in Bangalore and Hyderabad, this study discovered that UHI intensity varies seasonally, peaking in summer and decreasing in winter. The annual maximum UHI intensities range between 4.65 °C to 6.69 °C in Bengaluru and 5.74 °C to 6.82 °C in Hyderabad. Bengaluru particularly experiences notable fluctuations in average UHI intensity. Introducing the Urban Thermal Field Variance Index (UTFVI), the study indicates a consistent strong UHI effect in both cities, significantly impacting living conditions. Moreover, hotspot analysis demonstrates a rising trend in UHI-affected areas over the years in Bengaluru and Hyderabad. This research underscores the connection between air pollutant concentrations and land surface temperature (LST), highlighting the necessity of comprehending UHI dynamics for urban environmental management and public health. It contributes to a deeper understanding of UHI patterns in swiftly urbanizing areas, providing insights into the intricate relationship between urbanization, climate, and air quality. These findings serve as crucial guidance for policymakers, urban planners, and researchers, facilitating the development of innovative, sustainable strategies to mitigate the adverse impacts of uncontrolled expansion while promoting the well-being of local communities and the global environment.

Keywords: urban heat island effect, land surface temperature, air pollution, urban thermal field variance index

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984 Simulating Studies on Phosphate Removal from Laundry Wastewater Using Biochar: Dudinin Approach

Authors: Eric York, James Tadio, Silas Owusu Antwi

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Laundry wastewater contains a diverse range of chemical pollutants that can have detrimental effects on human health and the environment. In this study, simulation studies by Spyder Python software v 3.2 to assess the efficacy of biochar in removing PO₄³⁻ from wastewater were conducted. Through modeling and simulation, the mechanisms involved in the adsorption process of phosphate by biochar were studied by altering variables which is specific to the phosphate from common laundry phosphate detergents, such as the aqueous solubility, initial concentration, and temperature using the Dudinin Approach (DA). Results showed that the concentration equilibrate at near the highest concentrations for Sugar beet-120 mgL⁻¹, Tailing-85 mgL⁻¹, CaO- rich-50 mgL⁻¹, Eggshell and rice straw-48 mgL⁻¹, Undaria Pinnatifida Roots-190 mgL⁻¹, Ca-Alginate Granular Beads -240 mgL⁻¹, Laminaria Japonica Powder -900 mgL⁻¹, Pinesaw dust-57 mgL⁻¹, Ricehull-190 mgL⁻¹, sesame straw- 470 mgL⁻¹, Sugar Bagasse-380 mgL⁻¹, Miscanthus Giganteus-240 mgL⁻¹, Wood Bc-130 mgL⁻¹, Pine-25 mgL⁻¹, Sawdust-6.8 mgL⁻¹, Sewage Sludge-, Rice husk-12 mgL⁻¹, Corncob-117 mgL⁻¹, Maize straw- 1800 mgL⁻¹ while Peanut -Eucalyptus polybractea-, Crawfish equilibrated at near concentration. CO₂ activated Thalia, sewage sludge biochar, Broussonetia Papyrifera Leaves equilibrated just at the lower concentration. Only Soyer bean Stover exhibited a sharp rise and fall peak in mid-concentration at 2 mgL⁻¹ volume. The modelling results were consistent with experimental findings from the literature, ensuring the accuracy, repeatability, and reliability of the simulation study. The simulation study provided insights into adsorption for PO₄³⁻ from wastewater by biochar using concentration per volume that can be adsorbed ideally under the given conditions. Studies showed that applying the principle experimentally in real wastewater with all its complexity is warranted and not far-fetched.

Keywords: simulation studies, phosphate removal, biochar, adsorption, wastewater treatment

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983 Optimum Turbomachine Preliminary Selection for Power Regeneration in Vapor Compression Cool Production Plants

Authors: Sayyed Benyamin Alavi, Giovanni Cerri, Leila Chennaoui, Ambra Giovannelli, Stefano Mazzoni

Abstract:

Primary energy consumption and emissions of pollutants (including CO2) sustainability call to search methodologies to lower power absorption for unit of a given product. Cool production plants based on vapour compression are widely used for many applications: air conditioning, food conservation, domestic refrigerators and freezers, special industrial processes, etc. In the field of cool production, the amount of Yearly Consumed Primary Energy is enormous, thus, saving some percentage of it, leads to big worldwide impact in the energy consumption and related energy sustainability. Among various techniques to reduce power required by a Vapour Compression Cool Production Plant (VCCPP), the technique based on Power Regeneration by means of Internal Direct Cycle (IDC) will be considered in this paper. Power produced by IDC reduces power need for unit of produced Cool Power by the VCCPP. The paper contains basic concepts that lead to develop IDCs and the proposed options to use the IDC Power. Among various selections for using turbo machines, Best Economically Available Technologies (BEATs) have been explored. Based on vehicle engine turbochargers, they have been taken into consideration for this application. According to BEAT Database and similarity rules, the best turbo machine selection leads to the minimum nominal power required by VCCPP Main Compressor. Results obtained installing the prototype in “ad hoc” designed test bench will be discussed and compared with the expected performance. Forecasts for the upgrading VCCPP, various applications will be given and discussed. 4-6% saving is expected for air conditioning cooling plants and 15-22% is expected for cryogenic plants.

Keywords: Refrigeration Plant, Vapour Pressure Amplifier, Compressor, Expander, Turbine, Turbomachinery Selection, Power Saving

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982 The Dark History of American Psychiatry: Racism and Ethical Provider Responsibility

Authors: Mary Katherine Hoth

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Despite racial and ethnic disparities in American psychiatry being well-documented, there remains an apathetic attitude among nurses and providers within the field to engage in active antiracism and provide equitable, recovery-oriented care. It is insufficient to be a “colorblind” nurse or provider and state that call care provided is identical for every patient. Maintaining an attitude of “colorblindness” perpetuates the racism prevalent throughout healthcare and leads to negative patient outcomes. The purpose of this literature review is to highlight the how the historical beginnings of psychiatry have evolved into the disparities seen in today’s practice, as well as to provide some insight on methods that providers and nurses can employ to actively participate in challenging these racial disparities. Background The application of psychiatric medicine to White people versus Black, Indigenous, and other People of Color has been distinctly different as a direct result of chattel slavery and the development of pseudoscience “diagnoses” in the 19th century. This weaponization of the mental health of Black people continues to this day. Population The populations discussed are Black, Indigenous, and other People of Color, with a primary focus on Black people’s experiences with their mental health and the field of psychiatry. Methods A literature review was conducted using CINAHL, EBSCO, MEDLINE, and PubMed databases with the following terms: psychiatry, mental health, racism, substance use, suicide, trauma-informed care, disparities and recovery-oriented care. Articles were further filtered based on meeting the criteria of peer-reviewed, full-text availability, written in English, and published between 2018 and 2023. Findings Black patients are more likely to be diagnosed with psychotic disorders and prescribed antipsychotic medications compared to White patients who were more often diagnosed with mood disorders and prescribed antidepressants. This same disparity is also seen in children and adolescents, where Black children are more likely to be diagnosed with behavior problems such as Oppositional Defiant Disorder (ODD) and White children with the same presentation are more likely to be diagnosed with Attention Hyperactivity Disorder. Medications advertisements for antipsychotics like Haldol as recent as 1974 portrayed a Black man, labeled as “agitated” and “aggressive”, a trope we still see today in police violence cases. The majority of nursing and medical school programs do not provide education on racism and how to actively combat it in practice, leaving many healthcare professionals acutely uneducated and unaware of their own biases and racism, as well as structural and institutional racism. Conclusions Racism will continue to grow wherever it is given time, space, and energy. Providers and nurses have an ethical obligation to educate themselves, actively deconstruct their personal racism and bias, and continuously engage in active antiracism by dismantling racism wherever it is encountered, be it structural, institutional, or scientific racism. Agents of change at the patient care level not only improve the outcomes of Black patients, but it will also lead the way in ensuring Black, Indigenous, and other People of Color are included in research of methods and medications in psychiatry in the future.

Keywords: disparities, psychiatry, racism, recovery-oriented care, trauma-informed care

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