Search results for: health care waste management

Authors: Paola Villoria Sáez, Mercedes Del Río Merino, Jaime Santa Cruz Astorqui, Antonio Rodríguez Sánchez

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The Spanish construction industry generates large volumes of waste. However, despite the legislative improvements introduced for construction and demolition waste (CDW), construction waste recycling rate remains well below other European countries and also below the target set for 2020. This situation can be due to many difficulties. i.e.: The difficulty of onsite segregation or the estimation in advance of the total amount generated. Despite these difficulties, the proper management of CDW must be one of the main aspects to be considered by the construction companies. In this sense, some large national companies are implementing Integrated Management Systems (IMS) including not only quality and safety aspects, but also environment issues. However, although this fact is a reality for large construction companies still the vast majority of companies need to adopt this trend. In short, it is common to find in small and medium enterprises a decentralized management system: A single system of quality management, another for system safety management and a third one for environmental management system (EMS). In addition, the EMSs currently used address CDW superficially and are mainly focus on other environmental concerns such as carbon emissions. Therefore, this research determines and implements a specific best practice management system for CDW based on eight procedures in a Spanish Construction company. The main advantages and drawbacks of its implementation are highlighted. Results of this study show that establishing and implementing a CDW management system in building works, improve CDW quantification as the company obtains their own CDW generation ratio. This helps construction stakeholders when developing CDW Management Plans and also helps to achieve a higher adjustment of CDW management costs. Finally, integrating this CDW system with the EMS of the company favors the cohesion of the construction process organization at all stages, establishing responsibilities in the field of waste and providing a greater control over the process.

Keywords: construction and demolition waste, waste management, best practices, waste minimization, building, quality management systems

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Authors: M. A. Ojo, E. O. Ogbole, A. O. Ojo

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This study analysed improved household solid waste management system in Minna metropolis, Niger state. Multi-staged sampling technique was used to administer 155 questionnaires to respondents, where Minna was divided into two income groups A and B based on the quality of the respondent’s houses. Primary data was collected with the aid of structured questionnaires and analysed using descriptive statistics to obtain results for the socioeconomic characteristics of respondents, types of waste generated and methods of disposing solid waste, the level of awareness and reliability of waste disposal methods as well as the willingness of households to pay for solid waste management in the area. The results revealed that majority of the household heads in the study area were male, 94.20% of the household heads fell between the ages of 21 and 50 and also that 96.80% of them had one form of formal education or the other. The results also revealed that 47.10% and 43.20% of the households generated food wastes and polymers respectively as a major constituent of waste disposed. The results of this study went further to reveal that 81.90% of the household heads were aware of the use of collection cans as a method of waste disposal while only 32.90% of them considered the method highly reliable. Multiple regression was used to determine the factors affecting the willingness of households to pay for waste disposal in the study area. The results showed that 76.10% of the respondents were willing to pay for solid waste management which indicates that households in Minna are concerned and willing to cater for their immediate environment. The multiple regression results revealed that age, income, environmental awareness and household expenditure have a positive and statistically significant relationship with the willingness of households to pay for waste disposal in the area while household size has a negative and statistically significant relationship with households’ willingness to pay. Based on these findings, it was recommended that more waste management services be made readily available to residents of Minna, waste collection service should be privatised to increase their effectiveness through increased competition and also that community participatory approach be used to create more environmental awareness amongst residents.

Keywords: household, solid waste, management, WTP

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Authors: Anis A. Ansari, Aftab A. Ansari

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Electronic waste is inundating the traditional solid-waste-disposal facilities, which are inadequately designed to handle and manage such type of new wastes. Since electronic waste contains mostly hazardous and even toxic materials, the seriousness of its effects on human health and the environment cannot be ignored in present scenario. Waste from the electronic industry is increasing exponentially day by day. From the last 20 years, we are continuously generating huge quantities of e-waste such as obsolete computers and other discarded electronic components, mainly due to evolution of newer technologies as a result of constant efforts in research and development in this sector. Polymers, one of the major constituents in almost every electronic waste, such as computers, printers, electronic equipment, entertainment devices, mobile phones, television sets etc., are if properly recycled can create a new business opportunity. This would not only create potential market for polymers to improve economy but also the priceless land used as dumping sites of electronic waste, can be utilized for other productive purposes.

Keywords: polymer recycling, electronic waste, hazardous materials, electronic components

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Authors: S. Boulenouar, M. Sefir, M. Benahmed

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All facilities need medication and other pharmaceuticals for their operation. Management and supply is therefore to provide the different services of the facility goods and services in required quantity and quality. The permanent availability of drugs in the facilities is very difficult because most face many difficulties at the inventory management and drug supplies. Therefore, it is necessary for each health facility to know the causes for the malfunction of its management system to cope with them. It is in this context that we have undertaken to conduct this study to know the causes which should be taken into consideration by the concerned authorities to carry out their mission, which is to provide quality health care for the population. In terms of financial resources, the budget for medicines represents a significant part of the budget of the pharmacy. Our study shows that the share of the hospital budget reserved for the drugs procurement represent on average 70% of the budget of the pharmacy. The results show a state of lack of anticancer drugs at Oran teaching hospital. The analysis of the management process allowed us to know the level that the problem of stock-outs of anti-cancer drugs is at. Suggestions were made to that effect to improve the availability for these products and to respond better to the needs of patients.

Keywords: anticancer drugs, health care facility, budget, hospital pharmacist, hospital service

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Authors: Chizzoniti Domenico, Beggiora Klizia, Cattani Letizia, Moscatelli Monica

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This paper concerns the study of sustainable construction materials applied on the "Health Post", a prototype for the primary health care situated in alienated areas of the world. It's suitable for social and climatic Sub-Saharan context; however, it could be moved in other countries of the world with similar urgent needs. The idea is to create a Health Post with local construction materials that have a low environmental impact and promote the local workforce allowing reuse of traditional building techniques lowering production costs and transport. The aim of Primary Health Care Centre is to be a flexible and expandable structure identifying a modular form that can be repeated several times to expand its existing functions. In this way it could be not only a health care centre but also a socio-cultural facility.

Keywords: low costs building, sustainable construction materials, green construction system, prototype, health care, emergency

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Authors: T. Malmir, U. Eicker

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Landfilling of organic waste is still the predominant waste management method in the USA and Canada. Strategic plans for waste diversion from landfills are needed to increase material recovery and energy generation from waste. In this paper, we carried out a statistical survey on waste flow in the two cities New York and Montréal and estimated the energy recovery potential for each case. Data collection and analysis of the organic waste (food waste, yard waste, etc.), paper and cardboard, metal, glass, plastic, carton, textile, electronic products and other materials were done based on the reports published by the Department of Sanitation in New York and Service de l'Environnement in Montréal. In order to calculate the gas generation potential of organic waste, Buswell equation was used in which the molar mass of the elements was calculated based on their atomic weight and the amount of organic waste in New York and Montréal. Also, the higher and lower calorific value of the organic waste (solid base) and biogas (gas base) were calculated. According to the results, only 19% (598 kt) and 45% (415 kt) of New York and Montréal waste were diverted from landfills in 2017, respectively. The biogas generation potential of the generated food waste and yard waste amounted to 631 million m³ in New York and 173 million m³ in Montréal. The higher and lower calorific value of food waste were 3482 and 2792 GWh in New York and 441 and 354 GWh in Montréal, respectively. In case of yard waste, they were 816 and 681 GWh in New York and 636 and 531 GWh in Montréal, respectively. Considering the higher calorific value, this amount would mean a contribution of around 2.5% energy in these cities.

Keywords: energy recovery, organic waste, urban energy modelling with INSEL, waste flow

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Authors: Eva Queheille, Franck Taillandier, Nadia Saiyouri

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Waste management has become a major issue in demolition works, because of its environmental impact (energy consumption, resource consumption, pollution…). However, improving waste management requires to take also into account the overall demolition process and to consider demolition main objectives (e.g. cost, delay). Establishing a strategy with these conflicting objectives (economic and environment) remains complex. In order to provide a decision-support for demolition companies, a multi-objective optimization model was developed. In this model, a demolition strategy is computed from a set of 80 decision variables (worker team composition, machines, treatment for each type of waste, choice of treatment platform…), which impacts the demolition objectives. The model has experimented on a real-case study (demolition of several buildings in France). To process the optimization, different optimization algorithms (NSGA2, MOPSO, DBEA…) were tested. Results allow the engineer in charge of this case, to build a sustainable demolition strategy without affecting cost or delay.

Keywords: deconstruction, life cycle assessment, multi-objective optimization, waste management

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Authors: Md Monirul Islam, Shahaduz Zaman, Mosarraf H. Sarker

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Context: Medical waste management (MWM) is a critical sector in Bangladesh due to its impact on human health and the environment. There is a need to assess the current policies and identify the role of policy actors in the policy formulation and implementation process. Research Aim: The study aimed to evaluate the role of policy actors in the medical waste management policy-making process in Bangladesh, identify policy gaps, and provide actionable recommendations for improvement. Methodology: The study adopted a qualitative research method and conducted key informant interviews. The data collected were analyzed using the thematic coding approach through Atlas.ti software. Findings: The study found that policies are formulated at higher administrative levels and implemented in a top-down approach. Higher-level institutions predominantly contribute to policy development, while lower-level institutions focus on implementation. However, due to negligence, ignorance, and lack of coordination, medical waste management receives insufficient attention from the actors. The study recommends the need for immediate strategies, a comprehensive action plan, regular policy updates, and inter-ministerial meetings to enhance medical waste management practices and interventions. Theoretical Importance: The research contributes to evaluating the role of policy actors in medical waste management policymaking and implementation in Bangladesh. It identifies policy gaps and provides actionable recommendations for improvement. Data Collection: The study used key informant interviews as the data collection method. Thirty-six participants were interviewed, including influential policymakers and representatives of various administrative spheres. Analysis Procedures: The data collected was analyzed using the inductive thematic analysis approach. Question Addressed: The study aimed to assess the role of policy actors in medical waste management policymaking and implementation in Bangladesh. Conclusion: In conclusion, the study provides insights into the current medical waste management policy in Bangladesh, the role of policy actors in policy formulation and implementation, and the need for improved strategies and policy updates. The findings of this study can guide future policy-making efforts to enhance medical waste management practices and interventions in Bangladesh.

Keywords: key informant, medical waste management, policy maker, qualitative study

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Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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Authors: Garba Inuwa Kuta, Mohammed, Adamu, Mohammed Ahmed Emigilati, Ibrahim Ishiaku, Kudu Dangana

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The study sought to identify the problems of solid waste management in General Mohammed InuwaWushishi Housing Estate. The two broad types of data, the secondary and primary data were used in the study. Questionnaires and personal observations were also used to collect some of the data. Factors impeding the effective and efficient solid waste management were identified. The study revealed that sacks disposal method and open dumping are the most commonly used method of disposal, about 30.0% of the respondent use sacks disposal method in the estate while 24.9% dump their refuse on the floor. Wrong attitudes and perceptions of the people about sanitation issues contributed to solid waste management problems of General Mohammed InuwaWushishi Housing Estate. Majority of the households did not educate their members on the need to clean their surroundings and refuse to buy drum for waste disposal from Niger State Environmental Protection Agency (NISEPA) on the basis that the drums are expensive. Virtually, all the people depended on Niger State Environmental Protection Agency (NISEPA) facilities for the disposal of their household refuse. Solid waste management problems were partly the results of NISEPA’s inability to cope with the situation because of lack of equipment. It was recommended that there should be an increase in enlightenment to the people on domestic waste disposal to keep the surroundings clean.

Keywords: housing estate, assessment, solid waste, disposal, management

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Authors: Lutpi Ginanjar

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Environmental hygiene is indispensable for people to live healthy, safe and peaceful. In a small environment, the cleanliness of the environment is very easy to overcome, but on the larger environment requires a more complicated management and considerable investments. In general environmental hygiene are managed by the Department of Hygiene and Landscaper. Found a good management, but much less good management. The difficulties that are often encountered on waste management also caused public awareness itself. In addition, communities have difficulty in making a report about the rubbish because not dibangunnyasistem good information. Essai aims to build information systems environment clean especially the handling of waste in the city of Bandung, West Java province. The system was built with PHP software. Expected results obtained after the construction of the information system of environmental hygiene can be demonstrated to the community will be the health of the environment.

Keywords: information systems, SMS gateway, management, software, PHP

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Authors: Masaumi Nakahara, Sou Watanabe, Hiromichi Ogi, Atsuhiro Shibata, Kazunori Nomura

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In the Japan Atomic Energy Agency, three types of experimental research, advanced reactor fuel reprocessing, radioactive waste disposal, and nuclear fuel cycle technology, have been carried out at the Chemical Processing Facility. The facility has generated high level radioactive liquid and solid wastes in hot cells. The high level radioactive solid waste is divided into three main categories, a flammable waste, a non-flammable waste, and a solid reagent waste. A plastic product is categorized into the flammable waste and molten with a heating mantle. The non-flammable waste is cut with a band saw machine for reducing the volume. Among the solid reagent waste, a used adsorbent after the experiments is heated, and an extractant is decomposed for its stabilization. All high level radioactive solid wastes in the hot cells are packed in a high level radioactive solid waste can. The high level radioactive solid waste can is transported to the 2nd High Active Solid Waste Storage in the Tokai Reprocessing Plant in the Japan Atomic Energy Agency.

Keywords: high level radioactive solid waste, advanced reactor fuel reprocessing, radioactive waste disposal, nuclear fuel cycle technology

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Authors: Boitumelo Ditshwane, Zelda Janse van Rensburg, Wanda Jacobs,

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Health literacy is defined as competencies and skills that individuals need to find, comprehend, evaluate, and use to make knowledgeable choices to improve their health and well-being. Low health literacy has been found to affect people’s ability to take care of their own health. Incomprehension of health education and health care instructions due to low health literacy is often due to information given at a level that is above the patient’s level of understanding. The study aimed to test the health literacy levels of South African PHC patients using a previously developed health literacy assessment tool. Determining health literacy levels may assist PHC nurses in providing health education and health care instructions to the patient on the patient’s level of understanding and, therefore, ensuring positive health outcomes for the patient. A health literacy assessment tool, translated into ten official South African languages, was used to quantitatively determine the health literacy levels of 400 PHC patients in five clinics in Gauteng, South Africa. Patients’ health literacy levels were tested in English, and nine other official languages spoken in South Africa and were compared. The results revealed that patients understand information better when given in their preferred language. Giving health education in a language and level that is better understood by the patient may lead to better health outcomes and prevent adverse health. Patients may better understand instructions provided, be more likely to follow the correct route of medication, honor appointments, comply with medication, and thus have better treatment outcomes.

Keywords: health literacy, primary health care, South Africa, patients

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Authors: Pascal Gliesche, Kathrin Seibert, Christian Kowalski, Dominik Domhoff, Max Pfingsthorn, Karin Wolf-Ostermann, Andreas Hein

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Robotic assistance in nursing care is an increasingly important area of research and development. Facing a shortage of labor and an increasing number of people in need of care, the German Nursing Care Innovation Center (Pflegeinnovationszentrum, PIZ) aims to address these challenges from the side of technology. Little is known about nurses experiences with existing robotic assistance systems. Especially nurses perspectives on starting points for the development of robotic solutions, that target recurring burdensome tasks in everyday nursing care, are of interest. This paper presents findings focusing on robotics resulting from an explanatory mixed-methods study on nurses experiences with and their expectations for innovative technologies in nursing care in stationary and ambulant care facilities and hospitals in Germany. Based on the findings, eight scenarios for robotic assistance are identified based on the real needs of practitioners. An initial system addressing a single use-case is described to show perspectives for the use of robots in nursing care.

Keywords: robotics and automation, engineering management, engineering in medicine and biology, medical services, public health-care

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Authors: Erinetta P. Anjani, Karina Mariz, Rifqi K. Fathianto

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While Islam teaches its’ followers to be mindful of God’s creation, including the environment, Indonesia as one of the world’s largest Muslim country, is now also world’s second-largest plastic waste contributor. The problem of waste is a complicated matter in Indonesia and is worsening because many landfills are now on verge of overcapacity. The causes of this problem are at least due to two things. First is Indonesia’s bad waste management. Second, people’s low of eco-literacy, as can be seen in massive use of non-degradable materials, low rate of waste separation, low rate of recycling and up cycling, whereas households are the largest source of waste in Indonesia. Mostly dealing with patriarchal culture, women in Indonesia play big and important role in their households, from family matter to household management (including waste management), to economic matter. Uniquely, the majority of Muslim women in Indonesia are engaged in -arisan- women social gathering or in -majelis ta’lim- women community in Islamic prayer, which serves as a social mechanism. As many NGOs are working on tackling environmental issues by raising awareness in order for the people to adapt a more environmentally-friendly household management practices, the problem of waste in Indonesia is meeting a bright light. Using qualitative data and descriptive analysis, the following is a proposal for a program intended to spread eco-literacy for waste management to women in Indonesia through their social gathering in order for them to gain awareness and start implementing eco-actions in their households. We attempt Waste4Change, a social company which provides environmentally-friendly waste management services, to reach women with modules that consist of environmental education, trainings, and workshops. We will then monitor and counsel the women to make sure if the lesson is going to be fully applied in their houses. The program will take place nearby University of Indonesia, Depok, West Java.

Keywords: eco-literacy, environmental education, household waste management, Muslim women social gathering, Waste4Change

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Authors: A. Sainvil, J. Mallela, L. M. Pereira

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Adolescents and young adults (AYA) diagnosed with cancer are tasked with managing their health through treatment, a time when reliance on and independence from parents may change in unexpected ways. Resilience allows patients to cope and manage their own health through treatment, promoting motivation and a healthier lifestyle. The film acts as a source of reflection through the cancer journey, which may have an impact on how patients cope. The current research investigated relationships between resilient linguistic qualities of the video narratives and attitudes toward personal health management. N=24 patients diagnosed between ages 11-18 were recruited. First, participants provided demographic information, then made a video testimonial about their cancer experience. After filming, participants then completed a questionnaire on the perceived benefits for themselves and others for making the video. Videos were transcribed and analyzed for thematic content via codebook and for linguistic qualities, indicating resilience with the use of the Linguistic Inquiry and Word Count Analysis Program (LIWC). Linear regressions were then calculated to explore relationships between resilient qualities, thematic content, and participants’ perceptions of their medical team and willingness to care for themselves. Participants who spoke with greater narrator connectedness were more likely to change their view of their medical team (β=.628 p=.034). When a participant believed that providers were likely to view their video, they were marginally more likely to want to take better care of themselves (β=.367, p=.078). Participants who spoke in depth about their health reported higher intention to take better care of themselves (β=.785, p=.033). AYAs with cancer who showcased certain resilient qualities within their narrative were more likely to consider taking better care of themselves. Additionally, the more patients reflected on their health, the more they wanted to take better care of themselves. These relationships were stronger when a patient believed that a provider would watch their video. Study findings highlight the utility of film in uncovering aspects of resilience and coping that may lead to healthier behaviors in AYAs with cancer.

Keywords: adolescents, cancer, resilience, health management

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Authors: Lidia Lombardi

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Waste management in Europe and North America is evolving towards sustainable materials management, intended as a systemic approach to using and reusing materials more productively over their entire life cycles. Various waste management strategies are prioritized and ranked from the most to the least environmentally preferred, placing emphasis on reducing, reusing, and recycling as key to sustainable materials management. However, non-recyclable materials must also be appropriately addressed, and waste-to-energy (WtE) offers a solution to manage them, especially when a WtE plant is integrated within a complex system of waste and wastewater treatment plants and potential users of the output flows. To evaluate the environmental effects of such system integration, Life Cycle Assessment (LCA) is a helpful and powerful tool. LCA has been largely applied to the waste management sector, dating back to the late 1990s, producing a large number of theoretical studies and applications to the real world as support to waste management planning. However, LCA still has a fundamental role in helping the development of waste management systems supporting decisions. Thus, LCA was applied to evaluate the environmental performances of a Municipal Solid Waste (MSW) management system, with improved separate material collection and recycling and an integrated network of treatment plants including WtE, anaerobic digestion (AD) and also wastewater treatment plant (WWTP), for a reference study case area. The proposed system was compared to the actual situation, characterized by poor recycling, large landfilling and absence of WtE. The LCA results showed that the increased recycling significantly increases the environmental performances, but there is still room for improvement through the introduction of energy recovery (especially by WtE) and through its use within the system, for instance, by feeding the heat to the AD, to sludge recovery processes and supporting the water reuse practice. WtE offers a solution to manage non-recyclable MSW and allows saving important resources (such as landfill volumes and non-renewable energy), reducing the contribution to global warming, and providing an essential contribution to fulfill the goals of really sustainable waste management.

Keywords: anaerobic digestion, life cycle assessment, waste-to-energy, municipal solid waste

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Authors: Mary Josephine

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Waste of certain process can be the input source of other sectors in order to reduce environmental pollution. Today there are more and more solid wastes are generated, but only very small amount of those are recycled. So, the threatening of environmental pressure to public health is very serious. The methods considered for the treatment of solid waste are biogas tanks or processing to make animal feed and fertilizer, however, they did not perform well. An alternative approach is growing mushrooms on waste residues. This is regarded as an environmental friendly solution with potential economic benefit. The substrate producers do their best to produce quality substrate at low cost. Apart from other methods, this can be achieved by employing biologically degradable wastes used as the resource material component of the substrate. Mushroom growing is a significant tool for the restoration, replenishment and remediation of Earth’s overburdened ecosphere. One of the rational methods of waste utilization involves locally available wastes. The present study aims to find out the yield of mushroom grown on locally available waste for free and to conserve our environment by recycling wastes.

Keywords: biodegradable, environment, mushroom, remediation

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Authors: Seyed Ziya Tabatabaei, Azimi Bin Hj Hamzah, Fatemeh Ebrahimi

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The increase in proportion of older people in Malaysia has led to a significant growth of health care demands. The aim of this study is to explore how perceived health care needs influence on quality of life among elderly Malay residents who reside in a Malaysian residential home. This study employed a method known as ethnographic research from May 2011 to January 2012. Four data collection strategies were selected as the main data-collecting tools including participant observation, field notes, in-depth interviews, and review of related documents. The nine knowledgeable participants for the present study were selected using the purposive sampling method. Two themes were identified: (1) Medical concerns: Feeling secure, lack of information, inadequate medical staff; and (2) Health promotion: Body condition, health education, physiotherapy and rehabilitation. These results could evoke the attention of policy-makers and care providers to better meet elderly residents’ health care needs.

Keywords: ethnographic study, health care needs, Malay elderly people, Malaysia, Quality of life, Residential home

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Authors: Sonia Mannan, M. Jobair Alam

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The concept of palliative care in Bangladesh largely remained limited to the sympathetic caring of patients with a life-limiting illness. Quality of Life (QoL) issues are rarely practiced in Bangladesh. Furthermore, palliative medicine, in the perspective of holistic palliative care service, does not have its proper recognition in Bangladesh. Apart from those socio-medical aspects, palliative care patients face legal issues that impact their quality of life, including access to health services and social benefits and dealing with other life-transactions of the patients and their families (such as disposing of property; planning for children). This paper is an attempt to articulate these legal dimensions of the right to palliative care in the context of Bangladesh. The major focus of this paper will be founded on the doctrinal analysis of the constitutional provisions and other relevant legislation on the right to health and their judicial interpretation, which is argued to offer a meaningful space for the right to palliative care. This paper will also investigate the gaps in the said legal framework to better secure such care. In conclusion, a few recommendations are made so that the palliative care practices in Bangladesh are better aligned with international standards, and it can respond more humanely to the patients who need palliative care.

Keywords: Bangladesh, constitution, legal regime, palliative care, quality of life

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Authors: Hamad Almohamadi, Abdulrahman AlKassem, Majed Alamoudi

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Dumping Aluminum (Al) waste into landfills causes several health and environmental problems. The pyrolysis process could treat Al waste to produce AlCl₃ and H₂. Using the Aspen Plus software, a techno-economic and feasibility assessment has been performed for Al waste pyrolysis. The Aspen Plus simulation was employed to estimate the plant's mass and energy balance, which was assumed to process 100 dry metric tons of Al waste per day. This study looked at two cases of Al waste treatment. The first case produces 355 tons of AlCl₃ per day and 9 tons of H₂ per day without recycling. The conversion rate must be greater than 50% in case 1 to make a profit. In this case, the MSP for AlCl₃ is $768/ton. The plant would generate $25 million annually if the AlCl₃ were sold at $1000 per ton. In case 2 with recycling, the conversion has less impact on the plant's profitability than in case 1. Moreover, compared to case 1, the MSP of AlCl₃ has no significant influence on process profitability. In this scenario, if AlCl₃ were sold at $1000/ton, the process profit would be $58 million annually. Case 2 is better than case 1 because recycling Al generates a higher yield than converting it to AlCl₃ and H₂.

Keywords: aluminum waste, aspen plus, process modelling, fast pyrolysis, techno-economic assessment

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Authors: Lukasz Grzegorz Broda, Taiwo Oseni, Andrew Stranieri, Rodrigo Marino, Ronelle Welton, Mark Yates

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The oral health of residents in aged care centres in Australia is poor, contributing to infections, hospital admissions, and increased suffering. Although the use of electric toothbrushes has been deployed in many centres, smartbrushes that record and transmit information about brushing patterns and duration are not routinely deployed. Yet, the use of smartbrushes for aged care residents promises better oral care. Thus, a study aimed at investigating the appropriateness and suitability of a smartbrush for aged care residents is currently underway. Due to the peculiarity of the aged care setting, the incorporation of smartbrushes into residents’ care does require careful planning and design considerations. This paper describes an initial design process undertaken through the use of an actor to understand the important elements to be incorporated whilst installing a smartbrush for use in aged care settings. The design covers the configuration settings of the brush and app, including ergonomic factors related to brush and smartphone placement. A design science approach led to an installation re-design and a revised protocol for the planned study, the ultimate aim being to design installations to enhance perceived usefulness, ease of use, and attitudes towards the incorporation of smartbrushes for improving oral health care for aged care residents.

Keywords: smartbrush, applied computing, life and medical sciences, health informatics

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Authors: Sara Herrero Jaén, José María Santamaría García, María Lourdes Jiménez Rodríguez, Jorge Luis Gómez González, Adriana Cercas Duque, Alexandra González Aguna

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Background: Health concept has evolved throughout history. The health level is determined by the own individual perception. It is a dynamic process over time so that you can see variations from one moment to the next. In this way, knowing the health of the patients you care for, will facilitate decision making in the treatment of care. Objective: To design a technological tool that calculates the people health level in a sequential way over time. Material and Methods: Deductive methodology through text analysis, extraction and logical knowledge formalization and education with expert group. Studying time: September 2015- actually. Results: A computational tool for the use of health personnel has been designed. It has 11 variables. Each variable can be given a value from 1 to 5, with 1 being the minimum value and 5 being the maximum value. By adding the result of the 11 variables we obtain a magnitude in a certain time, the health level of the person. The health calculator allows to represent people health level at a time, establishing temporal cuts being useful to determine the evolution of the individual over time. Conclusion: The Information and Communication Technologies (ICT) allow training and help in various disciplinary areas. It is important to highlight their relevance in the field of health. Based on the health formalization, care acts can be directed towards some of the propositional elements of the concept above. The care acts will modify the people health level. The health calculator allows the prioritization and prediction of different strategies of health care in hospital units.

Keywords: calculator, care, eHealth, health

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Authors: Anisa Gumel

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This study examines the present condition of solid waste management in Nigeria. The author explores the challenges and opportunities affecting municipal solid waste management in "Nigeria" and determines the most profound challenges by analysing the interdependence and interrelationship among identified variables. In this study, multiple stakeholders, including 15 waste management professionals interviewed online, were utilised to identify the difficulties and opportunities affecting municipal solid waste in Nigeria. The interviews were transcribed and coded using NVivo to produce pertinent variables. An online survey of Nigerian internet and social media users was done to validate statements made by experts on the identified variable. In addition, a panel of five experts participated in a focus group discussion to discover the most influential factors that influence municipal solid waste management in Nigeria by analysing the interrelationships as well as the driving and reliant power of variables. The results show significant factors affecting municipal solid waste in Nigeria, including inadequate funding, lack of knowledge, and absence of legislation, as well as behavioural, financial, technological, and legal concerns grouped into five categories. Some claims stated by experts in the interview are supported by the survey data, while others are not. In addition, the focus group reveals patterns, correlations, and driving forces between variables that have been analysed. This study will provide decision-makers with a roadmap for resolving important waste management concerns in Nigeria and managing scarce resources effectively. It will also help non-governmental organisations combat malaria in Nigeria and other underdeveloped nations. In addition, the work contributes to the literature for future scholars to consult.

Keywords: municipal solid waste, stakeholders, public, experts

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Authors: Mdoe Mwajuma Bakari, Mselle Lilian Teddy, Kibusi Stephen Mathew

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Background: Due to the increase of caesarean section (CS), many women are discharge early to their home. Women should be aware on how to take care of themselves at home after CS. Evidence shows non-uniform health education on home care after CS are provided to post CS mothers because of lack of standard home care guideline on home after CS; as existing guidelines explore only care of women in hospital setting, for health care workers. There is a need to develop post CS home care guide; exploring contents of home based care education after CS provided by nurse midwives will inform the development of the guide. Objective: To explore the content of health education provided by nurse midwives to post CS mother about home care after hospital discharge in Dodoma, Tanzania. Methodology: An exploratory qualitative study using in-depth interview was conducted in this study using triangulation of data collection method; where 14 nurse midwives working in maternity unit and 11 post CS mother attending their post-natal clinic were recruited. Content analysis was used to generate themes that describe health education information provided by nurse midwives to post CS mother about home care after hospital discharge. Results: The study found that, nutrition health education, maternal and newborn hygiene care of caesarean wound at home were the component of health education provided to post CS mothers by nurse midwives. Contradicting instruction were found to be provided to post CS mothers. Conclusion: This study reported non-uniform health education provided by the nurse midwives on home care after CS. Despite of the fact that nurse midwives recognizes the need to provide health education to the post CS mothers, there is a need to develop home care guideline as a reference for their education to ensure uniform package of education is provided to post CS mothers in order to improve recovery of post CS mothers from CS.

Keywords: caesarean section, home care, discharge education, homecare after caesarean section

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Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

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Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

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Authors: Subhro Sarkar, Umesh Mishra

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Agartala Municipal Council (AMC) is the municipal body which regulates and governs the Agartala city. MSW management may be proclaimed as a tool which rests on the principles of public health, economy, engineering and other aesthetic or environmental factors by dealing with the controlled generation, collection, transport, processing and disposal of MSW. Around 220-250 MT of solid waste per day is collected by AMC out of which 12-14 MT is plastic and is disposed of in Devendra Chandra Nagar dumping ground (33 acres), nearly 12-15 km from the city. A survey was performed to list down the prevailing operations conducted by the AMC which includes road sweeping, garbage lifting, carcass removal, biomedical waste collection, dumping, and incineration. Different types of vehicles are engaged to carry out these operations. Door to door collection of garbage is done from the houses with the help of 220 tricycles issued by 53 NGOs. The location of the dustbin containers were earmarked which consisted of 4.5 cum, 0.6 cum containers and 0.1 cum containers, placed at various locations within the city. The total household waste was categorized as organic, recyclable and other wastes. It was found that East Pratapgarh ward produced 99.3% organic waste out of the total MSW generated in that ward which is maximum among all the wards. A comparison of the waste generation versus the family size has been made. A questionnaire for the survey of MSW from household and market place was prepared. The average waste generated (in kg) per person per day was found out for each of the wards. It has been noted that East Jogendranagar ward had a maximum per person per day waste generation of 0.493 kg/day.In view of the studies made, it has been found that AMC has failed to implement MSWM in an effective way because of the unavailability of suitable facilities for treatment and disposal of the large amount of MSW. It has also been noted that AMC is not following the standard procedures of handling MSW. Transportation system has also been found less effective leading to waste of time, money and manpower.

Keywords: MSW, waste generation, solid waste disposal, management

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Authors: Bogoro Audu Gani, Tobi Nzelibe Ajiji Haruna

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Women have both knowledge and expertise, whose recognition can lead to more efficient, effective, sustainable, and fair waste management operations. Studies have shown that the failure to take cognizance of the traditional role of women in the management of urban environments results in a serious loss of efficiency and productivity. However, urban managers in developing countries are yet to identify and integrate those critical roles of women into urban environmental management. This research is motivated not only due the poor solid waste management but also by the total neglect of the role of women in solid waste management in the Bauchi metropolis. Systematic random sampling technique was adopted for the selection of the samples and 4% of the study population was taken as the sample size. The major instruments used for data collection were questionnaires, interviews and direct measurement of household solid waste at source and the data is presented in tables and charts. It is found that over 95% of sweeping, cooking and food preparation are exclusively reserved for women in the study area. Women dominate the generation, storage and collection of household solid waste with 81%, 96% and 91%, respectively, within the study area. It is also discovered that segregation can be 95% effectively carried out by women that have free time. However, urban managers in the Bauchi metropolis are yet to identify the role of women with a view to integrating them into solid waste management in order to achieve a healthy and clean living environment in the Bauchi metropolis. Among other suggestions, the paper recommends that the role of women should be identified and integrated into developing policies and programs for a clean and healthy living urban environment; this will not only improve the environmental quality but would also increase the income base of the family.

Keywords: women, solid waste, integration, segregation

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Shiksha Thakur, Rashmi Jain

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Maternal health is the most crucial element in the primary health care delivery system of any healthy society. We aware that the maternal health situation in India has been a cause of concern for us, in spite of the rapidly progressing socio-economic environment overall. India has realized impressive gains in Mother & Child survival over the last two decades. MMR as per 2012-2013 in India is 167 as per MMR bulletin, though there are variations between states in the Country. In 2013, an estimated 2,89,000 women worldwide died from complications arising from pregnancy & childbirth. In view of the above facts, a study was conducted in Indore to analyse the maternal health status among urban slums and non-slums women.

Keywords: antenatal care, postnatal care, JSY, maternal health, child health, reproductive health

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