Search results for: Healthcare waste

Authors: Claudio D'Alonzo

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According to recent tendencies, progress on resource efficiency is possible and it will lead to economic, environmental, and social benefits. The passage to a circular economy system, in which all the materials and energy will maintain their value for as long as possible, waste is reduced and only a few resources are used, is one of the most relevant parts of the European Union's environmental policy to develop a sustainable, competitive and low-carbon economy. The concept of circular economy is to be found in Decision 1386/2013/EU of the European Parliament and of the Council on a General Union Environment Action Programme to 2020 named “Living well, within the limits of our planet”. To modernise waste management systems in the Union and to consolidate the European model as one of the most effective in the world, a revised waste legislative framework entered into force in July 2018. Regarding the Italian legislation, the laws to be modified are the Legislative Decree 3 April 2006, n. 152 and the laws ruling waste management, end-of-waste, by-products and, the regulatory principles regarding circular economy. European rules on end-of-waste are not fully harmonised and so there are legal challenges. The target to be achieved is full consistency between the laws implementing waste and chemicals policies. Only in this way, materials will be safe, fit-for-purpose and designed for durability; additionally, they will have a low environmental impact.

Keywords: Circular economy, end-of-waste, legislation, secondary raw materials.

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Authors: Sushovan Sarkar, Debabrata Mazumder

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Solid waste management in steel industry is broadly classified in “4 Rs” i.e. reduce, reuse, recycle and restore the materials. Reuse and recycling the entire solid waste generated in the process of steel making is a viable solution in targeting a clean, green and zero waste technology leading to sustainable development of the steel industry. Solid waste management has gained importance in steel industry in view of its uncertainty, volatility and speculation due to world competitive standards, rising input costs, scarcity of raw materials and solid waste generated like in other sectors. The challenges that the steel Industry faces today are the requirement of a sustainable development by meeting the needs of our present generation without compromising the ability of future generations. Technologies are developed not only for gainful utilization of solid wastes in manufacture of conventional products but also for conversion of same in to completely new products.

Keywords: Reuse, recycle, solid waste, sustainable development.

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Authors: S. Pechpoothong, M. Kopystecki

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The eco-efficient use of “waste" makes sense from economic, social, and environmental perspectives. By efficiency diverting “waste" products back into useful and/or profitable inputs, industries and entire societies can reap the benefits of improved financial profit, decreased environmental degradation, and overall well-being of humanity. In this project, several material flows at Company Limited were investigated. Principles of "industrial ecology" were applied to improve the management of waste rubbers that are used in the jewelry manufacturing process. complete this project, a brief engineering analysis stream, and investigated eco-efficient principles for more efficient handling of the materials and wastes were conducted, and the result were used to propose implementation strategies.

Keywords: Rubber, ecology, waste.

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Authors: Merita Dauti, Edita Alili-Idrizi, Sihana Ahmeti–Lika, Ledjan Malaj

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The extermination and proper disposal of pharmaceutical wastes from expired and unused medications remains a disputable issue due to their specific nature and characteristics. Even though the hazards from these wastes are already well known in terms of environment and human health, people still treat them as usual wastes. At a national level, in many countries the management of pharmaceutical and medical wastes has been one of the main objectives in order to protect people’s health and the environment. Even though many legal regulations exist in this respect, there has not been a single law that would clearly explain the procedures of returning medicines, ways of selection, treatment and extermination of pharmaceutical wastes. This paper aims at analyzing the practices of pharmaceutical waste management and treatment in some European countries as well as a review of the legislation and official guidelines in managing these kinds of wastes and protecting the environment and human health. A suitable treatment and management of expired medications and other similar wastes would be in the interest of public health in the first place, as well as in the interest of healthcare institutions and other bodies engaged in environment protection.

Keywords: Pharmaceutical waste, legal regulation, proper disposal, environment pollution.

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Authors: Guanglin Song

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Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city. The findings reveal that: 1) There exists overall maldistribution and over-concentration of healthcare resources in the study area, characterized by structural imbalance. 2) The low rate of primary care utilization in the study area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem. 3) Gradual optimization of the healthcare facility layout in the study area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance. This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. In addition, the study provides some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: Flow of public services, healthcare facilities, spatial planning, urban networks.

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Authors: Muammer Kaya

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The main purpose of this article is to provide a comprehensive review of various physical and chemical processes for electronic waste (e-waste) recycling, their advantages and shortfalls towards achieving a cleaner process of waste utilization, with especial attention towards extraction of metallic values. Current status and future perspectives of waste printed circuit boards (PCBs) recycling are described. E-waste characterization, dismantling/ disassembly methods, liberation and classification processes, composition determination techniques are covered. Manual selective dismantling and metal-nonmetal liberation at – 150 µm at two step crushing are found to be the best. After size reduction, mainly physical separation/concentration processes employing gravity, electrostatic, magnetic separators, froth floatation etc., which are commonly used in mineral processing, have been critically reviewed here for separation of metals and non-metals, along with useful utilizations of the non-metallic materials. The recovery of metals from e-waste material after physical separation through pyrometallurgical, hydrometallurgical or biohydrometallurgical routes is also discussed along with purification and refining and some suitable flowsheets are also given. It seems that hydrometallurgical route will be a key player in the base and precious metals recoveries from e-waste. E-waste recycling will be a very important sector in the near future from economic and environmental perspectives.

Keywords: E-waste, WEEE, PCB, recycling, metal recovery, hydrometallurgy, pyrometallurgy, biohydrometallurgy.

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Authors: M. S. Bani, Z. A. Rashid, K. H. K. Hamid, M. E. Harbawi, A.B.Alias, M. J. Aris

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Most Decision Support Systems (DSS) for waste management (WM) constructed are not widely marketed and lack practical applications. This is due to the number of variables and complexity of the mathematical models which include the assumptions and constraints required in decision making. The approach made by many researchers in DSS modelling is to isolate a few key factors that have a significant influence to the DSS. This segmented approach does not provide a thorough understanding of the complex relationships of the many elements involved. The various elements in constructing the DSS must be integrated and optimized in order to produce a viable model that is marketable and has practical application. The DSS model used in assisting decision makers should be integrated with GIS, able to give robust prediction despite the inherent uncertainties of waste generation and the plethora of waste characteristics, and gives optimal allocation of waste stream for recycling, incineration, landfill and composting.

Keywords: Review, decision support system, GIS and waste management.

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Authors: Helena Kovačič, Andrej Rus

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The authors of this paper compared ratings for leadership competences of managers in the healthcare sector and professional managers in Slovenia. Managers’ competence scores were analyzed for Slovenia and compared with some other EU countries. Comparisons of correlations yielded significant differences in leader/non-leader healthcare professionals in their relational competences. Cross-cultural comparisons also point to these differences in many countries included in the survey. Comparing these managers with the professional managers, one of the relational competences significantly distinguishes the two groups, namely the competence of taking initiative in establishing contacts with experts outside the organization. What is surprising from our analysis is the high number of competences that significantly differentiate leaders in healthcare from professional managers. Empirically based assessment provided a robust method for assessing and comparing leadership competences and point out significant results for leadership development.

Keywords: Leadership, competences, healthcare.

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Authors: S. Potivichayanon, T. Sungmon, W. Chaikongmao, S. Kamvanin

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Production of biogas from bakery waste was enhanced by additional bacterial cell. This study was divided into 2 steps. First step, grease waste from bakery industry-s grease trap was initially degraded by Pseudomonas aeruginosa. The concentration of byproduct, especially glycerol, was determined and found that glycerol concentration increased from 12.83% to 48.10%. Secondary step, 3 biodigesters were set up in 3 different substrates: non-degraded waste as substrate in first biodigester, degraded waste as substrate in secondary biodigester, and degraded waste mixed with swine manure in ratio 1:1 as substrate in third biodigester. The highest concentration of biogas was found in third biodigester that was 44.33% of methane and 63.71% of carbon dioxide. The lower concentration at 24.90% of methane and 18.98% of carbon dioxide was exhibited in secondary biodigester whereas the lowest was found in non-degraded waste biodigester. It was demonstrated that the biogas production was greatly increased with the initial grease waste degradation by Pseudomonas aeruginosa.

Keywords: Biogas production, carbon dioxide, methane, Pseudomonas aeruginosa

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Authors: S. R. Shamili, J. Karthikeyan

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Fast development of the total populace and far and wide urbanization has surprisingly expanded the advancement of the construction industry. As a result of these activities, old structures are being demolished to make new buildings. Due to these large-scale demolitions, a huge amount of debris is generated all over the world, which results in a landfill. The use of construction and demolition waste as landfill causes groundwater contamination, which is hazardous. Using construction and demolition waste as aggregate can reduce the use of natural aggregates and the problem of mining. The objective of this study is to provide a detailed overview on how the construction and demolition waste material has been used as aggregate in structural concrete. In this study, the preparation, classification, and composition of construction and demolition wastes are also discussed.

Keywords: Aggregate, construction and demolition waste, landfill, large scale demolition.

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Authors: Aseem Rajvanshi, Pankaj Kumar Pandey

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Increase in population has increased the demand of energy to fulfill all its needs. This will result in burden on fossil fuels especially crude oil. Waste oil due to its disposal problem creates environmental degradation. In this context, this paper studies utilization of waste cooking oil and waste motor sludge for making lubricating grease. Experimental studies have been performed by variation in time and concentration of mixture of waste cooking oil and waste motor sludge. The samples were analyzed using penetration test (ASTM D-217), dropping point (ASTM D-566), work penetration (ASTM D-217) and copper strip test (ASTM D-408). Among 6 samples, sample 6 gives the best results with a good drop point and a fine penetration value. The dropping point and penetration test values were found to be 205 °C and 315, respectively. The penetration value falls under the category of NLGI (National Lubricating Grease Institute) consistency number 1.

Keywords: Crude oil, copper strip corrosion test, dropping point, penetration test.

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Authors: Thaniya Kaosol

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General as well as the MSW management in Thailand is reviewed in this paper. Topics include the MSW generation, sources, composition, and trends. The review, then, moves to sustainable solutions for MSW management, sustainable alternative approaches with an emphasis on an integrated MSW management. Information of waste in Thailand is also given at the beginning of this paper for better understanding of later contents. It is clear that no one single method of MSW disposal can deal with all materials in an environmentally sustainable way. As such, a suitable approach in MSW management should be an integrated approach that could deliver both environmental and economic sustainability. With increasing environmental concerns, the integrated MSW management system has a potential to maximize the useable waste materials as well as produce energy as a by-product. In Thailand, the compositions of waste (86%) are mainly organic waste, paper, plastic, glass, and metal. As a result, the waste in Thailand is suitable for an integrated MSW management. Currently, the Thai national waste management policy starts to encourage the local administrations to gather into clusters to establish central MSW disposal facilities with suitable technologies and reducing the disposal cost based on the amount of MSW generated.

Keywords: MSW, management, sustainable, Thailand

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Authors: Kwok Tak Kit

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Combating climate change is becoming a hot topic in various sectors. Building construction and infrastructure sectors contributed a significant proportion of waste and greenhouse gas (GHG) emissions in the environment of different countries and cities. However, there is little research on the micro-level of waste management, “building construction material wastage management,” and fewer reviews about regulatory control in the building construction sector. This paper focuses on the potentialities and importance of material wastage management and reviews the deficiencies of the current standard to take into account the reduction of material wastage in a systematic and quantitative approach.

Keywords: Quantitative measurement, material wastage management plan, waste management, uncalculated waste, circular economy.

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Authors: P. I. Itoua, D. Sun, S. Shen

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This study aimed at investigating the properties of asphalt and mix asphalt based on the effects of waste toner sources (WT1 and WT2) with 8% dosage waste toner powders (WT). The test results included penetration, softening points, ductility, G*sinδ, G*/sinδ, Ideal cracking test (IDEAL-CT), and Ideal shear rutting test (IDEAL-RT). The results showed that the base binder with WT2 had a significantly higher viscosity value compared to the WT1 modified binder, and thus, higher energy for mixing and compaction is needed. Furthermore, the results of penetration, softening points, G*sinδ, and G*/sinδ were all affected by waste toner type. In terms of asphalt mixture, the IDEAL-RT test revealed that the addition of waste toner improved the rutting resistance of the asphalt mixture regardless of toner type. Further, CTindex values for waste toner-modified asphalt mixtures show no significant difference. Above all, WT-modified asphalt mixtures produced by the wet process have better rutting performance.

Keywords: Waste toner, waste toner-modified asphalt, asphalt mixture properties, IDEAL-RT test, IDEAL-CT test.

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Authors: T. Hui Teo, Wee Tiong Tan, Pradeep K. Gopalakrishnan, Victor K. H. Phay, Ma Su M. M. Shwe

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A healthcare monitoring system is presented in this paper. This system is based on ultra-low power sensor nodes and a personal server, which is based on hardware and software extensions to a Personal Digital Assistant (PDA)/Smartphone. The sensor node collects data from the body of a patient and sends it to the personal server where the data is processed, displayed and made ready to be sent to a healthcare network, if necessary. The personal server consists of a compact low power receiver module and equipped with a Smartphone software. The receiver module takes less than 30 × 30 mm board size and consumes approximately 25 mA in active mode.

Keywords: healthcare monitoring, sensor node, personal server, wireless.

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Authors: Ibrahim F. Elbaba, Paul T. Williams

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Hydrogen is regarded to play an important role in future energy systems because it can be produced from abundant resources and its combustion only generates water. The disposal of waste tyres is a major problem in environmental management throughout the world. The use of waste materials as a source of hydrogen is particularly of interest in that it would also solve a waste treatment problem. There is much interest in the use of alternative feedstocks for the production of hydrogen since more than 95% of current production is from fossil fuels. The pyrolysis of waste tyres for the production of liquid fuels, activated carbons and gases has been extensively researched. However, combining pyrolysis with gasification is a novel process that can gasify the gaseous products from pyrolysis. In this paper, an experimental investigation into the production of hydrogen and other gases from the bench scale pyrolysis-gasification of tyres has been investigated. Experiments were carried using a two stage system consisting of pyrolysis of the waste tyres followed by catalytic steam gasification of the evolved gases and vapours in a second reactor. Experiments were conducted at a pyrolysis temperature of 500 °C using Ni/Al2O3 as a catalyst. The results showed that there was a dramatic increase in gas yield and the potential H2 production when the gasification temperature was increased from 600 to 900 oC. Overall, the process showed that high yields of hydrogen can be produced from waste tyres.

Keywords: Catalyst, Hydrogen, Pyrolysis, Gasification, Tyre, Waste

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Authors: Nahid Hassanshahi, Ayoub Karimi-Jashni, Nasser Talebbeydokhti

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Due to the economic and environmental benefits of producing less waste, the US Environmental Protection Agency (EPA) introduces source reduction as one of the most important means to deal with the problems caused by increased landfills and pollution. Waste reduction involves all waste management methods, including source reduction, recycling, and composting, which reduce waste flow to landfills or other disposal facilities. Source reduction of waste can be studied from two perspectives: avoiding waste production, or reducing per capita waste production, and waste deviation that indicates the reduction of waste transfer to landfills. The present paper has investigated home composting as a managerial solution for reduction of waste transfer to landfills. Home composting has many benefits. The use of household waste for the production of compost will result in a much smaller amount of waste being sent to landfills, which in turn will reduce the costs of waste collection, transportation and burial. Reducing the volume of waste for disposal and using them for the production of compost and plant fertilizer might help to recycle the material in a shorter time and to use them effectively in order to preserve the environment and reduce contamination. Producing compost in a home-based manner requires very small piece of land for preparation and recycling compared with other methods. The final product of home-made compost is valuable and helps to grow crops and garden plants. It is also used for modifying the soil structure and maintaining its moisture. The food that is transferred to landfills will spoil and produce leachate after a while. It will also release methane and greenhouse gases. But, composting these materials at home is the best way to manage degradable materials, use them efficiently and reduce environmental pollution. Studies have shown that the benefits of the sale of produced compost and the reduced costs of collecting, transporting, and burying waste can well be responsive to the costs of purchasing home compost machine and the cost of related trainings. Moreover, the process of producing home compost may be profitable within 4 to 5 years and as a result, it will have a major role in reducing waste management.

Keywords: Compost, home compost, reducing waste, waste management.

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Authors: Hiraku Nunomiya, Takuo Ichiju, Yoshiyuki Higuchi

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In the management of industrial waste, conversion from the use of paper invoices to electronic forms is currently under way in developed countries. Difficulties in such computerization include the lack of synchronization between the actual goods and the corresponding data managed by the server. Consequently, a system which utilizes the incorporation of a QR code in connection with the waste material has been developed. The code is read at each stage, from discharge until disposal, and progress at each stage can be easily reported. This system can be linked with Japanese public digital authentication service of waste, taking advantage of its good points, and can be used to submit reports to the regulatory authorities. Its usefulness was confirmed by a verification test, and put into actual practice.

Keywords: Infectious Waste, Electronic Manifest, Real Time Management, QR code.

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Authors: Shogo Kato, Daisuke Okamoto, Satoko Tsuru, Yoshinori Iizuka, Ryoko Shimono

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Healthcare safety has been perceived important. It is essential to prevent troubles in healthcare processes for healthcare safety. Trouble prevention is based on trouble prediction using accumulated knowledge on processes, troubles, and countermeasures. However, information on troubles has not been accumulated in hospitals in the appropriate structure, and it has not been utilized effectively to prevent troubles. In the previous study, however a detailed knowledge acquisition process for trouble prediction was proposed, the knowledgebase for countermeasures was not involved. In this paper, we aim to propose the structure of the knowledgebase for countermeasures, in the knowledge acquisition process for trouble prediction in healthcare process. We first design the structure of countermeasures and propose the knowledge representation form on countermeasures. Then, we evaluate the validity of the proposal, by applying it into an actual hospital.

Keywords: Trouble prevention, knowledge structure, structured knowledge, reusable knowledge.

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Authors: Nergiz Fırıncı, Aysun Çelik, Ertan Akün, Md. Atif Khan

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A pilot project was carried out in 2007 by the senior students of Cyprus International University, aiming to minimize the total cost of waste collection in Northern Cyprus. Many developed and developing countries have cut their transportation costs – which lies between 30-40% – down at a rate of 40% percent, by implementing network models for their route assignments. Accordingly, a network model was implemented at Göçmenköy district, to optimize and standardize waste collection works. The work environment of the employees were also redesigned to provide maximum ergonomy and to increase productivity, efficiency and safety. Following the collection of the required data including waste densities, lengths of roads and population, a model was constructed to allocate the optimal route assignment for the waste collection trucks at Göçmenköy district.

Keywords: Minimization, waste collection, operations cost, transportation, ergonomy, productivity.

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Authors: Tal Ben-Zvi, Donald N. Lombardi

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This study uses a simulation to establish a realistic environment for laboratory research on Accountable Care Organizations. We study network attributes in order to gain insights regarding healthcare providers- conduct and performance. Our findings indicate how network structure creates significant differences in organizational performance. We demonstrate how healthcare providers positioning themselves at the central, pivotal point of the network while maintaining their alliances with their partners produce better outcomes.

Keywords: Social Networks, Decision-Making, Accountable Care Organizations, Performance

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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: Kalala Jalama

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A process flowsheet was developed in ChemCad 6.4 to study the effect of feed moisture contents on the pre-esterification of waste oils. Waste oils were modelled as a mixture of triolein (90%), oleic acid (5%) and water (5%). The process mainly consisted of feed drying, pre-esterification reaction and methanol recovery. The results showed that the process energy requirements would be minimized when higher degrees of feed drying and higher preesterification reaction temperatures are used.

Keywords: Waste oils, moisture content, pre-esterification.

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Authors: Dolores Hidalgo, Jesús M. Martín-Marroquín, Francisco Corona

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Municipal waste consist of a variety of items that are everyday discarded by the population. They are usually collected by municipalities and include waste generated by households, commercial activities (local shops) and public buildings. The composition of municipal waste varies greatly from place to place, being mostly related to levels and patterns of consumption, rates of urbanization, lifestyles, and local or national waste management practices. Each year, a huge amount of resources is consumed in the EU, and according to that, also a huge amount of waste is produced. The environmental problems derived from the management and processing of these waste streams are well known, and include impacts on land, water and air. The situation in remote areas is even worst. Difficult access when climatic conditions are adverse, remoteness of centralized municipal treatment systems or dispersion of the population, are all factors that make remote areas a real municipal waste treatment challenge. Furthermore, the scope of the problem increases significantly because the total lack of awareness of the existing risks in this area together with the poor implementation of advanced culture on waste minimization and recycling responsibly. The aim of this work is to analyze the existing situation in remote areas in reference to the production of municipal waste and evaluate the efficiency of different management alternatives. Ideas for improving waste management in remote areas include, for example: the implementation of self-management systems for the organic fraction; establish door-to-door collection models; promote small-scale treatment facilities or adjust the rates of waste generation thereof.

Keywords: Door to door collection, islands, isolated areas, municipal waste, remote areas, rural communities.

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Authors: Soukaina Oujana, Peggy Zwolinski

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Fines are heterogeneous residues created during the shredding of non-hazardous waste. They are one of the most challenging issues faced by recyclers, because they are at the present time considered as non-sortable and non-reusable mixtures destined to landfill. However, fines contain a large amount of recoverable materials that could be recycled or reused for the production of solid recovered fuel. This research is conducted in relation to a project named ValoRABES. The aim is to characterize fines and establish a suitable sorting process in order to extract the materials contained in the mixture and define their suitable recovery paths. This paper will highlight the importance of a good sampling and will propose a sampling methodology for fines characterization. First results about the characterization will be also presented.

Keywords: Fines, non-hazardous waste, recovery, shredding residues, waste characterization, waste sampling.

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Authors: G.Anjali, M.Bhavya, N.Arvind Kumar

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In order to avoid the potentially devastating consequences of global warming and climate change, the carbon dioxide “CO2" emissions caused due to anthropogenic activities must be reduced considerably. This paper presents the first study examining the feasibility of carbon sequestration in construction and demolition “C&D" waste. Experiments were carried out in a self fabricated Batch Reactor at 40ºC, relative humidity of 50-70%, and flow rate of CO2 at 10L/min for 1 hour for water-to-solids ratio of 0.2 to 1.2. The effect of surface area was found by comparing the theoretical extent of carbonation of two different sieve sizes (0.3mm and 2.36mm) of C&D waste. A 38.44% of the theoretical extent of carbonation equating to 4% CO2 sequestration extent was obtained for C&D waste sample for 0.3mm sieve size. Qualitative, quantitative and morphological analyses were done to validate carbonate formation using X-ray diffraction “X.R.D.," thermal gravimetric analysis “T.G.A., “X-Ray Fluorescence Spectroscopy “X.R.F.," and scanning electron microscopy “S.E.M".

Keywords: Alkaline waste, construction and demolition waste, CO2 sequestration, mineral carbonation.

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Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

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In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Keywords: Healthcare, flexibility, patient satisfaction, behavioral intention.

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Authors: S. M. Monavari, P. Hoasami, S. Tajziehchi, N. Khorramichokami.

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The practice of burying the solid waste under the ground is one of the waste disposal methods and dumping is known as an ultimate method in the fastest-growing cities like Rasht city in Iran. Some municipalities select the solid waste landfills without feasibility studies, programming, design and management plans. Therefore, several social and environmental impacts are created by these sites. In this study, the suitability of solid waste landfill in Rasht city, capital of Gilan Province is reviewed using Regional Screening Method (RSM), Geographic Information System (GIS) and Analytical Hierarchy Process (AHP). The results indicated that according to the suitability maps, the value of study site is midsuitable to suitable based on RSM and mid-suitable based on AHP.

Keywords: Analytical Hierarchy Process (AHP), Geographic Information System (GIS), Rasht City, Regional Screening Method (RSM), Solid Waste Landfill

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Authors: A. Naceri, M. Chikouche Hamina, P. Grosseau

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The effect of artificial pozzolan (waste brick) on the physico-chemical properties of cement manufactured was investigated. The waste brick is generated by the manufacture of bricks. It was used in the proportions of 0%, 5%, 10%, 15% and 20% by mass of cement to study its effect on the physico-chemical properties of cement incorporating artificial pozzolan. The physicochemical properties of cement at anhydrous state and the hydrated state (chemical composition, specific weight, fineness, consistency of the cement paste and setting times) were studied. The experimental results obtained show that the quantity of pozzolanic admixture (waste brick) of cement manufactured is the principal parameter who influences on the variation of the physico-chemical properties of the cement tested.

Keywords: Artificial pozzolan, waste brick, cement, physicochemicalcharacteristics.

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Authors: Towards Better Quality in Healthcare, Operations Management: A Developmental Literature Review

Abstract:

This work presents the various perspectives, dimensions, components and definitions given to quality in the operations management (OM) and healthcare services (HCS) literature in time, highlighting gaps and learning opportunities between the two disciplines through a thorough search into their rich and distinct body of knowledge. Greater and new insights about the general nature of quality are obtained with findings such as in OM, quality has been approached in six fairly distinct paradigms (excellence, value, conformity to specifications, attributes, satisfaction and meeting or exceeding customer expectations), whereas in HCS, two approaches are prominent (Donabedian’s structure, process and outcomes model and Lohr and Schroeder’s circumscribed definition). The two disciplines views on quality seem to have progressed much in parallel with little cross-learning from each other. This work then proposes an encompassing definition of quality as a lever and suggests further research and development avenues for a better use of the concept of quality by academics and practitioners alike toward the goals of greater organizational performance and improved management in healthcare and possibly other service domains.

Keywords: Healthcare, management, operations, quality, services.

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