Search results for: health-care waste management

Authors: Alemayehu Agizew Woldeamanuel, Mekonnen Maschal Tarekegn, Raj Mohan Balakrishina

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Composting is one of the conventional techniques adopted for organic waste management but the practice is very limited in emerging cities despite that most of the waste generated is organic. This paper aims to examine the viability of composting for organic waste management in the emerging city of Addis Ababa, Ethiopia by addressing the composting practice, quality of compost and application of compost in urban agriculture. The study collects data using compost laboratory testing and urban farm households’ survey and uses descriptive analysis on the state of compost production and application, physicochemical analysis of the compost samples, and regression analysis on the urban farmer’s willingness to pay for compost. The findings of the study indicated that there is composting practice at a small scale, most of the producers use unsorted feedstock materials, aerobic composting is dominantly used and the maturation period ranged from four to 10 weeks. The carbon content of the compost ranges from 30.8 to 277.1 due to the type of feedstock applied and this surpasses the ideal proportions for C:N ratio. The total nitrogen, pH, organic matter and moisture content are relatively optimal. The levels of heavy metals measured for Mn, Cu, Pb, Cd and Cr6+ in the compost samples are also insignificant. In the urban agriculture sector, chemical fertilizer is the dominant type of soil input in crop productions but vegetable producers use a combination of both fertilizer and other organic inputs including compost. The willingness to pay for compost depends on income, household size, gender, type of soil inputs, monitoring soil fertility, the main product of the farm, farming method and farm ownership. Finally, this study recommends the need for collaboration among stakeholders along the value chain of waste, awareness creation on the benefits of composting and addressing challenges faced by both compost producers and users.

Keywords: Composting, emerging city, organic waste management, urban agriculture.

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Authors: Rafenomananjara Tsinjo Nirina, Tomoo Sekito, Andrianaivoravelona Jaconnet Oliva

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Manufacturing a composite material from post-consumer bottles is an interesting outlet since Madagascar is still facing the challenges of managing plastic waste on the one hand and appropriate waste treatment facilities are not yet developed on the other hand. New waste management options are needed to divert End-Of-Life (EOL) soft plastic wastes from landfills and incineration. Waste polyethylene terephthalate (PET) bottles might be considered as a valuable resource and recovered into polymer concrete. The methodology is easy to implement and appropriate to the local context in Madagascar. This approach will contribute to the production of ecological building materials that might be profitable for the environment and the construction sector. This work aims to study the feasibility of using the post-consumer PET bottles as an alternative binding agent instead of the conventional Portland cement and water. Then, the mechanical and physical properties of the materials were evaluated.

Keywords: PET recycling, polymer concrete, ecological building materials, pollution mitigation.

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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: R. Poonsuph

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Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: Bujar Ismaili, Bahti Ismajli, Venhar Ismaili, Skender Ramadani

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In Kosovo, the problem with the electricity supply is huge and it does not meet the demands of consumers. Older thermal power plants, which are regarded as big environmental polluters, produce most of the energy. Our experiment is based on the production of electricity using the closed method that does not affect environmental pollution by using waste as fuel that is considered to pollute the environment. The experiment was carried out in the village of Godanc, municipality of Shtime, Kosovo. In the experiment, a production line based on the production of electricity and central heating was designed at the same time. The results are the benefits of electricity as well as the release of temperature for heating with minimal expenses and with the release of 0% gases into the atmosphere. During this experiment, coal, plastic, waste from wood processing, and agricultural wastes were used as raw materials. The method utilized in the experiment allows for the release of gas through pipes and filters during the top-to-bottom combustion of the raw material in the boiler, followed by the method of gas filtration from waste wood processing (sawdust). During this process, the final product, gas, is obtained. This gas passes through the carburetor, enabling the combustion process to put the internal combustion machine and the generator into operation and produce electricity that does not release gases into the atmosphere. The results show that the system provides energy stability without environmental pollution from toxic substances and waste, as well as with low production costs. From the final results, it follows that, in the case of using coal fuel, we have benefited from more electricity and higher temperature release, followed by plastic waste, which also gave good results. The results obtained during these experiments prove that the current problems of lack of electricity and heating can be met at a lower cost and have a clean environment and waste management.

Keywords: Energy, heating, atmosphere, waste management, gasification.

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Authors: Musaida M. M. Manyuchi, Anthony Phiri, Ngoni Chirinda, Perkins Muredzi, Joseph Govhaand, Thamary Sengudzwa

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Waste corn pulp was investigated as a potential feedstock during vermicomposting using Eisenia fetida. Corn pulp is the major staple food in Southern Africa and constitutes about 25% of the total organic waste. Wastecooked corn pulp was blended with cow dung in the ratio 6:1 respectively to optimize the vermicomposting process. The feedstock was allowed to vermicompost for 30 days. The vermicomposting took place in a 3- tray plastic worm bin. Moisture content, temperature, pH, and electrical conductivity were monitoreddaily. The NPK content was determined at day 30. During vermicomposting, moisture content increased from 27.68% to 52.41%, temperature ranged between 19- 25◦C, pH increased from 5.5 to 7.7, and electrical conductivity decreased from 80000μS/cm to 60000μS/cm. The ash content increased from 11.40% to 28.15%; additionally the volatile matter increased from 1.45% to 10.02%. An odorless, dark brown vermicompost was obtained. The vermicompost NPK content was 4.19%, 1.15%, and 6.18% respectively.

Keywords: Corn pulp, Eisenia fetida, vermicomposting, waste management.

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Authors: A. Todorut, T. Heput

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In technological processes, in addition to the main product, result a large amount of materials, called wastes, but due to the possibilities of recovery, by means of recycling and reusing it can fit in the category of by-products. These large amounts of dust from the steel industry are a major problem in terms of environmental and human health, landscape, etc. Solving these problems, the impressive amounts of waste can be done through their proper management and recovery for every type of waste. In this article it was watched the capitalizing through pelleting and briquetting of small and powdery waste aiming to obtain the sponge iron as raw material, used in blast furnaces and electric arc furnaces. The data have been processed in the Excel spreadsheet program, being presented in the form of diagrams.

Keywords: Agglomeration, industry, iron, pellets, wastes.

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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: 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: Nevena Stolba, A Min Tjoa

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Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.

Keywords: data mining, data warehousing, decision-support systems, evidence-based medicine.

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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: Kyomin Lee, Joohee Kim, Sangho Kang

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The commercial nuclear power reactor in South Korea, Kori Unit 1, which was a 587 MWe pressurized water reactor that started operation since 1978, was permanently shut down in June 2017 without an additional operating license extension. The Kori 1 Unit is scheduled to become the nuclear power unit to enter the decommissioning phase. In this study, the preliminary evaluation of the decommissioning wastes for the Kori Unit 1 was performed based on the following series of process: firstly, the plant inventory is investigated based on various documents (i.e., equipment/ component list, construction records, general arrangement drawings). Secondly, the radiological conditions of systems, structures and components (SSCs) are established to estimate the amount of radioactive waste by waste classification. Third, the waste management strategies for Kori Unit 1 including waste packaging are established. Forth, selection of the proper decontamination and dismantling (D&D) technologies is made considering the various factors. Finally, the amount of decommissioning waste by classification for Kori 1 is estimated using the DeCAT program, which was developed by KEPCO-E&C for a decommissioning cost estimation. The preliminary evaluation results have shown that the expected amounts of decommissioning wastes were less than about 2% and 8% of the total wastes generated (i.e., sum of clean wastes and radwastes) before/after waste processing, respectively, and it was found that the majority of contaminated material was carbon or alloy steel and stainless steel. In addition, within the range of availability of information, the results of the evaluation were compared with the results from the various decommissioning experiences data or international/national decommissioning study. The comparison results have shown that the radioactive waste amount from Kori Unit 1 decommissioning were much less than those from the plants decommissioned in U.S. and were comparable to those from the plants in Europe. This result comes from the difference of disposal cost and clearance criteria (i.e., free release level) between U.S. and non-U.S. The preliminary evaluation performed using the methodology established in this study will be useful as a important information in establishing the decommissioning planning for the decommissioning schedule and waste management strategy establishment including the transportation, packaging, handling, and disposal of radioactive wastes.

Keywords: Characterization, classification, decommissioning, decontamination and dismantling, Kori 1, radioactive waste.

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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: O. S. Saulters, S. D. Goldberg, W. A. Staples, E. I. Martinez, L. M. Sanchez, D. E. Archuleta, D. L. Williams, S. D. Johnson, A. M. Baker

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To address an important set of unverified field conditions, the Los Alamos National Laboratory Waste Compliance and Tracking System (WCATS) Wall-to-Wall Team performed an unprecedented and advanced inventory. This reconciliation involved confirmation analysis for approximately 5850 hazardous, low-level, mixed low-level, and transuranic waste containers located in more than 200 staging and storage areas across 33 Technical Areas. The interdisciplinary team scoped, planned, and developed the multidimensional assessments. Through coordination with cross-functional site hosts, they were able to verify and validate data while resolving discrepancies identified in WCATS. The results were extraordinary with an updated inventory, tailored outreach, more cohesive communications, and timely closed-loop feedbacks.

Keywords: Circular economy, environmental performance data, social-ecological-technological systems, waste management.

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Authors: D. Nouri, M.R. Sabour, M. Ghanbarzadeh Lak

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Proper management of residues originated from industrial activities is considered as one of the serious challenges faced by industrial societies due to their potential hazards to the environment. Common disposal methods for industrial solid wastes (ISWs) encompass various combinations of solely management options, i.e. recycling, incineration, composting, and sanitary landfilling. Indeed, the procedure used to evaluate and nominate the best practical methods should be based on environmental, technical, economical, and social assessments. In this paper an environmentaltechnical assessment model is developed using analytical network process (ANP) to facilitate the decision making practice for ISWs generated at Gilan province, Iran. Using the results of performed surveys on industrial units located at Gilan, the various groups of solid wastes in the research area were characterized, and four different ISW management scenarios were studied. The evaluation process was conducted using the above-mentioned model in the Super Decisions software (version 2.0.8) environment. The results indicates that the best ISW management scenario for Gilan province is consist of recycling the metal industries residues, composting the putrescible portion of ISWs, combustion of paper, wood, fabric and polymeric wastes as well as energy extraction in the incineration plant, and finally landfilling the rest of the waste stream in addition with rejected materials from recycling and compost production plants and ashes from the incineration unit.

Keywords: Analytical Network Process, Disposal Scenario, Gilan Province, Industrial Waste.

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Authors: A. Buruzs, M. F. Hatwágner, A. Torma, L. T. Kóczy

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Recently, an increasing number of researchers have been focusing on working out realistic solutions to sustainability problems. As sustainability issues gain higher importance for organisations, the management of such decisions becomes critical. Knowledge representation is a fundamental issue of complex knowledge based systems. Many types of sustainability problems would benefit from models based on experts’ knowledge. Cognitive maps have been used for analyzing and aiding decision making. A cognitive map can be made of almost any system or problem. A fuzzy cognitive map (FCM) can successfully represent knowledge and human experience, introducing concepts to represent the essential elements and the cause and effect relationships among the concepts to model the behaviour of any system. Integrated waste management systems (IWMS) are complex systems that can be decomposed to non-related and related subsystems and elements, where many factors have to be taken into consideration that may be complementary, contradictory, and competitive; these factors influence each other and determine the overall decision process of the system. The goal of the present paper is to construct an efficient IWMS which considers various factors. The authors’ intention is to propose an expert based system design approach for implementing expert decision support in the area of IWMSs and introduces an appropriate methodology for the development and analysis of group FCM. A framework for such a methodology consisting of the development and application phases is presented.

Keywords: Factors, fuzzy cognitive map, group decision, integrated waste management system.

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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: 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: 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: 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: Lucy Ampaw-Asiedu, Terri R. Norton

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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: Disaster management, safe spaces, structural design, tornado, vulnerability.

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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: 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: 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: Fahad K. Alqahtani

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Nowadays construction industry is developing means to incorporate waste products in concrete to ensure sustainability. To meet the need of construction industry, a synthetic aggregate was developed using optimized technique called compression moulding press technique. The manufactured aggregate comprises mixture of plastic, waste which acts as binder, together with by-product waste which acts as fillers. The physical properties and microstructures of the inert materials and the manufactured aggregate were examined and compared with the conventional available aggregates. The outcomes suggest that the developed aggregate has potential to be used as substitution of conventional aggregate due to its less weight and water absorption. The microstructure analysis confirmed the efficiency of the manufacturing process where the final product has the same mixture of binder and filler.

Keywords: Fly ash, plastic waste, quarry fine, red sand, synthetic aggregate.

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Authors: Yi-Jie Lin, Jyh-Cherng Chen

Abstract:

The fly ash of waste incineration processes is usually hazardous and the disposal or reuse of waste incineration fly ash is difficult. In this study, the waste incineration fly ash was converted to useful zeolites by the alkali fusion and hydrothermal synthesis method. The influence of different operating conditions (the ratio of Si/Al, the ratio of hydrolysis liquid to solid, and hydrothermal time) was investigated to seek the optimum operating conditions for the synthesis of zeolite from waste incineration fly ash. The results showed that concentrations of heavy metals in the leachate of Toxicity Characteristic Leaching Procedure (TCLP) were all lower than the regulatory limits except lead. The optimum operating conditions for the synthesis of zeolite from waste incineration fly ash by the alkali fusion and hydrothermal synthesis method were Si/Al=40, NaOH/ash=1.5, alkali fusion at 400 ^oC for 40 min, hydrolysis with Liquid to Solid ratio (L/S)= 200 at 105 ^oC for 24 h, and hydrothermal synthesis at 105 ^oC for 24 h. The specific surface area of fly ash could be significantly increased from 8.59 m²/g to 651.51 m²/g (synthesized zeolite). The influence of different operating conditions on the synthesis of zeolite from waste incineration fly ash followed the sequence of Si/Al ratio > hydrothermal time > hydrolysis L/S ratio. The synthesized zeolites can be reused as good adsorbents to control the air or wastewater pollutants. The purpose of fly ash detoxification, reduction and waste recycling/reuse is achieved successfully.

Keywords: Alkali fusion, hydrothermal, fly ash, zeolite.

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Authors: Z. Funda Türkmenoğlu, Mehmet Türkmenoglu, Demet Yavuz,

Abstract:

In this study, the effects of waste marbles as aggregate material on workability and hardened concrete characteristics of self compacting lightweight concrete are investigated. For this purpose, self compacting light weight concrete are produced by waste marble aggregates are replaced with fine aggregate at 5%, 7.5%, and 10% ratios. Fresh concrete properties, slump flow, T₅₀ time, V funnel, compressive strength and ultrasonic pulse velocity of self compacting lightweight concrete are determined. It is concluded from the test results that using waste marbles as aggregate material by replacement with fine aggregate slightly affects fresh and hardened concrete characteristics of self compacting lightweight concretes.

Keywords: Hardened concrete characteristics, self compacting lightweight concrete, waste marble, workability.

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Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

Abstract:

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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