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Introduction: The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. Methods: This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. Results: The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7–68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2–10.8%). Conclusion: Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to a surge in medical waste generation, posing hazards to both the environment and global health. The impacts of the COVID-19 pandemic's medical waste hazard may persist long after the pandemic itself subsides. Improper disposal of medical waste can contaminate environment, posing risks to ecosystems and public health. Discarded medical rubber gloves, for example, can become a source of infection, improper disposal of these gloves can escalate the spread of infectious diseases and increase the risk of transmission of the virus to the general public. This study proposes an innovative and sustainable method to reinforce cement mortar by adding recycled glove rubber as an additive to cement mortar to increase its resistance to impact loads. This study conducted uniaxial compression tests, separating hopkinson pressure bar (SHPB) experiments and SEM observations to evaluate the quasi-static compressive strength and dynamic stress of recycled rubber fiber mortar (RRFM) with varying recycled rubber fiber (RRF) contents (0, 1%, 2%, 3%). Strain curves, dynamic increase factor (DIF), energy absorption rules, failure modes, and microstructure of RRFM mixtures. The experimental results demonstrate that with the addition of RRF, the dynamic stress-strain curve flattens and the peak strain gradually increases. The RRFM sample shows stronger toughness. In comparison to regular cement mortar (NM), RRFM has a higher DIF and specific absorbed energy, a faster increase in dynamic compressive strength, and the ability to absorb more energy per unit volume. Under the same impact load, RRFM has fewer and smaller cracks than NM. Scanning electron microscopy (SEM) testing also observed that RRF formed a strong connection pattern with the cement mortar matrix. [ABSTRACT FROM AUTHOR]

Taiwan has been an active participant in waste recycling for a long period of time due to the need for resource sustainability. The country believes it can one day eventually achieve the goal of zero waste through the effective use of strategies such as source reduction, resource recovery, reuse, and recycling. Despite Taiwan's long‐standing commitment to waste recycling for purposes of resource sustainability, achieving the goal of zero waste remains an immense challenge. Therefore, putting into effect the previously mentioned strategies will obviously be necessary in order to realize this goal. However, the effective implementation of these strategies requires both comprehensive planning and coordination, particularly in large medical institutions. Here, we have aimed to promote waste reduction throughout the entire hospital system in Taiwan using 3 strategies: (1) standardizing the colors of garbage bags, marking patterns of waste, and reviewing and establishing an internal audit mechanism on a regular basis; (2) the systematic monitoring of individual departments with regard to on waste consumption, brands, and materials while linking departments to the procurement source management team. In addition, any related hardware has been upgraded, precisely controlled, and automatically uploaded to the cloud system for an improved intelligent management system. In addition, the Department of Nutrition has adjusted the handling of ingredients and consumption patterns of hospital employees in order to reduce food waste; and (3) with regard to the disposal of medical waste, medical centers will be consolidating and advancing the knowledge and ability of all hospital personnel through education and training programs established for them. After the implementation of this program to promote awareness, the ratio of biological waste percentage in regard to total hospital waste dropped from 37.3% in 2018 to 33.6% in 2022, with a 49% decrease being seen in food waste, and a 99.32% increase being realized in green designated procurement items. Such an efficient management of medical waste has no doubt been extremely beneficial to the hospital. [ABSTRACT FROM AUTHOR]

Traditional waste incineration generates a large amount of exhaust gas, resulting in adverse environmental impacts. Therefore, we developed an organic and intelligent photochemical processing system that utilizes high-energy lasers for incineration, thereby reducing the production of exhaust gas. A large-scale laser machine was set up, incorporating low-cost 2D Light Detection and Ranging (LiDAR) technology for system sensing, which performs angle range and threshold filtering, as well as multispectral laser allocation, integrated with the laser ablation machine system. After testing, the error was <5 mm (<8%), achieving precise object scanning and ranging and solving the problem of manual laser positioning. Experimental results showed that CO2 lasers can effectively process organic materials and medical waste of different sizes. This innovative research will have profound implications for the future development of environmental protection and incineration technologies. In the future, it has widespread application prospects in areas such as pet waste disposal and medical waste treatment. [ABSTRACT FROM AUTHOR]

This research explored the life cycle analysis and environmental cost-benefit assessment of converting ash waste from hospital medical waste incineration into environmentally safe paving block raw materials. The growing concerns about medical waste disposal and its environmental impact necessitate innovative solutions for sustainable waste management. This research aimed to evaluate the feasibility and environmental implications of reusing hospital waste into raw materials for paving block mixtures. This research, a comprehensive life cycle analysis, examined the environmental impacts of medical waste collection for the production and use of paving blocks. Additionally, we conducted an environmental cost-benefit assessment to ascertain the economic feasibility and potential environmental impact forecasts of this recycling approach. The research results show that converting hospital medical waste ash into mixed raw materials for paving blocks not only immobilizes heavy metals but also provides a sustainable alternative for non-building materials. These findings highlight the potential for significant environmental and economic benefits, making this approach a promising strategy for waste management and sustainable construction practices. The cost of preventing environmental damage (eco-cost) in the process of converting ash from the incineration of medical waste into a mixture of raw materials for paving blocks is IDR 600,180.9 per cycle. [ABSTRACT FROM AUTHOR]

Abstract Introduction The disposal of regulated medical waste (RMW) in the healthcare setting can be both costly and environmentally harmful. Prior studies have found large amounts of waste disposed of in RMW containers are inappropriately placed. Few studies to date have investigated the efficacy of waste reduction practices in the dermatology setting. Methods This study aims to evaluate the effectiveness of a practice-wide intervention in reducing RMW in the outpatient dermatology setting. By performing daily waste audits and two concurrent educational interventions, the amount of RMW produced and percent of appropriately placed RMW will be measured. Further analysis will occur by comparing pre-intervention values to post-intervention values. Results The percentage of waste properly placed in RMW containers prior to any intervention was 11%. Following both educational interventions, the percentage of waste properly placed in RMW containers increased by 56.1% (CI 43.7–68.5%) and the percentage of total waste produced that was identified and disposed of as RMW decreased by 6.0% (95% CI 1.2–10.8%). Conclusion Our study provides practical data for dermatology providers to make small changes which can result in significant reductions of regulated medical waste, potentially providing benefits to the environment and cost-savings.

Addressing the pollution problems caused by improper disposal of effluents and wastes from pharmaceutical companies and medical facilities are important for the safety of humans and animals. This work highlights the challenges and developments in medical and pharmaceutical waste management practices across the world as well as their potential for bio-energy production. It involves the study of these waste properties, their impacts on the ecosystem and treatment or recycling methods. Various studies have shown that successes have been recorded in converting some antibiotic contaminated wastewater to biogas in advance anaerobic digesters. Moreover, not all medical wastes are degradable, the use of placentas, hospital cotton waste, human urine, waste blood and surgery waste has been used in biogas plants built at close proximity to hospitals, in some cases. However, such plants are few and are only located in Tanzania, India and Philippines, among others to generate biogas to power hospitals, boil hot water needed by patients and for cooking. This is because the level of awareness as regards the dangers associated with indiscriminate disposal of medical and pharmaceutical waste is low and hence the development of waste disposal policy by countries is often overlooked. The implication of this is the spread of diseases in affected areas which can results in epidemics. It is therefore necessary to formulate policies that allow the harnessing of these wastes to biogas/ bioenergy or the creation of better waste management practices that is environmentally safe. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Pathology is the property of Canadian Association of Pathologists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Improvements in standard precaution related to infection prevention and control (IPC) at the national and local-level health facilities (HFs) are critical to ensuring patient's safety, preventing healthcare-associated infections (HAIs), mitigating Antimicrobial Resistance (AMR), protecting health workers, and improving trust in HFs. This study aimed to assess HF's readiness to implement standard precautions for IPC in Nepal. Methods: This study conducted a secondary analysis of the nationally-representative Nepal Health Facility Survey (NHFS) 2021 data and used the Service Availability and Readiness Assessment (SARA) Manual from the World Health Organization (WHO) to examine the HF's readiness to implement standard precautions for IPC. The readiness score for IPC was calculated for eight service delivery domains based on the availability of eight tracer items: guidelines for standard precautions, latex gloves, soap and running water or alcohol-based hand rub, single use of standard disposal or auto-disable syringes, disinfectant, safe final disposal of sharps, safe final disposal of infectious wastes, and appropriate storage of infectious waste. We used simple and multiple linear regression and quantile regression models to examine the association of HF's readiness with their characteristics. Results were presented as beta (β) coefficients and 95% confidence interval (95% CI). Results: The overall readiness scores of all HFs, federal/provincial hospitals, local HFs, and private hospitals were 59.9±15.6, 67.1±14.4, 59.6±15.6, and 62.6±15.5, respectively. Across all eight health service delivery domains, the HFs' readiness for tuberculosis services was the lowest (57.8±20.0) and highest for delivery and newborn care services (67.1±15.6). The HFs performing quality assurance activities (β = 3.68; 95%CI: 1.84, 5.51), reviewing clients' opinions (β = 6.66; 95%CI: 2.54, 10.77), and HFs with a monthly meeting (β = 3.28; 95%CI: 1.08, 5.49) had higher readiness scores. The HFs from Bagmati, Gandaki, Lumbini, Karnali and Sudurpaschim had readiness scores higher by 7.80 (95%CI: 5.24, 10.36), 7.73 (95%CI: 4.83, 10.62), 4.76 (95%CI: 2.00, 7.52), 9.40 (95%CI: 6.11, 12.68), and 3.77 (95%CI: 0.81, 6.74) compared to Koshi. Conclusion: The readiness of HFs to implement standard precautions was higher in HFs with quality assurance activities, monthly HF meetings, and mechanisms for reviewing clients' opinions. Emphasizing quality assurance activities, implementing client feedback mechanisms, and promoting effective management practices in HFs with poor readiness can help to enhance IPC efforts. [ABSTRACT FROM AUTHOR]

'Good health and well-being" (SDG3) is one of the 17 integrated sustainable development goals (SDG) adopted by the United Nations in 2015. When it comes to health and well-being, pharmaceuticals play a vital role. Pharmaceutical waste and contaminants of emerging concern (CEC) produced during the manufacturing, supply, usage and disposal of drugs, chemicals and personal care products can significantly affect the environment. Some serious global problems have been attributed, at least partly, to the prevalent practices in this sector. With increased awareness, regulations and corporate environmental responsibility, the pharmaceutical industry is making efforts toward sustainability through measures like green production, green technology, improved supply chains, collaborations and strategic partnerships. However, the need is still felt for additional measures to be incorporated into the practice like a circular economy, based on the 4Rs (reduce, recycle, reuse, recover); Artificial Intelligence (AI) can be used to recognise the best way to obtain maximum yield with minimum cost from available resources in an environment-friendly manner for the benefit of society; encouraging the use of renewable energy and promoting research focused on environmental supportive and profitable measures. The journey towards sustainable pharma is complex and requires collaboration across the entire value chain from all the stakeholders, but the benefits to society, the environment and the industry are profound and far-reaching. [ABSTRACT FROM AUTHOR]

Background: Medications including unused ones, might lead to financial and environmental costs. Not only they could have economic impact but also, harm the population safety. However, the nature and extent of leftover and unused medications in Saudi families and its economic impact remain unknown. Objectives: The aim of this study is to assess the potential economic cost of the unused medications in Saudi households. Method : A cross-sectional, observational study was conducted using a snowball method for recruiting the families. Descriptive data were collected face to face using a structured questionnaire. Result: A total of 116 family included in the study, 536 unused medications were found in their houses during the study period (December 2021- April 2022). Approximately, 42 % (227) of unused medications were stopped due to symptoms improvement. A total of 56 types of unused medications with different dosage forms were found at houses because of receiving excess medication in the packet (17%, 90) and purchased for emergency (14% 78) use. The total cost was SR 26249. ($ 6995.60) for the unused medications which found at 116 households. Of the total 41(34%) of the total households with unused medication have unused medication range between 1-99SR. The stoke of left over medication worth of above 500 SR for around six (5%) of the families. Conclusion: A significant number of unused medications were found at family's. The study also identified that there were different reasons for unused medications that can be prevented. The unused medications result in relatively high economic impact. Educational interventions are highly needed for families on unused medications. [ABSTRACT FROM AUTHOR]

Objective Unsafe opioid-related practices can lead to abuse, diversion, and accidental overdoses. In this study, we aimed to describe the patterns and beliefs regarding the storage, disposal, and use of opioids among Chinese patients with cancer in their home settings, which remain unclear. Methods A multicenter cross-sectional survey was conducted in Hubei Province from October 2022 to June 2023. We collected information on the storage, disposal, and use of opioids among cancer pain inpatients in the oncology department. Logistic regression was used to estimate the factors associated with unsafe disposal and use of opioids. Results The survey included 221 patients with a median age of 62 years. Only 3.2% stored their opioids under lock and key, and 49.8% were unaware of proper disposal methods. Nearly one-fifth (19.5%) reported having received information on the safe storage (14.0%) and/or disposal (10.0%) of opioids. A total of 44.3% reported unsafe use by sharing (1.8%), losing (4.1%), or taking opioids at a higher dose than prescribed (42.5%). Patients who did not receive information on the safe disposal of opioids (OR = 4.57, P  = .0423), had a history of alcohol use (OR = 1.91, P  = .0399), and used opioids other than morphine (OR = 2.31, P  = .0461) had higher odds of unsafe disposal practices. Individuals with an associate degree/bachelor's degree or above were less likely to dispose of (OR = 0.36, P  = .0261) and use (OR = 0.31, P  = .0127) opioids unsafely. Conclusion A significant proportion of Chinese patients with cancer exhibit unsafe practices in the storage, disposal, and use of opioids. The study highlights an urgent need for implementing routine education programs and drug "take-back" initiatives to improve opioid-related practices. [ABSTRACT FROM AUTHOR]

Medical wastes include the wastes created by biomedical research institutes, medical labs, and hospitals. Through exposure to infectious pathogens, improper waste treatment causes substantial hazards of disease transmission to waste workers, waste pickers, patients, health workers, and the population in general. Poor waste management releases dangerous and detrimental constituents into society. However, due of the volumes of wastes generated and its infectious nature, contamination of highly contagious agents such as the sudden pandemic has created huge instability in medical waste treatments and consequent recycling. Several nations have implemented safety procedures to counteract this pollution and manage medical wastes; nevertheless, these efforts are inadequate and vary depending on the nation. Moreover, worldwide organizations have recognized recommendations for the handling of medical wastes. Those rules are aiding in the management of highly infectious medical wastes generated by all-medical centers. Instead of sending things to landfills, proper medical wastes management may make available value by limiting disease transmission and enhancing recyclability. Disinfecting and classifying medical wastes enables for more sustainable management and reuse of important resources. This paper addresses the various medical solid wastes environmental impacts, management and disposal techniques used in various nations, the issues encountered throughout these strategies, and potential solutions to these challenges. [ABSTRACT FROM AUTHOR]

In the last several decades, Iran's ecosystem has suffered due to the careless usage of natural resources. Cities have grown in an uneven and non-normative way, and poor project management has been a major issue, particularly in large cities. An even greater number of environmental factors and engineering regulations are not relevant to projects. Because of this, in order to ascertain a project's environmental impact, an environmental impact assessment (EIA), is required. Using the rapid impact assessment matrix (RIAM) is one method of applying it to EIA. Reducing subjectivity brings objectivity and transparency. During the COVID-19 pandemic, a thorough EIA was carried out for the Tehran project utilizing the RIAM and other possibilities. This research is the first to combine the methodology that was discussed during the incident. Through the use of the RIAM technique, the environmental impact of COVID-19 was to be quantified in this inquiry. The research examined lockdown procedures and the COVID-19 pandemic to create an EIA indicator. In a real-world case study conducted in Tehran, Iran, the impact of the initiative was evaluated using the RIAM methodology during the COVID-19 epidemic. The results demonstrated that COVID-19 had both beneficial and harmful effects. Decision-makers were effectively informed about the COVID-19 pandemic's environmental consequences on people and the environment, as well as how to minimize negative effects, according to the EIA technique that used RIAM. This is the first research to integrate the EIA during a crisis, such as the COVID-19 pandemic, with the RIAM approach. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to enhance medication management efficiency by introducing a systematic approach to redistributing medications to high-utilization zones, thereby mitigating the volume and expenses associated with non-returnable expired medications. Methods: This quality improvement initiative encompassed 2 key phases. Initially, a standardized workflow for managing expiring medications was implemented across 2 satellite pharmacy areas. Subsequently, the impact of these interventions was assessed by comparing pre-implementation and post-implementation data on the quantity and monetary value of expired medications. Baseline data were derived from expired medication records spanning January 1, 2022, to December 31, 2022. The new workflow was established in December 2022, and post-implementation data were collected from January 1, 2023, to March 31, 2023. The process rollout involved devising workflow protocols, creating supportive documentation, and delivering training to pharmacy personnel. Data collection encompassed medication identifiers, stock locations, date medications were received, expiration dates, along with wholesale acquisition cost for each item. Descriptive statistical methods were employed for analysis. Results: Comparative analysis of pre-implementation and post-implementation data revealed substantial reductions in the annual estimated quantity of expired medications (284 fewer items, representing a 13.6% decrease) and corresponding wholesale acquisition costs ($5075 USD reduction, translating to a 19.7% decrease) within the satellite areas during the study period. Moreover, a comparison of post-implementation quarter one data with the corresponding data from the previous year highlighted even more significant reductions in the quantity of expired medications (203 fewer items, reflecting a 31.1% decrease) and associated wholesale acquisition costs ($2548 USD reduction, signifying a 33.0% decrease) within the satellite areas. Conclusions: This study underscores the potential advantages of employing a standardized process to proactively reallocate medications prior to their expiration, thereby enabling their utilization in other hospital sections. Future endeavors could concentrate on the wider implementation of similar workflows throughout different hospital locations and the broader enterprise. [ABSTRACT FROM AUTHOR]

Increased waste in health care is a widespread problem. Currently, modern clinical practices favour single-use products and pre-packaged supply kits. Many of these consist of various types of plastics. By weight, up to 25 per cent of total hospital waste is plastics. Common plastics used are polyethylene terephthalate, polypropylene, polyethylene, polyvinylchloride and polyurethane. Polyethylene terephthalate represents the highest volume, and accounts for 40 per cent of the plastics used in operating rooms. Health care has an enormous ecological footprint. Around the world, health care waste management strategies and clinician activities are starting to address how health care affects our planet and public health. Recovery of valuable waste, or product stewardship, is one of these strategies. In many countries, product stewardship in health care is still non-existent or unregulated. Clinicians and health service organisations must make product stewardship in health care an integral part of sustainable procurement and health care business activities. In addition, sustainable solutions require the engagement of suppliers of plastic packaging who can contribute to reducing waste in health care and minimising the impact of plastics on the environment and public health. [ABSTRACT FROM AUTHOR]

Over the past decade, the global outbreaks of SARS, influenza A (H1N1), COVID-19, and other major infectious diseases have exposed the insufficient capacity for emergency disposal of medical waste in numerous countries and regions. Particularly during epidemics of major infectious diseases, medical waste exhibits new characteristics such as accelerated growth rate, heightened risk level, and more stringent disposal requirements. Consequently, there is an urgent need for advanced theoretical approaches that can perceive, predict, evaluate, and control risks associated with safe disposal throughout the entire process in a timely, accurate, efficient, and comprehensive manner. This article provides a systematic review of relevant research on collection, storage, transportation, and disposal of medical waste throughout its entirety to illustrate the current state of safe disposal practices. Building upon this foundation and leveraging emerging information technologies like Internet of Things (IoT), cloud computing, big data analytics, and artificial intelligence (AI), we deeply contemplate future research directions with an aim to minimize risks across all stages of medical waste disposal while offering valuable references and decision support to further advance safe disposal practices. [ABSTRACT FROM AUTHOR]

Introduction: Special and infectious wastes are the most significant wastes generated in hospitals, health centers, and similar facilities. Reducing and recycling such wastes at the source pose significant challenges to waste management. Therefore, this study assesses the components of healthcare waste in terms of their recyclability, emphasizing different types of plastic. Materials and Methods: Data collection involved sampling normal and infectious waste in selected hospitals over three months using monthly checklists. The total waste generated in these hospitals was analyzed on a daily basis. Moreover, the average microbial load of infectious waste was determined through microbial strip tests and biological tests following patient companion. Tests were performed with the acceptable performance of safe hospital devices with the destruction of microorganisms. Results: Average waste composition in the selected hospitals included 65-70% general waste and 30-35% infectious waste. The most common generated infectious waste was polyethylene (PE) sets (800 kg/month), while the predominant general waste was nylon bags for polyethylene terephthalate (PETE) packaging (520 kg/month). Hospital 1 had the highest per capita production of recyclable waste, generating 7,900 kg and 2,550 kg of normal and infectious waste per month, respectively. The total revenue generated from selling normal and infectious plastic waste was 1.4 and 0.2, respectively. Conclusion: The mixing of waste can be prevented by properly segregating normal and infectious waste and adequate staff training. Given the escalating disposal costs of health-care waste (HCW) and the shrinking space in landfills, efforts to minimize waste generation are crucial for effective recycling and reuse processes.

This article discusses the issue of biomedical waste management in the healthcare sector and its impact on sustainability. It emphasizes the need for awareness among hospital staff and the general population to ensure proper disposal and management of biomedical waste. The article highlights the potential implications of inadequate waste management on public health and the environment. It also provides an overview of the different types of healthcare waste and the methods used for treatment and disposal. The article concludes that effective waste management strategies are necessary to mitigate the adverse effects of healthcare waste and protect human health and the environment. Additionally, the article presents the findings of a study conducted in South Delhi hospitals, which revealed a lack of knowledge and adherence to safe practices among healthcare staff, particularly nurses. The low percentage of staff vaccinated against Hepatitis B is also highlighted as a concern for preventing needle stick injuries. The article concludes by suggesting strategies to improve biomedical waste management and reduce its impact on the environment. The given document is a list of references to various articles and studies related to biomedical waste management in the healthcare industry, providing valuable information for library patrons conducting research on the topic. [Extracted from the article]

Background: People worldwide are concerned with the possibility of climate change, microplastics, air pollution, and extreme weather affecting human health. Countries are implementing measures to reduce environmental impacts. Nurses play a vital role, primarily through Green Teams, in the process of promoting sustainable practices and minimizing the environmental footprint of health care facilities. Despite existing knowledge on this topic, assessing nurses' environmental awareness and behavior, including the barriers they face, is crucial with regard to improving sustainable health care practices. Aim: To analyze the environmental awareness and behavior of nurses, especially nurse leaders, as members of the Green Team and to identify areas for improvement with regard to the creation of a sustainable environment. Methods: A sequential mixed-method study was conducted to investigate Spanish nurses. The study utilized an online survey and interviews, including participant observation. An online survey was administered to collect quantitative data regarding environmental awareness and behavior. Qualitative interviews were conducted with environmental nurses in specific regions, with a focus on Andalusia, Spain. Results: Most of the surveyed nurses (N = 314) exhibited moderate environmental awareness (70.4%), but their environmental behavior and activities in the workplace were limited (52.23% of participants rarely performed relevant actions, and 35.03% indicated that doing so was difficult). Nurses who exhibited higher levels of environmental awareness were more likely to engage in sustainable behaviors such as waste reduction, energy conservation, and environmentally conscious purchasing decisions (p < 0.05). Additionally, the adjusted model indicated that nurses' environmental behavior and activities in the workplace depend on the frequency of their environmental behaviors outside work as well as their sustainable knowledge (p < 0.01). The results of the qualitative study (N = 10) highlighted certain limitations in their daily practices related to environmental sustainability, including a lack of time, a lack of bins and the pandemic. Additionally, sustainable environmental behavior on the part of nursing leadership and the Green Team must be improved. Conclusions: This study revealed that most nurses have adequate knowledge, attitudes, and behaviors related to environmental sustainability both inside and outside the workplace. Limitations were associated with their knowledge and behaviors outside of work. This study also highlighted the barriers and difficulties that nurses face in their attempts to engage in adequate environmental behaviors in the workplace. Based on these findings, interventions led by nurses and the Green Team should be developed to promote sustainable behaviors among nurses and address the barriers and limitations identified in this research. [ABSTRACT FROM AUTHOR]

Copyright of University of Health Sciences Journal of Nursing is the property of Saglik Bilimleri Universitesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To identify evidence-based interventions that reduce greenhouse gas emissions in health-care systems in low- and middleincome countries and explore potential synergies from these interventions that aid climate change adaptation while mitigating emissions. Methods We systematically searched 11 electronic databases for articles published between 1990 and March 2023. We assessed risk of bias in each article and graded the quality of evidence across interventions in health-care operations, energy and supply chains. Findings After screening 25 570 unique records, we included 22 studies published between 2000 and 2022 from 11 countries across six World Health Organization regions. Identified articles reported on interventions spanning six different sources of emissions, namely energy, waste, heating and cooling, operations and logistics, building design and anaesthetic gases; all of which demonstrated potential for significant greenhouse gas emission reductions, cost savings and positive health impacts. The overall quality of evidence is low because of wide variation in greenhouse gas emissions measuring and reporting. Conclusion There are opportunities to reduce the greenhouse gas emissions from health-care systems in low- and middle-income countries, but gaps in evidence were identified across sources of emissions, such as the supply chain, as well as a lack of consideration of interactions with adaptation goals. As efforts to mitigate greenhouse gas intensify, rigorous monitoring, evaluation and reporting of these efforts are needed. Such actions will contribute to a strong evidence base that can inform policy-makers across contexts. [ABSTRACT FROM AUTHOR]

Objective: This review aims to address the critical role of sample size calculation in designing and conducting animal studies related to diabetes and obesity, particularly focusing on experimental comparison methods like ANOVA design. Materials and Methods: We discuss the factors influencing sample size decisions, including type I and type II errors, effect size, and standard deviation. We emphasize the importance of avoiding common pitfalls, such as using rules of thumb or arbitrary choices, and advocate for utilizing established formulas to ensure accurate and reliable sample size determination. Results: This review presents relevant equations for calculating sample size in animal studies with an ANOVA design, providing researchers with a framework for determining the appropriate number of animals needed to achieve robust and ethical research. Conclusion: Accurate sample size calculation is essential for achieving powerful and statistically sound animal studies in diabetes and obesity research. Utilizing established formulas and avoiding arbitrary choices ensures reliable and ethical research practices while minimizing resource waste and maximizing the validity of collected data. [ABSTRACT FROM AUTHOR]

Background: Biomedical waste is unwanted materials that contains potentially infectious elements and produced during medical procedures such as diagnosis, therapy, surgery, vaccination, or research. Healthcare waste poses serious dangers to public health and the environment, making its management crucial. This study aimed to assess knowledge and practices of nursing staff regarding biomedical waste management at rural health units in Tanta city. Research design: Descriptive study design was utilized to achieve the aim of this study. Setting: This study was conducted at 14 rural health units affiliated to Tanta district. Sample: All the available nursing staff working (325) at the previous mentioned settings was included in this study. Tool of the study: A structured questionnaire sheet was used including three parts: (1) Socio-demographic characteristics of the studied nursing staff, (2) Nurses' knowledge regarding biomedical waste and its management (3) Self-reported practices of nursing staff regarding biomedical waste management. Results: 43.4% nurses who were studied knew very little about biomedical waste management and 60.6% had unsatisfactory reported practice. Conclusion: Highly a statistically significant positive association between the study nurses' overall knowledge score and their overall reported practice score regarding biomedical waste management (p < 0.001). Recommendation: It is essential to identify nurses training needs regarding safe waste management policies and guidelines through ongoing evaluation of nurses' expertise and methods in waste control in health care units. [ABSTRACT FROM AUTHOR]

Background: Blood wastage leads to additional costs and reduced blood availability to patients. Above all is the moral issue of wasting donor gifts. This study aimed to determine the rate of blood wastage before and after implementing a new standard operating procedure (SOP) in Iran. Methods: In this interventional study, a SOP for wastage management was prepared and implemented in all blood centers throughout the country. Data were extracted from the integrated software of the Iranian Blood Transfusion Organization (IBTO). The wastage rate of blood components in the post-intervention years (2016-2017) was then compared with that in the pre-intervention years (2013-2015) using the Z test. Results: The overall wastage rate decreased by 36.86% (P < 0.001, 95% CI [36.84-36.88]) after the intervention. Red blood cell (RBC) wastage decreased from 2.6% to 2.5%, platelet wastage from 19.5% to 10.6% and plasma wastage from 15.5% to 7.3% (P < 0.001). The highest percentage of waste reduction pertained to plasma components, which decreased by 52.90% (P < 0.001, 95% CI [52.86-52.94]). Expiration was the most common cause of RBC and platelet wastage. The most common causes of plasma wastage were RBC contamination and rupture or leakage of the bags. The intervention resulted in a drop of over 250 000 discarded components each year, equal to approximately thirty-six million dollars in savings. Conclusion: This intervention effectively reduced waste and increased efficiency. Ongoing blood wastage reviews, auditing, and receiving feedback from the central headquarters were powerful tools in following the compliance of blood centers. Further studies are recommended, especially concerning blood wastage in hospital blood banks and various wards. [ABSTRACT FROM AUTHOR]

Proper disposal of waste medical masks has become increasingly urgent in order to protect the ecosystem. Our exploratory study has proven the feasibility of producing waste mask microfibers (WMMF) and pretreating them with graphene oxide (GO) to enhance the strengths of cement composites. This study further explored the resistance of designed WMMF/GO-WMMF mortar (w/c of 0.40) to chloride migration and frost damage, to address the knowledge gap related to durability. The GO-pretreated WMMF improved the chloride migration resistance (by ∼50%) and the freeze–thaw resistance (by ∼20%), likely due to the tortuosity-increasing, hydration-accelerating, and hydrates-regulating roles of GO in the cementitious material. The microscopic investigation, including backscatter electron imaging, scanning electron microscopy, and thermogravimetric analysis, shed light on the mechanistic roles of GO and WMMF in cement composites. In addition, the two-parameter Weibull distribution was employed to model the frost damage and compare the remaining capacity of freeze–thaw resistance of the three designed mortar samples at the same reliability level; the Bayesian method was also utilized to model the uncertainty during the cyclic freeze–thaw process. [ABSTRACT FROM AUTHOR]

This study explores the progression of global healthcare and medical waste (HMW) disposal technologies and emerging practices in China including the COVID-19 pandemic period through patent technology innovation analysis. Trends were identified through both the Derwent Innovation Index database and bibliometric methods. Based on the bibliometric analysis of 4128 patents issued from 2002 to 2021, the development status and research trends of HMW disposal technology were revealed. Regarding patents, China significantly advanced post-2011. However, a large number of applications are filed only in China and are more focused on domestic rather than overseas markets. As the pandemic remains a threat, and increasing amounts of medical waste are generated, new technologies are being sought in China that will be safer for humans and the environment, and will also be in line with the zero waste technology trend. Incineration and waste crushing are core methodologies in medical waste disposal. Future directions pivot towards innovations in large-scale and distributed processing equipment, automation and unmanned systems and high-temperature steam disinfection collaborative disposal methods—including the "High temperature steam–municipal solid waste incineration collaborative technology" and the "High temperature steam–thermal magnetic gasification collaborative technology". This patent analysis enhances our understanding of the impact of COVID-19 on HMW disposal practices, guiding improved policymaking and research in the HMW sector. [ABSTRACT FROM AUTHOR]

Background: In dental practices, biomedical waste (BMW) management is essential to preserving a clean and safe atmosphere for patients and medical personnel. Dental facilities generate different forms of BMW, which include sharps, contaminated materials, and/or potentially infectious substances, which require proper handling, storage, and disposal to minimize the risk of infection and environmental contamination. Aim: The study aimed to assess the knowledge and awareness of BMW management among dental students in Chennai city using paper-based questionnaire. Materials and Methods: An observational cross-sectional survey containing 28 questions was framed to assess the knowledge and awareness of BMW management among the final-year BDS, interns, and postgraduate students (a total of 100 students). Statistical analysis was done using SPSS version 27.0. Results: The results of our study showed statistically significant results with P = 0.01 among the study groups. The overall knowledge, attitude, and practice score was observed to be 67.5% for final-year BDS students, 68.09% for interns, and 71.76% for postgraduates. Conclusion: The knowledge assessed was found to be average among the participants. Hence, proper training and assessment are necessary for the proper handling and practice of BMW management. [ABSTRACT FROM AUTHOR]

Any hospital's primary goal is to restore human health and save lives through health services provided to patients, but at the same time, hazardous wastes are produced. Inconsistent management of unsafe wastes might cause adverse effects and other issues for workers, the environment, and public health. Segregation is considered the critical stage in successful medical waste management. Mixing hazardous medical waste with non-hazardous medical waste will be avoided by correctly applying practices at the segregation stage. This study aimed to assess personnel's knowledge about infectious medical waste and segregation practices used at six wards in Nicosia General Hospital. An analytical cross-sectional study was conducted, and data were collected through a structured self-administered questionnaire. The Statistical Package of Social Science (SPPS) version 25 was used with a minimum statistical significance of α = 0.05. The study population was nurses, nurse assistants, ward assistants, and cleaners working at the study wards. Out of 191 questionnaires, 82 were received, with a response rate of 42.93%. Most participants were female (72%) and nurses (85.4%). Participants had moderate knowledge about infectious medical waste management and good knowledge regarding segregation practices applied in their ward. Segregation was not carried out as it should have been, since most participants stated that infectious medical waste was mixed with non-hazardous medical waste. The number of correct answers the participants gave regarding the colour-coding of different medical waste categories was 67.5%, and only four answered correctly to all questions. Although participants knew segregation practices and the colour-coding process applied to medical waste, they did not use them satisfactorily. They applied methods regarding segregation without specific training, knowledge and guidance. Due to the issue's importance, training programs must be implemented and performed. [ABSTRACT FROM AUTHOR]

Background. Tokunoshima is a remote island in the Amami Islands, 470 km southwest of the Kagoshima mainland. It has a population of 23,000 and consists of three towns: Tokunoshima, Isen, and Amagi. Three medical institutions on the island are responsible for blood transfusion medicine, but there is no blood stockpiling station on the island, and blood is stockpiled in each of the hospitals. Although Tokunoshima Tokushukai Hospital is responsible for 70% of transfusion medicine on Tokunoshima, it is difficult to maintain a sufficient amount of blood in stock considering disposal. Aim. To determine whether changing the distribution of blood types in a hospital's stockpile would reduce the transfusion disposal rate. Methods. This was a retrospective survey. By changing the in-house stock of blood products for transfusions delivered to our hospital over 10 years from January 2013 to December 2017 (preintervention) and from January 2018 to December 2022 (postintervention), we compared the cost-saving effects of these two intervention strategies on disposal rates and blood inventories, as well as the survival rates of case profiles requiring transfusion interventions in hospital-donated transfusion and ABO-incompatible transfusion between two periods. The hospital's stock of RBC had changes that storage of type (A, B, O, AB) RBC from (4, 4, 4, 2) units in the pre-interventon to (2, 2, 6, 0) units in the postintervention. Results. The annual blood product waste rate decreased from 23.4% in the preintervention period to 17.9% in the post-intervention period. Conclusion. By changing the blood products stockpiled for transfusion medicine in Tokunoshima, the transfusion disposal rate can be reduced. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused a surge in essential medical supplies usage, leading to a notable increase in medical waste generation. Consequently, extensive research has focused on sustainable disposal methods to handle used medical equipment safely. Given the necessity to evaluate these methods considering qualitative and quantitative criteria, this falls within the realm of multi-criteria decision-making (MCDM). This study introduces a framework for selecting the most suitable medical waste treatment methods, taking into account economic, technological, environmental, and social aspects. Sixteen criteria were assessed using the Fuzzy Preference Selection Index (F–PSI) to determine the optimal waste disposal approach. Additionally, the Fuzzy Compromise Ranking of Alternatives from Distance to Ideal Solution (F-CRADIS) method was employed to evaluate nine technologies for medical waste disposal. Notably, disinfection efficiency emerged as the most crucial criterion, with autoclaving identified as the preferred method for medical waste treatment. A practical case study conducted in Sivas, Turkey, validates the feasibility of these strategies. Multiple sensitivity analyses were performed to ensure the stability and reliability of the proposed approach.

Abstract Background Several studies revealed that medical students have low performance levels of hand hygiene (HH) and biomedical waste management (BMWM). However, there have been limited interventions directed at young students targeting HH and BMWM enhancement. Given these data, we aimed at assessing HH and BMWM among medical students after two training methods. Methods We performed a quasi-experimental study from September 2021 to May 2022, which included fifth-year medical students enrolled in the faculty of Medicine of Monastir (Tunisia). We relied on a conventional training based on presentations and simulations guided by the teacher and a student-centred training method based on courses and simulated exercises prepared by students. We used the WHO HH Knowledge Questionnaire and the “BMWM audit” validated by The Nosocomial Infection Control Committee in France. Results A total of 203 medical students were included (105 in the control group and 98 in the experimental group) with a mean age of 23 ± 0.7 years. Regarding HH, we found a statistically significant increase in post-test scores for both training methods. A higher post-test mean score was noted for student-centred method (14.1 ± 1.9 vs. 13.9 ± 2.3). The overall improvement in good HH knowledge rates was greater after student-centred method compared to conventional training (40.5% vs. 25%). Concerning infectious waste, mean scores were higher after student-centred learning in all hazardous waste management steps (25 ± 3.3 vs. 23.6 ± 5.5). Results Coupling student-centred teaching and continuous supervision could improve HH and BMWM knowledge and practices among medical students.

Background: Expansion of pharmaceutical industries and improved availability of pharmaceuticals across the world have contributed to an increase in drug usage and accumulation in homes. Improper disposal of expired and unused medications has several consequences such as environmental pollution, and childhood poisoning. Objectives: The aim of the study was to assess the knowledge on disposal as well as disposal practices of unused and expired household medicines in the Parker Corner Road Community in Brewerville, Liberia. Methods: This study was a cross-sectional survey conducted among 162 residents of Parker Corner Road Community using face-to-face interviews. Outcomes measured were knowledge of disposal as well as disposal practices of unused and expired household medicines. The data collected were analysed using descriptive statistics. Results: Majority of respondents (55.6%) were female and 23.5% had university education. 71% of the respondents reported that they had not received any information on safe disposal practices while 64.2% admitted that they often did not read and follow disposal instructions. The most popular disposal practices were disposal of the drugs along with household waste (61.1%) and flushing them down the toilets or sinks (25.3%). Majority of the respondents (82.1%) were aware of the health effects arising from improper disposal of unused and expired medicines while 64.2% usually read medicine disposal instruction on the package. Only about 3% of them knew of expired medication take-back system and 33.3% knew nothing about medication expiration date. Conclusion: The study revealed insufficient knowledge as well as inappropriate disposal practices of unused and expired medicines among residents of Parker Corner Road Community in Brewerville. There is need to organize a public enlightenment programme on safe, appropriate use, as well as disposal of unused and expired medicines.

Background: The world faces a significant global health threat – climate change, which makes creating more environmentally sustainable healthcare systems necessary. As a resource-intensive specialty, anesthesiology contributes to a substantial fraction of healthcare's environmental impact. This alarming situation invites us to reconsider the ecological health determinants and calls us to action. Methods: We conducted a single-center qualitative study involving an online survey to explore the environmental sustainability from anesthesia providers' perspectives in a center implementing internal environmentally-sustainable anesthesia guidelines. We asked care providers how they perceive the importance of environmental issues in their work; the adverse effects they see on ecological sustainability in anesthesia practice; what measures they take to make anesthesia more environmentally friendly; what barriers they face in trying to do so; and why they are unable to adopt ecologically friendly practices in some instances. Using a thematic analysis approach, we identified dominating themes in participants' responses. Results: A total of 62 anesthesia providers completed the online survey. 89% of the participants stated that environmental sustainability is essential in their work, and 95% reported that they implement measures to make their practice greener. A conscious choice of anesthetics was identified as the most common step the respondents take to reduce the environmental impact of anesthesia. Waste production and improper waste management was the most frequently mentioned anesthesia-associated threat to the environment. Lacking knowledge/teaching in sustainability themes was recognized as a crucial barrier to achieving ecology goals. Conclusions: Sustainable anesthesia initiatives have the potential to both encourage engagement among anesthesia providers and raise awareness of this global issue. These findings inspire opportunities for action in sustainable anesthesia and broaden the capacity to decrease the climate impact of health care. [ABSTRACT FROM AUTHOR]

Introduction: To date, there is limited literature to guide emergency providers (EPs) on the proper dosing of prescription opioids. Our study aims to assess the self-reported opioid use, storage, and disposal practices of patients presenting to the emergency department (ED) with acute pain. Methods: This prospective cohort study employed a validated, cross-sectional survey of subjects identified using electronic medical records. The survey link was e-mailed to a continuous sample of eligible participants 3–4 weeks following ED discharge. Nonrespondents were surveyed through telephone after 1 week. We used descriptive and nonparametric statistics to report survey results. Results: Of 500 eligible subjects, 97 completed the questionnaire. Only 28% of respondents reported that they took all of the prescribed pills. Of the remaining responses, 20% stated that they did not take any pills, 33% took about one-fourth, 7.2% took about half, and 12.4% took about three-fourths of the pills. Among those who did not take any pills, 42% filled the prescription. Most (71.2%) reported storing their leftover pills; among those who stored their pills, less than one-fourth (23.8%) used a locked storage location. Conclusions: Our findings suggest that less than one-third of patients who receive prescriptions in the ED for acute pain use all of their prescribed pills, suggesting that many patients are unnecessarily prescribed opioids for acute conditions. The findings of this study also suggest that many patients with unused prescription opioids do not practice safe storage or proper disposal of leftover pills. This represents a potential opportunity for EPs to improve medication safety by educating patients on proper storage and disposal practices. Limitations include low response rate and the use of self-reporting. [ABSTRACT FROM AUTHOR]

Background: The reverse logistics of medicines consists of the logistical procedure of collection, transport, storage, treatment and final disposal of postconsumer or expired waste. Medicines can be toxic to the environment and affect the health of citizens of the territory. Community pharmacies, as a health facility, play a key role in this process. Objectives: Define the spatial analysis and cases of reverse logistics of medicines in community pharmacies in Brazil. Methods: This is a cross-sectional study, and the research covered the medicines collected by 400 community pharmacies in the period from 2020 to 2022. To obtain the data, the medicines were collected, weighed, segregated and the weight released on a dedicated waste management platform. All regions of Brazil subject to georeferencing were processed using the free software Geographic Information System (QGIS). Data were expressed as median and range or as frequency of occurrence. Chi-square t-test and Fisher's exact test were used to compare variables. The accepted significance level was 5%. Results: Of the five existing regions in Brazil, only three had records of reverse medication logistics. 4,519.74 Kg of products were collected, and the North region of Brazil was responsible for 69.1% of the collection. In the spatial analysis, it was possible to perceive a difference between the areas of concentration of the RDL, that is, locations where collections were carried out in the period from 2020 to 2022. Conclusion: The present study preliminarily analyzed the reverse logistics of medicines in Brazil. The data obtained can contribute to the knowledge of this area and to the strengthening of the process. Thus, these places must exercise a task force for the educational process of the population about the risks of incorrect disposal of medicines and that this could harm the environment, economic aspects of society, food and the entire context that involves health and well-being of citizens. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Good health and a safe environment are essential for sustainable development, including the appropriate management of healthcare wastes. The study intends to assess the generation rate and management methods of healthcare waste in the regional hospital center and a private clinic in Tangier, Morocco, with a focus on potential risks to health workers from infectious diseases. METHODS: The study collected data on healthcare waste generation over a period of two months by measuring and analyzing general and hazardous waste using an electronic scale. The data was presented as averages in kilograms per bed per day and as percentages. A questionnaire was provided to 100 healthcare workers. It included questions on their sociodemographic characteristics and their knowledge and attitudes regarding healthcare waste management. FINDINGS: The case study revealed that the healthcare waste production in the two institutions varied, with the private clinic producing 0.76 kilograms per day per bed and the regional hospital center producing 1.84 kilograms per day per bed. The survey also discovered that the hazardous fraction of waste generated in the regional hospital center was 40 percent, which was much higher than the World Health Organization's estimation. The daily amount of hazardous waste generated increased from 260.49 kilograms to 436.81 kilograms post-COVID-19. The survey found gaps in knowledge, attitudes, and daily challenges in waste management practices among the health workers in both facilities. CONCLUSION: The survey findings suggest that the healthcare waste management methods in Tangier are unsafe and may endanger the health workers and patients. The study found that the lack of monitoring and control contributed significantly to noncompliance with good practices. These findings can be used by the regional divisions of the Ministry of Health to develop specific protocols for managing sanitary emergencies and perform routine observation and training at all levels in the two facilities studied. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic actualized questions about the proper management of biomedical waste while creating several regulatory challenges and requiring countries to look for an appropriate response. These issues have become particularly relevant for Kazakhstan, where waste management issues traditionally face inefficient legal regulation and are particularly acute. This study aims to answer the question of what regulatory problems Kazakhstan currently face in the area of proper biomedical waste management, and how existing foreign experience can help solve them. The present study highlights several pertinent challenges within the context of medical waste management. These include issues concerning the licencing activities associated with waste management, the absence of well-defined regional plans for the management of medical waste and the lack of effective strategies to address the proper handling and disposal of this specific category of waste. At the same time, there are reasons to say that the country requires additional technical and expert support in the field of medical waste management. [ABSTRACT FROM AUTHOR]

In order to build a more comprehensive emergency disposal and transportation network system for medical waste, it is necessary to consider various uncertain factors and data characteristics. Therefore, in the context of intelligent transportation, this article considers the uncertainty of the quantity and regional population density of infectious medical waste generation as well as the emergency disposal of infectious medical waste under multi-cycle and multi-objective conditions, and it constructs a multi-cycle emergency disposal logistics network optimization model for infectious medical waste under uncertain conditions. Through deterministic transformation of the model and data mining of the medical waste disposal logistics network in Wuhan, China, the multi-objective model under uncertain conditions was also solved and sensitivity analyzed using the MOPSO-NSGA2 intelligent algorithm, verifying the effectiveness and superiority of the algorithm. [ABSTRACT FROM AUTHOR]

Background: Several studies revealed that medical students have low performance levels of hand hygiene (HH) and biomedical waste management (BMWM). However, there have been limited interventions directed at young students targeting HH and BMWM enhancement. Given these data, we aimed at assessing HH and BMWM among medical students after two training methods. Methods: We performed a quasi-experimental study from September 2021 to May 2022, which included fifth-year medical students enrolled in the faculty of Medicine of Monastir (Tunisia). We relied on a conventional training based on presentations and simulations guided by the teacher and a student-centred training method based on courses and simulated exercises prepared by students. We used the WHO HH Knowledge Questionnaire and the "BMWM audit" validated by The Nosocomial Infection Control Committee in France. Results: A total of 203 medical students were included (105 in the control group and 98 in the experimental group) with a mean age of 23 ± 0.7 years. Regarding HH, we found a statistically significant increase in post-test scores for both training methods. A higher post-test mean score was noted for student-centred method (14.1 ± 1.9 vs. 13.9 ± 2.3). The overall improvement in good HH knowledge rates was greater after student-centred method compared to conventional training (40.5% vs. 25%). Concerning infectious waste, mean scores were higher after student-centred learning in all hazardous waste management steps (25 ± 3.3 vs. 23.6 ± 5.5). Results: Coupling student-centred teaching and continuous supervision could improve HH and BMWM knowledge and practices among medical students. [ABSTRACT FROM AUTHOR]

This paper proposes a mathematical model of Sustainable Closed-Loop Supply Chain Networks (SCLSCNs). When an outbreak occurs, environmental, economic, and social aspects can be traded off. A novelty aspect of this paper is its emphasis on hygiene costs. As well as healthcare education, prevention, and control of COVID-19, this model offers job opportunities related to COVID-19 pandemic. COVID-19 damages lead to lost days each year, which is one of the negative social aspects of this model. COVID-19 was associated with two environmental novelties in this study. positive and negative effects of COVID-19 can be observed in the environmental context. As a result, there has been an increase in medical waste disposal and plastic waste disposal. Multi-objective mathematical modeling whit Weighted Tchebycheff method scalarization. In this process, the software Lingo is used. The COVID-19 pandemic still has a lot of research gaps because it's a new disease. An SC model that is sustainable and hygienic will be developed to fill this gap in the COVID-19 condition disaster. Our new indicator of sustainability is demonstrated using a mixed-integer programming model with COVID-19-related issues in a Closed-Loop Supply Chain (CLSC) overview. [ABSTRACT FROM AUTHOR]

COVID-19's developing trend has put the waste management systems of governments all over the world in jeopardy. The increasing rise of infectious medical waste has now become a serious problem. This paper presents a multi-period multi-objective model for designing a medical waste management system during the COVID-19 pandemic. The model aims to reduce total costs of infectious medical waste management while also reducing the environmental impact of treatment centers, disposal centers, and transportation. It also aims to maximize the suitability of treatment technology based on social considerations and reduce the risk associated with processing and transporting COVID-19 waste. Different strategic and operational decisions are taken into account that include the selection of treatment technologies, the location of treatment and disposal centers, the flow of generated medical waste between facilities, and the number of vehicles required for the medical waste transport. The model tackles the uncertainty associated with model parameters, and it uses a credibility-based possibilistic programming method to deal with uncertainties. The suggested model is solved using an interactive fuzzy programming method and the importance of social indicators for selecting treatment technology is determined using the fuzzy best–worst approach. The effectiveness of the model is demonstrated by a practical case study in Shiraz, Iran. The numerical results can help system designers to achieve the most suitable trade-off between the sustainability goals and the safety viewpoint. [ABSTRACT FROM AUTHOR]

DISCLOSURES: No funding was received for the writing of this letter. All authors were members of the National Academies study committee to which this letter refers, with Shortliffe as the chair. All committee members who contributed to the report were themselves vetted for potential conflicts of interest, as is described in the recently published version of the report. Lieu is an employee of Kaiser Permanente and the content does not represent the official views of Kaiser Permanente. The other authors have nothing to disclose.

This document contains a collection of abstracts, case reports, and studies related to anesthesia and critical care. The abstracts cover topics such as sedation during upper GI endoscopy procedures, healthcare access for people with disabilities, virtual reality hypnosis for pain management, and intranasal sedation for pediatric patients undergoing MRI scans. The case reports discuss acute kidney injury due to vancomycin toxicity and serotonin syndrome caused by multiple medications. These summaries provide valuable insights into perioperative care, anesthesia management, and medical complications. Researchers, healthcare professionals, and library patrons conducting research on healthcare topics can benefit from these findings. [Extracted from the article]

More and more serious games have been developed in recent years for patients with aging, rehabilitation, mental, and other healthcare needs. Often, such healthcare games have different experiments or evaluations associated. Rapid advancements in healthcare games see increased regulatory concerns. Unfortunately, there is no authority like the Food and Drug Administration (FDA) in United States for regulatory approvals of healthcare games. Yet, it is not appropriate to use the traditional pharmaceutical FDA approval, which is a tedious and time-consuming process, for healthcare games. We propose a Healthcare Game Blockchain (HGB) to support game developers, healthcare providers, healthcare authorities, and patients. For healthcare game developers, HGB is a common platform to deposit healthcare game prototypes or products. HGB can collect feedback data for analysis similar to drug clinical trials on efficacy and toxicity. Volunteers can be recruited for clinical trials using the healthcare games available on HGB. Once the healthcare games are accepted with a recommended usage, patient gamers can leverage the same HGB platform for treatments following the instructions of healthcare providers. HGB allows healthcare professionals to track the patient responses during their healthcare game medication. Big data analytics can be developed to monitor patient outcomes and healthcare game efficacy. Security and privacy issues are critical in healthcare data handling. HGB has the potential to resolve these limitations and inefficiencies improving data collection, data sharing, and data security by leveraging on the intrinsic properties that blockchain technology provides. This paper explores the possibility of integrating blockchain and healthcare games supporting clinical trials and treatment monitoring. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to assess staff nurses' knowledge of the health concerns connected with biomedical waste disposal. Materials and Methods: The descriptive study was performed with a sample of 50 staff nurses from a tertiary hospital. The semi-structured questionnaire was made to be used when interviewing participants. It has information about the person's age in years, religion, monthly family income, family type, marital status, previous biomedical waste management education exposure, and the source of information. Results: Participants were between the ages of 20 and 60. Only five 20-30-year olds are moderately knowledgeable. Out of 50 nurses, 41 (82%) had an adequate level of knowledge, 9 (18%) had a moderate level of knowledge on biomedical waste management, and none of them had too inadequate knowledge. Conclusions: The proper handling of biomedical waste necessitates that all hospital staff undergo extensive training on the collection, sorting, transportation, and storage of waste in color-coded bins before disposal and treatment. [ABSTRACT FROM AUTHOR]

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The generation of biomedical waste (BMW) is indispensable in the current era where there are so many diseases and so many health-care facilities and activities on continuous front. However, the safe management of BMW remains not only a social but also a legal obligation and responsibility of all health-care workers and any person associated with health-care activities. The recent 2016 BMW Management Rules have been clearly outlined all over the world, and India too accepts them, and the government has been very upfront for its application. India has observed a double reporting, generation, and treatment of BMW and its management after the application of BMW 2016. These new rules have been able to better segregate, transport, and dispose of the BMW leading to lesser environmental pollution. However, still many states are far away from reaching the goals and adequate implementation of BMW practices, where they may lack on various fronts such as financial support, technical support, knowledge, attitude, infrastructure, dedicated health‑care workers, and monitoring by the regulatory bodies. This review article takes into fronts all aspects related to BMW management from its definition till the disposal and various knowledge and practices that are being implemented in India. [ABSTRACT FROM AUTHOR]