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An overview of the environmental pollution and health effects associated with waste landfilling and open dumping
Landfilling is one of the most common waste management methods employed in all countries alike, irrespective of their developmental status. The most commonly used types of landfills are (a) municipal solid waste landfill, (b) industrial waste landfill, and (c) hazardous waste landfill. There is, also, an emerging landfill type called “green waste landfill” that is, occasionally, being used. Most landfills, including those discussed in this review article, are controlled and engineered establishments, wherein the waste ought to abide with certain regulations regarding their quality and quantity. However, illegal and uncontrolled “landfills” (mostly known as open dumpsites) are, unfortunately, prevalent in many developing countries. Due to the widespread use of landfilling, even as of today, it is imperative to examine any environmental- and/or health-related issues that have emerged. The present study seeks to determine the environmental pollution and health effects associated with waste landfilling by adopting a desk review design. It is revealed that landfilling is associated with various environmental pollution problems, namely, (a) underground water pollution due to the leaching of organic, inorganic, and various other substances of concern (SoC) contained in the waste, (b) air pollution due to suspension of particles, (c) odor pollution from the deposition of municipal solid waste (MSW), and (d) even marine pollution from any potential run-offs. Furthermore, health impacts may occur through the pollution of the underground water and the emissions of gases, leading to carcinogenic and non-carcinogenic effects of the exposed population living in their vicinity.
Graphical abstract
Journal Article
Managerial statistics
This book emphasizes problem solving and teaches students how to systematically solve business problems. Its comprehensive coverage and integrated computer examples and instructions provides enough material for a two-semester course.
Book
Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial
Therapeutic virtual reality (VR) has emerged as an effective, drug-free tool for pain management, but there is a lack of randomized, controlled data evaluating its effectiveness in hospitalized patients. We sought to measure the impact of on-demand VR versus \"health and wellness\" television programming for pain in hospitalized patients.
We performed a prospective, randomized, comparative effectiveness trial in hospitalized patients with an average pain score of ≥3 out of 10 points. Patients in the experimental group received a library of 21 VR experiences administered using the Samsung Gear Oculus headset; control patients viewed specialized television programming to promote health and wellness. Clinical staff followed usual care; study interventions were not protocolized. The primary outcome was patient-reported pain using a numeric rating scale, as recorded by nursing staff during usual care. Pre- and post-intervention pain scores were compared immediately after initial treatment and after 48- and 72-hours.
There were 120 subjects (61 VR; 59 control). The mean within-subject difference in immediate pre- and post-intervention pain scores was larger in the VR group (-1.72 points; SD 3.56) than in the control group (-0.46 points; SD 3.01); this difference was significant in favor of VR (P < .04). When limited to the subgroup of patients with severe baseline pain (≥7 points), the effect of VR was more pronounced vs. control (-3.04, SD 3.75 vs. -0.93, SD 2.16 points; P = .02). In regression analyses adjusting for pre-intervention pain, time, age, gender, and type of pain, VR yielded a .59 (P = .03) and .56 (P = .04) point incremental reduction in pain versus control during the 48- and 72-hour post-intervention periods, respectively.
VR significantly reduces pain versus an active control condition in hospitalized patients. VR is most effective for severe pain. Future trials should evaluate standardized order sets that interpose VR as an early non-drug option for analgesia.
Journal Article
Peer-supported self-management for people discharged from a mental health crisis team: a randomised controlled trial
High resource expenditure on acute care is a challenge for mental health services aiming to focus on supporting recovery, and relapse after an acute crisis episode is common. Some evidence supports self-management interventions to prevent such relapses, but their effect on readmissions to acute care following a crisis is untested. We tested whether a self-management intervention facilitated by peer support workers could reduce rates of readmission to acute care for people discharged from crisis resolution teams, which provide intensive home treatment following a crisis.
We did a randomised controlled superiority trial recruiting participants from six crisis resolution teams in England. Eligible participants had been on crisis resolution team caseloads for at least a week, and had capacity to give informed consent. Participants were randomly assigned to intervention and control groups by an unmasked data manager. Those collecting and analysing data were masked to allocation, but participants were not. Participants in the intervention group were offered up to ten sessions with a peer support worker who supported them in completing a personal recovery workbook, including formulation of personal recovery goals and crisis plans. The control group received the personal recovery workbook by post. The primary outcome was readmission to acute care within 1 year. This trial is registered with ISRCTN, number 01027104.
221 participants were assigned to the intervention group versus 220 to the control group; primary outcome data were obtained for 218 versus 216. 64 (29%) of 218 participants in the intervention versus 83 (38%) of 216 in the control group were readmitted to acute care within 1 year (odds ratio 0·66, 95% CI 0·43–0·99; p=0·0438). 71 serious adverse events were identified in the trial (29 in the treatment group; 42 in the control group).
Our findings suggest that peer-delivered self-management reduces readmission to acute care, although admission rates were lower than anticipated and confidence intervals were relatively wide. The complexity of the study intervention limits interpretability, but assessment is warranted of whether implementing this intervention in routine settings reduces acute care readmission.
National Institute for Health Research.
Journal Article
Insights into the management of food waste in developing countries: with special reference to India
Up to one third of the food that is purposely grown for human sustenance is wasted and never consumed, with adverse consequences for the environment and socio-economic aspects. In India, managing food waste is a significant environmental concern. Food waste output is increasing in Indian cities and towns as a result of the country’s urban expansion, modernization, and population growth. Poor management of food waste can have negative consequences for the environment and pose a risk to the public’s health issues. This review focuses on the current challenges, management strategies, and future perspectives of food waste management in India. The efficient management of food waste involves a comprehensive study regarding the characterization of food waste and improved waste management methods. In addition, the government policies and rules for managing food waste that is in effect in India are covered in this review.
Journal Article
Demand driven performance : using smart metrics
\"Learn how to implement demand driven metrics for vast improvement in measuring performance.Demand Driven Performance details why the outdated forms of measurement are inappropriate for current circumstances and reveals an elegant set of global and local metrics to fit today's demand driven world. The book shows how to minimize the organizational and supply chain conflicts that impede flow, and eventually, corporate success.Metrics are used to create a benchmark for measuring improvement and to identify and focus on those improvements that are most needed, and that have the highest ROI. However, the world has fundamentally changed in terms of delivering value and driving strong financial performance and growth. The continued use of outdated metrics is driving companies in the wrong direction giving them false signals, putting their personnel into conflict at all levels of the organization, and also wreaking havoc in the supply chain. This book offers solutions to remedy these issues. Defines a new demand driven approach for measuring total organizational performance and the corresponding local metrics that integrate with those measures Advocates a systems approach to measuring improvement, and shows how conventional metrics are no longer appropriate Focuses on reliability, stability, speed/velocity, strategic contribution, local operating expense, and local improvement waste A case study demonstrates the processes in the book and provides you with the technology and tools needed to achieve a demand driven system \"-- Provided by publisher.
Book
Effectiveness and safety of nurse-led different epidural analgesia methods based on symptom management theory in patients with severe acute pancreatitis: A single-center RCT protocol
Patients with severe acute pancreatitis (SAP) often experience intense pain that significantly impacts their quality of life and may hinder recovery. Current pain management approaches have limitations. Although continuous thoracic epidural analgesia (TEA) is generally effective, some patients still need additional intermittent injections of local anesthetics for sufficient pain relief. In the ICU, nurses are the primary providers responsible for pain management. Symptom Management Theory (SMT), though used in various fields, has not yet been fully validated for nurse-led pain management employing different TEA administration methods in SAP.
This protocol aims to assess the effectiveness and safety of SMT-based nurse-led TEA administration methods in patients with SAP, with the goal of optimizing pain management protocols.
This single-center, randomized, controlled clinical trial will enroll 76 patients with SAP, randomized into two groups (N = 38 each). The control group will receive continuous TEA with a 50 ml mixture containing nalbuphine 40 mg, ropivacaine 225 mg, lidocaine 0.2 g, and 6 ml of 0.9% saline, administered at 3-5 ml/h. If the patient's pain score (VAS-P) exceeds 3 or becomes intolerable, the infusion rate will be increased by 1-2 ml/h. In the experimental group, under SMT-guided nurse-led TEA management, nurses will report pain scores exceeding 3 to physicians, and intermittent epidural injections of 5 ml of the same mixture will be administered according to medical prescription, at intervals of ≥2 hours. Pain responses and patient feedback will be continuously monitored to guide timely adjustments of analgesics. The primary outcome is VAS-P. Secondary outcomes include intra-abdominal pressure (IAP), total dose of combined medication, number of additional interventions, duration of epidural placement, and incidence of 16 predefined adverse events. Endpoint outcomes consist of puncture success rate, ICU length of stay, 28-day mortality, and patient satisfaction with analgesia. Data will be analyzed using SPSS. Repeated measures data (e.g., VAS-P and IAP at 0 h, 1 h, 6 h, 12 h, 24 h, 48 h, and 72 h) will be examined with a multivariate mixed-effects repeated measures model (MMRM), which appropriately handles data missing at random. Other secondary outcomes, adverse events, and endpoint measures will be analyzed with descriptive statistics, and between-group comparisons will be conducted using t-tests, Mann-Whitney U tests, χ² tests, or Fisher's exact tests, as appropriate.
The experimental group is anticipated to demonstrate superior pain management outcomes compared to the control group, with no increase in adverse events. The SMT-based nurse-led TEA protocol is expected to be safe and effective in improving analgesia, reducing ICU length of stay, decreasing 28-day mortality, and enhancing patient satisfaction. This study will provide new insights and methods for pain management in SAP patients, thereby promoting optimization of clinical practice.
Journal Article