The impact of public acceptance on cost efficiency and environmental sustainability in decentralized energy systems.
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ABSTRACT:
SUBMITTER: Weinand JM
PROVIDER: S-EPMC8276048 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundMalnutrition is highly prevalent in hospitalized patients but seldom recognized and treated. Malnutrition poses several adverse events, such as increased infection rates, length of hospital stay, and mortality, as well as costs. Early nutrition interventions have been shown to decrease the associated malnutrition burdens, leading to relevant savings. Thus, this study aims to evaluate the cost-effectiveness of nutrition therapy, including oral supplements to at-risk or malnourished adult inpatients admitted to the Brazilian Public System (SUS) hospitals.MethodA cost-effectiveness model, encompassing a 1-year period and regarding total costs, length of hospital stay, readmissions, and mortality related to malnutrition, was developed, having the provision of early nutrition therapy as the intervention variable. The number of avoided hospitalization days, prevented hospital readmissions, and prevented deaths defined the effectiveness of the model. All the costs were estimated based on the SUS database.ResultsEarly nutrition therapy provided to all at-risk or malnourished patients would represent cost-effectiveness of US $92.24, US $544.59, US $1848.12, and US $3698.92, for each day of hospitalization avoided, for additional patients having access to hospitalization, for preventing readmission, and for prevented death, respectively. The highest impact on savings was represented by the mean reduction in the length of hospital stay.ConclusionEarly oral nutrition intervention for patients malnourished or at risk of malnutrition resulted in overall reduced hospital costs. These findings provide a rationale to tackle the implementation of educational programs focusing on the care of inpatients with malnutrition or its risk.
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Project description:For the first time, the fate of radicals generated in heterogeneous chemical oxidation treatment systems has been accounted for and used to assess treatment performance in three reaction compartments; reaction with the target compound, rhodamine B (RhB), the aqueous phase scavengers, and the solid phase scavengers. Radicals formed during the ultra-violet (UV) activation of hydrogen peroxide (H2O2) (UV-AHP) and persulfate (S2O82-) (UV-APS) include hydroxyl (•OH) and sulfate radicals (SO4•-), respectively. •OH and SO4•-, used in oxidation treatment systems to degrade a broad spectrum of environmental contaminants, may also react with non-target chemical species (scavengers) that limit treatment efficiency. UV-AHP and UV-APS treatment systems were amended with solid phase alumina to assess scavenging by solid surfaces. The overall rate of reaction and rate of radical scavenging was greater for •OH than SO4•-. Scavenging by dissolved constituents was dominated by the oxidant used (H2O2, S2O82-); and the rate of radical scavenging by alumina was greater than the rate of RhB oxidation in all cases. Treatment efficiency was lower in the UV-AHP than in the UV-APS treatment system and was attributed to greater aqueous and solid phase scavenging rates. The cost of commercially available H2O2 ($0.031 mol-1) and PS ($0.24 mol-1) was used in conjunction with the overall treatment efficiency to assess specific cost of treatment. The specific cost to treat the probe compound with UV-AHP was greater than UV-APS and was attributed to the much lower treatment efficiency with UV-AHP. The much-desired high reaction rate constants between •OH and environmental contaminants, relative to SO4•-, may come at the cost of greater combined scavenging rates, and consequently lower treatment efficiency.
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Project description:BackgroundOperating room waste is disposed of in landfill sites, recycled, or undergoes costly, energy-intensive incineration processes. By assessing the quantity and recyclability of waste in primary hip (THA) and knee arthroplasty (TKA), we aim to identify strategies to improve sustainability.MethodsA prospective waste audit of 15 primary THA and 16 primary TKA cases was conducted at a tertiary orthopedic hospital between April and July 2022. Waste was categorized into nonhazardous, hazardous, recycling, sharps, and linens. Each category was weighed. Items disposed as nonhazardous waste were cataloged for a sample of 10 TKA and 10 THA cases. Recyclability of items was determined using packaging.ResultsAverage total waste generated for THA and TKA was 14.46 kg and 17.16 kg, respectively. TKA generated significantly greater waste (P < .05). Of all waste, 5.4% was recycled in TKA and just 2.9% in THA cases. The mean amount of recycled waste was significantly greater in TKA cases than that in THA cases, 0.93 kg and 0.42 kg, respectively.Hazardous waste made up the largest proportion for both TKA (69.2%) and THA (73.4%). Nonhazardous waste made up 15.1% and 11.3% of total waste for TKA and THA, respectively. In the nonhazardous waste, only 2 items (scrub-brush packaging and towel packaging) were recyclable.ConclusionsWe estimate hip and knee arthroplasty generates over 2.7 million kg of waste in the United Kingdom annually. Currently, only a small percentage of waste is recycled in hip and knee arthroplasty, which could improve through increased use of recyclable plastics and clear labeling of items as recyclable by medical suppliers.
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