Espensengould7587

This paper presents downstream cost-benefit analysis for electronic waste (e-waste) recycling workers in Pakistan, a country that both generates large quantities of e-waste domestically and imports a significant amount from developed countries. Financial cost-benefit elements - reduction in productive capacity, lost wages, medical expenses, wages (and meals) and non-financial cost-benefit elements - opportunity cost, cost of illiteracy and value of life have been quantified. Primary data collected on site was analyzed using quantitative and qualitative methods. The estimated total net economic cost to recycling workers is between Rs.34,069 and Rs.85,478 (US$ 203-5101) per month or an average of Rs.50,363 (US$ 300) per worker. This main finding suggests that cost exceeds by 2.6-4.7 times the estimated economic benefits derived by these workers. Related qualitative data suggests government and owners of recycling businesses are largely blind to many of the less visible costs of this industry, while recycling workers and their families appear trapped in a vicious cycle of poverty. FR 180204 Understanding that what can be measured can be managed and improved, a systematic assessment of informal recycling based on identified impact factors may help mitigate and ideally also motivate a shift towards formal processing that would reduce the downstream negative impacts, both visible and hidden.Microplastic pollution is ubiquitous and has emerged as a severe global environmental issue. Recent research on microplastic pollution has mainly focused on aquatic ecosystems, while knowledge gaps still exist regarding microplastic in terrestrial environments. In this study, we established a new method for characterizing microplastic in complex soil substrate using FTIR spectroscopy. Microplastic was separated by density without removing soil organic matter to protect microplastic from damage. The Wizards feature was adopted to automatic, direct and continuous characterize micron-size plastic. Furthermore, 33 soil samples were taken from Guiyu, a notorious e-waste dismantling area in Guangdong Province, China, under different land-use. The results showed that microplastic was involved in 30 samples, and the abundance of microplastic varied considerably among different soils, ranged from 0 to 34,100n kg-1, implying that the e-waste dismantling sites have become the microplastic hotspots. There were 60 kinds of microplastic detected with 6 different shapes and 10 colors, most of which were secondary microplastic. They mainly consisted of engineering-plastic and modified plastic, 88.61% had a size range less then 1 mm, indicating that the majority of microplastics at Guiyu were derived from e-wastes. The surface morphology of microplastic showed signs of aging and degradation, possibly due to primitive dismantling methods and long-term exposure to the soil. The mean Pb, Cd, Cr, Ba, Cu, Co, As concentrations of microplastic were 20.94, 0.67, 11.82, 308.78, 4.11, 1.26, 3.06 μg·g-1, respectively. Our findings providescientific basis for monitoring and controlling microplastic pollution in terrestrial environments.The present research focused on evaluating the role of waste fishbone hydroxyapatite (FB-HAP) in stabilizing heavy metals, particularly Pb and Zn, in incineration fly ash (IFA). Bones were collected from various fish species and processed for batch experiments. A commercial apatite product (Apatite II™) was also obtained for a comparative analysis. The experiments were performed at fishbone/fly ash ratios of 0.0 (control group) and 110 (by weight), settling times of 6, 12, 24, and 672 h (28 days), and W/S ratios of 1.0 and 1.5 mL/g. The highest Pb removal efficiency reached 86.39% at 28 days settling periods, when the FB-HAP dose was only 10% at W/S 1.5 mL/g. FB-HAP was found noticeably more effective (approximately 1.5 to 2 times) than Apatite II™, particularly at shorter settling periods. Stabilization of Zn was efficient at longer settling period (28 days) using FB-HAP. The highest stabilization rate of Zn was 62.67% at W/S 1.0 mL/g. The results indicated that settling time and W/S ratio were the most important factors to enhance the stabilization of Pb and Zn in IFA. Utilization of waste fishbone is expected to be a low-cost and eco-friendly technology.With the economy growing rapidly, as well as the increasing diversification of human material and cultural needs, waste management poses a pressing challenge for local authorities in China. The primary aim of the present study is to examine the determinants of household waste-related behaviors, especially focusing on the roles of two important social interaction-based factors, social norms and networks, and their combinations. Specifically, this paper adopted the method of principal component analysis to capture social interactions and leveraged ordered logit models to explore their influences on the behaviors involving waste sorting, bringing their own shopping bags and reusing plastic bags in other aspects. Using the data from the Chinese General Social Survey in 2013 (CGSS2013), the results reveal that both social norms and social networks exert a significant positive influence on pure altruistic waste sorting while only social norms are positively associated with bringing their own shopping bags to store and reusing bags in other aspects with the nature of impure altruism. Meanwhile, there is no convincing evidence for the interaction effect between social norms and social networks on waste sorting, yet the interaction item does work together negatively influencing bringing their own bags and reusing bags behaviors. Moreover, the results show that social norms have a much larger effect on waste-related behaviors in males than females while social networks lead to significant promotion in waste sorting only for females. For people with higher education levels, the impacts of social norms and social networks on waste sorting and bringing their own bags behaviors are insignificant, while the higher income groups are weakly affected by social networks as well, partly because of time constraints and opportunity cost. Lastly, this paper provides new insight into waste management from the perspective of social interaction.

Despite digital health providing opportunities to enhance the quality, efficiency and safety of primary healthcare, the adoption of digital tools and technologies has been slow, partly because of poor digital health literacy. For primary healthcare systems to take full advantage of these technologies, a capable, digitally literate workforce is necessary. Still, the essential digital health competencies (DHCs) for primary healthcare have not been explored. This review aims to examine the broad literature on DHCs as it applies to Primary Care (PC) settings.

We performed a scoping review on all types of research linking DHCs to PC. We searched all major databases including Medline, Embase, CINAHL, and Cochrane Library in November 2019. Concurrently, a thorough grey literature search was performed through OpenGrey, ResearchGate, Google Scholar, and key government and relevant professional associations' websites. Screening and selection of studies was performed in pairs, and data was analysed and presented usial knowledge gaps and needs to be considered. Such a DHC set may be used for curricula development and for ensuring that the essential DHC for PC are met at a clinical or organizational level, and eventually improve health outcomes.

Literature explicitly linking DHCs to PC was mostly published over a decade ago. There is a need for an updated and current set of DHCs for PC professionals to more consistently reap the benefits of digital technologies. This review identified key DHC domains and statements that may be used to guide on the development of a set of DHC for PC, and critical knowledge gaps and needs to be considered. Such a DHC set may be used for curricula development and for ensuring that the essential DHC for PC are met at a clinical or organizational level, and eventually improve health outcomes.Lateral flow assay (LFA), performed with simple devices and short detection time, is popular in field applications. Herein, a novel sandwich type-based LFA was constructed for high sensitivity and selectivity detection of Staphylococcus aureus (S. aureus). Vancomycin-immobilized gold nanoparticles (VAN-Au NPs) were utilized as the first identifier to capture S. aureus and the specificity was guaranteed by the second recognition agent of pig immunoglobulin G (IgG). In addition, gold growth was adopted for signal amplification to further improve the detection sensitivity. S. aureus could be directly assayed by this LFA within the concentration range of 1.0 × 103-1.0 × 108 cfu mL-1 with a detection limit of 1.0 × 103 cfu mL-1. Furthermore, the novel sandwich LFA realized S. aureus detection in food samples with admissible recoveries and established a rapid, simple, cost-effective and sensitive platform, could meet the demand for on-site testing of S. aureus.

Previous investigation has shown that the combined predictive value of white blood cell count and ultrasound (US) findings to be superior to either alone in children with suspected appendicitis. The purpose of this study was to evaluate the impact of a diagnostic clinical pathway (DCP) leveraging the combined predictive value of these tests on computed tomography (CT) utilization and resource utilization.

Retrospective cohort study comparing 8mo of data before DCP implementation to 18mo of data following implementation. The pathway incorporated decision-support for disposition (operative intervention, observation, or further cross-sectional imaging) based on the combined predictive value of laboratory and US data (stratifying patients into low, moderate, and high-risk groups). Study measures included CT and magnetic resonance imaging utilization, imaging-related cost, time to appendectomy, and negative appendectomy rate.

Ninety-seven patients in the preintervention period were compared with 319 patients less then 0.001), and the negative appendectomy rate remained unchanged (5% versus 4%, P = 0.54). Magnetic resonance imaging utilization increased following pathway implementation (1% versus 7%, P = 0.02); however, median imaging-related cost was significantly lower in the postimplementation period ($283/case to $270/case, P = 0.002) CONCLUSIONS In children with suspected appendicitis, implementation of a DCP leveraging the combined predictive value of white blood cell and US data was associated with a reduction in CT utilization, time to appendectomy, and imaging-related cost.

Cholecystectomy is considered a low-risk procedure with proven safety in many high-risk patient populations. However, the risk of cholecystectomy in patients with active cancer has not been established.

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was queried to identify all patients with disseminated cancer who underwent cholecystectomy from 2005 to 2016. Postcholecystectomy outcomes were defined for patients with cancer and those without by comparing several outcomes measures. A multivariate model was used to estimate the odds of 30-d mortality.

We compared outcomes in 3097 patients with disseminated cancer to a matched cohort of patients without cancer. Patients with cancer had more comorbidities at baseline dyspnea (10.5% versus 7.0%, P<0.0001), steroid use (10.1% versus 3.0%, P<0.0001), and loss of >10% body weight in 6-mo prior (9.3% versus 1.6%, P<0.0001). Patients with cancer sustained higher rates of wound (2.3% versus 5.6%, P<0.