Implementation Of Management Program Research Articles

429 Implementation of Patient Blood Management Program Improves Blood Product Utilization in the Emergency Department

429 Implementation of Patient Blood Management Program Improves Blood Product Utilization in the Emergency Department

Implementation of a heart failure disease management program in the rural southern United States: a best practice implementation project.

Heart failure affects thousands of patients annually, often resulting in hospitalization, emergency room visits, and decreased quality of life. The scientific evidence indicates that disease management programs using a multidisciplinary approach improve outcomes for heart failure patients. The overarching aim of this evidence implementation project was to establish a disease management program for heart failure patients. Specifically, the project sought to promote compliance with best practices for the early identification of heart failure exacerbation symptoms to prevent emergency room visits and hospitalizations, thereby reducing morbidity and mortality. This project was guided by the JBI Evidence Implementation Framework, which is grounded in an audit, feedback, and re-audit strategy. A baseline audit was conducted, revealing the need for a heart failure disease management program. A policy was developed to implement a disease management program and virtual relationships were established to create a multidisciplinary team. A follow-up audit was conducted to determine whether the implemented interventions closed the gap in practice identified by the baseline audit. The baseline audit revealed 0% compliance with best practices for the management of patients with heart failure, while the follow-up audit revealed 93.3% compliance. This project enhanced best practices by implementing a protocol in a rural health clinic to ensure that all heart failure patients were enrolled in a disease management program. Recommendations include using the electronic health record to quickly identify heart failure patients and their status in a disease management program. Chart audits should be performed every 6 months to ensure the program's sustainability and to determine heart failure patients' enrollment status. http://links.lww.com/IJEBH/A270.

Assessment of Risk Management Practices in Public Higher Learning Institutions: A Case of Muhimbili University of Health and Allied Sciences

This study explores the risk management practices at Muhimbili University of Health and Allied Sciences (MUHAS) in Tanzania. It examines employees' perceptions, the challenges faced by management during the implementation of risk management programs, and the efforts made to address these challenges. Findings indicate a significant gap in awareness regarding risk management policies, substantial resistance to change, and financial constraints. The study underscores the need for enhanced communication, continuous training, and strategic resource allocation to improve risk management practices at MUHAS.

Incidental pulmonary nodules: Natural language processing analysis of radiology reports

BackgroundPulmonary nodules are a common incidental finding on chest Computed Tomography scans (CT), most of the time outside of lung cancer screening (LCS). We aimed to evaluate the number of incidental pulmonary nodules (IPN) found in 1 year in our hospital, as well as the follow-up (FUP) rate and the clinical and radiological features associated with FUP. MethodsWe trained a Natural Language Processing (NLP) tool to identify the transcripts mentioning the presence of a pulmonary nodule, among a large population of patients from a French hospital. We extracted nodule characteristics using keyword analysis. NLP algorithm accuracy was determined through manual reading from a sample of our population. Electronic health database and medical record analysis by clinician allowed us to obtain information about FUP and cancer diagnoses. ResultsIn this retrospective observational study, we analyzed 101,703 transcripts corresponding to the entire CTs performed in 2020. We identified 1,991 (2 %) patients with an IPN. NLP accuracy for nodule detection in CT reports was 99 %. Only 41 % received a FUP between January 2020 and December 2021. Patient age, nodule size, and the mention of the nodule in the impression part were positively associated with FUP, while nodules diagnosed in the context of COVID-19 were less followed. 36 (2 %) lung cancers were subsequently diagnosed, with 16 (45 %) at a non-metastatic stage. ConclusionsWe identified a high prevalence of IPN with a low FUP rate, encouraging the implementation of IPN management program. We also highlighted the potential of NLP for database analysis in clinical research.

Nuclear Facilities Maintenance Culture Development Study

Maintenance is an essential part of the assets and facilities in the organization/company. This deserves serious attention because it is necessary for organizational/company resources, especially for aging nuclear facilities/installations. Maintenance is the main program used to manage company assets and facilities. A lack of asset and facility maintenance culture increases management and maintenance costs. A maintenance culture is needed to improve maintenance skills, tenacity, and perseverance. Maintenance culture is recognized as an essential aspect to improve the quality of maintenance work to maintain structures, systems, and components (SSC) so that they are ready for use at any time/when needed, as well as part of the implementation of aging management programs to extend the life of assets and facilities. This paper will discuss the development of the maintenance culture and review poor maintenance cultures and their solutions. This paper aims to develop a maintenance culture to prevent premature aging and extend the life of assets and facilities. Factors developing maintenance culture include leadership, communication, rewards and recognition, responsibility, rules and standards, empowerment, motivation, involvement, policies, work strategy and planning, teamwork, training and education, awareness, and organizational structure. Corruption, poor leadership, attitude problems, and lack of policy cause poor maintenance culture. The solution to a poor maintenance culture is selecting the right people, improving job skills and knowledge, repairing equipment, ensuring machine/equipment readiness, good planning, scheduling, and general organization, measuring performance, motivating and encouraging desire, and providing sufficient funding. Maintenance culture has an impact on facility performance. Keywords: maintenance culture, nuclear organization, assets, nuclear facility

Realities, perceptions, and strategies for implementation of an ethical population management program for dogs and cats on university campuses.

Stray dogs and cats pose significant challenges for public health and animal welfare due to their potential involvement in zoonotic disease transmission, accidents, and aggressions. Large urban centers exacerbated challenges due to the presence of these animals in public areas with high human density. Ethical Population Management Programs (EPMP), rooted in the One Health approach, are crucial for addressing this issue comprehensively. This study aimed to demonstrate the approach on cats and dogs EPMP and evaluate the perceptions of academic community regarding EPMP implementation on a campus situated in urban territory. The study was conducted at the Pampulha campus of UFMG in Belo Horizonte, Brazil. In response to issues of animal abandonment and conflicts, the Permanent Commission for Animal Policies (CPPA-UFMG) was established in 2019 to manage the campus's dog, cat, and wildlife populations. The commission implemented the Trap-Neuter-Return (TNR) method, along with health assessments and vaccinations for animals. Interviews were conducted with campus staff to gauge their perception of animal management strategies. Retrospective and prospective analyses of the commission's actions were carried out to assess implementation processes and challenges. The animal population survey conducted on campus between July 2018 and September 2021 revealed a total of 266 animals recorded. Among these animals, 195 were cats (73.3%) and 71 were dogs (26.7%), with the majority being adults. Subsequent surveys in 2019 and 2021 showed a slight increase in the animal population, with measures such as sterilization contributing to population control. Perception analysis among campus users indicated strategies such as TNR were widely endorsed for population control. The employees perception questionnaire was applied to 115 individuals, representing 42 units/departments and five gates. Associations were found between these beliefs and support for institutional actions. The majority favored sterilization (92.17%) and agreed that TNR is an appropriate approach to population control. Overall, the study reflects a community concerned about animal welfare and supportive of measures to address population management and cruelty prevention. The continuous efforts of the university's CPPA have led to stability in the resident animal population, indicating success in achieving population control objectives.

Impact of Sustainable Land Management Program on the Livelihoods of Smallholder Farmers in Semen Bench District, South West Ethiopia

The Sustainable Land Management Programme was launched in 2008 to address to reduce land degradation, improve land productivity, contribute significantly to adaptation to and mitigation of climate change, to protect of soil erosion, conserve to natural resources, and improve of smallholder farmers' standard of living. The overall objective of the study is to impact of a sustainable land management program in southwest Ethiopia's Semen Bench district on the livelihoods of smallholder farmers. The study used to cross-sectional survey study design. Two Kebeles were purposively selected based on participation and coverage of soil and water conservation practices implemented by sustainable land management program established in the study area. systematic sampling techniques was used to select 124 respondents from the Kebeles household heads. The data were analyzed using descriptive statistics, chi-square test, and independent sample t-test. The study revealed significant differences in maize yield, taro and coffee yields. The results also showed a highly significant difference (p<0.05) in the mean total yearly income of adopter and non-adopter households, at 24,963.8±2783.12 and 14,927.9±2200.2 birr, respectively. It is determined that the implementation of a sustainable land management program enhances agricultural productivity and household income by conserving land resources. To improve household income, crop productivity, and land resource conservation, this study suggests that farmers be incentivized and supported to adopt integrated sustainable land management approaches.

Prevalence and factors associated with poor sleep quality among nurses in COVID-19 wards

The COVID-19 pandemic has significantly impacted the working conditions of nurses, leading to a detrimental effect on their sleep quality. This cross-sectional study aimed to investigate the prevalence of poor sleep quality and its associated factors among nurses working in COVID-19 wards in Kermanshah, Iran. A total of 97 nurses were selected through simple random sampling from COVID-19 wards. Data was collected using a demographic information sheet and the Pittsburgh Sleep Quality Index. Descriptive and inferential statistical methods, including chi-square and multiple logistic regression, were used for data analysis. The results showed that 74.2% (n = 72) of the nurses experienced poor sleep quality. Significant associations were found between poor sleep quality and work experience (p = 0.045) as well as the type of work shift (p = 0.001). However, no significant relationships were observed between poor sleep quality and factors such as age, sex, body mass index, overtime hours per month, physical activity, or underlying diseases. The high prevalence of poor sleep quality among nurses working in COVID-19 wards underscores the necessity of implementing targeted interventions to address this issue. In this regard, in addition to periodic shift schedule changes and reductions in working hours, it is necessary to adopt purposeful measures to improve working conditions and enhance the physical and mental health of nurses. These measures may include providing sufficient human resources to reduce the workload and fatigue of nurses, appropriate scheduling of working hours, and the implementation of stress management programs.

Risk management program implementation on low and medium-risk processed food manufacturers to enhance food safety control in Indonesia

Abstract The Risk Management Program (RMP) on food safety is an Indonesian Food and Drug Authority (FDA) initiative to stimulate the self-regulatory control system of food manufacturers. The study was conducted to analyze the association between RMP in low and medium-risk processed food manufacturers through Good Manufacturing Practices (GMP) implementation and food testing. A cross-sectional study was conducted in Indonesia through the Indonesian FDA food control in 2022-2023, involving 328 samples of low and medium-risk processed food from 7 food types and identified from a total of 131 manufacturers grouped by RMP implementation. Most of the manufacturers (95.1%) complied with GMP requirements. In line with this, the food test results showed that most of the samples (94.5%) met the standards, as well as the samples from RMP-implemented manufacturers (97.7%). Chi-square analysis revealed there was a significant association between GMP implementation and food test results (p-value<0.05), whereas the RMP implementation did not show a significant association with the food test results (p-value=0.314). Since the RMP was a prestige for manufacturers to gain the trust and recognition of the Indonesian FDA as a regulator in implementing a self-regulatory control system, low and medium-risk processed food manufacturers still implemented RMP.

EFFECTS OF CLIMATE CHANGE ON ADAPTATION OF FARMERS IN NORTH WEST REGIONS OF HERAT PROVINCE

Agriculture and Climate are mutually dependent. There is a need to understand the effect of climate change on agricultural sector both at global and as well as at regional level. The present study was conducted in 2020, to know the effects of climate change on farmers’ adaptation. Ex post facto research design applied for this research. Pre prepared questionnaires have been distributed to120 respondents in three districts of north - west regions of Herat province and analyzed with the help of suitable statistical tests and the findings showed that, all farmers opined that, wheat’s varieties were changed from long duration to short duration, time of planting, switching over to other crops was observed among farmers. Spacing between the rows/plants, quantity of seeds used and quantity of organic fertilizer application were increased after 2010. The major constraint to initiate adaptation measures was; difficult to work in the field due to severe temperature and the important suggestion to mitigate the ill effects of climate change was; planning to control and store rainwater through the implementation of watershed management program. Based on the results of this study, it is hoped that appropriate strategies/ measures can be worked out to create awareness and learning mechanisms to enable farmers to handle their situations better.

Do inexperienced nurses in the lactation period experience workplace violence? A qualitative study.

Among clinical healthcare personnel, nurses face the highest proportion of workplace violence, which has a significant impact on their physical and mental well-being as well as their personal and professional lives. However, little is known about the effects of workplace violence on inexperienced breastfeeding nurses and their experiences during and after breastfeeding when they return to work. This study aimed to explore the experiences of inexperienced breastfeeding nurses who encountered workplace violence and its resulting impacts. This study employed a descriptive qualitative design. Semi-structured in-depth interviews were conducted with 20 nurses working in various positions and departments at three tertiary hospitals. Purposive and maximum variation sampling techniques were employed. The interview data were analyzed using Colaizzi's method, and the research findings were reported according to Consolidated Criteria for Reporting Qualitative Studies (COREQ)standards. Inferences regarding workplace violence and risks for inexperienced breastfeeding nurses included physical labor (such as lifting heavy objects and performing cardiopulmonary resuscitation), conflicts, inadequate job skills, role confusion, occupational exposure risks, patient violence, and pressure from older adults. An inductive thematic investigation revealed the "Challenges faced during breastfeeding," "Conflicting professional and family roles," "Out of balance," and "Coping strategies." Inexperienced breastfeeding nurses experience several negative consequences due to workplace violence. Therefore, it is essential to plan and implement preventive strategies and management programs that specifically target workplace violence among inexperienced breastfeeding nurses.

Large cells suppress the reproduction of Varroa destructor.

The parasitic mite, Varroa destructor has posed a threat to the health and survival of European honey bees, Apis mellifera worldwide. There is a prevailing belief that small comb cells could provide a management tool against Varroa mites. However, the hypothesis that smaller cells can impede Varroa reproduction has not been fully tested. Here, we tested this hypothesis under laboratory conditions by using two distinct Varroa in vitro rearing systems: one involved gelatin capsules of different sizes, specifically size 00 (0.95 mL) versus size 1 (0.48 mL), and the second consisted of brood comb cells drawn on 3D printed foundations with varying cell sizes, ranging from 5.0 mm to 7.0 mm at 0.5 mm intervals. The results showed that mother mites in size 00 cells had significantly lower fecundity and fertility compared to those in size 1 cells. Interestingly, the reproductive suppression in larger cells could be reversed by adding an extra worker larva. Similarly, gonopore size of mother mites was smaller in size 00 cells, but restored with another host larva. Furthermore, both the fecundity and fertility of mother mites decreased linearly with the size of brood comb cells. Our results suggest that the reproduction of V. destructor is hindered by larger cells, possibly because larger brood cells disperse or weaken host volatile chemical cues that are crucial for Varroa reproduction. The insights derived from this study are expected to hold significant implications for the implementation of Varroa management programs. © 2024 Society of Chemical Industry.

1940-LB: Implementation of an Inpatient Glucose Management Program in a Large U.S. Health System

1940-LB: Implementation of an Inpatient Glucose Management Program in a Large U.S. Health System

A Study on One-Time Inspection for Aging Management of Operating Nuclear Power Plants

One-time inspection is used to confirm the effectiveness of nuclear power plant aging management programs such as water chemistry, fuel oil chemistry, and selective leaching program that is designed to prevent or minimize aging degradation during the plant operation. This paper represents one-time inspection experience of selected components and susceptible locations within the scope of water chemistry and fuel oil chemistry aging management programs. Prior to performing one-time inspection, sample sizes of components to be inspected were determined based on combination of materials, environment and aging effect. Examination techniques and relevant operating experience were analysed to obtain technical basis for further implementation of one-time inspection aging management programs. Existing correlation curves between sample size and total population number were reviewed to prepare further inspections for entire operating plants and ensure safety level of components subject to one-time inspection program.

Inter-annual variation in the microplastics abundance in feces of the Baird's tapir (Tapirus bairdii) from the Selva Maya, México

Microplastics (MPs) are found in a wide range of ecosystems, from the Arctic to the deep ocean. However, there is no data on their presence in terrestrial mammals that inhabit the Selva Maya. The aim of this study is to detect the presence of MPs in the feces of the Baird's tapir (Tapirus bairdii) from the region of Calakmul, located in the Yucatan Peninsula, Mexico. We analyzed 129 fecal samples collected during 2017 and 2018, obtaining 57 and 72 samples during the rainy and dry seasons respectively. Sixty-eight percent of the samples contained 743 MPs with a mean of 19.3 ± 28.1 MPs/kg of dry weight (DW) feces in both years. An inter-annual variation in the average abundance of microplastic was observed during the two-year period (2017–2018), with a 72 % increase in these plastic particles in feces. Fourteen polymers were identified, with ethylene vinyl acetate (EVA), polypropylene (PP) and polyester (PES) being the most abundant during both years. Although the effects of MPs on the health of tapirs are not known, their presence is cause for concern. There is an urgent need for the implementation of appropriate plastic waste management programs in communities of the Selva Maya to diminish the consumption of MPs in species including humans where they pose a significant risk to health. Environmental implicationsThe use of plastics worldwide is increasing every day, so the presence of microplastics is and will continue to be a major environmental problem. It is known that contaminants can adhere to plastics, making them hazardous materials. Microplastics can contaminate remote areas such as Biosphere Reserves. Terrestrial species such as the tapir can ingest microplastics, putting their health at risk. Knowing the dispersion of microplastics is very important in order to manage them properly, taking into account their emission sources and type of polymer.

Assessing inequalities in the hypertension management under national health insurance: Evidence from Southern Central Java, Indonesia

Equal access to disease management is crucial to control the impact of hypertension on the burden of disease in Indonesia. This study aimed to assess the extent of inequalities in the use, quality, and outcomes of hypertension management for beneficiaries of the National Health Insurance (NHI) program. This cross-sectional study consecutively recruited 797 beneficiaries of National Health Insurance who participated in the hypertension management program in the Banyumas District, Indonesia, between July and October 2021. The outcomes were regular visits, standard medication, and disease control. The inequalities were measured based on educational level, employment type, type of beneficiaries, and place of residence. The rate difference, rate ratio, and multiple logistic regression were used to estimate the extent of inequality. Compared to informal workers, formal workers had more regular visits to healthcare facilities (OR 1.78; 95%CI: 1.01-3.18) and had better disease control (OR 2.36; 95%CI: 1.28-4.38). Non-subsidized participants had fewer regular visits compared to subsidized participants (OR 0.51; 95%CI: 0.30-0.84). Urban residents tended to have more regular visits compared to rural residents (OR 2.14; 95%CI: 0.90-5.05). A substantial extent of inequalities in the use and outcomes of hypertension management still exists among beneficiaries of the NHI program. The future implementation of the hypertension management program of National Health Insurance in Indonesia should consider the geographical and socio-economic background of its participants.

Implementation and Outcomes of Multidisciplinary Diabetes Management Program Among Type 2 Diabetic Patients: A Comparative Study.

Current guidelines recommend shifting physician-led care (PLC) for type 2 diabetes mellitus (T2DM) to more effective multidisciplinary health care (MHC). However, few researchers have studied its real-life implementation in Saudi Arabia. Therefore, we aimed to assess the implementation and compare the outcomes of an MDC diabetes management program (DMP) among T2DM patients to a PLC at a general hospital after one year of follow-up in a real-world practice setting. We conducted this comparative patient files review study by analyzing medical records of all T2DM patients at two private care centers. Both were compared for their effectiveness in achieving two outcomes: the glycated hemoglobin (HbA1c) <7% and low-density lipoprotein-cholesterol (LDL-c) <70 mg/dl at the end of the first year.Additionally, we assessed the implementation of the DMP. Eight hundred thirty-four medical records were reviewed, 537 from DMP, and 279 from the PLC center. The personal health coordination was almost complete (97.8%) in the DMP, but the implementation was incomplete regarding nutrition (65.7%), dental exam (64.8%), and foot care (58.3%). Both care groups were matched for age (p = 0.056), gender (p = 0.085), duration of diabetes (p = 0.217), and basal glycemic control (p = 0.171). The DMP showed a significant net decrease in HbA1c (-0.5 [IQR 1.47%] vs-0.2 [IQR 3.05%], p = 0.0001) and LDL-c (-10 [IQR 50]vs -5 [IQR 60.5] mg/dl, p = 0.004) compared to PLC.A higher percentage of patients achieved glycemic control in the DMP than in the PLC (49.4% vs38.7%, p = 0.038). However, bothprograms demonstrated similar outcomesin lipid control (28.7% vs. 30%, p = 0.695). Despite some gaps in implementation, one year of DMP showed better glycemic control among T2DM patients compared to PLC. Both programs were comparable in terms of lipid control. Further studies identifying the gaps in care implementation could improve sustainability, future replication, and generalizability of similar programs to other healthcare systems in Saudi Arabia.

Combining species distribution models and big datasets may provide finer assessments of snakebite impacts.

Snakebite is a major poverty-related neglected tropical disease. An integrated scientific approach is needed to understand the dynamics of this important health issue. Our objective was to estimate snakebite occurrence in a tropical area by using a blend of ecological modelling and robust statistical analysis. The present study used climatic, environmental, and human population density data to determine the area with snakebite occurrence-probability for the first time in Bangladesh. We also analysed a large, 16-year dataset of hospitalized snakebite cases to reveal the epidemiology of snakebite in the south-eastern zone of the country. Our results show that cobra bite is the most commonly occurring venomous snakebite in humans (around ~12% of the total yearly snakebite records), and men are more frequently bitten than women (2/3 of human victims are men). Most bites occur during the rainy season for cobra and green pit viper, while krait bites are not restricted to any particular season. As snakebite incidents are closely related to climate conditions, we can model snakebite risk using temperature and precipitation variables. Whereas there is a lack of snakebite reports from several parts of the study area in official records, our models predict that the entire study area is favourable for snakebite incidents. Based on the combined evidence we estimate that about 200,000 snakebite events occur every year in the south-eastern part of Bangladesh alone. Considering future global climate change, our model projections show that snakebite incidence in Bangladesh might not significantly decrease in the future (- 2070-); however, the distribution of probabilities might change, with a predicted increase of snakebite incidence in the hilly areas of the country. Using climatic data to predict snakebite incidence in Bangladesh allowed us to provide estimations of the total annual number of snakebite cases in the study area. As in most countries, the scarcity of accurate epidemiological data in official records might have masked the real magnitude of this problem. Our analysis suggests that the problem of snakebite envenoming in Bangladesh might be worse than currently perceived. A long-term sustainable snakebite program plan should be designed and institutionalized, considering climatic, geographical and human demographic variables, to obtain better data and facilitate the implementation of accurate snakebite management programs for this country.

Facing the Garbage Piles: Implementation of Domestic Waste Management by Village-Owned Enterprises

As part of efforts towards Indonesia's Free of Waste, Bojonegoro Regency implemented the Garbage Emergency program in 2020. This program includes strategies for waste utilization and determining the location of Final Waste Disposal Sites. Through collaboration between the Village Government and Village-Owned Enterprises (BUMDesa), innovations have been created to address household waste issues. The domestic waste management program managed by BUMDesa targets the direct participation of households in waste sorting and storage according to its classification, with the hope of reducing the accumulation of waste that pollutes the environment. This research aimed to analyze the implementation of domestic waste management by Village-Owned Enterprises. The method used in this research employed a qualitative approach with a case study design. The research focused on six indicators: policy standards and objectives, resources, characteristics of implementing agents, inter-organizational communication, socio-economic-political conditions, and the disposition of implementers, with data collection techniques including interviews, literature review, and documentation. Findings from this research indicated that the implementation of waste management programs in Sambiroto Village involves cooperation between the village government, Village-Owned Enterprises, and residents. This program aimed to reduce the volume of waste originating from households by actively involving community participation. However, the implementation of this program faces challenges, including limited resources and a lack of financial support from the community. The village government needed to improve communication and provide training for the community and personnel involved in the program. Additionally, providing subsidies or assistance to low-income communities can also enhance participation in waste management. With the hope that this program can have a positive impact on environmental cleanliness and increase public awareness of the importance of sustainable waste management.

Implementation Of A Waste Bank Management Program In The South Tangerang City Area (Study In Benda Baru Subdistrict)

This research aims to analyze the implementation of the waste bank management program and the waste bank management model in Benda Baru Subdistrict, South Tangerang City. This research uses a qualitative approach, data collection techniques using observations, in-depth interviews, Focus Group Discussions (FGD) and documentation. The sampling technique used in this research was purposive sampling. The informants consisted of 5 groups of informants, namely the Environmental Service, Village Employees, Waste Bank Managers, Environmental Monitoring Institutions and the Community of Banda Baru Village, South Tangerang City. This research uses the Miles and Huberman Model Qualitative Data Analysis Technique where the implementation of the waste bank management program uses policy implementation theory from George C. Edwards III, namely four variables in public policy, namely Communication, Resources, attitudes (dispositions or attitudes) and bureaucratic structure and Van Horn Theory. The latest in this research is the collaboration between the use of information technology and public policy regarding waste bank management. Waste bank management model to implement a waste bank management program by including information technology elements in the information flow, sorting/sorting flow, bookkeeping flow and customer deposit distribution flow at the waste bank. Meanwhile, the model for implementing the waste bank management program in the flow of collecting or purchasing waste from local government waste banks requires establishing a Regional Owned Enterprise or regional company that specifically handles waste produced from waste banks. This has a massive impact on the green economy concept to improve community welfare.