Off-site Facility Research Articles

Comprehensive life cycle assessment of garden organic waste valorisation: A case study in regional Australia

This study evaluates the environmental impacts associated with the conversion of garden organic waste into value-added products, namely compost or biochar, employing various processes. Three distinct scenarios are considered: composting garden organic waste followed by screening of oversized materials (CBP), pyrolysis of oversized screenings of compost into biochar AP(I), and in-situ conversion of garden organics into biochar AP(II). A comprehensive Life Cycle Assessment (LCA) was conducted using OpenLCA software and life cycle impact assessment was conducted using Recipe 2016 midpoint methodology. The environmental ramifications of each scenario were assessed, optimising transport distances in AP(II) to achieve a functional unit of one tonne of biochar produced within a cradle-to-gate system boundary. For the first time, this study offers a holistic exploration of the benefits of soil biochar application, extending its scope to climate change mitigation, incorporating the optimisation of transport distance and its influence when scaling up the technology. The results revealed that global warming was increased from 125 kgCO2 eq during composting of garden waste to 232 kgCO2 eq where oversized screenings of compost is converted to biochar at an off-site facility. However, direct conversion of the oversized organic waste to biochar, without composting, showed reduced global warming impact of 56 kgCO2 eq, and is thus the most favourable scenario to limit climate impacts of this fraction of organic garden waste. However, among 18 environmental impact indicators studied, eight indicators were either not influenced or did not significantly increase by transport distance to an off-site pyrolysis facility, while the magnitude of 10 impact indicators increased with transport distance. The insights and methodologies presented in this study hold global relevance, based on an actual case study in regional Australia, offering valuable recommendations for sustainable waste management practices and establishing biochar as a carbon-neutral or carbon-negative solution. The findings contribute to existing waste management knowledge and provide guidance for accessible carbon dioxide removal and soil carbon sequestration technologies.

Dynamic Real-Time Optimization of Modular Unit Allocation to Off-Site Facilities in Postdisaster Reconstruction Using Deep Reinforcement Learning

Dynamic Real-Time Optimization of Modular Unit Allocation to Off-Site Facilities in Postdisaster Reconstruction Using Deep Reinforcement Learning

Advancing One Health through veterinary education: a mixed methods needs assessment for implementing a WOAH-harmonized national veterinary medicine curriculum in Ethiopia.

International organizations now actively promote and implement One Health collaborative approaches to prevent, detect, and control diseases in humans and animals, recognizing the critical importance of the veterinary and agricultural sectors. Moreover, Veterinary Services are chronically under-resourced, especially in low- and middle-income countries. Given the importance of National Veterinary Services to food security, nutrition, poverty alleviation, and global health security, strengthening veterinary capacity is a priority for the international community. The World Organisation for Animal Health (WOAH) outlines a set of minimum competencies veterinarians need to support National Veterinary Services effectively. To improve the quality of veterinary education, Ethiopia has developed a new 2020 national curriculum that is harmonized with the WOAH competencies. A mixed methods needs assessment was conducted to identify barriers and challenges that Ethiopian veterinary medicine programs have faced in implementing the new WOAH-harmonized national curriculum. Representatives from active veterinary programs granting a Doctor of Veterinary Medicine (DVM) degree were invited to share their experiences via an online survey and follow-up focus group discussion. Fourteen veterinary programs, representing 93% of eligible programs nationwide, participated in the needs assessment. Quantitative analysis indicated that the most difficult topics associated with the new curriculum included Organization of Veterinary Services (Competency 3.1), Inspection and Certification Procedures (3.2), and practical applications of the regulatory framework for disease prevention and control (multiple competencies). Challenges associated with specific instructional methodologies, particularly the facilitation of off-site (private and public sector) student training, were also perceived as barriers to implementation. Focus group discussions elucidated reasons for these challenges and included limitations in faculty expertise, resource constraints (e.g., supplies, infrastructure), and access to off-site facilities for hands-on teaching. The results of this needs assessment will be used to identify and prioritize solutions to implementation challenges, helping Ethiopian veterinary medicine programs move the new WOAH-harmonized curriculum from theory to practice. As veterinarians are integral partners in advancing One Health, strengthening the capacity of Veterinary Services can ultimately safeguard animal and human health, grow economies, and improve lives.

Decrease of the cost of drying compressed air by heat recovery at the compressor station

Compressed air is widely used as an energy carrier. The compressed air production systems are a part of the auxiliary systems of offsite facilities. It is worth noting that the production of com-pressed air is quite an energy-intensive process, so the potential for energy saving is quite large. There is increasing the efficiency of the compressed air production by developing technology solutions for air preparation in this work. The system of air drying by cooling and the source of cold are considered in this paper. The paper presents a comparison of cooling systems from steam compression and absorption refrigerating machines from the point of view of heat exchange, energy consumption for their own needs, providing cold with required parameters. The economic effect of the proposed circuit solution is given.

Analysis of sanitation system and coliform number in groundwater in Wonosari District, Gunungkidul Regency, Indonesia

Sanitation visualizes the environment’s health status, comprising housing, sewage disposal, and clean water provision. In general, sewerage can have on-site and offsite sanitation facilities. The research was conducted to characterize the sanitation system for sewage disposal, determine the water quality from biological parameters, and enumerate coliform bacteria in groundwater for every sanitation system observed in Wonosari District, Gunungkidul Regency, Indonesia. These sets of information can help detect groundwater contamination by coliform that reflects the sanitary characteristics of the sewage disposal to be further considered in sanitation management and treatment policies. The research used purposive sampling, field surveys, interviews with a questionnaire, laboratory analyses, and a descriptive-comparative design. The results showed that the sanitation system for sewage disposal at the study site consisted of individual septic tanks and wastewater treatment plants (WWTPs). In terms of quality, the coliform counts exceeded the existing standards, with the highest presence found in groundwater downstream of improperly maintained WWTPs and substandard septic tanks close to other sources of pollutants.

Clear the Floor: One Library’s Approach to the Removal and Integration of Items from Two Print Journal Collections

Due to the desire for more student space at the University of New Mexico Health Sciences Center, the Health Sciences Library and Informatics Center reviewed its serial holdings both in the library and in its offsite storage facility and determined which titles to retain and discard. This paper will briefly describe the selection process and then discuss the methods and phases of the project used to discard material in two shelving locations including auctioning material, donating material to another library, removing unselected material, and repurposing material for a decorative noise-abatement wall. This paper will also discuss the process of integrating items selected for retention from two shelving locations in separate buildings into one shelving location. The author will share the lessons learned throughout the project.

Environmental factors promoting the effective use of a computer-assisted clinical case for second-year osteopathic medical students.

Computer-aided clinical cases (CACC) have the potential to complement and/or supplement other types of problem-based learning exercises in modern medical curricula. Deploying a CACC learning experience requires institutional commitment to technology and a belief by administration, faculty, and students that "climbing a steep growth curve" is worth the effort. Several aspects of the institutional environment at the Kirksville College of Osteopathic Medicine (KCOM) led to the development of the CACC exercise described in this article, including the need to design a uniform, supplemental, Internet-based learning experience and assessment exercises for students doing clinical rotations at off-site facilities. The CACC learning experience was enthusiastically accepted by second-year medical students as an integrative and clinically relevant educational experience. The success of this CACC exercise has helped to promote the development of other innovative applications of technology to medical education at KCOM.

Access to information research in the digital era

Access to information research in the digital era

Application of the Analytic Hierarchy Process in selecting long-term storage option for spent nuclear fuel in South Africa

South Africa is one of the countries using nuclear power and has prospects to expand its use in the near future. The major issue with nuclear power generation is the management of spent nuclear fuel (SNF) which has become a challenge worldwide with South Africa also facing the same challenges.Radioactive waste management in South Africa is guided by a Radioactive Waste Management Policy and Strategy (RWMP&S) for the Republic of South Africa. In the Policy and Strategy, the government recognises that the practice of storing SNF in on-site storage pools is not sustainable and that regardless of any strategy chosen for the management of SNF, a long-term above-ground storage on an off-site facility is needed until a permanent solution is found.A number of options for dry storage systems are available from international vendors. The challenge is to select the most appropriate system for South Africa. The Analytic Hierarchy Process (AHP) is identified as a possible tool to aid the selection process. The study aims to demonstrate that the Analytic Hierarchy Process (AHP) is a tool that can be used to select a dry storage system option that will best meet South Africa’s needs.The study also presents the criteria to evaluate possible dry storage system options available in the international market. Pair-wise comparisons are conducted, and the ranking of the options is determined. Based on the results obtained from this study, it was demonstrated that the AHP tool can be applied to decide on the available option that will best meet South Africa’s needs.

Automated Model-Based 3D Scan Planning for Prefabricated Building Components

Modular construction can improve construction performance (i.e., cost, schedule, and safety) by prefabricating modules at an off-site facility and installing them at a construction site. However, when defects of modules are not easily repairable on the construction site, they cause additional cost overruns and delays due to long lead times of refabrication and reshipment. Thus, quality assessment of modular components at the fabrication facility before shipment is very important. The current inspection practices rely on manual measurement, which can be imprecise, labor-intensive, and time-consuming. To address this issue, some research efforts are made on the module inspection techniques (e.g., estimates of geometric properties and surface quality) using laser-scanned data. The accuracy of these techniques relies on the quality (i.e., coverage and resolution) of the scan data. However, ensuring the consistent quality of data is a major challenge as there is little to no research on optimal scan planning for modular components. Therefore, this paper proposes a model-based 3D scan planning method for modular components that ensures user-specified scan quality. Given a 3D computer-aided design (CAD) or building information modeling (BIM) model, scanner property, and user’s quality requirement, this method automatically computes the input parameters for the laser scanner (i.e., angular step and field of view) and optimal scan positions. It also predicts the scan quality and shows the areas that will not meet the user requirement due to geometric constraints (i.e., self-occluded surfaces). This study was validated through two case studies using two modular-sized structures in a fabrication facility. The results showed that the scan planner is able to accurately predict the scanning quality and ensure that the output scan will meet the user quality requirement.

A framework for the evaluation of the decision between onsite and offsite construction using life cycle analysis (LCA) concepts and system dynamics modeling

The decision to choose between onsite and offsite construction is important in the effort toward sustainable construction. Offsite construction is often promoted as an environmentally friendly approach to construction operations. However, previous studies have shown that there is a lack of clarity on the environmental trade-offs between onsite and offsite construction. Factors that can affect the decision to build onsite or offsite include the availability of a local offsite manufacturing facility, the distance of the offsite factory to the final place of use, the proximity of the site to the local supply of material and labor, etc. This study provides a framework to apply the system dynamic modeling technique to evaluate how various factors can affect the environmental impact of the building construction phase (for onsite or offsite construction methods). The system dynamic model (using Vensim software) that was developed provides a platform that allows users to input variables such as the distance that is expected for transportation of labor, material, and equipment to both the onsite facility and the offsite construction location, factors associated with the use of equipment for construction, the distance needed for transportation of building panels or modules from the offsite facility to the final site, etc. Among other things, the model showed that an increase in the distance from the offsite yard to the final construction site increases the total impacts of transportation of completed modules. An increase in the number of trips for the transportation of material to the onsite construction location increases the total impact of onsite construction. In terms of the environmental impact of construction, none of the two methods of construction gives an absolute superiority over the other. The environmental performance of offsite and onsite depends on various associated factors. It is recommended that building practitioners review various factors that are peculiar to their projects to make an informed decision on the best construction methods.

1357 THE ‘CONSULTATION COMMUNICATION’ PROFORMA: ENHANCING EFFECTIVE COMMUNICATION BETWEEN OUTPATIENTS AND INTERMEDIATE CARE

Abstract Introduction The Norman Power Centre (NPC) is a 32 bedded Intermediate Care Unit, run by an acute hospital trust in Birmingham, UK, for patients who require ongoing 24-hour care, rehabilitation or further assessment, but do not need to be in an acute hospital setting. These frail patients attend numerous outpatient hospital appointments, but rarely do staff receive communication back from these outpatient reviews. This can lead to delays in implementing specialist management plans, with potential for adverse outcomes for patients and increased staff workload in seeking out the required information. A ‘Consultation Communication’ proforma was designed, to be filled in at the appointment and brought back to NPC with the patient. Method Patients and escorts took proformas to outpatient appointments between March and June 2022. The information on the forms was then analysed to assess completeness and usefulness. Results Appointments were in surgical and medical specialities, as well as imaging in three hospitals within one trust. Proformas were taken to 19/20 appointments. 100% of these were at least partially completed, with only two forms being largely incomplete. 17/19 provided information about the assessment carried out. 12/19 included recommendations relevant to admission at NPC. 13/19 had information on medication changes. 14/19 stated whether follow up was required. Eight out of nine required follow-ups had specific details included. 13/19 had the professional’s details, 11 with contact numbers. Of those without details, two were imaging appointments where contact details were not relevant. Conclusions This easy to implement, simple intervention, with an excellent engagement rate from both NPC and outpatient appointment staff, has led to improved continuity of care for patients. The proforma has scope to be improved based on staff feedback, and its use could be expanded across other off-site facilities such as community hospitals or care homes.

Follow-up of Patients After Total Pancreatectomy and Islet Cell Autotransplantation at Off-Site Islet Isolation Facility.

Total pancreatectomy with islet autotransplantation (TPIAT) is a definitive management for intractable pain in patients with chronic pancreatitis. Islet autotransplantation (IAT) allows for the preservation of beta-cells to prevent complications of long-term diabetes. Our study follows TPIAT recipients for up to 12 years to determine the procedure's efficacy completed with an off-site islet isolation facility. Patient demographics, mixed meal tolerance test measures, glycosylated hemoglobin, insulin requirements, and homeostatic model assessment for insulin resistance values were collected prior to surgery and at the most recent follow-up. Forty-four patients (median age, 46.0 years; range, 20-78 years) underwent TPIAT for CP. At an overall median follow-up time of 845.5 days (range, 195-4470 days) 8 patients were insulin independent and 36 patients were insulin dependent. At the most recent follow-up, islet yield per kilogram was the strongest indicator of insulin independence. Homeostatic model assessment for insulin resistance values were comparable between insulin independent and dependent cohorts. Our long-term follow-up data suggest that IAT can effectively reduce insulin requirements and improve post-operative glycemic control.

344 LONG-TERM OUTCOMES FOR HIP FRACTURE PATIENTS WHO HAVE RECEIVED A PERIOD OF INPATIENT REHABILITATION

Abstract Background Twenty-eight percent of the 3,666 hip fractures reported by the Irish Hip Fracture Database (IHFD) in 2020 received a period of rehabilitation in an off-site facility nationally. Longer term outcomes for hip fracture patients are not yet included in the IHFD. This study aimed to describe recovery after hip fracture in patients admitted to a single inpatient rehabilitation facility. Methods Patients who experienced hip fracture between January 2020 and July 2020 were followed up for one year after their fracture. Baseline data was collected in relation to age, pre-fracture residence and New Mobility Score (NMS) and clinical frailty score. Residence, NMS and quality of life (EQ-5D-5L) were collected by a clinical physiotherapist at 30 days, 120 days and 1 year after hip fracture. Data was inputted and analysed using Microsoft Excel. Results Of 122 hip fracture patients admitted to rehabilitation,103 were followed up. The average age of patients was 79, 66% were female. The mortality rate was 9% (n=9) at 1 year follow up. Pre-fracture, n= 98 lived at home. Of these patients, 67%, 82% and 83% had returned home by 30 days, 120 days and 1 year. Pre-fracture 53% had high mobility levels (NMS>6). Of these patient 4%, 27% and 34% had returned to this level by 30 days, 120 and 1 year. 70% of patients had a low mobility score (0-6 on NMS) and 30 % had a high mobility score (7-9) at 1 year follow-up. 56% and 4% of patients reported no pain and severe pain at 1 year post op, respectively. 45% of patients had no issues performing their usual activities and 4% had severe issues/an inability to perform their usual activities at 1 year. Conclusion Our results show that recovery after hip fracture is slow with many not achieving baseline mobility or return to pre-fracture function within the first year.

PATIENT DECISION-MAKING PROCESS FOR DISPOSITION OF CRYOPRESERVED EMBRYOS

At our institution, cryopreserved embryos remain in onsite storage for up to three years, after which point patients are given the option to transfer embryos to an offsite storage facility, donate them to research, or discard them. This study aimed to assess factors influencing patient decision-making regarding embryo disposition, primarily the use of preimplantation genetic testing (PGT) and donor gametes, and secondarily household income. It was hypothesized that patients using PGT or donor gametes will be more likely to maintain embryos in storage.

VR–MOCAP-Enabled Ergonomic Risk Assessment of Workstation Prototypes in Offsite Construction

Workers in offsite construction facilities are often exposed to repetitive motion and awkward body postures that are associated with the risk of developing work-related musculoskeletal disorders despite the use of automated equipment on production lines. To reduce the exposure to these risks, an investigation of the physical demands that workstations impose on workers’ bodies is needed. Since traditional methods used to collect human body motions have limitations, such as workplace interruptions and biased results due to subjective observation, this paper proposes a virtual reality (VR)–motion capture (MOCAP)-based ergonomic assessment method to evaluate ergonomic risks in a laboratory setting during the design phase of workstation development. It is expected that the number of iterations of physical workstation prototypes would be reduced if ergonomic risk ratings are identified proactively in the initial phases of workstation design, which would thereby reduce the cost and time required to develop and implement an improved workstation design. The present study includes a feasibility analysis of the proposed method in which participants representative of specific percentiles of the population based on their physical stature were invited to voluntarily participate in a research experiment. The results obtained demonstrate that the proposed method can successfully simulate the elemental motions, referred to as therbligs, of reaching and positioning (Pearson’s correlation coefficient is found to equal 0.80 and 0.94, respectively), while the simulation of the assembling therblig requires further investigation. The contribution of this study is a virtual reality–motion captured-enabled ergonomic risk assessment method applied to workstation design for offsite construction production lines. In addition, the deployment of the proposed method allows a holistic ergonomic assessment that considers objective and subjective parameters.

A Robotic Storage Facility for the Dutch National Library Collections

ABSTRACT The KB National Library of the Netherlands (KB) is developing a new offsite storage facility for rehousing its entire physical collection. In an effort to become more sustainable, the national collection will be housed in a purpose-built passive building without elaborate heating, ventilation and air conditioning (HVAC) systems. Using a super high-density automated storage and retrieval system (ASRS), the combination of building and collections plays a major role in establishing a safe climate. Since control over the indoor environment in this new building is limited, it is vital to study the hygrothermal behavior of the building and collection by modelling. This simulation is novel in that it explores the impact of collections on the indoor environment. The effect on the indoor relative humidity (RH) of the way in which the storage volume is progressively filled and of the moisture content of the collection are evaluated.

Daily Oral Pre-exposure Prophylaxis (PrEP) Continuation Among Women from Durban, South Africa, Who Initiated PrEP as Standard of Care for HIV Prevention in a Clinical Trial

HIV incidence among women in Eastern and Southern Africa remains unacceptably high, highlighting the need for effective HIV prevention options, including pre-exposure prophylaxis (PrEP). The Evidence for Contraceptive Options and HIV Outcomes trial offered daily oral PrEP to participants during the latter part of the clinical trial as an additional HIV prevention choice. We explored daily oral PrEP continuation at trial exit among women enrolled from Durban, South Africa who initiated oral PrEP at the trial site. Of the 132 women initiating oral PrEP, 87% reported continuation of oral PrEP at month 1, 80% at month 3, and 75% continued using oral PrEP at their final trial visit and were referred to off-site facilities for ongoing oral PrEP access. The median duration of oral PrEP use in trial participants who used oral PrEP was 91 days (IQR 87 to 142 days). Women who disclosed their oral PrEP use to someone had increased odds of continuing oral PrEP at trial exit. Women who reported > 1 sex partner and those who felt they would probably or definitely get infected with HIV had reduced odds of continuing oral PrEP at trial exit. Of those discontinuing oral PrEP (n = 32), > 50% discontinued within the first month, and the most common reason for discontinuation was reporting side effects. The high rates of oral PrEP continuation in our study are encouraging and our findings can be utilized by other clinical trials providing oral PrEP as standard of care for HIV prevention and by oral PrEP implementation programmes.

24/7 Cold Chain Management System by Primary Health Care Corporation to support the National COVID-19 Mass Vaccination Program

Background: Across the world, the COVID-19 pandemic is causing unprecedented human and economic losses. The availability of safe and effective vaccines against the virus is instrumental in saving lives. Supply chain readiness is key to efficiently deliver vaccines to the target populations.1 To control temperature excursions and equipment breakdowns with an upgraded cold chain system with the latest technology suitable in a hot country are challenging. Methods: Primary Health Care Corporation (PHCC) institutionalized a continuous temperature monitoring system using a specific Temperature Monitoring Device (TMD) called a Digital Data Logger (DDL) mounted on cold chain medical equipment like pharmaceutical refrigerators, freezers, and the pre-qualified iceboxes of the World Health Organization (WHO). The DDL devices were affixed to the medical equipment to monitor the temperature and are supported by sound alarm when there are temperature excursions. Results: PHCC Cold Chain Management Ecosystem (Figure 1) involves vaccine vials stored in pharmaceutical refrigerators with a temperature range between 2°C to 8°C and freezers with a temperature range between -10°C to -30°C and WHO prequalified iceboxes for short periods of transportation.2 The DDL has a set point temperature measuring limit, measuring interval, and delay time (Table 1) defined for temperature monitoring.3 PHCC Bio-Medical Engineering Department has successfully institutionalized a 24-hour/7 day a week Cold Chain Management System across 27 PHCC health centers. Moreover, a Cold Chain Management System was arranged in an offsite facility within a short period of 72 hours at the Qatar National Convention Centre where the Covid-19 Mass Vaccination Program administered 650,000 doses over 4 months with Zero Wastage of Vaccines attributed to any temperature excursions. Conclusion: PHCC can rapidly deliver healthcare cold chain management solutions under any circumstances. To leverage economies of scale and utilize emerging technology, PHCC has envisioned a plan to migrate the cold chain medical equipment 24/7 temperature monitoring based on cloud services in 2022.

Tales of a Flow Stayed By Nothing: Menstruation in Immigration Detention


 
 
 When Fauziya Kassindja landed at New York’s JFK airport in 1994, she was seventeen, seeking asylum, and fleeing the brutal practice of female genital mutilation. She was also menstruating. Hours after her arrival, Fauziya was strip searched, forced to stand before a female officer “completely naked, soiled pad exposed, shamed beyond words.” She was then transferred to an off-site detention facility where she was strip- searched again. When Fauziya asked where she should place her soiled pad, the female guard responded: “I don’t know. Why don’t you eat it?” When Fauziya asked for a new pad, she was told she could ask for one the next morning. She was given absolutely nothing to stay her flow—not even toilet paper or paper towels. This was the beginning of Fauziya’s experience with immigration detention. She would remain there for sixteen months.