Search Results (358)

Occupational exposure to sharps waste represents a critical challenge for public health systems, directly affecting healthcare workers’ safety, institutional costs, and environmental sustainability. This study aimed to analyze sharps waste management practices and to structure improvement actions for biosafety governance in Brazilian Emergency Care Units (ECUs) through the application of the Lean Six Sigma (LSS) and DMAIC method (Define, Measure, Analyze, Improve, and Control). A single multiple-case study was conducted across three public units in different regions of Brazil, combining direct observation, regulatory checklists based on ANVISA Resolution No. 222/2018 (RDC), and cause–and–effect (5M) analysis. The diagnostic phase identified recurrent nonconformities in labeling, documentation, and internal transport routes, primarily due to managerial and behavioral gaps. Based on these findings, the DMAIC framework supported the development of a low-cost, evidence-based action plan that outlined proposed interventions, including visual checklists, standardized internal routes, and key performance indicators (KPIs), intended to strengthen biosafety traceability and occupational safety. The se proposed actions are expected to support continuous learning, staff engagement, and a culture of shared responsibility for safe practices. Overall, the study provides a structured basis for future implementation and empirical validation of continuous improvement initiatives, aimed at enhancing public health governance and occupational safety in resource-constrained healthcare environments. Full article

Polyhydroxyalkanoates (PHAs), a family of biodegradable polyesters produced through microbial fermentation of carbon-rich residues, are emerging as attractive alternatives to petroleum-based plastics. Their appeal lies in their exceptional biocompatibility, inherent biodegradability, and tunable physicochemical properties across diverse applications. These materials are environmentally friendly not just at the end of their life, but throughout their entire production–use–disposal cycle. This mini-review presents an update on the expanding biomedical relevance of PHAs, with emphasis on their utility in tissue engineering and drug delivery platforms. In addition, current clinical evaluations and regulatory frameworks are briefly discussed, underscoring the translational potential of PHAs in meeting unmet medical needs. As the healthcare sector advances toward environmentally responsible and patient-focused innovations, PHAs exemplify the convergence of waste valorization and biomedical progress, transforming discarded resources into functional materials for repair, regeneration, and healing. Full article

Background: The healthcare sector plays a significant role in environmental degradation, particularly through energy consumption, emissions, and resource use associated with hospital operations. Despite growing global awareness of the impacts, environmental sustainability remains only partially embedded with the design, planning, management, and evaluation of hospital facilities, and empirical evidence is still limited. Methods: This exploratory study employed a mixed-method, two-phase approach. First, a scoping literature review identified key environmental dimensions and approaches for environmental sustainability in hospitals infrastructures. Second, a structured survey was distributed to Italian hospitals from Lombardy Region, between May and June 2024, to assess environmental performance and environmental strategy adoption. Results: Eight (n = 8) core environmental sustainability dimensions emerged from the review: energy efficiency, resource and waste management, transportation and mobility, materials and construction, environmental compliance, emissions, site sustainability, and design strategies. The subsequent based on these dimensions, gathered responses from (n = 18) healthcare facilities from Lombardy region, Italy. Findings revealed substantial gaps, since key measures such as on-site renewable capacity, water reuse systems, environmental certification application and health-island mitigation practices appear to be adopted sporadically. In addition, many of the surveyed facilities show consumption levels that exceed the benchmarks outlined in the literature. Discussion: The findings of this study reveal a notable misalignment between the sustainability debate, maturity promoted in the academic literature and the actual practices implemented in the Italian regional context. This mismatch highlights the importance of developing more uniform evaluation tools, policy requirements, and strengthening the organizational capabilities, to improve environmental performance in Italian hospital facilities. Full article

The global expansion of healthcare services has made medical waste management an increasingly critical and complex issue. Medical wastes require specialized management due to their high infection risk, potential for environmental pollution, and adverse effects on public health. The correct collection, transportation, and final disposal are vital for protecting environmental health and ensuring the safety of hospital personnel and the community. Numerous disposal methods exist. Selecting the appropriate one, however, is a multi-dimensional decision-making problem, necessitating the simultaneous evaluation of various conflicting criteria. Adana, one of Turkey’s largest provinces, generates significant medical waste volumes due to its dense population and developed health infrastructure. Therefore, choosing the most suitable disposal method for hospitals in Adana is crucial for establishing an effective and sustainable waste management system. Making this decision using traditional methods is difficult. The multitude of criteria prevents any single method from being optimal across all aspects. This complexity mandates the use of Multi-Criteria Decision-Making (MCDM) methodologies. In this study, MCDM methods were applied, based on expert opinions, to select the disposal method at a university hospital in Adana. The research examined twelve criteria and four alternatives. The CRITIC (Criteria Importance Through Intercriteria Correlation) method was employed to objectively weigh the criteria. For the rigorous evaluation and ranking of the alternatives, three robust MCDM methods were utilized: PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluation), TOPSIS (Technique for Order Preference by Similarity to Ideal Solution), and EDAS (Evaluation based on Distance from Average Solution). The final results conclusively identified incineration as the most appropriate disposal method for the hospital. Full article

Period poverty refers to the lack of access to or affordability of menstrual hygiene supplies such as sanitary products and the inaccessibility of washing facilities, waste disposal and educational materials. Period poverty can significantly affect menstruating individuals’ physical, mental, and reproductive health and emotional wellbeing; negatively impact educational outcomes; cause financial strain; result in absenteeism from work and school; create barriers to healthcare access; and perpetuate poor health outcomes for generations. Barriers to menstrual equity include lack of access to period support, cost, poor sanitary facilities, lack of education, social and cultural stigma, and legal restrictions. Therefore, it is crucial to actively advocate for initiatives to increase access to menstrual hygiene products, raise public awareness, and educate individuals on safe menstrual practices. Approximately 500 million girls and women worldwide and an estimated 16.9 million people in the United States experience period poverty, with the issue being particularly common among marginalized groups such as Black or Hispanic menstruating individuals and those who are homeless, living in poverty, of low income, or attending college. This article investigates the physical, psychological, educational and social impacts of inequitable access to menstrual products, menstrual education, and sanitation facilities among menstruating individuals who are Black, Hispanic or of low income within the United States. We examine the threat this poses to health equity and propose recommendations to address this pervasive issue. Full article

Gastrointestinal (GI) endoscopy is a daily procedure in clinical practice but contributes substantially to healthcare’s environmental footprint. Data on sustainability policies in Switzerland, however, remain scarce. This study aimed to assess the implementation of sustainability practices among members of the Swiss Society of Gastroenterology (SGG-SSG). We conducted a web-based cross-sectional survey between September 2023 and January 2024, targeting all 463 practicing Swiss gastroenterologists listed in the latest SGG-SSG roster. The survey comprised eleven questions covering four domains: respondent demographics; waste and single-use device management and procurement; digitalization; and work–life balance. A total of 161 respondents participated (response rate: 34.8%). Less than half (45.1%) reported waste sorting, while policies for single-use device reduction (23.5%) and waste minimization initiatives (27.8%) were even less common. Nearly half (48.8%) reported including sustainability considerations in procurement policies. In contrast, 52.8% reported having policies to promote work–life balance, and 88.2% reported policies requiring the use of electronic health records, reflecting significant progress in digitalization. While procurement and digitalization efforts are more widely implemented, further coordinated action is needed. Future research should investigate professional attitudes, institutional barriers, and strategies to enhance the adoption of environmentally responsible practices in GI endoscopy. Furthermore, professional societies (particularly SGG-SSG), hospital administrators, and cantonal health authorities must coordinate to establish national standards, integrate sustainability into accreditation, and implement incentives and accountability to reduce the environmental impact of GI endoscopy without compromising quality of care. Full article

Smart textiles are emerging as transformative modern textiles in which sensing, actuation, and communication are directly embedded into textiles, extending their role far beyond passive wearables. This review presents a comprehensive analysis of the convergence between smart textiles, the Internet of Things (IoT), and human-centric design, with sustainability as a guiding principle. We examine recent advances in conductive fibers, textile-based sensors, and communication protocols, while emphasizing user comfort, unobtrusiveness, and ecological responsibility. Key breakthroughs, such as silk fibroin ionic touch screens (SFITS), illustrate the potential of biodegradable and high-performance interfaces that reduce electronic waste and enable seamless human–computer interaction. The paper highlights cross-sector applications ranging from healthcare and sports to defense, fashion, and robotics, where IoT-enabled textiles deliver real-time monitoring, predictive analytics, and adaptive feedback. The review also focuses on sustainability challenges, including energy-intensive manufacturing and e-waste generation, and reviews ongoing strategies such as biodegradable polymers, modular architectures, and design-for-disassembly approaches. Furthermore, to identify future research priorities in AI-integrated “textile brains,” self-healing materials, bio-integrated systems, and standardized safety and ethical frameworks are also visited. Taken together, this review emphasizes the pivotal role of smart textiles as a cornerstone of next-generation wearable technology, with the potential to enhance human well-being while advancing global sustainability goals. Full article

Effective medical waste planning relies on the reliable estimation of waste volumes. As operational factors diversify, traditional linear regressions often fail to capture the underlying structure, whereas latent variable–based and ensemble approaches can better represent this complexity. In this study, fine-tuned Partial Least Squares (PLS), scikit-learn–based Gradient Boosting regression (GBR), and a baseline Ordinary Least Squares (OLS) model were compared for estimating medical waste generation using 48 months (2021–2024) of approximate data from Dental Clinics affiliated with the Provincial Health Directorate in Kastamonu. The model inputs were the monthly procedure counts for endodontics, treatment, prosthetics, periodontology, orthodontics, pedodontics, and surgery. Performance was evaluated using Root Mean Square Error (RMSE), Mean Absolute Error (MAE) and R-squared (R²). All models produced accurate predictions; however, PLS provided the strongest fit (R² = 0.979; MAE = 30.488; RMSE = 37.043), outperforming GBR (R² = 0.962; MAE = 36.544; RMSE = 48.990) and the OLS baseline (R² = 0.927; MAE = 41.762; RMSE = 59.013). The findings demonstrate that modern, data-driven waste-management planning is feasible in healthcare institutions and highlight PLS as a robust option, particularly under conditions of small sample size and collinearity. Full article

Background/Objective: This cross-sectional study assessed the knowledge, attitudes, and practices (KAP) of radiology professionals in Saudi Arabia regarding environmental sustainability. Methods: An online survey with 298 participants revealed moderate knowledge and positive attitudes towards sustainability. Results: However, a significant gap between awareness and practice was observed. The most common sustainable practice was digital documentation (53.4%), while energy saving and water saving measures were rare, with more than half rarely or never practicing energy saving. The primary barrier to implementation was a lack of awareness and training (50%). The sustainability association was significantly higher among older, female, and hospital-based professionals. Conclusions: The findings underscore the urgent need for improved educational initiatives, strong institutional support, and clear policy frameworks to effectively integrate sustainable practices into radiology departments in Saudi Arabia. Full article

Background/Objectives: Environmental sustainability is increasingly recognized as a key component of healthcare governance, and dentistry represents a high-impact subsector due to its intensive use of materials, resources, and biosafety-driven disposables. Despite rising scientific interest, available evidence remains fragmented and methodologically heterogeneous. This study aims to systematically map the existing review-based evidence on sustainability in oral healthcare services. Methods: The protocol was prospectively registered on OSF. Narrative, scoping, and systematic reviews evaluating sustainability within oral healthcare services were eligible. Comprehensive searches were conducted in Embase, PubMed/MEDLINE, Scopus, Web of Science, LILACS, Cochrane Library, and regional databases (WPRIM, WHOLIS, BBO, BDENF, IBECS, PIE, ColecionaSUS), without language or date restrictions. Two reviewers independently screened studies via Rayyan, resolved discrepancies by consensus, and extracted descriptive and thematic data using a structured Population-Concept–Context eligibility framework. A qualitative inductive synthesis identified recurring domains, and methodological rigor was appraised with a modified 12-item AMSTAR-2 tool. Results: Of 5793 records retrieved, 17 reviews met inclusion criteria (8 narrative, 5 scoping, 4 systematic). Most publications (82.4%) were from the past five years. Three thematic axes were identified: (1) the 4Rs (rethink, reduce, recycle, reuse); (2) waste and effluent management; and (3) barriers, practices, and sustainability policies. Evidence was strongly concentrated in high-income countries, and methodological quality varied widely, with ten reviews scoring below 60% on AMSTAR-2. Conclusions: Review-based evidence on sustainable dentistry is expanding yet remains limited and operational in focus. The literature remains disproportionately centered on operational issues—primarily waste management and material consumption—while broader systemic determinants such as governance, equity, financing, and professional education receive comparatively little attention. Strengthening methodological rigor, harmonizing sustainability indicators, and advancing empirical evaluations are essential for guiding equitable and environmentally responsible oral healthcare systems. Full article

Background: Hospitals generate large volumes of single-use plastic waste, which are predominantly incinerated. To improve sustainability, standardized procedure-specific surgical trays have been implemented, reducing waste and setup time. This early feasibility study investigated whether all residual plastics from surgical procedures could be recycled via pyrolysis into high-quality oil for circular reuse in medical supply production. Methods: All residual plastics from five transurethral resection (TUR) trays were subjected to pyrolysis at 430–460 °C in a batch reactor. Condensable fractions were separated into heavy (HF) and light (LF) oils, while non-condensable gases and coke were quantified. Chemical analyses included the density, water content, heating value, and elemental composition. Results: From 1.102 kg of input material, the process yielded 78 weight percent (wt%) oil (HF 59.1%, LF 40.9%), 20.5 wt% gas, and 1.5 wt% coke. HF solidified at room temperature, whereas LF remained liquid, reflecting distinct hydrocarbon chain distributions. The oils exhibited densities of 767.0 kg/m³ (HF) and 748.9 kg/m³ (LF), heating values of 46.39–46.80 MJ/kg, low water contents (<0.05 wt%), and minimal contamination (silicone ≤ 193 mg/kg; chlorine ≤ 110 mg/kg). Conclusions: Pyrolysis of surgical tray plastics produces decontaminated high-energy oils comparable in quality to fossil fuels, with a material recovery rate exceeding 75% and potential CO₂ savings of ~ 2.9 ton per t plastic compared with incineration. This process provides a technically and ecologically viable pathway toward a scalable circular economy in healthcare. Full article

In the era of Industry 5.0, the digital revolution stands as the paramount tool for achieving efficiency and elevating the standards of quality and quantity. This study delves deeply into the invaluable applications of digital twins within real production settings, highlighting their transformative potential across a multitude of industries. Focusing particularly on textiles, machinery, and electronics manufacturing, the authors illustrate how digital twins enhance productivity, anticipate challenges, bolster the food supply chain, refine healthcare services, and propel sustainability initiatives within each sector. Through concrete examples, we demonstrate how digital twins can markedly decrease waste, energy consumption, and production downtime, all while elevating product quality and enabling virtualization. By virtually simulating physical systems, numerous operational issues can be mitigated, underscoring the pivotal role of digital twins in fostering hyper-personalization, sustainability, and resilience the foundational tenets of Industry 5.0. Nevertheless, this evaluation acknowledges the inherent challenges associated with the widespread adoption of digital twins, including concerns regarding data infrastructure, cybersecurity, and workforce adaptation. By presenting a balanced assessment of both the advantages and disadvantages, this review aims to guide future research and development endeavors, paving the way for the successful integration of this revolutionary technology as we journey toward Industry 5.0. Full article

This study compares certification systems for green healthcare facilities implemented worldwide. Healthcare facilities are complex structures designed to provide uninterrupted service while involving substantial resources, high energy consumption, and heavy human and material traffic. The COVID-19 pandemic emphasized the importance of designs that ensure hygiene, reduce environmental impact, and improve energy efficiency, making green certification systems for healthcare facilities increasingly critical. Eight certification systems currently in use across eight countries were examined, four from advanced economies (LEED in the U.S., BREEAM in the U.K., Green Star in Australia, and CASBEE in Japan) and four from developing economies (YeS-TR in Türkiye, IGBC in India, GBI in Malaysia, and GREENSHIP in Indonesia). Country selection considered regional diversity, similarities in environmental policies, and the potential for healthcare infrastructure development. A literature-based comparative analysis was conducted, and seven key categories were identified for evaluating sustainability: sustainable land and transport, water and waste management, energy efficiency, material and life cycle impact, indoor environmental quality, project management process, and innovation. The comparison revealed considerable overlap among the systems but also highlighted shortcomings in addressing healthcare-specific needs. This paper contributes to the advancement of sustainability assessment in the healthcare sector by highlighting the need for certification schemes specifically designed for medical facilities. The findings emphasize the necessity of developing healthcare-tailored frameworks that not only address environmental performance but also capture the unique operational, functional, and clinical dynamics of this sector. Full article

Background: Socioeconomic factors may influence maternal nutrition knowledge (MNK), which directly affects the nutritional status of children under five. This study aims to explore the importance of socioeconomic factors associated with MNK and nutritional status. Methods: This cross-sectional study focused on mothers of children aged 36–59 months (n = 657). A structured questionnaire was employed to collect data on socioeconomic factors. Anthropometric measurements were taken to assess nutritional status. The Boruta algorithm, implemented using R Studio version R.4.5.1, was used to identify the most important socioeconomic factors associated with MNK and nutrition status. Results: The analysis revealed that socioeconomic status (SES) emerged as an important factor associated with MNK and nutrition status, particularly stunting and wasting. However, SES was not confirmed as an important factor associated with underweight. This study uncovered a bidirectional relationship between child nutrition outcomes; underweight was found to be an important factor related to stunting and wasting, whereas stunting and wasting were important factors for underweight. Furthermore, infant and young child feeding (IYCF) indicators, such as weaning practices and exclusive breastfeeding (BF), were found to be important factors for stunting and wasting. Conclusions: The interlinkage among forms of undernutrition, where each nutritional outcome is related to other outcomes, underscores the importance of comprehensively addressing child undernutrition, rather than focusing on single outcomes independently. Moreover, the association between SES and MNK, wasting, and stunting supports approaches based on holistic and multi-sectoral strategies to reduce poverty by WASH programs, promote IYCF practices, and improve healthcare access by providing health insurance coverage. Full article

Smart devices and emerging technologies are highly popular devices and technologies that considerably improve our daily living by reducing or replacing human workforces, treating disease, monitoring healthcare, enhancing service performance, improving quality, and protecting the natural environment, and promoting non-gas emissions, sustainable working, green technologies, and renewable energy. Triboelectric nanogenerators (TENGs) have recently emerged as a type of advanced energy harvesting technology that is simple, green, renewable, flexible, and endurable as an energy resource. High-performance TENGs, denoted as advanced TENGs, have potential for use in many practical applications such as in self-powered sensors and sources, portable electric devices, power grid penetration, monitoring manufacturing processes for quality control, and in medical and healthcare applications that meet the criteria for smart devices and emerging technologies. Advanced TENGs are used as highly efficient energy harvesters that can convert many types of wasted mechanical energy into the electric energy used in a range of practical applications in our daily lives. This article reviews recently advanced TENGs and their potential for use with smart devices and emerging technology applications. The work encourages and strengthens motivation to develop new smart devices and emerging technologies to serve us in many fields of our daily living. When TENGs are introduced into smart devices and emerging technologies, they can be applied in a variety of practical applications such as the food processing industry, information and communication technology, agriculture, construction, transportation, marine technology, the energy sector, mechanical processing, manufacturing, self-powered sensors, Industry 4.0, drug safety, and robotics due to their sustainable and renewable energy, light weight, cost effectiveness, flexibility, and self-powered portable energy sources. Their advantages, disadvantages, and solutions are also discussed for further research. Full article