Adoption of lean philosophy in car dismantling companies in Sweden-a case study

At present, Lean manufacturing techniques are widely used in industries to improve the productivity by reducing different types of wastes. A case study has been conducted to investigate how Lean techniques can contribute in car dismantling companies in Sweden. This study gained insight of how car dismantling companies can be benefitted by adopting Lean philosophy. Some eccentric characteristics of this business which act as boundary condition for implementing Lean in Production Planning and control system were also identified

Implementation status of national tuberculosis infection control guidelines in Bangladeshi hospitals.

In response to the World Health Organization (WHO) recommendation to reduce healthcare workers' (HCWs') exposure to tuberculosis (TB) in health settings, congregate settings, and households, the national TB control program of Bangladesh developed guidelines for TB infection prevention and control (IPC) in 2011. This study aimed to assess the implementation of the TB IPC healthcare measures in health settings in Bangladesh. Between February and June 2018, we conducted a mixed-method study at 11 health settings. The team conducted 59 key-informant interviews with HCWs to understand the status of and barriers impeding the implementation of the TB IPC guidelines. The team also performed a facility assessment survey and examined TB IPC practices. Most HCWs were unaware of the national TB IPC guidelines. There were no TB IPC plans or committees at the health settings. Further, a presumptive pulmonary TB patient triage checklist was absent in all health settings. However, during facility assessment, we observed patient triaging and separation in the TB specialty hospitals. Routine cough-etiquette advice was provided to the TB patients mentioned during the key-informant interviews, which was consistent with findings from the survey. This study identified poor implementation of TB IPC measures in health settings. Limited knowledge of the guidelines resulted in poor implementation of the recommendations. Interventions focusing on the dissemination of the TB IPC guidelines to HCWs along with regular training may improve compliance. Such initiatives should be taken by hospital senior leadership as well as national policy makers

Examining pulmonary TB patient management and healthcare workers exposures in two public tertiary care hospitals, Bangladesh.

Implementation of tuberculosis (TB) infection prevention and control (IPC) guidelines in public tertiary care general hospitals remain challenging due to limited evidence of pulmonary TB (PTB) patients' duration of hospital stay and management. To fill this evidence gap, this study examined adult PTB patient management, healthcare workers' (HCWs) exposures and IPC practices in two public tertiary care hospitals in Bangladesh.Between December 2017 and September 2019, a multidisciplinary team conducted structured observations, a hospital record review, and in-depth interviews with hospital staff from four adult medicine wards.Over 20 months, we identified 1,200 presumptive TB patients through the hospital record review, of whom 263 were confirmed PTB patients who stayed in the hospital, a median of 4.7 days without TB treatment and possibly contaminated the inpatients wards. Over 141 observation hours, we found a median of 3.35 occupants present per 10 m2 of floor space and recorded a total of 17,085 coughs and 316 sneezes: a median of 3.9 coughs or sneezes per 10 m2 per hour per ward. Only 8.4% of coughs and 21% of sneezes were covered by cloths, paper, tissues, or by hand. The HCWs reportedly could not isolate the TB patients due to limited resources and space and could not provide them with a mask. Further, patients and HCWs did not wear any respirators.The study identified that most TB patients stayed in the hospitals untreated for some duration of time. These PTB patients frequently coughed and sneezed without any facial protection that potentially contaminated the ward environment and put everyone, including the HCWs, at risk of TB infection. Interventions that target TB patients screening on admission, isolation of presumptive TB patients, respiratory hygiene, and HCWs' use of personal protective equipment need to be enhanced and evaluated for acceptability, practicality and scale-up

An energy-efficient pumping system for sustainable cities and society: Optimization, mathematical modeling, and, impact assessment

In this research work, we have focused on one of the reasons called drawdown (difference between static and pumping heads) for getting maximum efficiency. Therefore, various mechanical attachments have been designed and fabricated for performance evaluation. Since pump performance and drawdown are inversely related, the primary goal is to reduce drawdown as much as possible. The effect of various types of mechanical attachments on pump performance is investigated in this research work. Three bowl-type mechanical attachments can be integrated at once and can increase efficiency by up to 58%, which is 8% more than utilizing no attachment. Additionally, the impact of bore well diameter on pump performance has been studied. In addition, the impact of applying mechanical attachment at two pumping sites has been investigated, and a considerable amount of energy savings has been found. The response surface methodology (RSM)-based optimization of the various input parameters has also been examined. It was found that the maximum 62.04 % could be achieved through a head of 66.5 m, a discharge of 0.012 m3/s, an input power of 12,605 W, and a bore well diameter of 0.215054 m, having three bowl-type mechanical attachments at a time. The mathematical modeling was also performed using analysis of variance (ANOVA) and formulated some equations for pumping efficiency with various pumping input parameters. Since there is very little variation between actual and anticipated performance, it can be used to evaluate the pumping system’s performance in relation to various input parameters. As a result, maintaining sustainable cities and societies might greatly benefit from the energy-efficient pumping system

Household-level effects of providing forecast-based cash in anticipation of extreme weather events:Quasi-experimental evidence from humanitarian interventions in the 2017 floods in Bangladesh

In 2017, Bangladesh experienced the worst floods in recent decades. Based on a forecast and pre-defined trigger level, a Red Cross Red Crescent project distributed an unconditional cash grant of BDT 5000 (USD 60 equivalent) to 1039 poor households in highly vulnerable, flood-prone communities in the Brahmaputra river basin before an early flood peak. Systems that can deliver forecast-based cash grants are a potential adaptation strategy to deal with changes in extreme events linked to climate change. This paper presents the results of a mixed-methods, quasi-experimental study, based on a post-disaster household survey. The research assesses the effectiveness of the forecast-based cash distribution in helping beneficiaries to take preparatory early actions and reduce the negative impacts of the flood on their health, well-being, assets and livelihoods. The assessment shows that the cash grants contributed to improving households' access to food, a reduction in high-interest debt accrual of vulnerable households, and reduced psychosocial stress during and after the flood period, compared to a control group of similarly vulnerable and flood-affected communities that did not receive the forecast-based cash assistance. The intervention may also have prevented households from being forced to make destitution sales of valuable assets, as indicated by qualitative data collected in July, but we do not see these benefits sustained after a second flood peak in August 2017. There is a need for further research to assess the longer-term effects of forecast-based cash on the socio-economic development and well-being of the most vulnerable

Impact of COVID-19 on hospital admission of acute stroke patients in Bangladesh.

BackgroundWith the proposed pathophysiologic mechanism of neurologic injury by SARS CoV-2, the frequency of stroke and henceforth the related hospital admissions were expected to rise. This paper investigated this presumption by comparing the frequency of admissions of stroke cases in Bangladesh before and during the pandemic.MethodsThis is a retrospective analysis of stroke admissions in a 100-bed stroke unit at the National Institute of Neurosciences and Hospital (NINS&H) which is considerably a large stroke unit. All the admitted cases from 1 January to 30 June 2020 were considered. Poisson regression models were used to determine whether statistically significant changes in admission rates can be found before and after 25 March since when there is a surge in COVID-19 infections.ResultsA total of 1394 stroke patients took admission in the stroke unit during the study period. Half of the patients were older than 60 years, whereas only 2.6% were 30 years old or younger. The male to female ratio is 1.06:1. From January to March 2020, the mean rate of admission was 302.3 cases per month, which dropped to 162.3 cases per month from April to June, with an overall reduction of 46.3% in acute stroke admission per month. In those two periods, reductions in average admission per month for ischemic stroke (IST), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH) and venous stroke (VS) were 45.5%, 37.2%, 71.4% and 39.0%, respectively. Based on weekly data, results of Poisson regressions confirm that the average number of admissions per week dropped significantly during the last three months of the sample period. Further, in the first three months, a total of 22 cases of hyperacute stroke management were done, whereas, in the last three months, there was an 86.4% reduction in the number of hyperacute stroke patients getting reperfusion treatment. Only 38 patients (2.7%) were later found to be RT-PCR SARS Cov-2 positive based on nasal swab testing.ConclusionThis study revealed a more than fifty percent reduction in acute stroke admission during the COVID-19 pandemic. Whether the reduction is related to the fear of getting infected by COVID-19 from hospitalization or the overall restriction on public movement or stay-home measures remains unknown