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Sample records for materiel electronique utilise

  1. Developpement d'un vibrateur acoustique pour precipiter les defauts latents de circuits electroniques

    NASA Astrophysics Data System (ADS)

    Lafleur, Francois

    2003-08-01

    Le procede de deverminage, ou Environmental Stress Screening (ESS), est employe principalement dans le domaine de l'electronique pour reduire les mortalites infantiles des produits avant leur livraison. Il utilise usuellement des stimulations environnementales telles que les vibrations ou la temperature produites a l'aide d'equipements conventionnels d'essais qui sont tres couteux et difficiles a implanter. Le but de cette recherche est le developpement d'une nouvelle methode d'excitation vibratoire des plaques de circuits electroniques a moindre cout par l'emploi de l'excitation acoustique. Le projet a mene au developpement d'un vibrateur acoustique pouvant etre utilise lors d'implantations du procede ESS en milieu industriel. L'utilisation de cette nouvelle technologie et des methodes novatrices de personnalisation des spectres ESS proposees dans cette these permettent la precipitation de defaillances latentes presentes dans les produits electroniques de facon efficace et securitaire et ce, a moindre cout par rapport aux technologies concurrentes. La methodologie des travaux presentes dans cette these inclus: (1) La generation acoustique des vibrations sur les circuits; (2) L'analyse modale acoustique des circuits par des methodes a reference unique et a references multiples; (3) La precipitation de defauts latents typiques des circuits electroniques; (4) Une methode d'individualisation des spectres vibratoires tenant compte des caracteristiques structurelles des circuits; (5) La presentation de la configuration de l'equipement acoustique et les resultats d'implantation du procede. Nonobstant la fabrication, l'installation et la mise en service d'un equipement en milieu industriel (depuis le mois de mai 2002), ces travaux ont permis l'obtention de trois familles de brevets et la publication de six articles de conference: trois portant sur l'analyse modale a reference unique, un portant sur l'analyse modale a references multiples, un autre portant sur la

  2. 31 CFR 543.301 - Arms or any related materiel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Arms or any related materiel. 543.301... Definitions § 543.301 Arms or any related materiel. The term arms or any related materiel means arms or... of arms and related materiel and technical training and assistance intended solely for support of...

  3. 31 CFR 547.301 - Arms or any related materiel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Arms or any related materiel. 547.301... REGULATIONS General Definitions § 547.301 Arms or any related materiel. The term arms or any related materiel means arms or related materiel of all types, including military aircraft and equipment, but excludes:...

  4. 31 CFR 543.301 - Arms or any related materiel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Arms or any related materiel. 543.301... Definitions § 543.301 Arms or any related materiel. The term arms or any related materiel means arms or... of arms and related materiel and technical training and assistance intended solely for support of...

  5. 31 CFR 547.301 - Arms or any related materiel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Arms or any related materiel. 547.301... REGULATIONS General Definitions § 547.301 Arms or any related materiel. The term arms or any related materiel means arms or related materiel of all types, including military aircraft and equipment, but excludes:...

  6. 31 CFR 543.301 - Arms or any related materiel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Arms or any related materiel. 543.301... Definitions § 543.301 Arms or any related materiel. The term arms or any related materiel means arms or... of arms and related materiel and technical training and assistance intended solely for support of...

  7. 31 CFR 547.301 - Arms or any related materiel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Arms or any related materiel. 547.301... REGULATIONS General Definitions § 547.301 Arms or any related materiel. The term arms or any related materiel means arms or related materiel of all types, including military aircraft and equipment, but excludes:...

  8. 31 CFR 543.301 - Arms or any related materiel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Arms or any related materiel. 543.301... Definitions § 543.301 Arms or any related materiel. The term arms or any related materiel means arms or... of arms and related materiel and technical training and assistance intended solely for support of...

  9. Proprietes de Transport Electronique du Rutile Stoechiometrique

    NASA Astrophysics Data System (ADS)

    Keroack, Danielle

    Le rutile est un oxyde metallique qui presente beaucoup de similitudes avec certains perovskites notamment le titanate de barium ou de strontium. Il est comme ces derniers, compose d'un agencement d'octaedres d'oxygene centres sur l'atome de titane. Ces octaedres sont responsables de la forte polarisabilite de ces cristaux et de leur grande constante dielectrique. Leurs proprietes optiques, seuil d'absorption et spectre de phonons, sont par exemple forts semblables. La presente etude vise a determiner la nature du transport electronique dans le rutile stoechiometrique pur et d'en comparer les resultats avec les proprietes de certains perovskites. Nous determinerons par differentes mesures optoelectroniques les parametres caracteristiques des pieges et leur influence sur le transport des electrons et des trous. Les resultats de conductivite et de capacitance de meme que les spectres de photoconductivite dans nos echantillons ont mis en evidence la presence d'au moins cinq niveaux energetiques dans la bande interdite du rutile agissant comme pieges pour les electrons ou pour les trous et qui jouent un role de premiere importance dans le comportement electrique du rutile. Par la technique de charge transitoire, nous determinerons pour la premiere fois dans le rutile stoechiometrique la grandeur de la mobilite de derive des trous a la temperature ambiante soit 3,4 cm^2/V cdots et nous etablierons une borne superieure a la mobilite des electrons soit 0,1 cm^2 /Vcdots.

  10. 31 CFR 546.301 - Arms or any related materiel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Arms or any related materiel. 546.301 Section 546.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... Definitions § 546.301 Arms or any related materiel. The term arms or any related materiel shall mean arms...

  11. 31 CFR 546.301 - Arms or any related materiel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Arms or any related materiel. 546.301 Section 546.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... Definitions § 546.301 Arms or any related materiel. The term arms or any related materiel shall mean arms...

  12. 31 CFR 546.301 - Arms or any related materiel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Arms or any related materiel. 546.301 Section 546.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... Definitions § 546.301 Arms or any related materiel. The term arms or any related materiel shall mean arms...

  13. 31 CFR 546.301 - Arms or any related materiel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Arms or any related materiel. 546.301 Section 546.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE... Definitions § 546.301 Arms or any related materiel. The term arms or any related materiel shall mean arms...

  14. Proposed Aural Nondetectability Limits for Army Materiel

    DTIC Science & Technology

    1985-03-01

    C U a 9\\91AD I@ Technical Meemorandum 3-35 PROPOSED AURAL NONDOTECTABILITY LIMITS FOR ARMY MATERIEL 0 Georges R. Garinther I Joel T. Kalb David C...LIMTTS FOR ARMY MATERIEL , ,, 6. P’ErFOPMIN CG RE POR T Njý 7. AUTHOR(s) 8. CONTRACT O;R C-RAId- HUM1cjRý.•; Georges R. Garinther David C. Hodge...Technical Memorandum 3-85 PROPOSED AUTRAL NONDETFCTABILITY LIMITS FOR ARMY MAT1ERIEL Georc~e% R. Garinther Joel T. Kalb David C. Hodge G. Richard Price March

  15. Storage Reliability of Missile Materiel Program. Missile Materiel Reliability Prediction Handbook - Parts Count Prediction

    DTIC Science & Technology

    1978-02-01

    OF MISSILE MATERIEL PROGRAM ,. MISSILE MATERIEL RELIABILITY PREDICTION HANDBOOK + "ARTS COUNT PREDICTION LC-78-1 FEBRUARY 1978 Prepared by: Dennis F...data for predicting the reliability of missile systems based on a "parts count" approach. The handbook is a result of a program whosa objective is the...has been extracted from existing reliability prediction sources. For more informations, contactz Commaz • •r U. S. h. ,y Missile R&D Command ATTN

  16. Materiel Solutions for Special Operations Forces

    DTIC Science & Technology

    2015-03-28

    UNC performance on STTR projects aimed at solving critical materiel capability gaps for SOF. UNC students participated in USASOC internships and...research, continuing education, internship and streamlined access to emergency clinical services for military working dogs. NCSU also hosted an Army...materials science, chemistry , mechanical and aerospace engineering, optoelectronics, nanoengineering, and electrical and computer engineering attended

  17. Developing a quality improvement program in materiel management.

    PubMed

    Kovar, M S

    1992-02-01

    Materiel management frequently considers itself a service organization but infrequently considers the service provided as contributing to quality patient care. Quality patient care can only be delivered if every department is delivering quality service. Materiel management's ultimate customer is the patient waiting for the supply that is to be delivered by central stores or the prosthetic device to be obtained through purchasing. Quality service is the key to success, and materiel management must be proactive and deliver quality services.

  18. Hazardous Materiel Data File (HMDF), quarterly update. Data file

    SciTech Connect

    Not Available

    1989-05-01

    The Hazardous Materiel Data File's purpose is to provide storage and transportation information on chemical, radioactive, and ammunition items in the Army inventory. Data are taken from the Army Central Logistics Data Bank.

  19. Hazardous Materiel Data File (HMDF), quarterly update. Data file

    SciTech Connect

    Not Available

    1990-05-01

    The Hazardous Materiel Data File (HMDF) purpose is to provide storage and transportation information on chemical, radioactive and ammunition items in the Army inventory. Data are taken from the Army Central Logistics Data Bank (ACLDB).

  20. Materiel management and radiology: building a teamwork relationship.

    PubMed

    Burke, M D; Cirino, J C

    1991-01-01

    Mr. Burke and Mr. Cirino explain how a teamwork relationship between radiology and materiel management can serve both well--radiology can continually strive to provide high quality diagnostic data and superior patient care, while materiel management can provide a continuous flow of supplies and services, keep inventory investment low, and develop a competent supplier base. Effective communication is the necessary element that will allow each to achieve its respective goals.

  1. Materiel Testing in the Tropics (6th Ed)

    DTIC Science & Technology

    1979-04-01

    ceramics Test methodology Panama Canal Zone Textiles Plastics Tropic Test Center Protective coatings Tropical animals 20. (cont) of Materiel Testing in...Canal Zone . .. 1-3 D Materiel Testing in the Panama Canal Zone . . . . . . . ... . 1-5 E Canal Zone Environment--Brief Overview .. .. .... ...... 1-6...trapped there, and by the heavy biomass of the canopy itself. E. CANAL ZONE ENVIRONMENT--BRIEF OVERVIEW The Canal Zone (see frontispiece) bisects the

  2. Business ethics: the materiel/manufacturing perspective.

    PubMed

    Marucheck, A S; Robbins, L B

    1990-08-01

    The discussion of purchasing practices and product integrity, which have ethical implications for materiel/manufacturing management, serves to illustrate how routine decisions can have larger implications for the firm as a whole. Management needs to take a proactive role in confronting ethical issues by (1) demonstrating a corporate commitment to sound ethics in business practices, (2) providing written policies where appropriate to provide a basis for sound ethical conducts, (3) educating various functional areas to understand their responsibility in seeming unrelated ethical problems, (4) delegating authority in ethical issues where such issues are considered in decision making, and (5) fostering interfunctional communication as a means in establishing corporatewide responsibility. The basic philosophical principles of JIT serve as a blueprint for recognizing and managing ethical responsibility. The unexpected by-products of a JIT implementation may be vendor/customer good will and an excellent reputation for the firm.

  3. PROFILE: Chemical Warfare Materiel: Unique Regulatory Issues.

    PubMed

    Etnier; King; Watson

    2000-04-01

    / The US Army manages an extensive program of environmental restoration that is carried out primarily under authority of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), which establishes response authority for cleanup of inactive waste sites. The Resource Conservation and Recovery Act (RCRA) regulates the management and cleanup of hazardous materials at active hazardous waste facilities. Based on the definitions found in these acts, and corresponding promulgated regulations, environmental media contaminated with chemical warfare materiel (CWM) can be regulated as CERCLA "pollutants or contaminants" but do not appear to be regulated either as CERCLA hazardous substances or RCRA hazardous wastes.In those states that have not included CWM as hazardous materials in their RCRA programs, the RCRA requirements for management of hazardous waste would not strictly apply to any of the CWM. The Army has historically implemented procedures requiring that chemical warfare agents be managed as RCRA hazardous waste regardless of the concentration, physical form, or configuration of the agent. Such application of strict hazardous waste requirements to management of potentially nonhazardous CWM can result in remedial costs well out of proportion to potential human health and environmental benefits. Recent development of chronic toxicity values for the CWM has opened the door for development of cleanup and waste management standards for waste streams or media containing small residual amounts of CWM. Implementation of this health-based approach to management of CWM remediation wastes may, in part, help to reduce potentially unnecessary hazardous waste management costs for the nonhazardous CWM.

  4. Electronic data interchange in hospital materiel management.

    PubMed

    Law, W K; Ooten, H

    1992-08-01

    The survey findings reported here support the continued trend toward increasing application of computer linkages in hospital operations. A majority of the hospitals surveyed already had some sort of computer linkages with their suppliers, possibly an EOE system. There were strong indications of expanding computer linkages to other health care institutions, financial institutions, business partners (i.e., insurance companies), purchasing groups, supporting agencies (i.e., libraries, research laboratories, and counseling agencies), electronic mail, and patient billing. Private hospitals, especially nonprofit hospitals, were more aggressive in the implementation of computer linkages. The initial costs of electronic linkage systems seemed to be affordable, or well justified, as indicated by the relatively large number of medium-size hospitals already linked electronically to other institutions. Top management attention was positively related to the implementation of computer linkages to suppliers but played a lesser role in establishing other types of linkages. The overall optimism concerning future expansion of computer linkages suggests an increasingly important role for electronic linkages in materiel management.

  5. Organizational change and survival skills for materiel managers.

    PubMed

    Giunipero, L C

    1996-02-01

    In an effort to be cost effective and meet changing customer needs, organizations are evolving in their structure. In this environment, leading edge organizations change their culture and create knowledge to continuously improve. Hospital materiel managers need to understand and support their organization's culture changes and respond by adapting or acquiring new skill sets.

  6. 31 CFR 547.301 - Arms or any related materiel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Arms or any related materiel. 547.301 Section 547.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE...) through (a)(3) of this section are delivered or provided only to receiving sites as designated by the...

  7. 31 CFR 547.301 - Arms or any related materiel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Arms or any related materiel. 547.301 Section 547.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE...) through (a)(3) of this section are delivered or provided only to receiving sites as designated by the...

  8. 31 CFR 543.301 - Arms or any related materiel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Arms or any related materiel. 543.301 Section 543.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY CôTE D'IVOIRE SANCTIONS REGULATIONS...

  9. Collaborative partnering: a new paradigm in materiel management.

    PubMed

    Partridge, T

    1993-05-01

    Materiel managers have virtually unlimited opportunities to gain support through a measurable quality and service focus. This support can be achieved through organizational strategies, organizational development, customer service, advanced inventory management and purchasing systems, the power and use of information and, ultimately, mutually beneficial partnerships with distributors and manufacturers.

  10. The cost management organization: the next step for materiel management.

    PubMed

    Schuweiler, R C

    1997-06-01

    With Materiel Management's transition over the last decade from simple logistics to analysis and cost management, it has gained recognition as a key part of the management team responsible for supplies, equipment, standards, and associated processes to identify, purchase, store, distribute, issue, and dispose of supplies and equipment. The materiel manager's job consists of putting the right product in the right place at the right time and in the right quantity at the best total delivered cost. In this context, Materiel Management has made powerful impacts to lower costs associated with: Distribution--costs have been lowered by actively adopting advanced supply channel management techniques such as primary suppliers, JIT, stockless programs, case cart/custom kit/procedure based delivery systems, modified stockless programs as well as margin management through cost plus, flat fee, or margins paid per activity. Cost of goods--lowered through aggregated purchasing in the forms of regional and national purchasing alliances and local capitation or other gain/risk share programs. Internal process costs--lowered by out-sourcing and/or integrating supplier processes and personnel into operations via partnership approaches. We have also reduced transactional costs through EDI transaction sets and the emerging use of the inter and intranet/electronic commerce, procurement cards, and evaluated receipt settlement processes. De-layering--We have lowered the operating costs of Materiel Management overhead by re-design/re-engineering, resulting in reduced management and greater front line authority. Quality--We have learned to identify and respond to customer and supplier needs by using quality improvement tools and ongoing measurement and monitoring techniques. Through this we have identified the waste of non-beneficial products and services. We have adopted supplier certification measurers to ensure quality is built into processes and outcomes. With so much already accomplished

  11. AGARD Flight Test Techniques Series. Volume 17. Electronic Warfare Test and Evaluation. (Les Essais et l’Evaluation du Materiel de Guerre Electronique)

    DTIC Science & Technology

    2000-03-01

    ESPAGNE ITALIE MladoboleslavskA ul., 197 06 Praha 9 INTA (RTO/AGARD Publications) Centro documentazione ROYAUME-UNI Carretera de Torrej6n a Ajalvir, Pk...Ndrodnf informa~nf st-edisko Director of Aviation Carretera de Torrej6n a Ajalvir, Pk.4 obrann6ho v~zkumu (NISiR) c/o Flugrad 28850 Torrej6n de Ardoz

  12. The people side of MRP (materiel requirements planning).

    PubMed

    Lunn, T

    1994-05-01

    A montage of ideas and concepts have been successfully used to train and motivate people to use MRP II systems more effectively. This is important today because many companies are striving to achieve World Class Manufacturing status. Closed loop Materiel Requirements Planning (MRP) systems are an integral part of the process of continuous improvement. Successfully using a formal management planning system, such as MRP II, is a fundamental stepping stone on the path toward World Class Excellence. Included in this article are techniques that companies use to reduce lead time, simplify bills of materiel, and improve schedule adherence. These and other steps all depend on the people who use the system. The focus will be on how companies use the MRP tool more effectively.

  13. Prototype Environmental Digital Data for Materiel Design, Testing, and Evaluation

    DTIC Science & Technology

    1990-10-01

    areas (cities, towns, and villages) and for structure heights and densi- ties had already been compiled in digital format from the WES study by Doiron ...description of the procedures used in the collection of the field data is provided by Doiron and West (1988). Site-Specific Data 32. High-resolution (2.5-m...be developed for other geographic areas for which materiel will be designed and fielded for operational use. 15 REFERENCES Doiron , Phillip L., and

  14. Spent potlining utilisation possibilities.

    PubMed

    Miksa, Dragan; Homsak, Marko; Samec, Niko

    2003-10-01

    As the world's capacity for aluminium production increases, the amount of waste connected with this industry is also increasing. Spent potlining (SPL) from aluminium reduction cell cathodes presents a major environmental concern in the primary aluminium industry. It is concluded, after laboratory tests, that leachable cyanide and fluoride compounds present the major problem in SPL disposal. The behaviour of cyanide and fluoride under high temperature treatment has been investigated. On the basis of this laboratory investigation, the possibilities for SPL utilisation in red brick manufacturing, cement industry and thermal power stations were evaluated. SPL refractory material is already re-used in red brick manufacturing. In the cement industry, a pilot test on the utilisation of 25 t SPL carbon waste mixed with green petrol coke gave positive results. Additionally a fluoride emission forecast for a thermal power station utilising carbon waste SPL mixed with coal was elaborated.

  15. 30 CFR 1220.015 - Pricing of materiel purchases, transfers, and dispositions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... dispositions. 1220.015 Section 1220.015 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... suitable for reuse without reconditioning: (A) Materiel transferred to the NPSL project area shall be priced at 75 percent of current Condition A price. (B) Materiel transferred from the NPSL project area...

  16. 48 CFR 208.7003-1 - Assignments under integrated materiel management (IMM).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Assignments under integrated materiel management (IMM). 208.7003-1 Section 208.7003-1 Federal Acquisition Regulations System... SUPPLIES AND SERVICES Coordinated Acquisition 208.7003-1 Assignments under integrated materiel...

  17. 48 CFR 208.7003-1 - Assignments under integrated materiel management (IMM).

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Assignments under integrated materiel management (IMM). 208.7003-1 Section 208.7003-1 Federal Acquisition Regulations System... SUPPLIES AND SERVICES Coordinated Acquisition 208.7003-1 Assignments under integrated materiel...

  18. 48 CFR 208.7003-1 - Assignments under integrated materiel management (IMM).

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Assignments under integrated materiel management (IMM). 208.7003-1 Section 208.7003-1 Federal Acquisition Regulations System... SUPPLIES AND SERVICES Coordinated Acquisition 208.7003-1 Assignments under integrated materiel...

  19. 48 CFR 208.7003-1 - Assignments under integrated materiel management (IMM).

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Assignments under integrated materiel management (IMM). 208.7003-1 Section 208.7003-1 Federal Acquisition Regulations System... SUPPLIES AND SERVICES Coordinated Acquisition 208.7003-1 Assignments under integrated materiel...

  20. 48 CFR 208.7003-1 - Assignments under integrated materiel management (IMM).

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Assignments under integrated materiel management (IMM). 208.7003-1 Section 208.7003-1 Federal Acquisition Regulations System... SUPPLIES AND SERVICES Coordinated Acquisition 208.7003-1 Assignments under integrated materiel...

  1. Storage of Medical Unit Prepositioned War Reserve Materiel

    DTIC Science & Technology

    1978-01-01

    Bal IC3-02 6505-00-110-6640 Boric Acid 1C2-02 3 3/4 X 2 5/8 X 5 6505-00-136-7000 Potassium 111-29 3 3/8 X 2 3/8 X 5 1/2 6505-00-146-4874 Sulfosalic Acid ...standardization and to control the item package size and unit pack quantity. The report explores and provides the alternatives available to protect... alternative including inspec- tion, servicing, and maintaining of the total package consideration. /or <a\\ ’d . US MRMY MATERIEL DEVELOPMENT AND READINESS

  2. CEO expectation: the Star Wars materiel manager of the 1990s, or C-3PO as role model.

    PubMed

    Zenty, T F; Olson, M R

    1993-05-01

    Materiel-intensive expenditures account for a significant portion of all hospital costs, second only to salaries and wages, yet materiel managers may often be overlooked as key members of the management team. This is alarming since the potential exists for materiel managers to impact annual savings of hundreds of thousands of dollars by operating efficient departments. Materiel managers have a tremendous opportunity to enhance their image and improve hospital productivity in the coming decade. The challenges of the 1990s will stretch materiel managers' skills toward enhancing their professionalism and achieving the expectations of themselves and top management. If materiel managers will effectively utilize (C3)PO they will increase their educational levels, continue to learn new skills, maintain a customer-oriented management style, exercise creativity, develop and adhere to standards, and be proactive in their responsibilities. The benefits of their success will be felt by patients, hospitals, the industry, and materiel managers everywhere.

  3. Electronic Messaging for the 90s (Les Messageries Electroniques des Annees 90)

    DTIC Science & Technology

    1993-05-01

    surtout si celle-ci est g~ographiquement r~partie. La messagerie electronique peut s’appliquer h toute topologie d’organisation, et permet de la mime...l’espace de circulation 2 2.2 Caract~ristiques de la circulation de l’information dans cet espace 3 2.2.1 Un peu de topologie 3 2.2.2 Modes de...rdponse. 2.2.1 Un pen de topologie Exemple bien connu de mode transactionnel, la relation entre un distributeur de billets de banque et Ie Revenons donc A

  4. Imitation and utilisation behaviour.

    PubMed Central

    De Renzi, E; Cavalleri, F; Facchini, S

    1996-01-01

    OBJECTIVE: To investigate the incidence, anatomical correlates, and clinical features of imitation and utilisation behaviour, which are thought by Lhermitte and coworkers to represent a reliable and frequent index of frontal lobe disease. METHODS: 78 patients with hemispheric local lesions were tested in two separate sessions, in which their reactions to a series of gestures performed by the examiner and to the presentation of a set of objects were recorded. The patients were stratified into a frontal (n = 52) and a non-frontal group (n = 26) on the basis of their CT data. RESULTS AND CONCLUSIONS: Imitation behaviour was present in 39% of the frontal patients and was mainly associated with medial and lateral lesions, at odds with the claim of Lhermitte et al that it is a constant accompaniment of lower, mediobasal lesions. In the non-frontal group it was found in three patients, all with damage to the deep nuclei region. Utilisation behaviour was a much rarer phenomenon, present in only two patients, both of whom had frontal damage. Neither imitation behaviour nor utilisation behaviour were found in patients with retrorolandic cortical lesions. PMID:8890779

  5. Army Materiel Requirements to Support the Continental United States Military Mobilization Base Structure

    DTIC Science & Technology

    1989-10-01

    Level of Organization AMC ............... Army Materiel Command AMOPS ............. Army Mobilization and Operations Planning System AMPC ...Military Personnel Center ( AMPC ) uses an automated mobilization manpower (MOB MAN) requirements data manipulator system to prepare time- phased

  6. Army Materiel Requirements to Support the Continental United States Military Mobilization Base Structure

    DTIC Science & Technology

    1989-10-01

    Materiel Command AMOPS ............. Army Mobilization and Operations Planning System AMPC .............. Army Military Personnel Center AR...must train. The Army Military Personnel Center ( AMPC ) uses an automated mobilization manpower (MOB MAN) requirements data manipulator system to

  7. Department of Defense Materiel Distribution System Study. Volume 3, Book 2. Appendices A, B and C

    DTIC Science & Technology

    1978-07-01

    for modernization of DOD depot storage facilities. Their Phase II report provided DOD components with concepts for modernization based on stockage...mobilization requirements. II . MISSION A. Review and analyze current materiel distribution system processes. B. Identify future peacetime and...Logistics Commanders’ Panel for the DOD Materiel Distribution System Study, 14 February 1975. II . SCOPE AND APPLICABILITY: A. The study effort will be to

  8. 32 CFR Appendix C to Part 623 - Agreement for Loan of US Army Materiel (DA Form 4881-R)

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Agreement for Loan of US Army Materiel (DA Form... ARMY SUPPLIES AND EQUIPMENT LOAN OF ARMY MATERIEL Pt. 623, App. C Appendix C to Part 623—Agreement for Loan of US Army Materiel (DA Form 4881-R) EC24OC91.013 EC24OC91.014 EC24OC91.015 EC24OC91.016...

  9. Integrating MRP (materiel requirements planning) into modern business.

    PubMed

    Lunn, T

    1994-05-01

    Time is the commodity of the '90s. Therefore, we all must learn how to use our manufacturing systems to shorten lead time and increase customer satisfaction. The objective of this article is to discuss practical ways people integrate the techniques of materiel requirements planning (MRP) systems with just-in-time (JIT) execution systems to increase customer satisfaction. Included are examples of new ways people use MRP systems to exemplify the process of continuous improvement--multiple items on work orders, consolidated routings, flexing capacity, and other new developments. Ways that successful companies use MRP II for planning and JIT for execution are discussed. There are many examples of how to apply theory to real life situations and a discussion of techniques that work to keep companies in the mode of continuous improvement. Also included is a look at hands-on, practical methods people use to achieve lead time reduction and simplify bills of material. Total quality management concepts can be applied to the MRP process itself. This in turn helps people improve schedule adherence, which leads to customer satisfaction.

  10. Restructuring materiel management functions: a method for prioritizing changes and reducing costs.

    PubMed

    Craig, K W

    1992-02-01

    The success of any manager depends highly on the ability to seize on opportunities that will achieve the organization's goals. Hospitals are currently searching for ways to reduce costs while maintaining or enhancing the quality of services. Quality services are increasingly being defined as those that are most responsive to customer needs. It is important, as hospital management restructures materiel systems or methods of operation for reduced costs, to focus on the user departments as the customers. The consolidation of materiel management activity should not be seen as a loss of control at the user department level. Instead it can be seen as a new way of providing service with higher quality. User departments should see concrete benefits on a weekly basis, including reduced time spent on materiel management functions; increased planning of purchasing, inventory, and distribution functions; and assistance in meeting restricted supply budgets.

  11. 32 CFR 623.3 - Submission of requests for loan of Army materiel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... agency, civil authority, or civilian activity desiring the materiel. An exception is that requests from..., Anytown, USA, (telephone number with area code) 123-456-7890. (D) Type of loan; e.g., Boy Scout National... requirement to the proper command (or staff agency) which will contact the designated Federal civil...

  12. 32 CFR 623.3 - Submission of requests for loan of Army materiel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., liabilities, and costs related to the movement, use, care, security, loss, damage, and repair of the loaned materiel. (N) Citation of funds to cover reimbursable costs. Also, a statement that an adequate bond will..., received from Federal authorities by Army field commands or activities, will be forwarded through command...

  13. 32 CFR 623.3 - Submission of requests for loan of Army materiel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., liabilities, and costs related to the movement, use, care, security, loss, damage, and repair of the loaned materiel. (N) Citation of funds to cover reimbursable costs. Also, a statement that an adequate bond will..., received from Federal authorities by Army field commands or activities, will be forwarded through command...

  14. An Analysis of U.S. Army Health Hazard Assessments During the Acquisition of Military Materiel

    DTIC Science & Technology

    2010-06-03

    has undergone an AWWA cross-connection survey. Developers must outline disinfection procedures and specifications of reverse osmosis elements if...circulation (Cheauvront, Goodman, Kenefick, Montain, & Sawka, 2008). Environmental factors such as solar load and high ambient temperatures frequently...exclusion devices populations in all scenarios - Outline disinfection procedures for all materiel - Provide documentation of a cross

  15. An Analysis of U.S. Army Health Hazard Assessments During the Acquisition of Military Materiel

    DTIC Science & Technology

    2010-06-03

    NSF criteria and water-handling equipment has undergone an AWWA cross-connection survey. Developers must outline disinfection procedures and...storage by inhibiting sweating or reducing circulation (Cheauvront, Goodman, Kenefick, Montain, & Sawka, 2008). Environmental factors such as solar load...include screens, air curtains or other pest exclusion devices populations in all scenarios - Outline disinfection procedures for all materiel

  16. Report of the Defense Science Board Task Force ON Control of Military Excess and Surplus Materiel

    DTIC Science & Technology

    1998-12-01

    Commerce Control List (CCL). Each CCL entry is preceded by a four-digit Export Control Classification Number ( ECCN ) and those ECCNs ending in the...Administration EAR Export administration Regulation ECCN Export Control Classification Number Control of Military Excess and Surplus Materiel D-1 FAA FBI

  17. How to get top management support for MRP (materiel requirements planning) II.

    PubMed

    Correll, J G

    1994-05-01

    Getting top management support for materiel requirements planning (MRP) is not impossible. When senior management supports the effort, the success rate skyrockets and companies experience results that improve their bottom-line performance. This article describes a step-by-step process for gaining top management's commitment to the effort.

  18. A Model of U.S. Army Materiel Command (AMC) Energy Consumption. Volume 2. Installation Equations and Related Statistics.

    DTIC Science & Technology

    1986-03-01

    AD-AU? 32? A MODEL OF US ARMY MATERIEL COMND (ASI) ENERGY 1/3 CONSUMPTION VOLUME 2 INS.. (U) CONSTRUCTION ENGINEERING RESEARCH LAB (ARMY) CHAMPAIGN...02Research Laboratory March 1986DARCOM Energy System Modernization A Model of U.S. Army Materiel Command (AMC) Energy Consumption, Volume II: Installation...ACCES.SION NO. 3. RECIPIENT’S CATALOG NUMBER CERI TR E-86/02 4TITLE (end Subtitle) STYPE OF REPORT A PIERIOD COVERED A MODEL OF U.S. ARMY MATERIEL

  19. 32 CFR Appendix C to Part 623 - Agreement for Loan of US Army Materiel (DA Form 4881-R)

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 3 2012-07-01 2009-07-01 true Agreement for Loan of US Army Materiel (DA Form 4881-R) C Appendix C to Part 623 National Defense Department of Defense (Continued) DEPARTMENT OF THE... Loan of US Army Materiel (DA Form 4881-R) EC24OC91.013 EC24OC91.014 EC24OC91.015 EC24OC91.016...

  20. 32 CFR Appendix C to Part 623 - Agreement for Loan of US Army Materiel (DA Form 4881-R)

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false Agreement for Loan of US Army Materiel (DA Form 4881-R) C Appendix C to Part 623 National Defense Department of Defense (Continued) DEPARTMENT OF THE... Loan of US Army Materiel (DA Form 4881-R) EC24OC91.013 EC24OC91.014 EC24OC91.015 EC24OC91.016...

  1. 32 CFR Appendix C to Part 623 - Agreement for Loan of US Army Materiel (DA Form 4881-R)

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Agreement for Loan of US Army Materiel (DA Form 4881-R) C Appendix C to Part 623 National Defense Department of Defense (Continued) DEPARTMENT OF THE... Loan of US Army Materiel (DA Form 4881-R) EC24OC91.013 EC24OC91.014 EC24OC91.015 EC24OC91.016...

  2. 32 CFR Appendix C to Part 623 - Agreement for Loan of US Army Materiel (DA Form 4881-R)

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Agreement for Loan of US Army Materiel (DA Form 4881-R) C Appendix C to Part 623 National Defense Department of Defense (Continued) DEPARTMENT OF THE... Loan of US Army Materiel (DA Form 4881-R) EC24OC91.013 EC24OC91.014 EC24OC91.015 EC24OC91.016...

  3. Strategic Planning Within Air Force Materiel Command: A Focus on External Stakeholders’ Involvement

    DTIC Science & Technology

    1994-09-01

    158). Patton states: Basic and applied researchers publish in scholarly journals, where their audience is other researchers who will judge their...decision. This issue will be further adressed in Chapter V, Conclusions and Recommendations. Unlike civilian industry, AFMC does not have established...are present in Air Force Materiel Command’s (AFMC) programs which specifically address their customers, or external stakeholders. The target population

  4. Solid Geometric Modeling - The Key to Improved Materiel Acquisition from Concept to Deployment

    DTIC Science & Technology

    1984-09-01

    Modeling Weights and Moments Computer Graphics Infrared Modeling Weapons Engineering Raycasting Ballistic Analysis Nuclear Survivability ZQ A3tSnACT@acz@w...survival infrared and structural integrity mobility, and the like. By virtue of its long history in the analysis of materiel in both the nuclear and...Modeling can also be applied to the problem of infrared signature analysis . In the design of smart munitions it is important to know the nature of vehicle

  5. Prepositioned Materiel and Equipment: DOD Would Benefit from Developing Strategic Guidance and Improving Joint Oversight

    DTIC Science & Technology

    2012-09-20

    analysis by having two analysts independently compare the prepositioned materiel and equipment information in DOD’s fiscal year 2011 report with the 12...Source: GAO analysis . We assessed five of the elements as being addressed because the information provided in the report was responsive to the...report did not include Air Force munitions, auxiliary fuel tanks, missile launchers, pylons, ejector racks, and adapters, medical stocks, fuel, and

  6. A Study of Age Demographics across the Aviation and Missile Materiel Enterprise

    DTIC Science & Technology

    2016-03-31

    becomes apparent as there is a smaller pool of human resources to fill the vacancies left by the baby boomers. This paper studies the severity of the... human resource challenge in researching a microcosm of the defense acquisition workforce- the Aviation and Missile Materiel Enterprise located at...in the future. The results should be an aid to the human resource managers across the civilian acquisition workforce who are forced with tackling

  7. Etude des proprietes electroniques des etats fondamentaux aux facteurs de remplissage entiers dans la bicouche de graphene

    NASA Astrophysics Data System (ADS)

    Lemonde, Marc-Antoine

    Dans ce document, on etudie les proprietes electroniques d'un systeme compose de deux couches de graphene separees par un dielectrique en presence d'un fort champ magnetique perpendiculaire. L'epaisseur du dielectrique est choisie de facon a pouvoir negliger le transfert de charges par effet tunnel. Ce type de systeme est etudie par quelques groupes de recherche dans le principal but de predire et comprendre la formation de condensat de Bose-Einstein d'excitons dont les composants sont des fermions relativistes sans masse [1] [2] [3]. Nous nous interessons a l'effet de l'interaction electron-electron sur les etats fondamentaux de ce systeme et 'a leurs excitations collectives a facteur de remplissage entier. Plus precisement, nous etudions les diagrammes de phase de cette bicouche de graphene sans terme tunnel dans le niveau de Landau n = 0 pour les facteurs de remplissage nu = 1 et nu = 2 dans la limite ou la temperature tend vers zero. Lors de cette etude, nous appuyons les predictions faites par Allan H. MacDonald et Yogesh N. Joglekar a propos de la formation d'un condensat de Bose-Einstein d'excitons pour differentes zones des diagrammes de phase. Nous etudions aussi la relation de dispersion des excitations collectives soutenues par les etats fondamentaux et leur effet sur le systeme. Finalement, nous nous interessons a la conductivite du systeme. Nous demontrons alors les regles de selection pour l'absorption inter-niveaux de Landaux et nous etudions l'effet des modes collectifs sur l'absorption .intrarniveau de Landau, Ce dernier phenomene ressort directement de la forme particuliere du reseau atomique du graphene et nous proposons dans ce document une toute premiere etude de ce concept. Mots-cles : graphene, gaz d'electrons bidimensionnel, effets Hall quantiques, proprietes electroniques, modes collectifs

  8. A Relative Ranking Approach for Nano-Enabled Applications to Improve Risk-Based Decision Making: A Case Study of Army Materiel

    DTIC Science & Technology

    2014-12-24

    measure of the ‘empty’ spaces in a materiel as volume Crystallinity The degree of ordered structures in the materiel (closely related to porosity and...works. Nanotoxicology 6:196–212 Höck J, Hofmann H, Krug H, Lorenz C, Limbach L, Nowack B et al (2008) Precautionary matrix for synthetic nanomaterials

  9. Wartime Requirements for Ammunition, Materiel, and Personnel (WARRAMP). Volume IV. Ammunition Post-Processor Program Maintenance Manual.

    DTIC Science & Technology

    1982-02-01

    7 AD-A~L1 692 CACI INC-FEDERAL ARLINGTON VA F/. 15/7 WARTIME REQUIREMENTS FOR AMMUNITION, MATERIEL, AND PERSONNEL (W-ETC(Ul FEB 82 Rt G RHOADES...REPORT S, PERIOo COVERED0 Wartime Requirements for Ammunition, Materiel Final: Sep 80 -- Feb 82 and Personnel (WARRAMP), Volume-IV, Ammunition...Dome 20. \\JABSMICT on the UNIVAC 1100/ 82 installed at the US Army Concepts Analysis A~eacy. NTIS owA& ED7IC TOI DIstribution/ C IOD a:I i Ava a

  10. A methodology for the quantification of doctrine and materiel approaches in a capability-based assessment

    NASA Astrophysics Data System (ADS)

    Tangen, Steven Anthony

    Due to the complexities of modern military operations and the technologies employed on today's military systems, acquisition costs and development times are becoming increasingly large. Meanwhile, the transformation of the global security environment is driving the U.S. military's own transformation. In order to meet the required capabilities of the next generation without buying prohibitively costly new systems, it is necessary for the military to evolve across the spectrum of doctrine, organization, training, materiel, leadership and education, personnel, and facilities (DOTMLPF). However, the methods for analyzing DOTMLPF approaches within the early acquisition phase of a capability-based assessment (CBA) are not as well established as the traditional technology design techniques. This makes it difficult for decision makers to decide if investments should be made in materiel or non-materiel solutions. This research develops an agent-based constructive simulation to quantitatively assess doctrine alongside materiel approaches. Additionally, life-cycle cost techniques are provided to enable a cost-effectiveness trade. These techniques are wrapped together in a decision-making environment that brings crucial information forward so informed and appropriate acquisition choices can be made. The methodology is tested on a future unmanned aerial vehicle design problem. Through the implementation of this quantitative methodology on the proof-of-concept study, it is shown that doctrinal changes including fleet composition, asset allocation, and patrol pattern were capable of dramatic improvements in system effectiveness at a much lower cost than the incorporation of candidate technologies. Additionally, this methodology was able to quantify the precise nature of strong doctrine-doctrine and doctrine-technology interactions which have been observed only qualitatively throughout military history. This dissertation outlines the methodology and demonstrates how potential

  11. Sago starch and its utilisation.

    PubMed

    Abd-Aziz, Suraini

    2002-01-01

    The importance and development of industrial biotechnology processing has led to the utilisation of microbial enzymes in various applications. One of the important enzymes is amylase, which hydrolyses starch to glucose. In Malaysia, the use of sago starch has been increasing, and it is presently being used for the production of glucose. Sago starch represents an alternative cheap carbon source for fermentation processes that is attractive out of both economic and geographical considerations. Production of fermentable sugars from the hydrolysis of starches is normally carried out by an enzymatic processes that involves two reaction steps, liquefaction and saccharification, each of which has different temperature and pH optima with respect to the maximum reaction rate. This method of starch hydrolysis requires the use of an expensive temperature control system and a complex mixing device. Our laboratory has investigated the possibility of using amylolytic enzyme-producing microorganisms in the continuous single-step biological hydrolysis of sago flour for the production of a generic fermentation medium. The ability of a novel DNA-recombinated yeast, Saccharomyces cerevisiae strain YKU 107 (expressing alpha-amylase production) to hydrolyse gelatinised sago starch production has been studied with the aim of further utilizing sago starch to obtain value-added products.

  12. Application of AMORE (Analysis of Military Organizational Effectiveness) Methodology to Manpower, Personnel and Training Front-End Analysis of New Materiel Systems

    DTIC Science & Technology

    1984-08-01

    There are limitations which should be recognized with regard to the application of AMORE . The actions of unit personnel and equipment can not be modeled...Research Note 84-118 APPLICATION OF AMORE METHODOLOGY TO MANPOWER, PERSONNEL AND 0) TRAINING FRONT-END ANALYSIS OF NEW MATERIEL SYSTEMS Richard E...REPORT & PERIOD COVERED PPLICATION OF AMORE METHODOLOGY TO MANPOWER, FINAL -- *ERSONNEL, AND TRAINING FRONT-END ANALYSIS OF Mar 83-Feb 84 EW MATERIEL

  13. A Study to Develop an Implementation Plan for a Centralized Materiel Management System at the US Army Medical Department Activity, Ft. Sill, OK

    DTIC Science & Technology

    1986-08-01

    Functional Roles Met by Centralized Materiel Managenent System ...... ................. 9 2. Comparative Flow Diagrams for Supply Distribution to...Perspective," Hospital Materiel Management Quarterly 2 (Winter 1980): 90. Fig. 2. Comparative Flow Diagrams for Supply Distribution to Nursing Floor 13 and...methods of distribution are the PAR-level and the exchange cart system.37 These systems are compared in Figure 2, above. Implementation of a

  14. The evolution of a health hazard assessment database management system for military weapons, equipment, and materiel.

    PubMed

    Murnyak, George R; Spencer, Clark O; Chaney, Ann E; Roberts, Welford C

    2002-04-01

    During the 1970s, the Army health hazard assessment (HHA) process developed as a medical program to minimize hazards in military materiel during the development process. The HHA Program characterizes health hazards that soldiers and civilians may encounter as they interact with military weapons and equipment. Thus, it is a resource for medical planners and advisors to use that can identify and estimate potential hazards that soldiers may encounter as they train and conduct missions. The U.S. Army Center for Health Promotion and Preventive Medicine administers the program, which is integrated with the Army's Manpower and Personnel Integration program. As the HHA Program has matured, an electronic database has been developed to record and monitor the health hazards associated with military equipment and systems. The current database tracks the results of HHAs and provides reporting designed to assist the HHA Program manager in daily activities.

  15. Chemical Warfare Materiel in Sediment at a Deep-Water Discarded Military Munitions Site

    NASA Astrophysics Data System (ADS)

    Briggs, C. W.; Bissonnette, M. C.; Edwards, M.; Shjegstad, S. M.

    2016-12-01

    Understanding the release and transformation of chemical agent (CA) at underwater discarded military munitions (DMM) sites is essential to determine the potential risk to human health and impact on the ocean environment; yet few studies have been conducted at sites in excess of 250 m, the depth at which most U.S. CA munitions were disposed. Maritime construction workers installing cables or pipelines at a CA DMM site, as well as fishermen and scientific researchers deploying bottom-contact gear, represent possible exposure pathways to human receptors. The Hawai`i Undersea Military Munitions Assessment (HUMMA) sought to characterize a historic munitions sea-disposal site at depths between 400-650 m. During the 2014 HUMMA Sampling Survey, the Jason 2 remotely operated vehicle was used to collect sediments within two meters of suspected World War II chemical munitions, confirmed to be 100-lb M47 series bombs containing sulfur mustard. When environmental media was brought to the surface, samples were screened for distilled sulfur mustard (HD) and related agent breakdown products (ABP) (collectively referred to as chemical warfare materiel [CWM]). Detectable concentrations of HD and/or its ABP 1,4-dithiane were found in sediments collected at all CA DMM sites; HD was also detected at two control sites. The location and extent of munitions casing deterioration strongly influenced the distribution and level of CWM in sediment. The interior of the casing contained levels of CWM orders of magnitudes higher than that observed in the surrounding sediment at one meter distance, indicating the majority of the CWM is hydrolyzed as it is released from the munitions casing and a fraction of the fill materiel persists in the environment for decades following disposal. Although the potential for future site users to become exposed to CWA in recovered sediments and debris exists, the level of risk is significantly mitigated by the depth and location of the sea-disposal site.

  16. Imagerie Resolue dans le Temps des Photons et Neutres Metastables Emis D'une Surface Par Stimulation Electronique

    NASA Astrophysics Data System (ADS)

    Leclerc, Gregoire

    L'appareil que nous presentons ici a ete mis au point pour permettre d'accumuler des images numeriques, resolues dans le temps, de la desorption par stimulation electronique (DSE) d'ions positifs et negatifs, de photons et de neutres metastables, tout en conservant des capacites de base de diffraction d'electrons lents (DEL) et de transmission d'electrons lents (TEL). Le spectrometre comporte un monochromateur d'electrons a secteur cylindrique de 127^ circ dont l'optique de sortie permet la focalisation du faisceau d'electrons sur une large gamme d'energies. Le detecteur consiste en un empilement de galettes de microcanaux et d'une anode resistive a encodage de division de charges. La reponse spatiale du detecteur a ete calibree et plusieurs causes de non-linearite ont ete localisees et corrigees. Des methodes de correction materielle et logicielle des distorsions spatiales sont presentees. La resolution temporelle des evenements est obtenue en pulsant le faisceau d'electrons, et de facon synchrone la detection, laquelle est couplee a un micro-ordinateur. La premiere partie de ce travail est consacree a la caracterisation du spectrometre et la presentation de nombreux parametres operationnels, obtenus soit au moment de la conception, soit experimentalement. Suit la presentation de donnees de DEL et de DSE pour le systeme Ar/Pt(111) en films minces a 15K. Les sequences temporelles d'images de metastables d'Ar desorbes ont revele la presence de plusieurs populations distinctes, ayant des distributions angulaires et distributions d'energie cinetique que nous avons pu separer. Les fonctions d'excitation de l'emission de photons et de la desorption de differentes composantes de metastables, ainsi que la dependance de ces signaux sur l'epaisseur des films d'Ar, sont aussi presentees et analysees. Les techniques que nous avons developpees ont permis de cerner les mecanismes en jeu pour la desorption et la luminescence.

  17. A Comparison of Neutron-Based Non-Destructive Assessment Methods for Chemical Warfare Materiel and High Explosives

    SciTech Connect

    E.H. Seabury; D.L. Chichester; C.J. Wharton; A.J. Caffrey

    2008-08-01

    Prompt Gamma Neutron Activation Analysis (PGNAA) systems employ neutrons as a probe to interrogate items, e.g. chemical warfare materiel-filled munitions. The choice of a neutron source in field-portable systems is determined by its ability to excite nuclei of interest, operational concerns such as radiological safety and ease-of-use, and cost. Idaho National Laboratory’s PINS Chemical Assay System has traditionally used a Cf-252 isotopic neutron source, but recently a Deuterium-Tritium (DT) Electronic Neutron Generator (ENG) has been tested as an alternate neutron source. This paper presents the results of using both of these neutron sources to interrogate chemical warfare materiel (CWM) and high explosive (HE) filled munitions.

  18. A Comparison of Neutron-Based Non-Destructive Assessment Methods for Chemical Warfare Materiel and High Explosives

    NASA Astrophysics Data System (ADS)

    Seabury, E. H.; Chichester, D. L.; Wharton, C. J.; Caffrey, A. J.

    2009-03-01

    Prompt Gamma Neutron Activation Analysis (PGNAA) systems employ neutrons as a probe to interrogate items, e.g. chemical warfare materiel-filled munitions. The choice of a neutron source in field-portable systems is determined by its ability to excite nuclei of interest, operational concerns such as radiological safety and ease-of-use, and cost. Idaho National Laboratory's PINS Chemical Assay System has traditionally used a 252Cf isotopic neutron source, but recently a deuterium-tritium (DT) electronic neutron generator (ENG) has been tested as an alternate neutron source. This paper presents the results of using both of these neutron sources to interrogate chemical warfare materiel (CWM) and high explosive (HE) filled munitions.

  19. Etude des defauts microscopiques et des proprietes optiques, electroniques et magnetiques du compose neodyme cerium oxyde de cuivre

    NASA Astrophysics Data System (ADS)

    Richard, Pierre

    La presente these, qui combine des mesures de diffusion Raman, de transmission infrarouge, de conductivite hyperfrequence et d'interferometrie ultrasonore sur les composes Nd 2-xCexCuO 4, traite des defauts d'oxygene, ainsi que des proprietes optiques, electroniques et magnetiques de ces materiaux. Les resultats experimentaux obtenus sont correles avec plusieurs donnees experimentales disponibles dans la litterature. D'abord, la caracterisation des modes Raman et des niveaux d'energie de champ cristallin de l'ion Nd3+ au moyen de techniques optiques, en fonction du dopage en cerium et du contenu en oxygene, permettent de conclure a la presence de defauts lies a une non-stoechiometrie en oxygene dans ces composes. En effet, des excitations de champ cristallin assignees a des ions Nd3+ en sites irreguliers sont observees, en plus des bandes d'absorption associees aux ions Nd3+ en site regulier, dans les spectres correspondant aux multiplets 4I11/2, 4I13/2 et 4I 15/2 de l'ion Nd3+. Les resultats experimentaux indiquent que, contrairement a la croyance largement repandue, les oxygenes apicaux, bien que presents dans les echantillons dopes, ne sont pas enleves lors du processus de reduction des echantillons necessaire pour faire apparaitre la supraconductivite dans cette famille de cuprates. Au contraire, des lacunes d'oxygene, dont le type varie en fonction du dopage, sont creees lors de ce processus. En particulier, il est montre dans ce travail que la reduction des echantillons dopes de maniere optimale conduit a la creation de lacunes d'oxygene dans les plans CuO2. Les consequences de telles lacunes sont largement discutees. En outre, il est suggere que de telles lacunes sont responsables de la perte de l'ordre antiferromagnetique a longue portee des ions Cu2+. Finalement, l'interaction d'echange anisotrope Nd3+-Cu 2+ dans le compose nondope est caracterisee au moyen de la transmission infrarouge sous champ magnetique. L'eclatement des doublets de Kramers mesure

  20. Integrating MRP (materiel requirements planning) II and JIT to achieve world-class status.

    PubMed

    Titone, R C

    1994-05-01

    The concepts and principles of using manufacturing resource planning (MRP II) for planning are not new. Their success has been proven in numerous manufacturing companies in America. The concepts and principles of using just-in-time (JIT) inventory for execution, while more recent, have also been available for some time, and their success in Japan well documented. However, it is the effective integration of these two powerful tools that open the way to achieving world-class manufacturing status. This article will utilize a newly developed world-class manufacturing model, which will review the aspects of planning, beginning with a business plan through the production planning process and culminating with a master schedule that drives a materiel/capacity plan. The importance and interrelationship of these functions are reviewed. The model then illustrates the important aspects of executing these plans beginning with people issues, through total quality control (TQC) and pull systems. We will then utilize this new functional model to demonstrate the relationship between these various functions and the importance of integrating them with a total comprehensive manufacturing strategy that will lead to world-class manufacturing and profits.

  1. Targeted Human Factors and Ergonomics Recommendations for Materiel and Concept Developers from the 2013 US Army Capabilities Integration Center Dismounted Non-network-Enabled Limited Objective Experiment (ARCIC DNNE LOE)

    DTIC Science & Technology

    2014-11-01

    Targeted Human Factors and Ergonomics Recommendations for Materiel and Concept Developers from the 2013 US Army Capabilities Integration...Laboratory Aberdeen Proving Ground, MD 21005-5425 ARL-TN-0645 November 2014 Targeted Human Factors and Ergonomics Recommendations for...To) 1 January–31 December 2013 4. TITLE AND SUBTITLE Targeted Human Factors and Ergonomics Recommendations for Materiel and Concept Developers from

  2. Associated gas utilisation in Sabah, Malaysia

    SciTech Connect

    Kia, T.E.; Sikchi, K.G.

    1984-02-01

    Based on extensive studies and planning, the State Government of Sabah are now investing the equivalent of 1 billion US Dollars in a gas utilisation project which will stop the venting of associated gas produced offshore Sabah and broaden the state's economy base. The project involves the installation of new platform facilities adjacent to existing oil production platforms in the Samarang and Erb West fields for collection, processing and transmission of up to 90 mmscfd of gas to the island of Labuan where gas will be utilised by a 47MW combined cycle power plant, a 2000 ton/day hot briquetted iron plant and a 2000 ton/day methanol plant, presently under construction. The project is targetted to come on stream second quarter of 1984.

  3. Air compliance through pollution prevention at Air Force Materiel Command facilities.

    SciTech Connect

    Kolpa, R.; Ryckman, S.J. Jr.; Smith, A.E.

    1999-03-19

    Options for air compliance through pollution prevention (P2) have been identified at 14 facilities of the US Air Force Materiel Command, ranging from depots with significant light industrial activity to laboratories. Previous P2 efforts concentrated on reducing hazardous and solid wastes, with any reduction in air impacts generally being a collateral benefit. This work focused on reducing air emissions and air compliance vulnerabilities. P2 options were identified in three stages. First, potentially applicable P2 options were identified from Internet and published information. Attention was given to identifying the types of sources to which an option could be applied, the option's state of development, and constraints that could limit its application. Traditional P2 options involving technology or equipment changes and material substitution were considered. In addition, newer approaches based on administrative ''controls'' were considered. These included inserting P2 into operating permits in exchange for administrative relief, privatization, derating boilers, and reducing an installation's potential to emit and compliance vulnerability by separating sources not under the Air Force's ''common control.'' Next, criteria and toxic emissions inventories by source category were prepared from inventory data supplied by facilities. The major problems at this stage were differences in the levels of detail provided by facilities and in the categories used by different installations. Emitting categories were matched to P2 option categories to identify candidate options. Candidates were screened to account for local regulations and technical information about sources in the inventories. When possible, emission reductions were estimated to help facility personnel prioritize options. Some options identified are being actively pursued by facilities to determine their site-specific feasibility. Although much work has been done to implement material substitution programs, this

  4. Uptake of munitions materiels (TNT, RDX) by crop plants and potential interactions of nitrogen nutrition

    SciTech Connect

    Fellows, R.J.; Harvey, S.D.; Cataldo, D.A.; Mitchell, W.

    1995-12-31

    Munitions materiel such as trinitrotoluene (TNT) and hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) and their combustion/decomposition products can accumulate/cycle in terrestrial environs. High soil organic matter and fertility have been previously shown to negatively correlate with both TNT or RDX uptake in plants such as grass, wheat, and bean. The present study was therefore conducted using low fertility soil to assess uptake and distribution patterns of C-radiolabelled TNT and RDX (15 and 30 {micro}g/g) within corn (Zea mays), spinach (Spinacea oleraceae), carrot (Daucus carota), and alfalfa (Medicago sativa) grown to maturity in growth chambers. Uptake by the plants at maturity (90- to 120-days) ranged from 1.8 to 2.7% of total amended {sup 14}C-TNT for carrots and corn respectively and 17 to 33% of total amended {sup 14}C-RDX for corn and carrots respectively. Distribution patterns of total radiolabel indicate that the TNT-derived label was primarily retained within the roots (60 to 85%) while the RDX-derived label was distributed to the shoots (85 to 97%). Less than 0.01 {micro}g/g dry wt. TNT was found in all analyzed shoot tissues with > 90% of the TNT-derived radiolabel in the form of polar metabolites. Concentrations of RDX in shoot tissues of corn exceeded 180 {micro}g/g dry wt. Alfalfa grown in unfertilized, fertilized (NO{sub 3}), or unfertilized-inoculated (Rhizobia) soil exhibited a 70 to 100% increase in dry wt. after 45 days in the TNT-amended (15 {micro}g/g) fertilized and unfertilized-inoculated plants versus the controls. A potential TNT/nitrogen interaction will be discussed.

  5. Utilisation of magnets to enhance gastrointestinal endoscopy

    PubMed Central

    Rahman, Imdadur; Patel, Praful; Boger, Philip; Thomson, Mike; Afzal, Nadeem Ahmad

    2015-01-01

    Methods to assess, access and treat pathology within the gastrointestinal tract continue to evolve with video endoscopy replacing radiology as the gold standard. Whilst endoscope technology develops further with the advent of newer higher resolution chips, an array of adjuncts has been developed to enhance endoscopy in other ways; most notable is the use of magnets. Magnets are utilised in many areas, ranging from endoscopic training, lesion resection, aiding manoeuvrability of capsule endoscopes, to assisting in easy placement of tubes for nutritional feeding. Some of these are still at an experimental stage, whilst others are being increasingly incorporated in our everyday practice. PMID:26722611

  6. Utilisation of Thermal Radiation for Process Monitoring

    NASA Astrophysics Data System (ADS)

    Weberpals, Jan; Hermann, Tobias; Berger, Peter; Singpiel, Holger

    Particularly the automation of thermal material processing makes high demands on monitoring and controlling the resulting quality. A new promising approach is the utilisation of the emitted thermal radiation to get detailed information about temperature distributions and geometrical structures. Indeed, current laser systems with strong focusability exhibit a high innovation potential in many application ranges, for example the possibility of adjusting the welding depth to even small material thicknesses. However, the usability of these advantages is limited because the suitable process windows are considerably constricted at increased welding speed. Therefore, a reliable monitoring of thermal material processing is of vital importance.

  7. Fabrication de transistors mono-electroniques en silicium pour le traitement classique et quantique de l'information: une approche nanodamascene

    NASA Astrophysics Data System (ADS)

    Harvey-Collard, Patrick

    Les transistors mono-electroniques (SETs) sont des dispositifs ayant un grand potentiel d'applications, comme la detection de charge ultra-sensible, la logique a basse consommation de puissance, la memoire ou la metrologie. De plus, la possibilite de pieger un seul electron et de manipuler son etat de spin pourrait permettre des applications en informatique quantique. Le silicium est un materiau interessant pour fabriquer l'ilot d'un SET. Son gap semi-conducteur permet le fonctionnement du dispositif dans le regime a un seul electron ou trou et pourrait permettre d'etendre la plage d'operation du SET en temperature en augmentant l'energie d'addition du diamant central de la valeur du gap. En outre, le silicium beneficie de plus de quarante annees d'expertise en microfabrication et d'une compatibilite avec la technologie metal--oxyde--semi-conducteur complementaire (CMOS). Cependant, la fabrication de ces dispositifs fait face a de serieuses limitations a cause de la taille nanometrique requise pour l'ilot. A ce jour, les procedes de fabrication proposes permettant l'operation a la temperature ambiante sont trop peu reproductibles pour permettre des applications a grande echelle. Dans ce memoire de maitrise, la fabrication de transistors mono-electroniques en silicium (Si-SETs) pour le traitement classique et quantique de l'information est realisee avec un procede nanodamascene. Le polissage chimico-mecanique (CMP) est introduit comme etape clef de la fabrication du transistor, permettant le controle au nanometre pres (nanodamascene) de l'epaisseur du transistor. Cet outil permet la fabrication de dispositifs ayant une geometrie auparavant impossible a realiser et ouvre la porte a l'innovation technologique. De plus, un procede de gravure du silicium par plasma a couplage inductif (ICP) est developpe pour permettre la fabrication de nanostructures de silicium sur une nanotopographie alliant le nano et le 3D. Les Si-SETs fabriques sont caracterises a basse

  8. Environmental assessment of incinerator residue utilisation.

    PubMed

    Toller, S; Kärrman, E; Gustafsson, J P; Magnusson, Y

    2009-07-01

    Incineration ashes may be treated either as a waste to be dumped in landfill, or as a resource that is suitable for re-use. In order to choose the best management scenario, knowledge is needed on the potential environmental impact that may be expected, including not only local, but also regional and global impact. In this study, A life cycle assessment (LCA) based approach was outlined for environmental assessment of incinerator residue utilisation, in which leaching of trace elements as well as other emissions to air and water and the use of resources were regarded as constituting the potential environmental impact from the system studied. Case studies were performed for two selected ash types, bottom ash from municipal solid waste incineration (MSWI) and wood fly ash. The MSWI bottom ash was assumed to be suitable for road construction or as drainage material in landfill, whereas the wood fly ash was assumed to be suitable for road construction or as a nutrient resource to be recycled on forest land after biofuel harvesting. Different types of potential environmental impact predominated in the activities of the system and the use of natural resources and the trace element leaching were identified as being relatively important for the scenarios compared. The scenarios differed in use of resources and energy, whereas there is a potential for trace element leaching regardless of how the material is managed. Utilising MSWI bottom ash in road construction and recycling of wood ash on forest land saved more natural resources and energy than when these materials were managed according to the other scenarios investigated, including dumping in landfill.

  9. ETUDE QUANTITATIVE PAR RADIOAUTOGRAPHIE AU MICROSCOPE ELECTRONIQUE DE L'UTILISATION DE LA DL-LEUCINE-3H PAR LES CELLULES DE L'HYPOPHYSE DU CANARD EN CULTURE ORGANOTYPIQE

    PubMed Central

    Tixier-Vidal, A.; Picart, R.

    1967-01-01

    The synthesis, intracellular transport, storing, and excretion of proteins by duck hypophyseal cells in organ culture were studied with tritiated DL-leucine and high resolution radioautography (pulse-labeling experiments). Quantitative study of the radioautographs allowed a determination of the relative proportions of cytoplasmic radioactivity located in each cellular compartment (ergastoplasm, Golgi apparatus, and protein granules) as well as the variations in these proportions as a function of time. The number of labeled protein granules as opposed to the total number of granules in the cell was also determined (RSg). These data were separately analyzed for the two types of cells present in the explants: prolactin cells and "MSH" cells. The synthetic process follows a course common to both cell types, each of which is distinguished by its particular modalities. The labeled proteins, synthesized within several minutes in the ergastoplasm, are concentrated in the Golgi zone within 30 min. They then migrate out of this area, the emptying of which is accomplished in about 4 hr. These proteins become equally distributed between the protein granules, on the one hand, and the cytoplasm ("sedentary" proteins), on the other. The RSg reaches its maximum when the Golgi zone is emptied, but this figure remains very low (3%). The RSg then decreases slowly (1% in 40 hr). It is concluded that hypophyseal cells are able to store protein in their granules and that their processes of synthesis and excretion are not continuous. The prolactin cells differ from the "MSH" cells in that they have a slower migration of newly synthesized proteins, and these proteins pass via the dilated ergastoplasmic cisterns in which they may possibly be stored. PMID:6064363

  10. The consequences of introducing stochasticity in nutrient utilisation models: the case of phosphorus utilisation by pigs.

    PubMed

    Symeou, V; Leinonen, I; Kyriazakis, I

    2016-02-14

    Simulation models of nutrient utilisation ignore that variation in pig system components can influence the predicted mean and variance of the performance of a group of pigs. The objective of this study was to develop a methodology to investigate how variation in feed composition would (a) affect the outputs of a nutrient utilisation model and (b) interact with variation that arises from the traits of individual pigs. We used a P intake and utilisation model to address these characteristics. Introduction of stochasticity gave rise to a number of methodological challenges--for example, how to generate variation in both feed composition and pigs and account for correlations between ingredients when modelling variation associated with feed mixing efficiency. Introducing variation in feed composition and pig phenotype resulted in moderate decreases in mean digested, retained and excreted P predicted for a population of pigs and an increase in their associated CV. A lower percentage of pigs in the population were predicted to meet their requirements during the feeding period considered, by comparison with the no-variation scenario. Variation in feed ingredient composition contributed more to performance variation than variation due to mixing efficiency. When variations in both feed composition and pig traits were considered, it was the former rather than the latter that had the dominant influence on variability in pig performance. The developed framework emphasises the consequences of random variability on the predictions of nutrient utilisation models. Such consequences will have a significant impact on decisions about management strategies such as feeding that are subject to variation.

  11. Perspectives and visions on CO2 capture and utilisation.

    PubMed

    North, M; Styring, P

    2015-01-01

    This article summarises and contextualises the debates which occurred during the Carbon Dioxide Utilisation Faraday Discussion meeting. The utilisation of carbon dioxide is discussed in terms of both conversion to fuel, with a potential impact on atmospheric carbon dioxide levels, and conversion to chemicals with a potential impact on sustainability.

  12. Utilisation of chip thickness models in grinding

    NASA Astrophysics Data System (ADS)

    Singleton, Roger

    Grinding is now a well established process utilised for both stock removal and finish applications. Although significant research is performed in this field, grinding still experiences problems with burn and high forces which can lead to poor quality components and damage to equipment. This generally occurs in grinding when the process deviates from its safe working conditions. In milling, chip thickness parameters are utilised to predict and maintain process outputs leading to improved control of the process. This thesis looks to further the knowledge of the relationship between chip thickness and the grinding process outputs to provide an increased predictive and maintenance modelling capability. Machining trials were undertaken using different chip thickness parameters to understand how these affect the process outputs. The chip thickness parameters were maintained at different grinding wheel diameters for a constant productivity process to determine the impact of chip thickness at a constant material removal rate.. Additional testing using a modified pin on disc test rig was performed to provide further information on process variables. The different chip thickness parameters provide control of different process outputs in the grinding process. These relationships can be described using contact layer theory and heat flux partitioning. The contact layer is defined as the immediate layer beneath the contact arc at the wheel workpiece interface. The size of the layer governs the force experienced during the process. The rate of contact layer removal directly impacts the net power required from the system. It was also found that the specific grinding energy of a process is more dependent on the productivity of a grinding process

  13. Integrated nuclear data utilisation system for innovative reactors.

    PubMed

    Yamano, N; Hasegawa, A; Kato, K; Igashira, M

    2005-01-01

    A five-year research and development project on an integrated nuclear data utilisation system was initiated in 2002, for developing innovative nuclear energy systems such as accelerator-driven systems. The integrated nuclear data utilisation system will be constructed as a modular code system, which consists of two sub-systems: the nuclear data search and plotting sub-system, and the nuclear data processing and utilisation sub-system. The system will be operated with a graphical user interface in order to enable easy utilisation through the Internet by both nuclear design engineers and nuclear data evaluators. This paper presents an overview of the integrated nuclear data utilisation system, describes the development of a prototype system to examine the operability of the user interface and discusses specifications of the two sub-systems.

  14. An analysis of the materiel fielding plan for the SINCGARS (Single Channel Ground and Airborne Radio System) radio

    NASA Astrophysics Data System (ADS)

    Tegen, C. M.

    1984-12-01

    This thesis is an analysis of the materiel fielding plan (MFP) for the Army's Single Channel Ground and Airborne Radio System (SINCGARS). Objectives of the study are to identify major potential problem areas in the MFP, and to generate recommendations for resolving these problems. The study involves a specific analysis of the maintenance and supply support aspects of the MFP within the context of the Major System acquisition framework. Research included extensive field interviews with personnel in the functional management areas of the Communications and Electronics Command (CECOM), the Project Office, and the Department of Army Staff. Potential problems identified concern the redistribution of VRC-12 series and PRC-77 radios, the imbedded COMSEC modification, and the issue of warranties. Recommendations include purchasing a warranty for the original production contract, improving the planning for redistribution of old radios, and providing strict control over the design of the imbedded COMSEC modification.

  15. Utilisation of cancer screening services by disabled women in Chile.

    PubMed

    Sakellariou, Dikaios; Rotarou, Elena S

    2017-01-01

    Research has shown that women with disabilities face additional challenges in accessing and using healthcare services compared to non-disabled women. However, relatively little is known about the utilisation of cancer screening services for women with disabilities. This study addresses this gap by examining the utilisation of the Papanicolaou test and mammography for disabled women in Chile. We used cross-sectional data, taken from a 2015 nationally-representative survey. Initially, we employed logistic regressions to test for differences in utilisation rates for the Papanicolaou test (66,281 observations) and the mammogram (35,294 observations) between disabled and non-disabled women. Next, logistic regressions were used to investigate the demographic, socioeconomic, and health-related factors affecting utilisation rates for cancer screening services for disabled women (sample sizes: 5,823 observations for the Papanicolaou test and 5,731 observations for the mammogram). Disabled women were less likely to undergo screening tests than non-disabled women. For the Papanicolaou test and mammography, the multivariable regression models showed that living in rural areas, having higher education, being affiliated with a private health insurance company, giving a good health self-assessment score, and being under medical treatment for other illnesses were associated with higher utilisation rates. On the other hand, being single, inactive with regard to employment, and having a better income were linked with lower utilisation. While utilisation rates for both disabled and non-disabled women have increased since 2006, the utilisation disparity has slightly increased. This study shows the influence of various factors in the utilisation rates of preventive cancer screening services for disabled women. To develop effective initiatives targeting inequalities in the utilisation of cancer screening tests, it is important to move beyond an exclusively single-disease approach and

  16. Dietary sugar utilisation by putative oral probiotics.

    PubMed

    Stamatova, I; Kari, K; Hervonen, L; Meurman, J H

    2012-09-01

    Probiotic consumption and repeated probiotic intake have shown promising results as adjunct therapies in prevention and alleviation of some chronic disease conditions in the gastrointestinal tract. Recent evidence suggests that probiotics may also be beneficial in preventing oral diseases. An efficient probiotic candidate in the mouth, however, should not impose any risk to oral tissues, such as acid demineralisation of tooth enamel because of sugar fermentation. The aim of the present in vitro study was to evaluate the utilisation of some sugars and sugar alcohols by yogurt starter Lactobacillus delbrueckii subsp. bulgaricus strains and to assess the influence of these carbohydrate sources on cell surface properties. For comparsion, a commercially available probiotic, Lactobacillus rhamnosus GG, was used. The results showed that lactose, glucose and fructose were readily metabolised by all strains tested. However, strain-specific metabolic patterns were observed when other sugars and sugar alcohols were used as sole carbohydrate source in the growth medium. Surface properties of the bacteria such as hydrophobicity and surface-associated proteins appeared to vary with the carbohydrate content of the growth medium. Based on these results it can be concluded that among the L. delbrueckii subsp. bulgaricus strains probiotic candidate strains are available that warrant further studies due to their inability to ferment sugars with pronounced cariogenic properties.

  17. Energy and nutrient utilisation by embryonic reptiles.

    PubMed

    Thompson, Michael B; Speake, Brian K

    2002-11-01

    Most reptiles are oviparous, with the developing embryos relying on the contents of the yolk to sustain development until hatching (lecithotrophy). The yolk is composed primarily of lipid and protein, which act as an energy source and the essential components to build embryonic tissue. Nevertheless, yolk and the resulting embryos contain many other nutrients, including inorganic ions, vitamins, carotenoids, water and hormones. Apart from water and oxygen, which may be taken up by eggs, and some inorganic ions that can come from the eggshell or even from outside the egg, everything required by the embryo must be in the egg when it is laid. Approximately 20% of squamate reptiles are viviparous, exhibiting a variety of placental complexities. Species with complex placentae have reduced yolk volumes, with the mother augmenting embryonic nutrition by provision across the placenta (placentotrophy). Despite assumed advantages of placentotrophy, only 5 out of approximately 100 lineages of viviparous squamates exhibit substantial placentotrophy. This paper reviews available and recent information on the yolk contents of a variety of squamate reptiles to ask the question, how are nutrients transported from the yolk to the embryo or across the placenta? Although, current available data suggest that, in broad terms, yolk is taken up by embryos without discrimination of the nutrients, there are some apparent exceptions, including the very long chain polyunsaturated fatty acids. In addition, fundamental differences in the patterns of energy utilisation in lizards and snakes suggest fundamental differences in lipid profiles in these taxa, which appear to reflect the differences between placentotrophic and lecithotrophic viviparous lizards.

  18. Patient non-attendance: utilising clinical time.

    PubMed

    Bateman, Heidi; Thomason, J Mark; Ellis, Janice

    2016-06-01

    In undergraduate dental or medical programmes clinical time with exposure to patients is limited. A priority for all those involved in the delivery of a clinical programme is to ensure that this time is used effectively and to maximum potential. Patient non-attendance is a reality, and developing organised activities to provide alternative learning opportunities is important. We have developed a range of close-contact teaching and learning activities (CCTLs) for dental students to productively use patient non-attendance time. CCTLs are short, skills-based tasks that are directly observed and have structured assessment criteria. Used formatively, they are performed in the clinical environment utilising the materials, equipment and clinical staff usually available during the clinical session. The CCTLs have proved particularly useful for early-stage clinical students, by developing understanding and skills, reinforcing protocols and promoting the role of the wider dental team in teaching. Students have welcomed these activities and engagement has been high. In addition to improving skills, they have proved helpful in familiarising students with direct observation, and have inspired peer collaboration and feedback. The CCTLs have promoted opportunities for students to receive direct feedback, which may be difficult to deliver if a patient were present. Empowering students to lead on their own learning requirements also promotes the ethos of lifelong learning that will be fundamental to future professional development. Investment of resources to develop these activities has proved worthwhile, as we have found that CCTLs can complement and maximise the potential of clinical attachments. Patient non-attendance is a reality, and developing organised activities to provide alternative learning opportunities is important. © 2015 John Wiley & Sons Ltd.

  19. Plutonium utilisation in future UK PWRs

    SciTech Connect

    Thomas, G. M.; Worrall, A.

    2006-07-01

    Plutonium recycling in the form of Mixed Oxide (MOX) fuels is already a reality in over 30 reactors in Europe (in Belgium, Switzerland, Germany and France). Japan also plans to use MOX in approximately 30% of its reactors in the near future[1]. This paper describes potential near to mid-term disposition strategies for the United Kingdom's stockpile of plutonium. In order to be confident that MOX fuel can be utilised effectively in Pressurised Water Reactors (PWRs) in the UK, details are given of studies carried out recently at Nexia Solutions on PWR cores loaded with MOX containing typical UK plutonium isotopic compositions. Three dimensional steady state neutronic models of a standard Westinghouse four loop PWR design are constructed using state of the art tools (Studsvik of America's Core Management System[2, 3, 4]). Initially, a standard 18-month equilibrium UO{sub 2} fuel cycle is generated, followed by safety analyses and fuel performance calculations to demonstrate its feasibility. This equilibrium UO{sub 2} core is then gradually transitioned through loading patterns containing increasing MOX core loading fractions. Finally, an equilibrium MOX core loading pattern is determined. Technical safety analyses are also carried out on the transition cores and the final equilibrium scenario to ensure that all of the MOX cores are robust from a technical and safety viewpoint. Once these studies are completed the annual fuel throughputs for each scenario can be determined and used to produce options for managing the UK's plutonium stockpile. This work is part of a wider exercise currently being carried out by Nexia Solutions to explore the options for the safe disposition of the UK civil stockpile of separated PUO{sub 2}. (authors)

  20. Natural gas development and utilisation pattern in India

    SciTech Connect

    Mulchandani, H.K.; Balakrishnan, M.

    1984-02-01

    In this era of energy consciousness, Natural Gas is destined to play an important role in the economic life of India. The luxury of flaring into atmosphere is over. Rather stocks are being assessed and capital investments are planned for the optimum development and utilisation of gas. In this paper, authors have attempted to tie up various data on different aspects of gas business such as supply, source, production, utilisation pattern and its share in energy and economy. The optimal utilisation plan as discussed here could be of some value to the planners.

  1. U.S. Air Force Operational Medicine: Using the Enterprise Estimating Supplies Program to Develop Materiel Solutions for the Air Force Optometry Augmentation Team (FFDOT)

    DTIC Science & Technology

    2010-11-09

    for a range of non- surgical injuries and illnesses that would typically be seen and treated by an optometrist and one technician working 12-hour days...Code 800.13. FFDOT Materiel Solutions 7 Capability The FFDOT AS is used by optometrists as a component of the Aerospace Medical Contingency... optometrist (42E3) and an optometric technician (4V071). Results Change Justification Changes to the AS are categorized as modernization, clinical

  2. Utilisation of Riverine Dom By Coastal Bacteria

    NASA Astrophysics Data System (ADS)

    Rochelle-Newall, E.; Pizay, M.-D.; Gattuso, J.-P.

    % and 69% and was generally highest in the LMW-DOM incubations. These results fur- ther demonstrate the flexibility of bacteria in their ability to utilise different sources of DOM.

  3. Social determinants of dental health services utilisation of Greek adults.

    PubMed

    Pavi, E; Karampli, E; Zavras, D; Dardavesis, T; Kyriopoulos, J

    2010-09-01

    To identify the determinants of dental care utilisation among Greek adults, with a particular emphasis on socio-economic determinants. Data were collected through a national survey on health and health care services utilisation of a sample of 4,003 Greek adults stratified by geographic region, age and gender. A purpose made questionnaire was used during face-to-face interviews. A 2-stage model was developed to assess the impact of independent variables on dental utilisation likelihood and frequency. 39.6% (1,562) of Greek adults reported having visited a dentist within the last year. Among dental attenders, 32.6% reported prevention as the reason for visit. Statistically significant differences in dental care utilisation were observed in relation to demographic, socioeconomic and lifestyle factors. Logistic regression analysis showed that gender, age, income, education, place of residence, private insurance coverage and self-rated oral health are important determinants of dental services utilisation. Mean number of dental visits within previous year was 1.6. Results from Poisson regression analysis indicated that lower income level correlates to lower number of dental visits, while having visited for treatment (rather than for prevention) correlated to higher number of dental visits. Greek adults do not exhibit satisfactory dental visiting behaviour. Extent of care sought is associated with need for treatment rather than preventive reasons. The findings confirm the existence of socioeconomic inequalities in dental services utilisation among Greek adults.

  4. Jarosite characteristics and its utilisation potentials.

    PubMed

    Pappu, Asokan; Saxena, Mohini; Asolekar, Shyam R

    2006-04-15

    During metallic zinc extraction from zinc sulphide or sulphide ore, huge quantity of jarosite is being released universally as solid residues. The jarosite mainly contains iron, sulphur, zinc, calcium, lead, cadmium and aluminium. Jarosite released from such industrial process is complex and its quality and quantity make the task more complex for safe disposal. Apart from water contamination, jarosite already accumulated and its increasing annual production is a major source of pollution for surrounding environment including soil, vegetation and aquatic life and hence its disposal leads to major concern because of the stringent environmental protection regulations. An attempt was made to evaluate the characteristics of Indian jarosite with an objectives to understand its potentials for recycling and utilising as raw materials for developing value added products. Sand and Coal Combustion Residues (CCRs) was used as an admixture to attain good workability and detoxify the toxic substance in the jarosite. Result revealed that jarosite is silty clay loam in texture having 63.48% silt sized and 32.35% clay sized particles. The particle size of jarosite (D90=16.21+/-0.20 microm) is finer than the CCRs (D90=19.72+/-0.18 microm). The jarosite is nonuniform in structure and shape as compared to the CCRs having spherical, hollow shaped and some of them are cenosphere in nature. The major mineral phase of jarosite is Potassium Iron Sulphate Hydroxide {KFe3(SO4)2(OH)6}and Iron Sulphate Hydrate {2 Fe2O3SO3 x 5 H2O}. In CCRs the dominant phases are quartz {SiO2}, mullite {3 Al2O3 x 2 SiO2} and hematite {Fe2O3}. The high electrical conductivity of jarosite (13.26+/-0.437 dS/m) indicates that the presence of cations and anions are predominant over CCRs (0.498+/-0.007 dS/m). The major portion of jarosite consists of iron (23.66+/-0.18%), sulphur (12.23+/-0.2%) and zinc (8.243+/-0.075%). But CCRs main constituents are silicon (27.41+/-0.74%), aluminium (15.167+/-0.376%) and iron (4

  5. Standard operating procedure for air quality stationary source management at Air Force installations in the Air Force Materiel Command

    SciTech Connect

    Powell, C.M.; Ryckman, S.J.

    1997-12-31

    To sustain compliance and avoid future enforcement actions associated with air quality stationary sources and to provide installation commanders with a certification process for Title V permitting, and Air Force Materiel Command (AFMC) Standard Operating Procedure (SOP) for Stationary Source Management has been developed. The SOP consists of two major sections: Stationary Source Planning and Administration, and Stationary Source Operations These two main sections are further subdivided into twelve subsections which delineate requirements (e.g. maintaining inventories, applying for and maintaining permits, keeping records, reporting and certifying compliance) and assign ownership of processes and responsibilities (e.g. appointing a manager/alternate for each identified stationary air source). In addition, the SOP suggests training that should be provided from operator to commander levels to ensure that all personnel involved with a stationary air source are aware of their responsibilities. Implementation of the SOP should provide for the essential control necessary for installation commanders to eliminate stationary air source non-compliance and to certify compliance in accordance with the Title V Operating Permit requirements. This paper will discuss: the background and purpose for the SOPs content, the twelve subsections of the SOP, the success of implementation at various installations, the relevance or the recommended training, the success of negotiating with various labor unions for SOP implementation and the success of the SOP in reference to its intended purpose.

  6. Modular operation of membrane bioreactors for higher hydraulic capacity utilisation.

    PubMed

    Veltmann, K; Palmowski, L M; Pinnekamp, J

    2011-01-01

    Using data from 6 full-scale municipal membrane bioreactors (MBR) in Germany the hydraulic capacity utilisation and specific energy consumption were studied and their connexion shown. The average hydraulic capacity utilisation lies between 14% and 45%. These low values are justified by the necessity to deal with intense rain events and cater for future flow increases. However, this low hydraulic capacity utilisation leads to high specific energy consumption. The optimisation of MBR operation requires a better utilisation of MBR hydraulic capacity, particularly under consideration of the energy-intensive membrane aeration. A first approach to respond to large influent flow fluctuations consists in adjusting the number of operating modules. This is practised by most MBR operators but so far mostly with variable flux and constant membrane aeration. A second approach is the real-time adjustment of membrane aeration in line with flux variations. This adjustment is not permitted under current manufacturers' warranty conditions. A further opportunity is a discontinuous operation, in which filtration takes place over short periods at high flux and energy for membrane aeration is saved during filtration pauses. The integration of a buffer volume is thereby indispensable. Overall a modular design with small units, which can be activated/ inactivated according to the influent flow and always operate under optimum conditions, enables a better utilisation of MBR hydraulic capacity and forms a solid base to reduce MBR energy demand.

  7. Regulation of methanol utilisation pathway genes in yeasts

    PubMed Central

    Hartner, Franz S; Glieder, Anton

    2006-01-01

    Methylotrophic yeasts such as Candida boidinii, Hansenula polymorpha, Pichia methanolica and Pichia pastoris are an emerging group of eukaryotic hosts for recombinant protein production with an ever increasing number of applications during the last 30 years. Their applications are linked to the use of strong methanol-inducible promoters derived from genes of the methanol utilisation pathway. These promoters are tightly regulated, highly repressed in presence of non-limiting concentrations of glucose in the medium and strongly induced if methanol is used as carbon source. Several factors involved in this tight control and their regulatory effects have been described so far. This review summarises available data about the regulation of promoters from methanol utilisation pathway genes. Furthermore, the role of cis and trans acting factors (e.g. transcription factors, glucose processing enzymes) in the expression of methanol utilisation pathway genes is reviewed both in the context of the native cell environment as well as in heterologous hosts. PMID:17169150

  8. COPD: Health Care Utilisation Patterns with Different Disease Management Interventions.

    PubMed

    Luk, Edwin K; Hutchinson, Anastasia F; Tacey, Mark; Irving, Louis; Khan, Fary

    2017-08-01

    The management of COPD is a significant and costly issue worldwide, with acute healthcare utilisation consisting of admissions and outpatient attendances being a major contributor to the cost. Pulmonary rehabilitation (PR) and integrated disease management (IDM) are often offered. Whilst there is strong evidence of physical and quality of life outcomes following IDM and PR, few studies have looked into healthcare utilisation. The aims of this study were to confirm whether IDM and PR reduce acute healthcare utilisation and to identify factors which contribute to acute health care utilisation or increased mortality. This was a retrospective cohort study of patients with COPD who were referred to IDM over a 10-year period. Patients were also offered an 8-week PR program. Data collected were matched with the hospital dataset to obtain information on inpatient, ED and outpatient attendances. 517 patients were enrolled to IDM. 315 (61%) also commenced PR and 220 (43%) completed PR. Patients who were referred to PR were younger and had less comorbidities (p < 0.001). Both groups (IDM only and IDM + PR referred) had reductions in healthcare utilisation but the IDM-only group had greater reductions. A survival benefit (HR 0.68, 95% CI 0.50-0.92) was seen in those who were PR completers compared to patients who received IDM only. Patients with COPD who successfully complete PR in addition to participating in IDM have improved survival. IDM alone was effective in the reduction of healthcare utilisation; however, the addition of PR did not reduce healthcare usage further.

  9. Optimal radiotherapy utilisation rate in developing countries: An IAEA study.

    PubMed

    Rosenblatt, Eduardo; Barton, Michael; Mackillop, William; Fidarova, Elena; Cordero, Lisbeth; Yarney, Joel; Lim, Gerard; Abad, Anthony; Cernea, Valentin; Stojanovic-Rundic, Suzana; Strojan, Primoz; Kobachi, Lotfi; Quarneti, Aldo

    2015-07-01

    Optimal radiotherapy utilisation rate (RTU) is the proportion of all cancer cases that should receive radiotherapy. Optimal RTU was estimated for 9 Middle Income Countries as part of a larger IAEA project to better understand RTU and stage distribution. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Improving the Utilisation of Management Information Systems in Secondary Schools

    ERIC Educational Resources Information Center

    Bosker, R. J.; Branderhorst, E. M.; Visscher, A. J.

    2007-01-01

    Although most secondary schools do use management information systems (MISs), these systems tend not to be used to support higher order managerial activities but are currently primarily used for clerical purposes. This situation is unsatisfactory as MISs fully utilised could offer invaluable support to schools, which are increasingly being granted…

  11. Redirecting Under-Utilised Computer Laboratories into Cluster Computing Facilities

    ERIC Educational Resources Information Center

    Atkinson, John S.; Spenneman, Dirk H. R.; Cornforth, David

    2005-01-01

    Purpose: To provide administrators at an Australian university with data on the feasibility of redirecting under-utilised computer laboratories facilities into a distributed high performance computing facility. Design/methodology/approach: The individual log-in records for each computer located in the computer laboratories at the university were…

  12. Improving the Utilisation of Management Information Systems in Secondary Schools

    ERIC Educational Resources Information Center

    Bosker, R. J.; Branderhorst, E. M.; Visscher, A. J.

    2007-01-01

    Although most secondary schools do use management information systems (MISs), these systems tend not to be used to support higher order managerial activities but are currently primarily used for clerical purposes. This situation is unsatisfactory as MISs fully utilised could offer invaluable support to schools, which are increasingly being granted…

  13. Redirecting Under-Utilised Computer Laboratories into Cluster Computing Facilities

    ERIC Educational Resources Information Center

    Atkinson, John S.; Spenneman, Dirk H. R.; Cornforth, David

    2005-01-01

    Purpose: To provide administrators at an Australian university with data on the feasibility of redirecting under-utilised computer laboratories facilities into a distributed high performance computing facility. Design/methodology/approach: The individual log-in records for each computer located in the computer laboratories at the university were…

  14. Healthcare utilisation and empowerment among women in Liberia.

    PubMed

    Sipsma, Heather; Callands, Tamora A; Bradley, Elizabeth; Harris, Benjamin; Johnson, Billy; Hansen, Nathan B

    2013-11-01

    Many efforts have been undertaken to improve access to healthcare services in low-income settings; nevertheless, underutilisation persists. Women's lack of empowerment may be a central reason for underutilisation, but empirical literature establishing this relationship is sparse. We conducted a cross-sectional study using data from the 2007 Liberia Demographic and Health Survey. Our sample included all non-pregnant women who were currently married or living with a partner (N=3925 unweighted). We used multivariate logistic regression to assess the associations between constructs derived from the Theory of Gender and Power (TGP) and healthcare utilisation. Two-thirds of women (65.6%) had been to a healthcare facility for herself or her children in the past 12 months. Constructs from the three major theoretical structures were associated with healthcare utilisation. Women with no education, compared with women with some education, were less likely to have been to a healthcare facility (OR=0.76; 95% CI 0.62 to 0.93) as were women who had experienced sexual abuse (OR=0.65; 95% CI 0.45 to 0.95) and women who were married (OR=0.69, 95% CI 0.54 to 0.88). Women in higher wealth quintiles, compared with women in the next lower wealth quintile, and women with more decision-making power had greater odds of having been to a healthcare facility (OR=1.22; 95% CI 1.10 to 1.36 and OR=1.10; 95% CI 1.01 to 1.20; respectively). Strong associations exist between healthcare utilisation and empowerment among women in Liberia, and gender imbalances are prevalent. This fundamental issue likely needs to be addressed before large-scale improvement in health service utilisation can be expected.

  15. The European Space Agency standard for space packet utilisation

    NASA Astrophysics Data System (ADS)

    Kaufeler, J.-F.; Parkes, A.; Pidgeon, A.

    1993-03-01

    This paper presents the ESA concept for the use of CCSDS defined Telemetry and Telecommand Packets at the application level. These Packets are used to monitor and control remotely a space born application. This concept is defined in a Packet Utilisation Standard (PUS) which should become applicable for all ESA missions using Packets. The production of this standard is under the responsibility of an ESA standardization group called 'COES'.

  16. Healthcare Utilisation and Empowerment Among Women in Liberia

    PubMed Central

    Sipsma, Heather; Callands, Tamora A; Bradley, Elizabeth; Harris, Benjamin; Johnson, Billy; Hansen, Nathan B

    2014-01-01

    Background Many efforts have been undertaken to improve access to healthcare services in low-income settings; nevertheless, underutilisation persists. Women’s lack of empowerment may be a central reason for underutilisation, but empirical literature establishing this relationship is sparse. Methods We conducted a cross-sectional study using data from the 2007 Liberia Demographic and Health Survey. Our sample included all non-pregnant women who were currently married or living with a partner (N=3925 unweighted). We used multivariate logistic regression to assess the associations between constructs derived from the Theory of Gender and Power (TGP) and healthcare utilisation. Results Two-thirds of women (65.6%) had been to a healthcare facility for herself or her children in the past 12 months. Constructs from the three major theoretical structures were associated with healthcare utilisation. Women with no education, compared with women with some education, were less likely to have been to a healthcare facility (OR=0.76; 95% CI 0.62 to 0.93) as were women who had experienced sexual abuse (OR=0.65; 95% CI 0.45 to 0.95) and women who were married (OR=0.69, 95% CI 0.54 to 0.88). Women in higher wealth quintiles, compared with women in the next lower wealth quintile, and women with more decision-making power had greater odds of having been to a healthcare facility (OR=1.22; 95% CI 1.10 to 1.36 and OR=1.10; 95% CI 1.01 to 1.20; respectively). Conclusions Strong associations exist between healthcare utilisation and empowerment among women in Liberia, and gender imbalances are prevalent. This fundamental issue likely needs to be addressed before large-scale improvement in health service utilisation can be expected. PMID:23929617

  17. The Utilisation of Music by Casino Managers: An Interview Study.

    PubMed

    Bramley, Stephanie; Dibben, Nicola; Rowe, Richard

    2016-12-01

    Music is ubiquitous in retail and commercial environments, with some managers believing that music can enhance the customer experience, increase footfall and sales and improve consumer satisfaction. Casino gambling is popular in the United Kingdom and anecdotal evidence suggests that music is often present. However, little is known about the rationale for music use from the perspective of casino managers. In this study semi-structured interviews were conducted with five casino managers to establish their motivations for utilising music, the factors informing their choice of music and the extent to which music is used with the intention of influencing gambling behaviour. Results showed that casino managers utilised two types of music-recorded background music, often sourced via external music supply companies and live music. Live music was often situated away from the gaming floor and used primarily to accompany participation in non-gambling activities. Recorded background music was not used with the direct aim of influencing customers' gambling behaviour, but to create the right atmosphere for gambling and to promote certain moods within the casinos. To achieve these aims casino managers manipulated the tempo, volume and genre of the recorded background music. Casino managers also reported that some gamblers listen to music via portable music players, possibly with the intention of customising their gambling experience. This study is unique as it has provided a first-hand account of casino managers' implicit theories with regards to why they utilise music and the roles which music is considered to fulfil in casinos.

  18. An analysis of partial efficiencies of energy utilisation of different macronutrients by barramundi (Lates calcarifer) shows that starch restricts protein utilisation in carnivorous fish.

    PubMed

    Glencross, Brett D; Blyth, David; Bourne, Nicholas; Cheers, Susan; Irvin, Simon; Wade, Nicholas M

    2017-02-01

    This study examined the effect of including different dietary proportions of starch, protein and lipid, in diets balanced for digestible energy, on the utilisation efficiencies of dietary energy by barramundi (Lates calcarifer). Each diet was fed at one of three ration levels (satiety, 80 % of initial satiety and 60 % of initial satiety) for a 42-d period. Fish performance measures (weight gain, feed intake and feed conversion ratio) were all affected by dietary energy source. The efficiency of energy utilisation was significantly reduced in fish fed the starch diet relative to the other diets, but there were no significant effects between the other macronutrients. This reduction in efficiency of utilisation was derived from a multifactorial change in both protein and lipid utilisation. The rate of protein utilisation deteriorated as the amount of starch included in the diet increased. Lipid utilisation was most dramatically affected by inclusion levels of lipid in the diet, with diets low in lipid producing component lipid utilisation rates well above 1·3, which indicates substantial lipid synthesis from other energy sources. However, the energetic cost of lipid gain was as low as 0·65 kJ per kJ of lipid deposited, indicating that barramundi very efficiently store energy in the form of lipid, particularly from dietary starch energy. This study defines how the utilisation efficiency of dietary digestible energy by barramundi is influenced by the macronutrient source providing that energy, and that the inclusion of starch causes problems with protein utilisation in this species.

  19. U.S. Air Force Operational Medicine: Using the Enterprise Estimating Supplies Program to Develop Materiel Solutions for the Mobile Aeromedical Staging Facility (FFQM1)

    DTIC Science & Technology

    2012-05-30

    SYSTEM: SNOW LT WT RADAR SCAT W/O SPT SYS EA 4 4 340.00 19.56 $2,612.00 340.00 19.56 $2,612.00 A 7240013375269 CAN MILITARY GASOLINE PLAS ENAMELED ...1.38 $57.04 1.60 1.38 $57.04 A 7105002698463 CHAIR FOLDING W/O ARMS STEEL GRAY ENAMEL EA 3 3 15.00 3.00 $38.73 15.00 3.00 $38.73 FFQM1 Materiel...EA 20 20 100.00 10.00 $340.00 100.00 10.00 $340.00 A 5140002269018 TOOL BOX PORTABLE STL 24"X12"X12" ENAMEL EA 1 1 12.50 2.10 $64.90 12.50 2.10

  20. Fish utilisation of wetland nurseries with complex hydrological connectivity.

    PubMed

    Davis, Ben; Johnston, Ross; Baker, Ronald; Sheaves, Marcus

    2012-01-01

    The physical and faunal characteristics of coastal wetlands are driven by dynamics of hydrological connectivity to adjacent habitats. Wetlands on estuary floodplains are particularly dynamic, driven by a complex interplay of tidal marine connections and seasonal freshwater flooding, often with unknown consequences for fish using these habitats. To understand the patterns and subsequent processes driving fish assemblage structure in such wetlands, we examined the nature and diversity of temporal utilisation patterns at a species or genus level over three annual cycles in a tropical Australian estuarine wetland system. Four general patterns of utilisation were apparent based on CPUE and size-structure dynamics: (i) classic nursery utlisation (use by recently settled recruits for their first year) (ii) interrupted peristence (iii) delayed recruitment (iv) facultative wetland residence. Despite the small self-recruiting 'facultative wetland resident' group, wetland occupancy seems largely driven by connectivity to the subtidal estuary channel. Variable connection regimes (i.e. frequency and timing of connections) within and between different wetland units (e.g. individual pools, lagoons, swamps) will therefore interact with the diversity of species recruitment schedules to generate variable wetland assemblages in time and space. In addition, the assemblage structure is heavily modified by freshwater flow, through simultaneously curtailing persistence of the 'interrupted persistence' group, establishing connectivity for freshwater spawned members of both the 'facultative wetland resident' and 'delayed recruitment group', and apparently mediating use of intermediate nursery habitats for marine-spawned members of the 'delayed recruitment' group. The diversity of utilisation pattern and the complexity of associated drivers means assemblage compositions, and therefore ecosystem functioning, is likely to vary among years depending on variations in hydrological connectivity

  1. Fish Utilisation of Wetland Nurseries with Complex Hydrological Connectivity

    PubMed Central

    Davis, Ben; Johnston, Ross; Baker, Ronald; Sheaves, Marcus

    2012-01-01

    The physical and faunal characteristics of coastal wetlands are driven by dynamics of hydrological connectivity to adjacent habitats. Wetlands on estuary floodplains are particularly dynamic, driven by a complex interplay of tidal marine connections and seasonal freshwater flooding, often with unknown consequences for fish using these habitats. To understand the patterns and subsequent processes driving fish assemblage structure in such wetlands, we examined the nature and diversity of temporal utilisation patterns at a species or genus level over three annual cycles in a tropical Australian estuarine wetland system. Four general patterns of utilisation were apparent based on CPUE and size-structure dynamics: (i) classic nursery utlisation (use by recently settled recruits for their first year) (ii) interrupted peristence (iii) delayed recruitment (iv) facultative wetland residence. Despite the small self-recruiting ‘facultative wetland resident’ group, wetland occupancy seems largely driven by connectivity to the subtidal estuary channel. Variable connection regimes (i.e. frequency and timing of connections) within and between different wetland units (e.g. individual pools, lagoons, swamps) will therefore interact with the diversity of species recruitment schedules to generate variable wetland assemblages in time and space. In addition, the assemblage structure is heavily modified by freshwater flow, through simultaneously curtailing persistence of the ’interrupted persistence’ group, establishing connectivity for freshwater spawned members of both the ‘facultative wetland resident’ and ‘delayed recruitment group’, and apparently mediating use of intermediate nursery habitats for marine-spawned members of the ‘delayed recruitment’ group. The diversity of utilisation pattern and the complexity of associated drivers means assemblage compositions, and therefore ecosystem functioning, is likely to vary among years depending on variations in

  2. Feasibility study for an innovative industrial red mud utilisation method.

    PubMed

    Kounalakis, Petros; Aravossis, Konstantinos; Karayianni, ChS

    2016-02-01

    Red mud is a high volume industrial waste, and its management poses a unique challenge. For the utilisation of red mud, an economical, energy saving, environmental friendly and widely applicable method has been found. The proposed novel method is purely chemical, and achieves the recovery of all the oxides contained in red mud totally and transforms them into high value added products. The present work shows that an investment in an industrial plant, treating red mud and turning a toxic industrial waste in commercial products, is safe and viable. © The Author(s) 2015.

  3. Materiel Acquisition Management Guide

    DTIC Science & Technology

    1980-02-11

    Guide, therefore, is designed to ,ollect, collate, and organize se’lected areas of the DARCOM "corporate memory " that emphasize three arenas of Army...the DARCOM "institutional memory " through an integration of "lessons learned" into its format, The Guide also provides a tool that each manager may u-e...to collect and collate his own "institutional memory " in identifying and organizing the status of his program or assessing the impact of al- ternative

  4. Reengineering hospital materiel management.

    PubMed

    Giunipero, L C

    1995-08-01

    Reengineering involves significant change and dramatic rethinking of the business process. The expected result of these changed processes is dramatic improvement. Hospital cost pressures and technological change necessitate review or reengineering the process to enhance customer service at a lower cost. Three areas that yield significant results include reducing the cost of purchasing, implementing new technologies, and empowering teams to accomplish customer driven goals.

  5. Materiel Acquisition Handbook. Revision

    DTIC Science & Technology

    1987-03-26

    effects (E3), rain, fog, haze, and dust). Performance characteristics will be expressed in bands of performance . Reliability and maintainability will...structure or MOS workload. A summary of the relationship of soldier performance to measures of system effectiveness should be included. c. Training...summary of the relationship of soldier performance to measures of system effectiveness should be included. c. Training Assessment. Discuss the overall

  6. Energetic utilisation of refuse derived fuels from landfill mining.

    PubMed

    Rotheut, Martin; Quicker, Peter

    2017-04-01

    The residence of municipal solid waste within a landfill body results in a significant change of material properties. Experiences with the energetic utilisation of the burnable fractions from formerly landfilled waste are hardly documented, the influence of refuse derived fuels (RDF) from such materials on the performance of modern waste-to-energy plants is not sufficiently described in scientific literature. Therefore this study focuses on the energetic utilisation of refuse derived fuel from landfilled waste, processed in a mechanical waste treatment facility, and the impact of the material on the operation of the incineration plant. Additionally, the possibility of direct combustion of non-pre-treated excavated landfill material has been evaluated in the same facility. First, sampling and analysis of the fuel has been carried out. Based on this, a large-scale combustion experiment was planned and conducted in an industrial waste-to-energy plant. Steam mass flow rate, concentration of harmful substances in the raw gas, as well as total emissions of the facility have been monitored in detail. Furthermore, the influence of the landfilled material on the additive consumption has been determined. The combustion residues (bottom ash) were also sampled and analysed. Based on the evaluation of operating data and analysis of both fuel and residue, suitable thermal treatment approaches for the refuse-derived fuel and the non-pre-treated excavated material have been assessed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Application Development for the Utilisation of ENVISAT Data

    NASA Astrophysics Data System (ADS)

    Csornai, G.; Suba, Zs.; Wirnhardt, Cs.; Nádor, G.; Tikász, L.; László, I.; Csekõ, Á.; Martinovich, L.

    2004-05-01

    Natural disasters connected to climatic extremities (floods, waterlog and drought) tend to occur more frequently in Hungary in the past decade. Serious waterlog affecting more than 100 000 hectares of arable land, flood peak records during spring and serious drought in summer causing losses to agriculture and to the whole economy happened yearly between 1998-2002. After the development and application of monitoring methods, FÖMI RSC have started to develop a cost-effective satellite based model to monitor these natural disaster at regional level. The ESA- titled "Application development for the utilisation of ENVISAT data in remote sensing based regional flood/waterlog and drought monitoring (2000-2003)" aimed at the rapid and large scale monitoring of these disasters utilising available low- and medium resolution operational satellite data (NOAA AVHRR, SPOT VEGETATION, IRS-1C/1D WiFS and ERS SAR) involving the new ESA ENVISAT (specially MERIS and ASAR) data. This paper describes the present status of the project and shows several examples about the achievements.

  8. Self-Assembled Hydrogels Utilising Polymer-Nanoparticle Interactions

    PubMed Central

    Appel, Eric A.; Tibbitt, Mark W.; Webber, Matthew J.; Mattix, Bradley A.; Veiseh, Omid

    2015-01-01

    Mouldable hydrogels that flow upon applied stress and rapidly self-heal are increasingly utilised as they afford minimally invasive delivery and conformal application. Here we report a new paradigm for the fabrication of self-assembled hydrogels with shear-thinning and self-healing properties employing rationally engineered polymer-nanoparticle interactions. Biopolymer derivatives are linked together by selective adsorption to nanoparticles. The transient and reversible interactions between biopolymers and nanoparticles enable flow under applied shear stress, followed by rapid self-healing when the stress is relaxed. We develop a physical description of polymer-nanoparticle gel formation that is utilised to design biocompatible gels for minimally-invasive drug delivery. Owing to the hierarchical structure of the gel, both hydrophilic and hydrophobic drugs can be entrapped and delivered with differential release profiles, both in vitro and in vivo. The work introduces a facile and generalizable class of mouldable hydrogels amenable to a range of biomedical and industrial applications. PMID:25695516

  9. Utilisation of community pharmacists by the general public in Malaysia.

    PubMed

    Chua, Siew Siang; Lim, Kien Ping; Lee, Hong Gee

    2013-02-01

    The study was conducted to assess how the general public in the Klang Valley, Malaysia, utilised community pharmacists. This was a prospective observational study which documented interactions between community pharmacists and their customers. A researcher was stationed in 10 participating community pharmacies around the Klang Valley to observe and record all the interactions, using a structured data-collection form. KEYS FINDINGS: Interactions between 1914 customers and the pharmacists of the 10 community pharmacies were recorded. A total of 2199 requests were made by these customers. The main types of request were for medications by brand name (32.2%), advice on minor health problems (25.9%) and for health supplements (11.7%). Only 65 prescriptions were received by the community pharmacies; that is, fewer than two prescriptions per pharmacy per day. The pharmacists provided counselling for only 54.4% of the requests where a medication or health supplement was dispensed. Counselling by pharmacist was significantly associated with the type of request (P < 0.001). The main reason for the general public to visit a community pharmacy in Malaysia was to purchase a particular medication. Few prescriptions were filled at community pharmacies in Malaysia, indicating the under-utilisation of community pharmacists as a safety net for prescribed medications in primary care. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  10. Landscape Utilisation, Animal Behaviour and Hendra Virus Risk.

    PubMed

    Field, H E; Smith, C S; de Jong, C E; Melville, D; Broos, A; Kung, N; Thompson, J; Dechmann, D K N

    2016-03-01

    Hendra virus causes sporadic fatal disease in horses and humans in eastern Australia. Pteropid bats (flying-foxes) are the natural host of the virus. The mode of flying-fox to horse transmission remains unclear, but oro-nasal contact with flying-fox urine, faeces or saliva is the most plausible. We used GPS data logger technology to explore the landscape utilisation of black flying-foxes and horses to gain new insight into equine exposure risk. Flying-fox foraging was repetitious, with individuals returning night after night to the same location. There was a preference for fragmented arboreal landscape and non-native plant species, resulting in increased flying-fox activity around rural infrastructure. Our preliminary equine data logger study identified significant variation between diurnal and nocturnal grazing behaviour that, combined with the observed flying-fox foraging behaviour, could contribute to Hendra virus exposure risk. While we found no significant risk-exposing difference in individual horse movement behaviour in this study, the prospect warrants further investigation, as does the broader role of animal behaviour and landscape utilisation on the transmission dynamics of Hendra virus.

  11. Efficiency of energy utilisation and voluntary feed intake in ruminants.

    PubMed

    Tolkamp, B J

    2010-07-01

    Energy requirements of animals are most readily expressed in terms of net energy (NE), while the energy yield of feed is, at least initially, expressed in terms of metabolisable energy (ME). Energy evaluation systems 'translate' NE requirements into ME requirements (ME systems) or assign NE values to feeds (NE systems). Efficiency of ME utilisation is higher for maintenance than for production and the NE yield of a feed varies, therefore, with ME intake. In addition, energetic efficiency for maintenance and production is thought to be different for lactating and non-lactating animals and to be affected by diet quality. As a result, there are currently many national energy evaluation systems that are complex, differ in their approach and are, as a result, difficult to compare. As ruminants in most production systems are fed ad libitum, this is also the most appropriate intake level at which to estimate energetic efficiency. Analyses of older as well as more recent data suggest that ad libitum feeding (i) abolishes the effects of diet quality on energetic efficiency (almost) completely, (ii) abolishes the differences between lactating and non-lactating animals (almost) entirely and (iii) results in overall energetic efficiencies that are always close to 0.6. The paper argues that there is now sufficient information to develop an international energy evaluation system for ad libitum fed ruminants. Such a system should (i) unify ME and NE systems, (ii) avoid the systematic bias and large errors that can be associated with current systems (iii) be simpler than current systems and (iv) have as a starting point a constant efficiency of ME utilisation, with a value of around 0.6. The remarkably constant efficiency of ME utilisation in ad libitum fed ruminants could be the result of energetic efficiency as well as feed intake regulation being affected by the same variables or of a direct role of energetic efficiency in feed intake regulation. Models to predict intake on the

  12. Technologies for the utilisation of biogenic waste in the bioeconomy.

    PubMed

    O'Callaghan, Kenneth

    2016-05-01

    A brief review has been done of technologies involved in the exploitation of biogenic wastes, in order to provide an introduction to the subject from the technological perspective. Biogenic waste materials and biomass have historically been utilised for thousands of years, but a new conversation is emerging on the role of these materials in modern bioeconomies. Due to the nature of the products and commodities now required, a modern bioeconomy is not simply a rerun of former ones. This new dialogue needs to help us understand how technologies for managing and processing biogenic wastes--both established and novel--should be deployed and integrated (or not) to meet the requirements of the sustainability, closed-loop and resource-security agendas that evidently sit behind the bioeconomy aspirations now being voiced in many countries and regions of the world. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Clean coal technology. Coal utilisation by-products

    SciTech Connect

    2006-08-15

    The need to remove the bulk of ash contained in flue gas from coal-fired power plants coupled with increasingly strict environmental regulations in the USA result in increased generation of solid materials referred to as coal utilisation by-products, or CUBs. More than 40% of CUBs were sold or reused in the USA in 2004 compared to less than 25% in 1996. A goal of 50% utilization has been established for 2010. The American Coal Ash Association (ACCA) together with the US Department of Energy's Power Plant Improvement Initiative (PPPI) and Clean Coal Power Initiative (CCPI) sponsor a number of projects that promote CUB utilization. Several are mentioned in this report. Report sections are: Executive summary; Introduction; Where do CUBs come from?; Market analysis; DOE-sponsored CUB demonstrations; Examples of best-practice utilization of CUB materials; Factors limiting the use of CUBs; and Conclusions. 14 refs., 1 fig., 5 tabs., 14 photos.

  14. Folic acid utilisation related to sulfa drug resistance in Saccharomyces cerevisiae.

    PubMed

    Bayly, A M; Berglez, J M; Patel, O; Castelli, L A; Hankins, E G; Coloe, P; Hopkins Sibley, C; Macreadie, I G

    2001-11-13

    Saccharomyces cerevisiae mutants deficient in folate synthesis have been constructed and employed to study the utilisation of exogenous folates in yeast. One mutant specifically lacked dihydropteroate synthase while the second lacked dihydrofolate synthase. Exogenous folinic acid restored optimal growth to both strains. Folic acid did not generally rescue growth but spontaneous isolates capable of utilising folic acid were selected. The folic acid synthesis pathway in the folate utilising isolates was restored via transformation with FOL1 or FOL3 expression plasmids and transformants were tested for resistance to sulfamethoxazole (SMX). The presence of elevated levels of folic acid led to greatly reduced SMX sensitivity regardless of whether strains were folate utilisers or not.

  15. Trends in metformin utilisation and dose appropriateness in Australia.

    PubMed

    Moon, J; Kumar, S S; Graham, G G; Baysari, M T; Williams, K M; Chen, W; Viardot, A; Greenfield, J R; Day, R O

    2016-12-01

    The study aimed to (1) determine the trends in the utilisation of metformin in Australia, (2) determine the appropriateness of metformin dosing in an Australian teaching hospital and (3) gather the opinions of prescribers on the relationship between metformin dose and renal function. National prescription data between 1990 and 2012 were accessed. A retrospective audit (2008-2012) of metformin doses and patient renal function (20 % random sample of all in-patients prescribed metformin) was conducted at St Vincent's Hospital (SVH), Sydney. Prescribers of metformin were interviewed (semi-structured; consultants at SVH) or surveyed (Australian endocrinologists) to gather their understanding of metformin dosing in relation to renal function. Metformin utilisation increased fivefold nationally between 1995 and 2012. Metformin tended to be under-dosed in SVH patients with normal renal function (83.5 %) and over-dosed in patients with impaired renal function (estimated glomerular filtration rate (eGFR) <30 mL/min, 50 %). Consultants indicated that metformin doses needed to be reduced in renal impairment. Most endocrinologists (61 %) were comfortable prescribing metformin down to eGFRs around 30 mL/min. The use of metformin increased greatly over the period of the study. Metformin is prescribed frequently for patients with eGFR values below the minimal level approved in the product label (60 mL/min). While prescribers expressed their understanding of the need to reduce metformin doses in patients with renal impairment, we found that metformin doses were higher than appropriate in patients with impaired renal function. Metformin may be used safely when renal function is poor provided dosage is appropriately reduced.

  16. Utilising shade to optimize UV exposure for vitamin D

    NASA Astrophysics Data System (ADS)

    Turnbull, D. J.; Parisi, A. V.

    2008-06-01

    Numerous studies have stated that humans need to utilise full sun radiation, at certain times of the day, to assist the body in synthesising the required levels of vitamin D3. The time needed to be spent in the full sun depends on a number of factors, for example, age, skin type, latitude, solar zenith angle. Current Australian guidelines suggest exposure to approximately 1/6 to 1/3 of a minimum erythemal dose (MED), depending on age, would be appropriate to provide adequate vitamin D3 levels. The aim of the study was to determine the exposure times to diffuse solar UV to receive exposures of 1/6 and 1/3 MED for a changing solar zenith angle in order to assess the possible role that diffuse UV (scattered radiation) may play in vitamin D3 effective UV exposures (UVD3). Diffuse and global erythemal UV measurements were conducted at five minute intervals over a twelve month period for a solar zenith angle range of 4° to 80° at a latitude of 27.6° S. For a diffuse UV exposure of 1/3 MED, solar zenith angles smaller than approximately 50° can be utilised for exposure times of less than 10 min. Spectral measurements showed that, for a solar zenith angle of 40°, the UVA (315-400 nm) in the diffuse component of the solar UV is reduced by approximately 62% compared to the UVA in the global UV, whereas UVD3 wavelengths are only reduced by approximately 43%. At certain latitudes, diffuse UV under shade may play an important role in providing the human body with adequate levels of UVD3 (290-315 nm) radiation without experiencing the high levels of UVA observed in full sun.

  17. Utilising shade to optimize UV exposure for vitamin D

    NASA Astrophysics Data System (ADS)

    Turnbull, D. J.; Parisi, A. V.

    2008-01-01

    Numerous studies have stated that humans need to utilise full sun radiation, at certain times of the day, to assist the body in synthesising the required levels of vitamin D3. The time needed to be spent in the full sun depends on a number of factors, for example, age, skin type, latitude, solar zenith angle. Current Australian guidelines suggest exposure to approximately 1/6 to 1/3 of a minimum erythemal dose (MED), depending on age, would be appropriate to provide adequate vitamin D3 levels. The aim of the study was to determine the exposure times to diffuse solar UV to receive exposures of 1/6 and 1/3 MED for a changing solar zenith angle in order to assess the possible role that diffuse UV (scattered radiation) may play in vitamin D3 effective UV exposures (UVD3). Diffuse and global erythemal UV measurements were conducted at five minute intervals over a twelve month period for a solar zenith angle range of 4° to 80° at a latitude of 27.6° S. For diffuse UV exposures of 1/6 and 1/3 MED, solar zenith angles smaller than 60° and 50° respectively can be utilised for exposure times of less than 10 min. Spectral measurements showed that, for a solar zenith angle of 40°, the UVA (315-400 nm) in the diffuse component of the solar UV is reduced by approximately 62% compared to the UVA in the global UV, whereas UVD3 wavelengths are only reduced by approximately 43%. At certain latitudes, diffuse UV under shade may play an important role in providing the human body with adequate levels of UVD3 (290-330 nm) radiation without experiencing the high levels of damaging UVA observed in full sun.

  18. Utilisation of rheumatology care services in Germany: the case of physical therapy and self-help groups

    PubMed Central

    Thieme, Holm; Borgetto, Bernhard

    2012-01-01

    Physical Therapy (PT) and self-help groups (SHG) are important components of health care in rheumatic diseases. The utilisation of PT and SHG by patients with rheumatic diseases may be influenced by several factors. The aim of this study is to summarize the evidence on PT and SHG utilisation of patients with rheumatic diseases in Germany. We systematically searched the MEDLINE-database for studies that evaluated the utilisation and factors that possibly influence the utilisation of PT and SHG. Eight studies were found for PT-utilisation and one for SHG-utilisation. Between 25 and 59 percent of patients with rheumatic diseases received PT services. Several individual and contextual factors that may influence the utilisation could be identified. In conclusion, evidence exists for wide variations in the utilisation of PT services and an underuse of such services among patients with rheumatic diseases in Germany. By contrast, little evidence exists on the utilisation of SHG. PMID:23133502

  19. University Counselling Service Utilisation by Local and International Students and User Characteristics: A Review

    ERIC Educational Resources Information Center

    Raunic, Adam; Xenos, Sophia

    2008-01-01

    This paper reviews research on students' usage of university counselling services across countries and their demographic and psychological characteristics. In doing so, emphasis is given to reported distinctions between local and international university students. Utilisation rates, encouraging factors and barriers to utilisation, presenting…

  20. Utilising multimedia for training merchant mariners as paramedics.

    PubMed

    Anogianakis, G; Maglavera, S

    2000-01-01

    MERMAID is a telemedicine project with global reach and a 24-hour, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model is not limited to medical diagnostics but it encompasses all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications are considered while the full range of network choices is explored in terms of the cost/performance tradeoffs inherent to them and the developmental stage each of these options occupies in its life cycle. MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialty care best suited to each particular case. Finally, the development of programme modules for training and education of the seafarers in the use of the MERMAID medical communications system is given top priority as such modules constitute the firmest basis for the promotion of proper practice of telemedicine at sea.

  1. Possibilities for the efficient utilisation of spent geothermal waters.

    PubMed

    Tomaszewska, Barbara; Szczepański, Andrzej

    2014-10-01

    Waters located at greater depths usually exhibit high mineral content, which necessitates the use of closed systems, i.e. re-injecting them into the formation after recovering the heat. This significantly reduces investment efficiency owing to the need to drill absorption wells and to perform anti-corrosion and anti-clogging procedures. In this paper, possibilities for the efficient utilisation of cooled geothermal waters are considered, particularly with respect to open or mixed geothermal water installations. Where cooled water desalination technologies are used, this allows the water to be demineralised and used to meet local needs (as drinking water and for leisure purposes). The retentate left as a by-product of the process contains valuable ingredients that can be used for balneological and/or leisure purposes. Thus, the technology for desalinating spent geothermal waters with high mineral content allows improved water management on a local scale and makes it possible to minimise the environmental threat resulting from the need to dump these waters into waterways or surface water bodies and/or inject them into the formation. The paper is concerned with Polish geothermal system and provides information about the parameters of Polish geothermal waters.

  2. Potential of palm oil utilisation in aquaculture feeds.

    PubMed

    Ng, Wing-Keong

    2002-01-01

    One key ingredient used in the formulation of aquafeed is fish oil, which is produced from small marine pelagic fish and represents a finite fishery resource. At the present time, global fish oil production has reached a plateau and is not expected to increase beyond current levels. Recent estimates suggest that fish oils may be unable to meet demands from the rapidly growing aquaculture industry by as early as 2005. Therefore, there is currently great interest within the aquafeed industry in evaluating alternatives to fish oils. The ever-expanding oil palm cultivation in Malaysia and other tropical countries offers the possibility of an increased and constant availability of palm oil products for aquafeed formulation. Research into the use of palm oil in aquafeed begun around the mid-1990s and this review examines some of the findings from these studies. The use of palm oil in fish diets has generally shown encouraging results. Improved growth, feed efficiency, protein utilisation, reproductive performance and higher concentrations of alpha-tocopherol in fish fillets have been reported. Recent evidence for the ability of palm oil to substitute for fish oil in catfish diets is reviewed. The potential of palm oil use in aquafeed and future experimental directions are suggested. The aquaculture feed industry offers a great avenue to increase and diversify the use of palm oil-based products.

  3. Eye care services utilisation among pregnant women in Nigeria.

    PubMed

    Ibraheem, Waheed A; Ibraheem, Anifat B; Owonikoko, Musliudeen; Tijani, Aramide; Olamoyegun, Michael Adeyemi; AbdSalam, Soliu

    2016-07-01

    One hundred and sixty-five pregnant Nigerian women attending the antenatal clinic of LAUTECH teaching hospital, Ogbomoso, Nigeria between January and April 2014 were interviewed using a structured questionnaire. Socio-demographic characteristics of the respondents were obtained. Respondents were also asked: if they had had their eye examined by an eye specialist during the index pregnancy, frequencies of visit to eye care centers and indications for their visitation. A history of previous eye examination by eye care specialist/visit to eye clinic was considered as eye care utilisation. Selection of eligible subjects who consented to participate in the study was done using simple random technique. Logistic regression model was used to control sociodemographic and obstetric factors in order to determine independent covariate factor influencing the use of eye care services. Among the population studied, only 46 (32%) had eye examination during the index pregnancy. Level of education and occupational status of the respondents were found to be statistically significant factors (p = 0.001 and 0.008, respectively). There is a need for a policy that will encourage regular eye care services usage during pregnancy.

  4. Chronic catecholamine depletion switches myocardium from carbohydrate to lipid utilisation.

    PubMed

    Drake-Holland, A J; Van der Vusse, G J; Roemen, T H; Hynd, J W; Mansaray, M; Wright, Z M; Noble, M I

    2001-03-01

    Chronic cardiac transplantation denervation (i.e., global sympathetic denervation with myocardial catecholamine depletion, plus parasympathetic denervation) is known to inhibit myocardial oxidation of glucose. It is not known whether this is due to increased utilization of lactate, lipid or ketone bodies. The purpose of the present study was to test the hypothesis that the extraction and contribution of blood-borne fatty acids (FA) to overall oxidative energy conversion is increased. In anaesthetised dogs (control n = 6, cardiac denervated n = 6), we investigated fatty acid (FA) utilization. The studies were made at least four weeks after surgical cardiac denervation. Measurements were made of total FAs and with a radio-labelled tracer (U-14C palmitate). The contribution of FA utilisation to overall substrate oxidation rose from 31% (control) to 48% (cardiac denervated). The increase in the ratio (%) of CO2 production from palmitate oxidation to total CO2 production increased from 4.0 +/- 1.8 (control) to 10.6 +/- 5.8 (denervated, p = 0.04). The time from uptake of FA to release of CO2 product was unaltered. We conclude that the contribution of FA oxidation to overall energy conversion is increased in chronically denervated hearts, which is postulated to result from a decline in the active form of pyruvate dehydrogenase. This would appear to be a result of chronic catecholamine depletion.

  5. Biological carbon dioxide utilisation in food waste anaerobic digesters.

    PubMed

    Fernández, Y Bajón; Green, K; Schuler, K; Soares, A; Vale, P; Alibardi, L; Cartmell, E

    2015-12-15

    Carbon dioxide (CO2) enrichment of anaerobic digesters (AD) was previously identified as a potential on-site carbon revalorisation strategy. This study addresses the lack of studies investigating this concept in up-scaled units and the need to understand the mechanisms of exogenous CO2 utilisation. Two pilot-scale ADs treating food waste were monitored for 225 days, with the test unit being periodically injected with CO2 using a bubble column. The test AD maintained a CH4 production rate of 0.56 ± 0.13 m(3) CH4·(kg VS(fed) d)(-1) and a CH4 concentration in biogas of 68% even when dissolved CO2 levels were increased by a 3 fold over the control unit. An additional uptake of 0.55 kg of exogenous CO2 was achieved in the test AD during the trial period. A 2.5 fold increase in hydrogen (H2) concentration was observed and attributed to CO2 dissolution and to an alteration of the acidogenesis and acetogenesis pathways. A hypothesis for conversion of exogenous CO2 has been proposed, which requires validation by microbial community analysis. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  6. Rhinovirus infection and healthcare utilisation in prematurely born infants.

    PubMed

    Drysdale, Simon B; Alcazar-Paris, Mireia; Wilson, Theresa; Smith, Melvyn; Zuckerman, Mark; Broughton, Simon; Rafferty, Gerrard F; Peacock, Janet L; Johnston, Sebastian L; Greenough, Anne

    2013-10-01

    Our aim was to determine whether rhinovirus (RV) lower respiratory tract infections (LRTIs) in prematurely born infants increase health-related cost of care during infancy. 153 infants born at <36 weeks of gestation were prospectively followed to 1 year. Cost of care was calculated from the National Health Service reference costing scheme and healthcare utilisation determined by examining hospital/general practitioner records. 20 infants developed RV LRTIs (RV group), 17 respiratory syncytial virus (RSV) LRTIs (RSV group), 12 both RV and RSV LRTIs (RV/RSV group) and 74 had no LRTI (no LRTI group). Compared with the no LRTI group, the RV/RSV LRTI group had the greatest increase in adjusted mean cost (difference GBP 5769), followed by the RV LRTI group (difference GBP 278) and, finally, the RSV LRTI group (difference GBP 172) (p=0.045). The RV group had more outpatient (p<0.05) and respiratory-related general practitioner (p<0.05) attendances, more wheezed at follow-up (p<0.001) than the no LRTI group and more had respiratory-related outpatient attendances than the RSV LRTI group (p<0.05). We conclude that RV LRTIs were associated with increased health-related cost of care during infancy; our results suggest that the RV group compared with the RSV group suffered greater chronic respiratory morbidity.

  7. Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study

    PubMed Central

    Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

    2016-01-01

    Objective While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. Design We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. Setting We interviewed participants at Japan Clubs and their offices. Participants 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. Results We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. Conclusions The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. PMID:27006344

  8. Outpatient echocardiography in the evaluation of innocent murmurs in children: utilisation benchmarking.

    PubMed

    Frias, Patricio A; Oster, Matthew; Daley, Patricia A; Boris, Jeffrey R

    2016-03-01

    We sought to benchmark the utilisation of echocardiography in the outpatient evaluation of heart murmurs by evaluating two large paediatric cardiology centres. Although criteria exist for appropriate use of echocardiography, there are no benchmarking data demonstrating its utilisation. We performed a retrospective cohort study of outpatients aged between 0 and 18 years at the Sibley Heart Center Cardiology and the Children's Hospital of Philadelphia Division of Cardiology, given a sole diagnosis of "innocent murmur" from 1 July, 2007 to 31 October, 2010. Using internal claims data, we compared the utilisation of echocardiography according to centre, patient age, and physician years of service. Of 23,114 eligible patients (Sibley Heart Center Cardiology: 12,815, Children's Hospital of Philadelphia Division of Cardiology: 10,299), 43.1% (Sibley Heart Center Cardiology: 45.2%, Children's Hospital of Philadelphia Division of Cardiology: 40.4%; p1-5 years had the lowest utilisation (32.7%). In two large paediatric cardiology practices, the overall utilisation of echocardiography by physicians with a sole diagnosis of innocent murmur was similar. There was significant and similar variability in utilisation by provider at both centres. Although these data serve as initial benchmarking, the variability in utilisation highlights the importance of appropriate use criteria.

  9. Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study.

    PubMed

    Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

    2016-03-22

    While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. We interviewed participants at Japan Clubs and their offices. 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Structural insight into the Clostridium difficile ethanolamine utilisation microcompartment.

    PubMed

    Pitts, Alison C; Tuck, Laura R; Faulds-Pain, Alexandra; Lewis, Richard J; Marles-Wright, Jon

    2012-01-01

    Bacterial microcompartments form a protective proteinaceous barrier around metabolic enzymes that process unstable or toxic chemical intermediates. The genome of the virulent, multidrug-resistant Clostridium difficile 630 strain contains an operon, eut, encoding a bacterial microcompartment with genes for the breakdown of ethanolamine and its utilisation as a source of reduced nitrogen and carbon. The C. difficile eut operon displays regulatory genetic elements and protein encoding regions in common with homologous loci found in the genomes of other bacteria, including the enteric pathogens Salmonella enterica and Enterococcus faecalis. The crystal structures of two microcompartment shell proteins, CD1908 and CD1918, and an uncharacterised protein with potential enzymatic activity, CD1925, were determined by X-ray crystallography. CD1908 and CD1918 display the same protein fold, though the order of secondary structure elements is permuted in CD1908 and this protein displays an N-terminal β-strand extension. These proteins form hexamers with molecules related by crystallographic and non-crystallographic symmetry. The structure of CD1925 has a cupin β-barrel fold and a putative active site that is distinct from the metal-ion dependent catalytic cupins. Thin-section transmission electron microscopy of Escherichia coli over-expressing eut proteins indicates that CD1918 is capable of self-association into arrays, suggesting an organisational role for CD1918 in the formation of this microcompartment. The work presented provides the basis for further study of the architecture and function of the C. difficile eut microcompartment, its role in metabolism and the wider consequences of intestinal colonisation and virulence in this pathogen.

  11. Utilisation of Intensive Foraging Zones by Female Australian Fur Seals

    PubMed Central

    Hoskins, Andrew J.; Costa, Daniel P.; Arnould, John P. Y.

    2015-01-01

    Within a heterogeneous environment, animals must efficiently locate and utilise foraging patches. One way animals can achieve this is by increasing residency times in areas where foraging success is highest (area-restricted search). For air-breathing diving predators, increased patch residency times can be achieved by altering both surface movements and diving patterns. The current study aimed to spatially identify the areas where female Australian fur seals allocated the most foraging effort, while simultaneously determining the behavioural changes that occur when they increase their foraging intensity. To achieve this, foraging behaviour was successfully recorded with a FastLoc GPS logger and dive behaviour recorder from 29 individual females provisioning pups. Females travelled an average of 118 ± 50 km from their colony during foraging trips that lasted 7.3 ± 3.4 days. Comparison of two methods for calculating foraging intensity (first-passage time and first-passage time modified to include diving behaviour) determined that, due to extended surface intervals where individuals did not travel, inclusion of diving behaviour into foraging analyses was important for this species. Foraging intensity ‘hot spots’ were found to exist in a mosaic of patches within the Bass Basin, primarily to the south-west of the colony. However, the composition of benthic habitat being targeted remains unclear. When increasing their foraging intensity, individuals tended to perform dives around 148 s or greater, with descent/ascent rates of approximately 1.9 m•s-1 or greater and reduced postdive durations. This suggests individuals were maximising their time within the benthic foraging zone. Furthermore, individuals increased tortuosity and decreased travel speeds while at the surface to maximise their time within a foraging location. These results suggest Australian fur seals will modify both surface movements and diving behaviour to maximise their time within a foraging patch

  12. Utilisation of intensive foraging zones by female Australian fur seals.

    PubMed

    Hoskins, Andrew J; Costa, Daniel P; Arnould, John P Y

    2015-01-01

    Within a heterogeneous environment, animals must efficiently locate and utilise foraging patches. One way animals can achieve this is by increasing residency times in areas where foraging success is highest (area-restricted search). For air-breathing diving predators, increased patch residency times can be achieved by altering both surface movements and diving patterns. The current study aimed to spatially identify the areas where female Australian fur seals allocated the most foraging effort, while simultaneously determining the behavioural changes that occur when they increase their foraging intensity. To achieve this, foraging behaviour was successfully recorded with a FastLoc GPS logger and dive behaviour recorder from 29 individual females provisioning pups. Females travelled an average of 118 ± 50 km from their colony during foraging trips that lasted 7.3 ± 3.4 days. Comparison of two methods for calculating foraging intensity (first-passage time and first-passage time modified to include diving behaviour) determined that, due to extended surface intervals where individuals did not travel, inclusion of diving behaviour into foraging analyses was important for this species. Foraging intensity 'hot spots' were found to exist in a mosaic of patches within the Bass Basin, primarily to the south-west of the colony. However, the composition of benthic habitat being targeted remains unclear. When increasing their foraging intensity, individuals tended to perform dives around 148 s or greater, with descent/ascent rates of approximately 1.9 m•s-1 or greater and reduced postdive durations. This suggests individuals were maximising their time within the benthic foraging zone. Furthermore, individuals increased tortuosity and decreased travel speeds while at the surface to maximise their time within a foraging location. These results suggest Australian fur seals will modify both surface movements and diving behaviour to maximise their time within a foraging patch.

  13. Utilisation of Wearable Computing for Space Programmes Test Activities Optimasation

    NASA Astrophysics Data System (ADS)

    Basso, V.; Lazzari, D.; Alemanni, M.

    2004-08-01

    New technologies are assuming a relevant importance in the Space business domain also in the Assembly Integration and Test (AIT) activities allowing process optimization and capability that were unthinkable only few years ago. This paper has the aim to describe Alenia Spazio (ALS) gained experience on the remote interaction techniques as a results of collaborations established both on European Communities (EC) initiatives, with Alenia Aeronautica (ALA) and Politecnico of Torino (POLITO). The H/W and S/W components performances increase and costs reduction due to the home computing massive utilization (especially demanded by the games business) together with the network technology possibility (offered by the web as well as the hi-speed links and the wireless communications) allow today to re-think the traditional AIT process activities in the light of the multimedia data exchange: graphical, voice video and by sure more in the future. Aerospace business confirm its innovation vocation which in the year '80 represents the cradle of the CAD systems and today is oriented to the 3D data visualization/ interaction technologies and remote visualisation/ interaction in collaborative way on a much more user friendly bases (i.e. not for specialists). Fig. 1 collects AIT extended scenario studied and adopted by ALS in these years. ALS experimented two possibilities of remote visualization/interaction: Portable [e.g. Fig.2 Personal Digital Assistant (PDA), Wearable] and walls (e.g.VR-Lab) screens as both 2D/3D visualisation and interaction devices which could support many types of traditional (mainly based on EGSE and PDM/CAD utilisation/reports) company internal AIT applications: 1. design review support 2. facility management 3. storage management 4. personnel training 5. integration sequences definition 6. assembly and test operations follow up 7. documentation review and external access to AIT activities for remote operations (e.g. tele-testing) EGSE Portable Clean room

  14. Quality Horizons. Volume I.

    DTIC Science & Technology

    1979-11-15

    PRODUCTS PRODUCTS Bruel & Kjaer Standard Electric GOVERNMENT AGENCIES US Embassy Office of Defense Cooperation Ministry of Commerce Royal Danish Air Force...Combined Material Agency (DCMA) BELGIUM COMMERCIAL & MILITARY PRODUCTS MBLE (Manufacture Beige DeLampes St De Materiel Electronique ) GOVERnMENT AGENCIES

  15. An Evaluation of the Environmental Fate and Behavior of Munitions Materiel (Tetryl and Polar Metabolites of TNT) in Soil and Plant Systems. Preliminary Evaluation of TNT-Polar Metabolites in Plants

    DTIC Science & Technology

    1992-11-01

    sorptive processes of the soil and the contaminant’s relative water solubility. Organic contaminants, such as the munitions materiel, may undergo chemical...homogenized with water and subsequently extracted with diethyl ether, only 4% of the label present in this tissue (less than I 0.3% of total plant label...was found to partition into the ether layer; 57% of the leaf’s label (less than 4.9% of total plant label) remained in the water layer, and the

  16. Expenditure and resource utilisation for cervical screening in Australia

    PubMed Central

    2012-01-01

    Background The National Cervical Screening Program in Australia currently recommends that women aged 18–69 years are screened with conventional cytology every 2 years. Publicly funded HPV vaccination was introduced in 2007, and partly as a consequence, a renewal of the screening program that includes a review of screening recommendations has recently been announced. This study aimed to provide a baseline for such a review by quantifying screening program resource utilisation and costs in 2010. Methods A detailed model of current cervical screening practice in Australia was constructed and we used data from the Victorian Cervical Cytology Registry to model age-specific compliance with screening and follow-up. We applied model-derived rate estimates to the 2010 Australian female population to calculate costs and numbers of colposcopies, biopsies, treatments for precancer and cervical cancers in that year, assuming that the numbers of these procedures were not yet substantially impacted by vaccination. Results The total cost of the screening program in 2010 (excluding administrative program overheads) was estimated to be A$194.8M. We estimated that a total of 1.7 million primary screening smears costing $96.7M were conducted, a further 188,900 smears costing $10.9M were conducted to follow-up low grade abnormalities, 70,900 colposcopy and 34,100 histological evaluations together costing $21.2M were conducted, and about 18,900 treatments for precancerous lesions were performed (including retreatments), associated with a cost of $45.5M for treatment and post-treatment follow-up. We also estimated that $20.5M was spent on work-up and treatment for approximately 761 women diagnosed with invasive cervical cancer. Overall, an estimated $23 was spent in 2010 for each adult woman in Australia on cervical screening program-related activities. Conclusions Approximately half of the total cost of the screening program is spent on delivery of primary screening tests; but the

  17. Target prediction utilising negative bioactivity data covering large chemical space.

    PubMed

    Mervin, Lewis H; Afzal, Avid M; Drakakis, Georgios; Lewis, Richard; Engkvist, Ola; Bender, Andreas

    2015-01-01

    In silico analyses are increasingly being used to support mode-of-action investigations; however many such approaches do not utilise the large amounts of inactive data held in chemogenomic repositories. The objective of this work is concerned with the integration of such bioactivity data in the target prediction of orphan compounds to produce the probability of activity and inactivity for a range of targets. To this end, a novel human bioactivity data set was constructed through the assimilation of over 195 million bioactivity data points deposited in the ChEMBL and PubChem repositories, and the subsequent application of a sphere-exclusion selection algorithm to oversample presumed inactive compounds. A Bernoulli Naïve Bayes algorithm was trained using the data and evaluated using fivefold cross-validation, achieving a mean recall and precision of 67.7 and 63.8 % for active compounds and 99.6 and 99.7 % for inactive compounds, respectively. We show the performances of the models are considerably influenced by the underlying intraclass training similarity, the size of a given class of compounds, and the degree of additional oversampling. The method was also validated using compounds extracted from WOMBAT producing average precision-recall AUC and BEDROC scores of 0.56 and 0.85, respectively. Inactive data points used for this test are based on presumed inactivity, producing an approximated indication of the true extrapolative ability of the models. A distance-based applicability domain analysis was also conducted; indicating an average Tanimoto Coefficient distance of 0.3 or greater between a test and training set can be used to give a global measure of confidence in model predictions. A final comparison to a method trained solely on active data from ChEMBL performed with precision-recall AUC and BEDROC scores of 0.45 and 0.76. The inclusion of inactive data for model training produces models with superior AUC and improved early recognition capabilities, although

  18. Expenditure and resource utilisation for cervical screening in Australia.

    PubMed

    Lew, Jie-Bin; Howard, Kirsten; Gertig, Dorota; Smith, Megan; Clements, Mark; Nickson, Carolyn; Shi, Ju-Fang; Dyer, Suzanne; Lord, Sarah; Creighton, Prudence; Kang, Yoon-Jung; Tan, Jeffrey; Canfell, Karen

    2012-12-05

    The National Cervical Screening Program in Australia currently recommends that women aged 18-69 years are screened with conventional cytology every 2 years. Publicly funded HPV vaccination was introduced in 2007, and partly as a consequence, a renewal of the screening program that includes a review of screening recommendations has recently been announced. This study aimed to provide a baseline for such a review by quantifying screening program resource utilisation and costs in 2010. A detailed model of current cervical screening practice in Australia was constructed and we used data from the Victorian Cervical Cytology Registry to model age-specific compliance with screening and follow-up. We applied model-derived rate estimates to the 2010 Australian female population to calculate costs and numbers of colposcopies, biopsies, treatments for precancer and cervical cancers in that year, assuming that the numbers of these procedures were not yet substantially impacted by vaccination. The total cost of the screening program in 2010 (excluding administrative program overheads) was estimated to be A$194.8M. We estimated that a total of 1.7 million primary screening smears costing $96.7M were conducted, a further 188,900 smears costing $10.9M were conducted to follow-up low grade abnormalities, 70,900 colposcopy and 34,100 histological evaluations together costing $21.2M were conducted, and about 18,900 treatments for precancerous lesions were performed (including retreatments), associated with a cost of $45.5M for treatment and post-treatment follow-up. We also estimated that $20.5M was spent on work-up and treatment for approximately 761 women diagnosed with invasive cervical cancer. Overall, an estimated $23 was spent in 2010 for each adult woman in Australia on cervical screening program-related activities. Approximately half of the total cost of the screening program is spent on delivery of primary screening tests; but the introduction of HPV vaccination, new

  19. Analysis of Biota to Evaluate the Risks Associated with Chemical Warfare Materiel Present in Sea-Disposed Military Munitions to Human Health and the Environment

    NASA Astrophysics Data System (ADS)

    Briggs, C. W.; Bissonnette, M. C.; Edwards, M.; Shjegstad, S. M.

    2016-12-01

    Thousands of 100-lb M47A series bombs containing sulfur mustard were disposed in the ocean following World War II yet few studies have been conducted at sites in excess of 250 m, the depth where most discarded military munitions (DMM) were disposed. The Hawai`i Undersea Military Munitions Assessment (HUMMA) project was conducted to evaluate the risk from chemical warfare materiel (CWM) in DMM to human health, measuring ecological differences between the disposal area and nearby but otherwise similar areas, and evaluating the most efficient platforms for surveying DMM sea-disposal sites located at depths between 400-650 m. During the 2014 HUMMA Sampling Survey, the Jason 2 remotely operated vehicle was used to collect data. Shrimp were collected and analyzed to assess the potential for bioaccumulation of CWM, energetics and metals from munitions. No CWM was detected in H. ensifer tissue samples, indicating bioaccumulation is not occurring. Low levels of 2,4,6-trinitrotoluene, 4-amino-2,6-­dinitrotoluene, 1,3,5-trinitrobenzene, nitrobenzene, arsenic, copper, and lead were detected and the concentrations were not significantly different at DMM and control sites. No visible deformities, eroded fins, lesions, or tumors were observed on the shrimp living in the vicinity of M47A bombs. Given these results and under current and potential future uses of the HUMMA study area, health risks to likely receptors are within EPA acceptable levels. Photographic data and benthic infauna analysis were used to study benthic organisms that lived on or near munitions. There was no statistically distinguishable difference between organism distributions in dense and sparse munitions fields. Conventional munitions were found to have the greatest number of benthic infauna individuals, with control sites generally having the least number of individuals. This is consistent with the benthic macro-fauna analysis, which shows that munitions provide habitat.

  20. The utilisation of health research in policy-making: concepts, examples and methods of assessment

    PubMed Central

    Hanney, Stephen R; Gonzalez-Block, Miguel A; Buxton, Martin J; Kogan, Maurice

    2003-01-01

    The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies. PMID:12646071

  1. Floodwater utilisation values of wetland services - a case study in Northeastern China

    NASA Astrophysics Data System (ADS)

    Lü, S. B.; Xu, S. G.; Feng, F.

    2012-02-01

    Water plays a significant role in wetlands. Floodwater utilisation in wetlands brings a wide range of wetland services, from goods production and water regulation to animal protection and aesthetics related to water supply in wetlands. In this study, the floodwater utilisation values of wetland services were estimated within the Momoge wetland and Xianghai wetland in western Jilin province of northeastern China. From 2003 to 2008, the floodwater diverted from the Nenjiang and Tao'er River is 381 million m3, which translates into a monetary value of approximately 1.35 billion RMB in 2008 (RMB: Chinese Currency, RMB 6.80 = US 1), and the ratio of economic value, eco-environmental value, and social value is 1:12:2. Besides the monetary value of the water itself, excessive floodwater utilisation may bring losses to wetlands; the threshold floodwater utilisation volumes in wetlands are discussed. Floodwater utilisation can alleviate water shortages in wetlands, and the evaluation of floodwater utilisation in wetland services in monetary terms is a guide for the effective use of the floodwater resources and for the conservation of wetlands.

  2. Utilisation of aromatic organosulfur compounds as sulfur sources by Lipomyces starkeyi CBS 1807.

    PubMed

    Linder, Tomas

    2016-10-01

    Aromatic organosulfur compounds that contain aryl carbon-sulfur bonds are rare in nature but occur frequently in industrial processes and products. The utilisation of aryl sulfur compounds as a sulfur source has not been described previously among the budding yeasts (phylum Ascomycota, sub-phylum Saccharomycotina). A total of 31 strains representing 30 species and 28 genera of the budding yeasts were assayed for utilisation of benzene sulfonate as source of sulfur. Lipomyces starkeyi CBS 1807 was the only strain in this screen that was able to utilise benzene sulfonate as a sulfur source. Further study of L. starkeyi demonstrated that it could also utilise methyl phenyl sulfoxide, 1-naphthalene sulfonate, 2-naphthalene sulfonate, 1-anthraquinone sulfonate and 2-anthraquinone sulfonate as sulfur sources but not diphenylsulfone. This study represents the first reported case of the utilisation of sulfonated naphthalenes and anthraquinones as sulfur sources by a fungus. However, it should be stressed that the remaining 30 strains in this study were not assayed for the utilisation of these additional aryl sulfur compounds as sulfur sources. The present study highlights the potential of L. starkeyi and related species as a source of novel enzyme activities with possible applications in chemical manufacturing, disposal of xenobiotics and bioremediation.

  3. Evaluation de l'intergiciel de communication DDS pour son utilisation dans le domaine avionique

    NASA Astrophysics Data System (ADS)

    Levesque-Landry, Kevin

    Les aeronefs modernes doivent combler de plus en plus de fonctionnalites afin de satisfaire les besoins de la clientele. De ce fait, les besoins en communications des systemes avioniques sont grandissants. De plus, la portabilite et la reutilisabilite des applications sont des defis d'actualite dans le domaine avionique. De ce fait, ce projet de recherche vise a faire une evaluation de la technologie d'intergiciel de service de distribution de donnees (DDS) pour son utilisation dans le domaine avionique. Cette technologie permettrait de reduire la complexite des communications et faciliter la portabilite et reutilisabilite des applications grâce a son interface standardisee. Dans ce projet de recherche, la norme DDS est tout d'abord etudiee pour cibler les fonctionnalites qui sont utiles au domaine avionique. Les differentes polices de qualite de services sont ainsi etudiees et denotent la flexibilite de la technologie DDS. Un intergiciel DDS est egalement evalue dans un environnement de laboratoire afin de mesurer l'impact de l'utilisation de cette technologie sur les performances de latence ainsi que sur l'utilisation de la bande passante. Les resultats montrent une faible augmentation de la latence moyenne lorsque l'intergiciel DDS est utilise. L'intergiciel DDS est egalement utilise dans une etude de cas avec un AFCS (automatic flight control system) afin de quantifier les effets de son utilisation sur une application avionique. Les resultats montrent que l'utilisation de l'intergiciel DDS n'empeche pas l'AFCS d'atteindre la stabilite, mais qu'elle ralentit l'atteinte de cette derniere. Finalement, une etude de cas est effectuee afin de valider que la technologie DDS peut etre utilisee pour construire des systemes redondants. Les resultats montrent que l'intergiciel DDS permet de faire de la redondance de reserve sans avoir un impact visible sur les performances du systeme redondant.

  4. The experiences of culturally and linguistically diverse family caregivers in utilising dementia services in Australia

    PubMed Central

    2013-01-01

    Background Older people from culturally and linguistically diverse groups are underrepresented in residential aged care but overrepresented in community aged care in Australia. However, little is known about culturally and linguistically diverse family caregivers in utilising dementia services in Australia because previous studies mainly focused on the majority cultural group. Experiences of caregivers from culturally and linguistically diverse groups who are eligible to utilise dementia services in Australia are needed in order to optimize the utilisation of dementia services for these caregivers. Methods The aim of the study was to explore the experiences of family caregivers from Chinese, Greek, Italian and Vietnamese groups in utilising dementia services. Gadamer's philosophical hermeneutics was used to interpret the experiences of the participants. Focus group discussions and in-depth individual interviews were used to collect data. Data collection was conducted over a six month period in 2011. In total, 46 family caregivers who were caring for 39 persons with dementia participated. Results Four themes were revealed: (1) negotiating services for the person with dementia; (2) the impact of acculturation on service utilisation; (3) the characteristics of satisfactory services; and (4) negative experiences in utilising services. The present study revealed that the participation of caregivers from culturally and linguistically diverse groups in planning and managing dementia services ranged markedly from limited participation to full participation. Conclusions The findings of this study suggest that caregivers from culturally and linguistically diverse groups need to be fully prepared so they can participate in the utilisation of dementia services available to them in Australia. PMID:24148155

  5. Demographic and clinical predictors of unplanned hospital utilisation among chronically ill patients: a prospective cohort study.

    PubMed

    Mallitt, Kylie-Ann; Kelly, Patrick; Plant, Natalie; Usherwood, Tim; Gillespie, James; Boyages, Steven; Jan, Stephen; Leeder, Stephen

    2015-04-03

    In urban Australia, patients with serious and continuing illnesses make frequent use of hospital emergency department (ED) services. However, the risk factors for hospital utilisation among the broad population of people with chronic illness are not well known. The aim of this study was to assess the predictors of hospital utilisation (either inpatient admissions or ED visits) in a cohort of 308 patients with chronic illness. We studied patients with serious and continuing chronic illnesses presenting to an ED in a large periurban hospital in western Sydney, Australia, between 2010 and 2013. ED presentations and hospital admissions were observed over two years. Multivariate negative-binomial regression analyses were used to identify risk factors for the number of presentations to hospital. The main risk factors for hospital utilisation were having a live-in carer, and a history of hospital utilisation. Having a live-in carer was associated with an increase in number of ED presentations by 88% (RR 1.88; 95% CI 1.41-2.51), and of admissions by 116% (RR 2.16; 95% CI 1.61-2.92). Seventy-seven percent of hospital utilisation in the cohort was attributable to carer status. Each additional ED presentation that a person had in the 12 months prior to the study led to an increased risk of an ED presentation in the follow-up period by 6% (RR = 1.06, 95% CI = 1.03-1.08). Between 20% and 25% of variability in hospital utilisation in the cohort was attributable to the number of hospital admissions or ED presentations in the previous 12 months. Patients with a live-in carer and with a history of hospital utilisation are at high risk for future hospital use.

  6. Time utilisation trends of supported employment services by persons with mental disability in South Africa.

    PubMed

    Van Niekerk, Lana; Coetzee, Zelda; Engelbrecht, Madri; Hajwani, Zerina; Terreblanche, Santie

    2015-01-01

    This paper reports on the second phase of a two-phased study that was undertaken to determine the feasibility of supported employment (SE) as a strategy with which to facilitate the employment of persons with disability in competitive work contexts. The study population comprised people with mental disabilities receiving SE in the Western Cape Province, South Africa. To describe the components of SE utilised by persons with mental disability (i.e. psychiatric or intellectual disability) in terms of type and time utilisation patterns over 12 months. Criterion sampling, a form of purposive sampling, was used to identify 29 study participants - 19 with intellectual disability and 10 with psychiatric disability. Data collection commenced for each participant when a work placement had been identified and preparation for such ensued. Data was collected prospectively for a period of 12 months. SE service components utilised by participants were captured using a data capture sheet that was developed for this purpose. Time utilisation indicated a steep downwards trend for both cohorts. The decrease in utilisation of SE service components over a period of one year was more pronounced in the psychiatric disability (PD) cohort, who utilized almost half the total SE services in the first month. SE services can be considered as a viable option for return to work in resource-constrained environments. Providers of SE services will need to modify approaches in order to meet contextual realities.

  7. Service utilisation by carers of people with dementia in rural Victoria.

    PubMed

    Ervin, Kaye; Reid, Carol

    2015-12-01

    To explore the use of community and dementia-specific services by informal carers caring for someone with dementia in a rural setting. Carers of people with dementia were recruited through a variety of rural community services and invited to complete a survey related to the utilisation of community services. A total of 39 carers completed surveys. Despite 84% reporting use of the Aged Care Assessment Service and 61% reporting provision of printed information on the services available, less than half of the carers utilised commonly available support services. Only 46% received financial compensation for their carer role. Rural carers of care recipients with behavioural and psychological symptoms of dementia underutilise community services. Services that may assist with carer stress and depression and services that provide advice on the management of distressing behavioural and psychological symptoms of dementia were utilised by less than half of the carers surveyed. © 2014 AJA Inc.

  8. Impact of continuous Medical Aid utilisation on healthcare utilisation: unique insight using the 2008–2012 Korean Welfare Panel Study (KOWEPS)

    PubMed Central

    Kim, Jae-Hyun; Kim, Na Rae; Park, Eun-Cheol; Han, Kyu-Tae; Choi, Young; Lee, Sang Gyu

    2016-01-01

    Objectives Although there has been considerable discussion about the social safety net, few studies related to effect of duration of continuous receipt of Medical Aid on healthcare utilisation have been conducted. Therefore, we investigate whether the duration of receiving Medical Aid affected medical care utilisation. Setting Data were collected from the Korean Welfare Panel Study conducted from 2008 to 2012. Participants We included 11 783 samples. Interventions Estimating changes in their healthcare utilisation during specific time intervals (1, 2 and ≥3 years) after they switched from National Health Insurance to Medical Aid. Primary and secondary outcome measures Number of outpatient visits. Results The number of outpatient visits per year was 0.0.051-fold higher (p value: 0.434) among those who were Medical Aid beneficiaries for a continuous period of 1 year, 0.0.267-fold higher (p value: 0.000) among those who were beneficiaries for a continuous period of 2 years, and 0.0.562-fold higher (p value:<0.0001) among those who were beneficiaries for a continuous period of 3 years than it was among those who were beneficiaries of National Health Insurance. Conclusions Our results reflect an association between the number of consecutive years of receiving Medical Aid and number of outpatient visits. Since duration of dependence is correlated with reduced exit rates, limits on length of benefits should be considered to strengthen the incentive to return to work. PMID:27053265

  9. Health services utilisation disparities between English speaking and non-English speaking background Australian infants

    PubMed Central

    2010-01-01

    Background To examine the differences in health services utilisation and the associated risk factors between infants from non-English speaking background (NESB) and English speaking background (ESB) within Australia. Methods We analysed data from a national representative longitudinal study, the Longitudinal Study of Australian Children (LSAC) which started in 2004. We used survey logistic regression coupled with survey multiple linear regression to examine the factors associated with health services utilisation. Results Similar health status was observed between the two groups. In comparison to ESB infants, NESB infants were significantly less likely to use the following health services: maternal and child health centres or help lines (odds ratio [OR] 0.56; 95% confidence intervals [CI], 0.40-0.79); maternal and child health nurse visits (OR 0.68; 95% CI, 0.49-0.95); general practitioners (GPs) (OR 0.58; 95% CI, 0.40-0.83); and hospital outpatient clinics (OR 0.54; 95% CI, 0.31-0.93). Multivariate analysis results showed that the disparities could not be fully explained by the socioeconomic status and language barriers. The association between English proficiency and the service utilised was absent once the NESB was taken into account. Maternal characteristics, family size and income, private health insurance and region of residence were the key factors associated with health services utilisation. Conclusions NESB infants accessed significantly less of the four most frequently used health services compared with ESB infants. Maternal characteristics and family socioeconomic status were linked to health services utilisation. The gaps in health services utilisation between NESB and ESB infants with regard to the use of maternal and child health centres or phone help, maternal and child health nurse visits, GPs and paediatricians require appropriate policy attentions and interventions. PMID:20374663

  10. Determinants of utilisation differences for cancer medicines in Belgium, Scotland and Sweden.

    PubMed

    Ferrario, Alessandra

    2016-12-09

    Little comparative evidence is available on utilisation of cancer medicines in different countries and its determinants. The aim of this study was to develop a statistical model to test the correlation between utilisation and possible determinants in selected European countries. A sample of 31 medicines for cancer treatment that obtained EU-wide marketing authorisation between 2000 and 2012 was selected. Annual data on medicines' utilisation covering the in- and out-patient public sectors were obtained from national authorities between 2008 and 2013. Possible determinants of utilisation were extracted from HTA reports and complemented by contacts with key informants. A longitudinal mixed effect model was fitted to test possible determinants of medicines utilisation in Belgium, Scotland and Sweden. In the all-country model, the number of indications reimbursed positively correlated with increased consumption of medicines [one indication 2.6, 95% CI (1.8-3.6); two indications 2.4, 95% CI (1.4-4.3); three indications 4.9, 95% CI (2.2-10.9); all P < 0.01], years since EU-wide marketing authorisation [1.2, 95% CI (1.02-1.4); p < 0.05], price per DDD [0.9, 95% CI (0.998-0.999), P < 0.01], and Prescrire rating [0.5, 95% CI (0.3-0.9), P < 0.05] after adjusting for time and other covariates. In this study, the most important correlates of increased utilisation in a sample of cancer medicines introduced in the past 15 years were: medicines coverage and time since marketing authorisation. Prices had a negative effect on consumption in Belgium and Sweden. The positive impact of financial MEAs in Scotland suggests that the latter may remove the regressive effect of list prices on consumption.

  11. Utilisation trends of rosiglitazone and pioglitazone in Australia before and after safety warnings

    PubMed Central

    2014-01-01

    Background A see on cardiovascular diseases and bladder cancer. The changes to the patterns of rosiglitazone and pioglitazone utilisation in Australia following the timing of these various health authority warnings such as the Australian Therapeutic Good Administration (TGA), European Medicines Agency (EMA) press releases or U.S. Food and Drug Administration (FDA) is unknown. This study investigated the utilisation patterns of rosiglitazone and pioglitazone in Australia before and after warnings of major drug authorities. Methods We evaluated rosiglitazone and pioglitazone dispensing using the Pharmaceutical Benefit Scheme (PBS) subsidised drug dispensing data for the Australian population from February 2004 to July 2012. The World Health Organisation Anatomic Therapeutic Chemical (ATC)/Defined Daily Dose (DDD) system was used to compare the drug utilisation patterns following the announcements of EMA, FDA, and TGA safety warnings, which first occurred in May 2007. The DDD/1000population/day were examined in a series of time-series regression analysis with the drug safety warnings specified as interventions. Results Rosiglitazone utilisation increased steadily from 2004 until reaching a peak at 1.96/1000population/day in January 2007. Then rosiglitazone use decreased significantly after the initial EMA press release and FDA warning on cardiovascular risk in May 2007 (with a 15.04% average monthly decline, p-value <0.001), however use did not significantly decrease after the TGA warning or subsequent EMA and FDA warnings. Pioglitazone utilisation proceeded rosiglitazone in September 2008 and remained above 1.5/1000/day during 2009–2010. However, pioglitazone utilisation has slightly declined after the FDA, EMA, and TGA warnings related to bladder cancer. Conclusions Drug safety warnings were associated with a decrease in rosiglitazone and pioglitazone utilisation in Australia. Rosiglitazone began to decline prior to TGA warnings in December 2007, which suggests

  12. Variation in nitrogen source utilisation by nine Amanita muscaria genotypes from Australian Pinus radiata plantations.

    PubMed

    Sawyer, Nicole A; Chambers, Susan M; Cairney, John W G

    2003-08-01

    The abilities of nine genotypes of Amanita muscaria (L.:Fr) Pers. to utilise a range of inorganic and organic nitrogen sources for growth was examined in axenic liquid cultures. Considerable intraspecific variation was observed in biomass yields on all substrates; however biomass yield was highest on glutamine and/or NH4+ for all genotypes. Yields on aspartic acid, glutamic acid and histidine were generally low relative to NH4+, while utilisation of arginine and glycine showed marked variation between genotypes. Eight genotypes produced significantly less biomass on bovine serum albumin than on NH4+, raising questions regarding classification of A. muscaria as a 'protein fungus'.

  13. Science Teachers' Utilisation of Innovative Strategies for Teaching Senior School Science in Ilorin, Nigeria

    ERIC Educational Resources Information Center

    Oyelekan, Oloyede Solomon; Igbokwe, Emoyoke Faith; Olorundare, Adekunle Solomon

    2017-01-01

    Efforts have been made to improve science teaching in secondary schools in Nigeria, yet, students continue to perform poorly in science subjects. Many innovative teaching strategies have been developed by educators and found to impact significantly on students' academic performance when utilised. Hence, this study was aimed at examining science…

  14. ICT and OTs: a model of information and communication technology acceptance and utilisation by occupational therapists.

    PubMed

    Schaper, Louise K; Pervan, Graham P

    2007-06-01

    There is evidence to suggest that health professionals are reluctant to accept and utilise information and communication technologies (ICT) and concern is growing within health informatics research that this is contributing to the lag in adoption and utilisation of ICT across the health sector. Technology acceptance research within the field of information systems has been limited in its application to health and there is a concurrent need to develop and gain empirical support for models of technology acceptance within health and to examine acceptance and utilisation issues amongst health professionals to improve the success of information system implementation in this arena. This paper outlines a project that examines ICT acceptance and utilisation by Australian occupational therapists. It describes the theoretical basis behind the development of a research model and the methodology being employed to empirically validate the model using substantial quantitative, qualitative and longitudinal data. Preliminary results from Phase II of the study are presented. The theoretical significance of this work is that it uses a thoroughly constructed research model, with potentially the largest sample size ever tested, to extend technology acceptance research into the health sector.

  15. Stoichiometric modelling of assimilatory and dissimilatory biomass utilisation in a microbial community

    PubMed Central

    Hunt, Kristopher A.; Jennings, Ryan deM.; Inskeep, William P.; Carlson, Ross P.

    2017-01-01

    Summary Assimilatory and dissimilatory utilisation of autotroph biomass by heterotrophs is a fundamental mechanism for the transfer of nutrients and energy across trophic levels. Metagenome data from a tractable, thermoacidophilic microbial community in Yellowstone National Park was used to build an in silico model to study heterotrophic utilisation of autotroph biomass using elementary flux mode analysis and flux balance analysis. Assimilatory and dissimilatory biomass utilisation was investigated using 29 forms of biomass-derived dissolved organic carbon (DOC) including individual monomer pools, individual macromolecular pools and aggregate biomass. The simulations identified ecologically competitive strategies for utilizing DOC under conditions of varying electron donor, electron acceptor or enzyme limitation. The simulated growth environment affected which form of DOC was the most competitive use of nutrients; for instance, oxygen limitation favoured utilisation of less reduced and fermentable DOC while carbon-limited environments favoured more reduced DOC. Additionally, metabolism was studied considering two encompassing metabolic strategies: simultaneous versus sequential use of DOC. Results of this study bound the transfer of nutrients and energy through microbial food webs, providing a quantitative foundation relevant to most microbial ecosystems. PMID:27387069

  16. The Utilisation of Psychological Support Services in Primary Schools in Gauteng

    ERIC Educational Resources Information Center

    Pillay, Jace; Wasielewski, Tanya

    2007-01-01

    This qualitative study was conducted in four Gauteng public primary schools to assess the utilisation of psychological support services. Individual and focus group interviews were conducted with various stakeholders. The results indicated an underutilisation of Psychological Support Services attributed to lack of staff within the support…

  17. Utilisation of Local Inputs in the Funding and Administration of Education in Nigeria

    ERIC Educational Resources Information Center

    Akiri, Agharuwhe A.

    2014-01-01

    The article discussed how, why and who is in charge of administering and funding schools in Nigeria. The author utilised the relevant statistical approach which examined and discussed various political and historical trends affecting education. Besides this, relevant documented statistical data were used to both buttress and substantiate related…

  18. To fractionate municipal solid waste incineration bottom ash: Key for utilisation?

    PubMed

    Sormunen, Laura Annika; Rantsi, Riina

    2015-11-01

    For the past decade, the Finnish waste sector has increasingly moved from the landfilling of municipal solid waste towards waste incineration. New challenges are faced with the growing amounts of municipal solid waste incineration bottom ash, which are mainly landfilled at the moment. Since this is not a sustainable or a profitable solution, finding different utilisation applications for the municipal solid waste incineration bottom ash is crucial. This study reports a comprehensive analysis of bottom ash properties from one waste incineration plant in Finland, which was first treated with a Dutch bottom ash recovery technique called advanced dry recovery. This novel process separates non-ferrous and ferrous metals from bottom ash, generating mineral fractions of different grain sizes (0-2 mm, 2-5 mm, 5-12 mm and 12-50 mm). The main aim of the study was to assess, whether the advanced bottom ash treatment technique, producing mineral fractions of different grain sizes and therefore properties, facilitates the utilisation of municipal solid waste incineration bottom ash in Finland. The results were encouraging; the bottom ash mineral fractions have favourable behaviour against the frost action, which is especially useful in the Finnish conditions. In addition, the leaching of most hazardous substances did not restrict the utilisation of bottom ash, especially for the larger fractions (>5 mm). Overall, this study has shown that the advanced bottom ash recovering technique can be one solution to increase the utilisation of bottom ash and furthermore decrease its landfilling in Finland.

  19. Public Health Knowledge Utilisation by Policy Actors: An Evaluation Study in Midden-Holland, the Netherlands

    ERIC Educational Resources Information Center

    de Goede, Joyce; Steenkamer, Betty; Treurniet, Henriëtte; Putters, Kim; van Oers, Hans

    2011-01-01

    A comprehensive report has been prepared on the state of public health and healthcare in the Midden-Holland region of the Netherlands. This study describes the development of the report and the mechanisms behind public health knowledge utilisation by three groups of health policy actors: local authorities, public health professionals and regional…

  20. Uncontrolled diabetes and health care utilisation: panel data evidence from Spain.

    PubMed

    Gil, Joan; Sicras-Mainar, Antoni; Zucchelli, Eugenio

    2017-08-10

    Despite size and relevance of uncontrolled diabetes, robust evidence on its effects on health care utilisation is very limited, especially among European countries. We employed longitudinal administrative data from Spain (2004-2010) to explore the relationship between uncontrolled type 2 diabetes and health care utilisation. We used a biomarker (glycated haemoglobin, HbA1c) to detect the presence of uncontrolled diabetes and explore its effects on both primary and secondary health care. We estimated a range of panel count data models, including negative binomials with random effects, dynamic and hurdle specifications to account for unobserved heterogeneity, previous utilisation and selection. We found uncontrolled diabetes in between 27 and 30% of patients of both genders. Our estimates suggested that although women appeared to systematically consume more health care compared to men, their consumption levels did not seem to be influenced by uncontrolled diabetes. Conversely, among men uncontrolled diabetes increased the average number of GP visits per year by between 3 and 3.4%, specialist visits by 5.3-6.1%, depending on specifications, and also extended annual hospital length of stay by 15%. We also found some evidence of heterogeneity in utilisation based on the level of uncontrolled diabetes among male individuals. Overall, our results suggested the need for different diabetes management plans depending on gender and levels of glycaemic control.

  1. Coping and health service utilisation in a UK study of paediatric sickle cell pain

    PubMed Central

    Anie, K; Steptoe, A; Ball, S; Dick, M; Smalling, B

    2002-01-01

    Aims: To assess sickle cell pain and coping in children and to examine the relation between these factors and the utilisation of health services. Methods: Cross sectional study involving 67 children with sickle cell disease attending three London hospitals. Interviews and questionnaires involved measures of pain, health service utilisation, and coping responses (measured with the Coping Strategies Questionnaire (CSQ), revised for children with sickle cell disease). Medical data on complications, haemoglobin (Hb) levels, and foetal haemoglobin (HbF) percentage were also collected. Results: Pain accounted for about 24% of hospital service use, independent of age, sex, number of with sickle cell disease complications, and Hb levels. However, 42% of patients had not utilised hospital services in the past 12 months. Three higher order factors emerged from analysis of the CSQ (active coping, affective coping, passive adherence coping). Pain severity was predicted by passive adherence coping, while utilisation of hospital services was predicted by active coping. Conclusions: Sickle cell disease in children involves severe recurrent pain leading to hospitalisation in some cases. Psychological coping patterns are relevant to both pain experience, and the use of acute hospital services. It is likely that children would benefit from community based interventions that incorporate both medical and psychological assessments. PMID:11970920

  2. Utilisation of Local Inputs in the Funding and Administration of Education in Nigeria

    ERIC Educational Resources Information Center

    Akiri, Agharuwhe A.

    2014-01-01

    The article discussed how, why and who is in charge of administering and funding schools in Nigeria. The author utilised the relevant statistical approach which examined and discussed various political and historical trends affecting education. Besides this, relevant documented statistical data were used to both buttress and substantiate related…

  3. Infant care practices in rural China and their relation to prenatal care utilisation.

    PubMed

    Nwaru, B I; Wu, Z; Hemminki, E

    2011-01-01

    Studies describing postpartum childcare practices and the influence of prenatal care on infant care outcomes in rural China are scarce. This study looked at data for 1479 women who had given birth during the preceding 2 years (median age of the child was 8 months). Data were available from a Knowledge, Attitude and Perception cross-sectional survey collected from 2001 to 2003, after a prenatal care intervention in Anhui County, China, with a response rate of 97%. Prenatal care utilisation was categorised using the Adequacy of Prenatal Care Utilisation index. Logistic regression was used to study the association between prenatal care utilisation and infant care practices. Mothers' uptake of breastfeeding, introduction of milk formula, cereal/porridge, meat and uptake of any immunisation were found to be in accordance with national recommendations. Intermediate prenatal care uptake was positively associated with never breastfeeding and early introduction of cereal/porridge. Inadequate care was positively associated with never breastfeeding, early introduction of milk formula and cereal/porridge, and early start of work after delivery. Initiation to prenatal care after the third month was positively associated with early introduction of milk formula and cereal/porridge. Having no prenatal care was positively associated with never breastfeeding and early introduction of milk formula. Mothers' uptake of infant care practices in this population was largely in accordance with national recommendations. Women with less than adequate utilisation of prenatal care and those who had initiated prenatal care late were less likely to follow recommendations on infant care.

  4. Skills Utilisation at Work, the Quality of the Study Programme and Fields of Study

    ERIC Educational Resources Information Center

    Støren, Liv Anne; Arnesen, Clara Åse

    2016-01-01

    This paper examines the factors that may have impact on the extent to which the knowledge and skills of master's degree graduates in Norway are utilised at work, three years after graduation. The focus is on the impact of the quality of the study programme as well as the graduates' fields of study, when also taking into account other factors…

  5. Utilisation of Used Palm Oil as an Alternative Fuel in Thailand

    NASA Astrophysics Data System (ADS)

    Permchart, W.; Tanatvanit, S.

    2007-10-01

    This paper summarises the overview of the current situation of alternative energies in Thailand. The utilisation of bio-diesel as an alternative energy in two economic sectors (i.e. transport and industrial sectors), which have the largest energy consumption in the country, is mainly presented because it has seemed to be the most promising project among various energy conservation projects of the Thai government. Actually, there is another bio-fuel project, namely, the ethanol project for blending with gasoline to produce gasohol (E10) used in gasoline engines, which has been developed and already become to an important policy for energy conservation of the country. Due to much more large number of diesel has been utilised, the bio-diesel project has been the first priority one to solve the petroleum crisis problems. However, it is remarked that the utilisation of bio-diesel as an alternative fuel seems to be unsatisfactory because of various reasons. Some issues in terms of both government policies and technical problems have not been clearly addressed. Therefore, this paper not only presents the utilisation of bio-diesel in these two sectors but also discusses the production processes, characterisations and some experimental testing results of bio-diesel.

  6. Extent of ESL Teachers' Access To, Utilisation and Production of Research

    ERIC Educational Resources Information Center

    Sibanda, Jabulani; Begede, Martin P.

    2015-01-01

    This study employed the survey design on a purposive sample of 100 English Second Language (ESL) teachers from Swaziland and South Africa's Eastern Cape Province, to investigate the extent to which they accessed, utilised and conducted research to better their practice. A survey questionnaire and follow-up structured interviews generated…

  7. Stoichiometric modelling of assimilatory and dissimilatory biomass utilisation in a microbial community.

    PubMed

    Hunt, Kristopher A; Jennings, Ryan deM; Inskeep, William P; Carlson, Ross P

    2016-12-01

    Assimilatory and dissimilatory utilisation of autotroph biomass by heterotrophs is a fundamental mechanism for the transfer of nutrients and energy across trophic levels. Metagenome data from a tractable, thermoacidophilic microbial community in Yellowstone National Park was used to build an in silico model to study heterotrophic utilisation of autotroph biomass using elementary flux mode analysis and flux balance analysis. Assimilatory and dissimilatory biomass utilisation was investigated using 29 forms of biomass-derived dissolved organic carbon (DOC) including individual monomer pools, individual macromolecular pools and aggregate biomass. The simulations identified ecologically competitive strategies for utilizing DOC under conditions of varying electron donor, electron acceptor or enzyme limitation. The simulated growth environment affected which form of DOC was the most competitive use of nutrients; for instance, oxygen limitation favoured utilisation of less reduced and fermentable DOC while carbon-limited environments favoured more reduced DOC. Additionally, metabolism was studied considering two encompassing metabolic strategies: simultaneous versus sequential use of DOC. Results of this study bound the transfer of nutrients and energy through microbial food webs, providing a quantitative foundation relevant to most microbial ecosystems. © 2016 Society for Applied Microbiology and John Wiley & Sons Ltd.

  8. Exploring the Extent to Which ELT Students Utilise Smartphones for Language Learning Purposes

    ERIC Educational Resources Information Center

    Yaman, Ismail; Senel, Müfit; Yesilel, Deren Basak Akman

    2015-01-01

    The advent of smartphones has had dramatic influences on our daily lives and has rendered human beings "walking computers." This holds important reflections in the realm of language learning, as well as in many other areas. This study aimed to explore the extent to which English Language Teaching (ELT) students utilise smartphones for…

  9. Interventions to improve patient access to and utilisation of genetic and genomic counselling services

    PubMed Central

    Benjamin, Caroline M; Thomas, Lois H; Skirton, Heather; Gustafson, Shanna; Coupe, Jacqueline; Patch, Christine; Belk, Rachel; Tishkovskaya, Svetlana; Calzone, Kathleen; Payne, Katherine

    2015-01-01

    This is the protocol for a review and there is no abstract. The objectives are as follows: Primary objective The primary objective is to assess the effectiveness of interventions to improve patient identification, access to and utilisation of genetic and genomic counselling services when compared to: No intervention; Usual or current practice; and Other active intervention. Secondary objective The secondary objective is to explore the resource use and costs associated with interventions aimed at improving patient identification, access to and utilisation of genetic and genomic counselling services from studies meeting the eligibility criteria. We will report on factors that may explain variation in the effectiveness of interventions aimed at improving patient identification, access to and utilisation of genetic and genomic counselling services from studies meeting the eligibility criteria. Another secondary objective is to explore how interventions which target improved patient identification, access to and utilisation of genetic and genomic counselling services affect the subsequent appropriate use of health services for the prevention or early detection of disease. It is also possible that the genetic counselling interaction itself will contribute to the possible use of preventative services. PMID:26989348

  10. Closing the Gap between Research Evidence and Clinical Practice: Jordanian Nurses' Perceived Barriers to Research Utilisation

    ERIC Educational Resources Information Center

    Al Khalaileh, Murad; Al Qadire, Mohammad; Musa, Ahmad S.; Al-Khawaldeh, Omar A.; Al Qudah, Hani; Alhabahbeh, Atalla

    2016-01-01

    Background: The nursing profession is a combination of theory and practical skill, and nurses are required to generate and develop knowledge through implementing research into clinical practice. Considerable number of barriers could hind implementing research findings into practice. Barriers to research utilisation are not identified in the…

  11. Utilising Benchmarking to Inform Decision-Making at the Institutional Level: A Research-Informed Process

    ERIC Educational Resources Information Center

    Booth, Sara

    2013-01-01

    Benchmarking has traditionally been viewed as a way to compare data only; however, its utilisation as a more investigative, research-informed process to add rigor to decision-making processes at the institutional level is gaining momentum in the higher education sector. Indeed, with recent changes in the Australian quality environment from the…

  12. The impact of reducing financial barriers on utilisation of a primary health care facility in Rwanda.

    PubMed

    Dhillon, Ranu S; Bonds, Matthew H; Fraden, Max; Ndahiro, Donald; Ruxin, Josh

    2012-01-01

    This study investigates the impact of subsidising community-based health insurance (mutuelle) enrolment, removing point-of-service co-payments, and improving service delivery on health facility utilisation rates in Mayange, a sector of rural Rwanda of approximately 25,000 people divided among five 'imidugudu' or small villages. While comprehensive service upgrades were introduced in the Mayange Health Centre between April 2006 and February 2007, utilisation rates remained similar to comparison sites. Between February 2007 and April 2007, subsidies for mutuelle enrolment established virtually 100% coverage. Immediately after co-payments were eliminated in February 2007, patient visits levelled at a rate triple the previous value. Regression analyses using data from Mayange and two comparison sites indicate that removing financial barriers resulted in about 0.6 additional annual visits for curative care per capita. Although based on a single local pilot, these findings suggest that in order to achieve improved health outcomes, key short-term objectives include improved service delivery and reduced financial barriers. Based on this pilot, higher utilisation rates may be affected if broader swaths of the population are enrolled in mutuelle and co-payments are eliminated. Health leaders in Rwanda should consider further studies to determine if the impact of eliminating co-payments and increasing subsidies for mutuelle enrolment as seen in Mayange holds at greater levels of scale. Broader studies to better elucidate the impact of enrolment subsidies and co-payment subsidies on utilisation, health outcomes, and costs would also provide policy insights.

  13. Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: a qualitative study

    PubMed Central

    2013-01-01

    Background Aboriginal Australians suffer from poorer overall health compared to the general Australian population, particularly in terms of cardiovascular disease and prognosis following a cardiac event. Despite such disparities, Aboriginal Australians utilise health care services at much lower rates than the general population. Improving health care utilisation (HCU) among Aboriginal cardiac patients requires a better understanding of the factors that constrain or facilitate use. The study aimed to identify ecological factors influencing health care utilisation (HCU) for Aboriginal cardiac patients, from the time of their cardiac event to 6–12 months post-event, in central Australia. Methods This qualitative descriptive study was guided by an ecological framework. A culturally-sensitive illness narrative focusing on Aboriginal cardiac patients’ “typical” journey guided focus groups and semi-structured interviews with Aboriginal cardiac patients, non-cardiac community members, health care providers and community researchers. Analysis utilised a thematic conceptual matrix and mixed coding method. Themes were categorised into Predisposing, Enabling, Need and Reinforcing factors and identified at Individual, Interpersonal, Primary Care and Hospital System levels. Results Compelling barriers to HCU identified at the Primary Care and Hospital System levels included communication, organisation and racism. Individual level factors related to HCU included language, knowledge of illness, perceived need and past experiences. Given these individual and health system barriers patients were reliant on utilising alternate family-level supports at the Interpersonal level to enable their journey. Conclusion Aboriginal cardiac patients face significant barriers to HCU, resulting in sub-optimal quality of care, placing them at risk for subsequent cardiovascular events and negative health outcomes. To facilitate HCU amongst Aboriginal people, strategies must be implemented

  14. Validity of self reported utilisation of primary health care services in an urban population in Spain

    PubMed Central

    Bellon, J. A.; Lardelli, P.; Luna, J. d.; Delgado, A.

    2000-01-01

    STUDY OBJECTIVE—To assess the validity and factors related with the validity of self reported numbers of visits to a primary health care centre, in comparison with the recorded number.
DESIGN—Cross sectional study.
SETTING—The urban area served by the Zaidín-Sur Primary Health Care Centre (Granada, Spain).
PARTICIPANTS—Two population samples (236 high users and 420 normal users) who were seen at the centre from 1985 to 1991 were interviewed in 1993.
MAIN RESULTS—A net tendency to overreport the actual number of visits was observed. Absolute concordance between self reported and recorded utilisation decreased as time interval lengthened, although this mainly reflected the increase in maximum variability both with time interval length and with the number of recorded visits. Corrected Spearman ρ coefficients obtained between the number of self reported and recorded visits ranged from 0.602 for the two weeks before the interview to 0.678 for the year before. Regression slopes of self reported utilisation upon recorded utilisation did not change between periods. In multiple regression analyses the actual number of visits was the main factor associated with both underreporting and overreporting. Older age was also significantly associated with underreporting. Poor health status and high satisfaction with health care were significantly associated with overreporting.
CONCLUSIONS—There was a substantial degree of inaccuracy in self reported utilisation, with a net tendency to overreport the number of visits. In relative terms, however, accuracy of self reports did not seem to decrease appreciably as the recall time lengthened. To compare the accuracy of different measures, it is important to take into account the maximum variability of each one. Otherwise, contradictory results may be obtained.


Keywords: self reported utilisation; primary health care; validity PMID:10846198

  15. Synthesis and evaluation of 2,5-dihydrochorismate analogues as inhibitors of the chorismate-utilising enzymes.

    PubMed

    Payne, Richard J; Bulloch, Esther M M; Toscano, Miguel M; Jones, Michelle A; Kerbarh, Olivier; Abell, Chris

    2009-06-07

    A library of 2,5-dihydrochorismate analogues were designed as inhibitors of the chorismate-utilising enzymes including anthranilate synthase, isochorismate synthase, salicylate synthase and 4-amino-4-deoxychorismate synthase. The inhibitors were synthesised in seven or eight steps from shikimic acid, sourced from star anise. The compounds exhibited moderate but differential inhibition against the four chorismate-utilising enzymes.

  16. Impact of continuous Medical Aid utilisation on healthcare utilisation: unique insight using the 2008-2012 Korean Welfare Panel Study (KOWEPS).

    PubMed

    Kim, Jae-Hyun; Kim, Na Rae; Park, Eun-Cheol; Han, Kyu-Tae; Choi, Young; Lee, Sang Gyu

    2016-04-06

    Although there has been considerable discussion about the social safety net, few studies related to effect of duration of continuous receipt of Medical Aid on healthcare utilisation have been conducted. Therefore, we investigate whether the duration of receiving Medical Aid affected medical care utilisation. Data were collected from the Korean Welfare Panel Study conducted from 2008 to 2012. We included 11,783 samples. Estimating changes in their healthcare utilisation during specific time intervals (1, 2 and ≥3 years) after they switched from National Health Insurance to Medical Aid. Number of outpatient visits. The number of outpatient visits per year was 0.0.051-fold higher (p value: 0.434) among those who were Medical Aid beneficiaries for a continuous period of 1 year, 0.0.267-fold higher (p value: 0.000) among those who were beneficiaries for a continuous period of 2 years, and 0.0.562-fold higher (p value:<0.0001) among those who were beneficiaries for a continuous period of 3 years than it was among those who were beneficiaries of National Health Insurance. Our results reflect an association between the number of consecutive years of receiving Medical Aid and number of outpatient visits. Since duration of dependence is correlated with reduced exit rates, limits on length of benefits should be considered to strengthen the incentive to return to work. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Unit Materiel Fielding Point Europe.

    DTIC Science & Technology

    1985-10-01

    AMSAA provided cost factors. f. NCAD, AMC-E, MZAD, DESCOM, and MRSA provided qualitative data used in evaluating benefits and operating procedures. g...n0% nV C 1I ^W " nJI -- 4-Z 2 6- ac I -f - -~ - 6 a 4. 0. .Z - 4 j A6W 6 6M * 67 AIAXSY-LLSO 2"’’*v 1O2 s SUBJECT: LSO ProJect fW Evaluation of...xith’ raprisa:nt.ativ.S ,f :)ESC, I: APC, A -’C-F, anI -’ainz Arrily Oepot to ’ljSijscu th" scop .ind~ 4.tiz. require-ients for thp evaluation . 1. The

  18. Medical Materiel Acquisition Management Handbook

    DTIC Science & Technology

    1986-09-30

    Acquisition; Non-lzJ or Programs; Deve opoent Programs; Nondevelopment Items; Modified Nondevelopnnt Item; Product Improvement; MANPRINT: Integrated ...SYMBOL M’. Anrep P. qwis -- t 1 (3011663-7536 1 SGRD-UMS-B DD FORM 147 3.84 MAR 83 APR edition may be used until exhausted SECURITY CLASSIFICATION OF...Product Development; Pharmaceutical Product Development. Block 19 -?oonsists of eighteen acquisition process chapters (such as Integrated Logistics Support

  19. Field Materiel Handling Robot Workcell

    DTIC Science & Technology

    1986-04-02

    Sea-Land pioneer Malcom McLean, took their truck bodies to sea rather * Page 1 oi • ~ AJJ.%~*j. **j.~pP A 07 than have them towed individually across...containers are loaded, the shipping company picks up the loaded container either by truck or rail depending on lo- cation and, at the same time, provides...land portion, the lifting of containers from trucks by gantry cranes onto ocean going vessels, the off-loading at the OCONUS port, and the truck or

  20. Desert Testing of Military Materiel.

    DTIC Science & Technology

    1981-08-01

    t onIrr poper 1\\. conduted chiamber teARN 1I.1 hatC tMyae nlot 1.1is10 osred ntill I reid tsts (ifi sert iC Ilse kit the eqiuipmient IN generally... Thermal aglog 1115- 41l I ."i 1-, 61!oe. olweaiori 160 Fstorage, Orddtrun Pic Tpe’!C a re’ 1, 1’s rL’. Stru. rural change ’A 6"’N - Chemincal reaction...mechanical and thermal stresses inpoed hb desert operating conditions. Although solution- for these problems were, in general, not di ftciuh, the

  1. Antenatal Care Utilisation and Content between Low-Risk and High-Risk Pregnant Women

    PubMed Central

    Yeoh, Ping Ling; Hornetz, Klaus; Dahlui, Maznah

    2016-01-01

    Background The purpose of antenatal care is to monitor and improve the wellbeing of the mother and foetus. The World Health Organization recommends risk-oriented strategy that includes: (i) routine care to all women, (ii) additional care for women with moderately severe diseases and complications, (iii) specialised obstetrical and neonatal care for women with severe diseases and complications. Antenatal care is concerned with adequate care in order to be effective. Measurement for adequacy of antenatal care often applies indexes that assess initiation of care and number of visits. In addition, adequacy of care content should also be assessed. Results of studies in developed settings demonstrate that women without risk factors use antenatal services more frequently than recommended. Such over-utilisation is problematic for low-resourced settings. Moreover, studies show that a substantial proportion of high-risk women had utilisation or content of care below the recommended standard. Yet studies in developing countries have seldom included a comparison between low-risk and high-risk women. The purpose of the study was therefore to assess adequacy of care and pregnancy outcomes for the different risk groups. Methods A retrospective study using a multistage sampling technique, at public-funded primary health care clinics was conducted. Antenatal utilisation level was assessed using a modified Adequacy of Prenatal Care Utilisation index that measures the timing for initiation of care and observed-to-expected visits ratio. Adequacy of antenatal care content assessed compliance to routine care based on the local guidelines. Results Intensive or “adequate-plus” antenatal care utilisation as defined by the modified index was noted in over half of the low-risk women. On the other hand, there were 26% of the high-risk women without the expected intensive utilisation. Primary- or non-educated high-risk women were less likely to have a higher antenatal care utilisation

  2. Hospital emergency department utilisation rates among the immigrant population in Barcelona, Spain

    PubMed Central

    Buron, Andrea; Cots, Francesc; Garcia, Oscar; Vall, Oriol; Castells, Xavier

    2008-01-01

    Background The recent increase in the number of immigrants of Barcelona represents a challenge for the public healthcare system, the emergency department being the most used healthcare service by this group. However, utilisation rates in our environment have not yet been studied. We aimed to compare emergency department utilisation rates between Spanish-born and foreign-born residents in a public hospital of Barcelona. Methods The study population included all adults residing in the area of study and visiting the emergency department of Hospital del Mar in 2004. The emergency care episodes were selected from the Emergency Department register, and the population figures from the Statistics Department of Barcelona. Emergency care episodes were classified into five large clinical categories. Adjusted rate ratios (RR) of utilisation among foreign-born vs. Spanish-born residents were assessed through negative binomial regression. Results The overall utilisation rate was 382 emergency contacts per 1,000 persons-years. The RR for foreign-born versus Spanish-born residents was 0.62 (95% CI: 0.52; 0.74%). The RR was also significantly below one in surgery (0.51, 95% CI: 0.42; 0.63), traumatology (0.47, 95% CI: 0.38; 0.59), medicine (0.48, 95% CI: 0.38; 0.59) and psychiatry (0.42, 95% CI: 0.18; 0.97). No differences were found in utilisation of gynaecology and minor emergency services. Conclusion The overall lower utilisation rates obtained for foreign-born residents is consistent with previous studies and is probably due to the "healthy immigrant effect". Thus, the population increase due to immigration does not translate directly into a corresponding increase in the number of emergency contacts. The lack of differences in minor and gynaecological emergency care supports the hypothesis that immigrants overcome certain barriers by using the emergency department to access to health services. The issue of healthcare barriers should therefore be addressed, especially among

  3. Controlling chromium slag pollution utilising scavengers: a case of Shandong Province, China.

    PubMed

    Liu, Changhao; Côté, Raymond P

    2015-04-01

    The problem of chromium slag pollution is a great challenge for China. It is now an urgent task for China to take effective measures to eliminate chromium slag pollution. This article examines the case of the treatment of chromium slag in Shandong Province and explores how chromium slag pollution can be eliminated in Shandong Province. It shows that the chromium slag stockpiled by the chemical plants was successfully utilised by local steel companies, who act as 'scavenger companies'. The driving mechanism, seeking a potential 'scavenger company' within the local region and the role of the local government on the case of Shandong Province are discussed. This article concludes that local steel companies can be utilised to effectively and efficiently treat the chromium slag while benefiting the steel companies. The local governments need to play multiple roles in solving the problem of chromium slag pollution. Seeking and identifying 'scavenger companies' within a region could be an important approach to reducing pollution within the region.

  4. Life cycle assessment of biohydrogen and biomethane production and utilisation as a vehicle fuel.

    PubMed

    Patterson, Tim; Esteves, Sandra; Dinsdale, Richard; Guwy, Alan; Maddy, Jon

    2013-03-01

    Environmental burdens for the production and utilisation of biomethane vehicle fuel or a biohydrogen/biomethane blend produced from food waste or wheat feed, based on data from two different laboratory experiments, have been compared. For food waste treated by batch processes the two stage system gave high hydrogen yields (84.2l H2kg(-1) VS added) but a lower overall energy output than the single stage system. Reduction in environmental burdens compared with diesel was achieved, supported by the diversion of waste from landfill. For wheat feed, the semi continuously fed two stage process gave low hydrogen yields (7.5l H2kg(-1) VS added) but higher overall energy output. The process delivers reduction in fossil fuel burdens, and improvements in process efficiencies will lead to reduction in CO2 burdens compared with diesel. The study highlights the importance of understanding and optimising biofuel production parameters according to the feedstock utilised.

  5. Sustainability indicator system and policy processes in Malaysia: a framework for utilisation and learning.

    PubMed

    Hezri, A A

    2004-12-01

    Formulation of effective sustainability indicators for national assessment demands a comprehensive understanding of the utilisation, diffusion and dissemination of information in policy processes. To illustrate the dynamic of sustainability assessment within the context of policy processes, this paper uses a case study of national sustainability indicators development in Malaysia. Subsequently, this paper ascribes the limited achievement of national sustainability assessment in Malaysia to four types of constraints: meta-policy issues; technical capacities; communication concerns; and the inherent knowledge gaps within the indicator developer community vis-a-vis their theoretical limitations. It is proposed that such constraints will be encountered in many countries. Drawing from the literature on public policy, this paper outlines a framework for investigating indicator behaviour within policy processes based on well-established concepts such as knowledge utilisation and policy learning. I conclude this paper by elaborating on the corresponding future challenges that must be addressed before effective integration of sustainability indicators within policy systems can occur.

  6. Effect of a sports food bar on fat utilisation and exercise duration.

    PubMed

    Kolkhorst, F W; MacTaggart, J N; Hansen, M R

    1998-06-01

    The manufacturer claims that using the Access Fat Conversion Activity Bar increases fat utilisation, which would have a glycogen-sparing effect and delay the onset of fatigue from endurance exercise. This claim was tested using seven trained distance runners who performed two trials of treadmill running at 73% of VO2max to exhaustion. In a counterbalanced design, subjects ingested either one Access Bar with water or water only prior to treadmill running. Times to exhaustion for the control and Access treatment trials were 104.6 +/- 24.9 min and 93.9 +/- 21.4 min, respectively, and were not significantly different (p > .05). Differences between trials were not observed for the respiratory exchange ratio, blood lactate or glucose concentrations, plasma glycerol concentration, or perceived exertion. Based on results from this study, it was concluded that the Access Bar does not affect fat or carbohydrate utilisation and does not improve exercise endurance.

  7. The specificity of energy utilisation by trained and untrained adolescent boys.

    PubMed

    Armstrong, N; Davies, B; Heal, M

    1983-09-01

    This study examined the relationship between estimates of alactacid anaerobic power, lactacid anaerobic power and aerobic power in a sample of trained swimmers (age 14.4 yr., n = 8) and a sample of untrained boys (age 13.7 yr., n = 13). The anaerobic power outputs were estimated using a modification of the Wingate Anaerobic Test and aerobic power was estimated using a continuous, incremental cycle ergometer test. In addition to leg power outputs the swimmers' arm power using each energy system was estimated and compared with the corresponding leg value. There was no relationship between the estimates of the power of the three energy systems with either the trained or untrained boys. Furthermore with the trained boys there was no relationship between estimates of the power of the same energy system utilised by different limbs. The data support a specificity hypothesis of energy utilisation during exercise with both trained and untrained adolescent boys.

  8. Validity and reliability of the Evidence Utilisation in Policymaking Measurement Tool (EUPMT).

    PubMed

    Imani-Nasab, M H; Yazdizadeh, B; Salehi, M; Seyedin, H; Majdzadeh, R

    2017-08-04

    As a well-known theory in studying the effective factors on behaviour, the theory of planned behaviour (TPB) is frequently used in evaluating the health behaviour of people and healthcare providers, but rarely applied in studying the behaviour of health policymakers. The aim of the present study is to design and validate a TPB-based measurement tool for evidence utilisation in health policymaking (the EUPMT) through a mixed approach using confirmatory factor analysis. The study population consisted of all the specialised units and their employees in the five deputies of Iran's Ministry of Health and Medical Education in 2013. All those eligible were invited to participate in the study, which comprised 373 persons. The reliability of the EUPMT was determined through test-retest and internal consistency. Additionally, its validity was determined by face, content, convergent, discriminant and construct validities. SPSS-20 and LISREL-8.8 were employed to analyse the data. To assess the fitness of the measurement models, three groups of indices were used, i.e. absolute, relative and parsimonious. The content and face validities of the tool were 83% and 67%, respectively. Cronbach's alpha of different constructs ranged from 0.7 to 0.9. In the test-retest method, the intra-class correlations were between 0.75 and 0.87. Confirmatory factor analysis showed that the penta-factorial structure of the experimental data had acceptable fitness with the TPB (GFI = 0.86, NFI = 0.94, RSMEA = 0.075). TPB is able to explain the behaviour of evidence utilisation in health policymaking. The finalised TPB-based tool has relatively good reliability and validity to assess evidence utilisation in health policymaking. The EUPMT can be applied to determine the status quo of evidence utilisation in health policymaking, whilst designing interventions for its improvement and assessing their outcomes.

  9. Characteristics of unturned eggs: critical period, retarded embryonic growth and poor albumen utilisation.

    PubMed

    Deeming, D C

    1989-06-01

    1. The physiological effects of egg turning during incubation are described. 2. There was a critical period for turning, from days 3 to 7 of incubation, which affected hatchability, embryo growth and utilisation of extra-embryonic fluids. 3. Failure to turn eggs retarded formation of allantoic and amniotic fluids, restricted alumen uptake and retarded growth of the embryo, but only after day 12 of incubation.

  10. A rapid appraisal of access to and utilisation of psychotropic medicines in Bihar, India

    PubMed Central

    2014-01-01

    Background A major aspect of providing mental healthcare is access to and use of psychotropic medications. Bihar is a state in northeast India with limited mental healthcare provision; consequently access to and utilisation of psychotropic medications are likely to be limited. However, to date there has been no research assessing the situation. This study therefore aims to analyse the psychotropic medications management cycle (selection, procurement, distribution and use), and identify the barriers to access and utilisation, and their underlying causes. Method A rapid appraisal method was used in which primary and secondary data sources were collected and analysed. Semi-structured interviews were conducted with twenty-two stakeholders and twenty-one service users from the government, non-governmental organisation (NGO) and private sectors. The qualitative data collected was analysed using a comparative thematic approach. The research was supported by the NGOs BasicNeeds and Nav Bharat Jagriti Kendra. Results Availability, distance and cost were the main barriers to access and utilisation. At the medical college hospital level a lack of supply appears to be due to a discrepancy between orders made by the hospital and medications supplied by the manufacturers. At the primary health centre and district hospital level the main barrier is a cycle between lack of demand for treatments for mental illness by doctors and patients. Conclusion Further investigation and monitoring is necessary to ensure the availability of psychotropic medications at the medical college hospital level. In addition, implementation of the District Mental Health Programme is likely to address the access and utilisation barriers due to its potential to break the current cycle of lack of demand. PMID:25053976

  11. Automatic Detection of Military Targets Utilising Neural Networks and Scale Space Analysis

    DTIC Science & Technology

    2001-04-01

    Detection of Military Targets utilising Neural Networks and Scale Space Analysis A. Khashman Chairman, Department of Computer Engineering Near East...and 3) high computational cost. This required for the employment of neural networks and new approach to edge detection is formalized in the providing...analysis, edge detection and of the Laplacian of the Gaussian (FLoG) edge neural networks . The result is an automatic edge detection operator [1][2], as

  12. Determinants analysis of outpatient service utilisation in Georgia: can the approach help inform benefit package design?

    PubMed

    Gotsadze, George; Tang, Wenze; Shengelia, Natia; Zoidze, Akaki

    2017-05-02

    The healthcare financing reforms initiated by the Government of Georgia in 2007 have positively affected inpatient service utilisation and enhanced financial protection, especially for the poor, but they have failed to facilitate outpatient service use among chronic patients. Non-communicable diseases significantly affect Georgia's ageing population. Consequently, in this paper, we look at the evidence emerging from determinants analysis of outpatient service utilisation and if the finding can help identify possible policy choices in Georgia, especially regarding benefit package design for individuals with chronic conditions. We used Andersen's behavioural model of health service utilisation to identify the critical determinants that affect outpatient service use. A multinomial logistic regression was carried out with complex survey design using the data from two nationally representative cross-sectional population-based health utilisation and expenditure surveys conducted in Georgia in 2007 and 2010, which allowed us to assess the relationship between the determinants and outpatient service use. The study revealed the determinants that significantly impede outpatient service use. Low income, 45- to 64-year-old Georgian males with low educational attainment and suffering from a chronic health problem have the lowest odds for service use compared to the rest of the population. Using Andersen's behavioural model and assessing the determinants of outpatient service use has the potential to inform possible policy responses, especially those driving services use among chronic patients. The possible policy responses include reducing financial access barriers with the help of public subsidies for sub-groups of the population with the lowest access to care; focusing/expanding state-funded benefits for the most prevalent chronic conditions, which are responsible for the greatest disease burden; or supporting chronic disease management programs for the most prevalent chronic

  13. Mental Health Status, Health Care Utilisation, and Service Satisfaction among Immigrants in Montreal: An Epidemiological Comparison.

    PubMed

    Whitley, Rob; Wang, JiaWei; Fleury, Marie-Josee; Liu, Aihua; Caron, Jean

    2017-08-01

    To examine variations between immigrants and nonimmigrants in 1) prevalence of common mental disorders and other mental health variables; 2) health service utilisation for emotional problems, mental disorders, and addictions, and 3) health service satisfaction. This article is based on a longitudinal cohort study conducted from May 2007 to the present: the Epidemiological Catchment Area Study of Montreal South-West (ZEPSOM). Participants were followed up at 4 time points (T1, n = 2433; T4, n = 1095). Core exposure variables include immigrant status (immigrant vs. nonimmigrant), duration of residence, and region of origin. Key outcome variables included mental health status, health service utilisation, and health service satisfaction. Data were analysed both cross-sectionally and longitudinally. Immigrants had been in Canada for 20 years on average. Immigrants had significantly lower rates of high psychological distress (32.6% vs. 39.1%, P = 0.016), alcohol dependence (1.4% vs. 3.9%, P =0.010), depression (5.2% vs. 9.2%, P = 0.008), and various other mental disorders. They had significantly higher scores of mental well-being (48.9 vs. 47.1 score, P = 0.014) and satisfaction with social (34.0 vs. 33.4 score, P = 0.021) and personal relationships (16.7 vs. 15.6 score, P < 0.001). Immigrants had significantly lower rates of health service utilisation for emotional problems, mental disorders, and addictions and significantly higher rates of health service satisfaction at all time points. Asian and African immigrants had particularly low rates of utilisation and high rates of satisfaction. Immigrants had better overall mental health than nonimmigrants.

  14. Socioeconomic determinants of psychotropic drug utilisation among elderly: a national population-based cross-sectional study

    PubMed Central

    2010-01-01

    Background Psychotropic drugs are commonly utilised among the elderly. This study aimed to analyse whether two socioeconomic determinants - income and marital status - are associated with differences in utilisation of psychotropic drugs and potentially inappropriate psychotropic drugs among elderly in Sweden. Methods All individuals aged 75 years and older who had purchased a psychotropic drug in Sweden during 2006 were included (68.7% women, n = 384712). Data was collected from national individual-based registers. Outcome measures were utilisation of three or more psychotropic drugs and utilisation of potentially inappropriate psychotropic drugs, as classified by the Swedish National Board of Health and Welfare. Results Individuals with low income were more likely to utilise three or more psychotropic drugs compared to those with high income; adjusted odds ratio (aOR) 1.12 (95% confidence interval [CI] 1.10-1.14). The non-married had a higher probability for utilising three or more psychotropic drugs compared to the married (aOR 1.22; CI 1.20-1.25). The highest probability was observed among the divorced and the never married. Potentially inappropriate psychotropic drugs were more common among individuals with low compared to high income (aOR 1.14; CI 1.13-1.16). Compared to the married, potentially inappropriate psychotropic drug utilisation occurred more commonly among the non-married (aOR 1.08; CI 1.06-1.10). The never married and the divorced had the highest probability. Conclusions There was an association between socioeconomic determinants and psychotropic drug utilisation. The probability for utilising potentially inappropriate psychotropics was higher among individuals with low income and among the non-married. PMID:20214796

  15. Health care utilisation and problems in accessing health care of female undocumented immigrants in the Netherlands

    PubMed Central

    Loeffen, Maartje J.; van den Muijsenbergh, Maria E.; Lagro-Janssen, Antoine L. M.

    2010-01-01

    Objective To obtain information about the actual use of health care facilities by undocumented women and to identify obstacles they experience in accessing health care facilities. Methods A mixed methods study, with structured questionnaires and semi-structured interviews, was chosen to obtain a complete understanding. One-hundred undocumented women were recruited. Diversity was sought according to age, origin and reason for being undocumented. Results Undocumented female immigrants have unmet health care needs (56%) and low health care utilisation. Sixty-nine per cent of the women reported obstacles in accessing health care facilities. These included many personal obstacles such as shame, fear and/or lack of information. Poor language proficiency (OR 0.28;. CI 0.09–0.90) reduces utilisation of primary health care services. Conclusion Health care utilisation of undocumented women is low. Undocumented women refrain from seeking health care because of personal obstacles. These women need to be identified and informed about their rights, the health care system and the duty of professional confidentiality of doctors. Finally, institutional obstacles to access care should be removed since they strengthen reluctance to seek help. PMID:20502936

  16. Health care utilisation and problems in accessing health care of female undocumented immigrants in the Netherlands.

    PubMed

    Schoevers, Marianne A; Loeffen, Maartje J; van den Muijsenbergh, Maria E; Lagro-Janssen, Antoine L M

    2010-10-01

    To obtain information about the actual use of health care facilities by undocumented women and to identify obstacles they experience in accessing health care facilities. A mixed methods study, with structured questionnaires and semi-structured interviews, was chosen to obtain a complete understanding. One-hundred undocumented women were recruited. Diversity was sought according to age, origin and reason for being undocumented. Undocumented female immigrants have unmet health care needs (56%) and low health care utilisation. Sixty-nine per cent of the women reported obstacles in accessing health care facilities. These included many personal obstacles such as shame, fear and/or lack of information. Poor language proficiency (OR 0.28;. CI 0.09-0.90) reduces utilisation of primary health care services. Health care utilisation of undocumented women is low. Undocumented women refrain from seeking health care because of personal obstacles. These women need to be identified and informed about their rights, the health care system and the duty of professional confidentiality of doctors. Finally, institutional obstacles to access care should be removed since they strengthen reluctance to seek help.

  17. How are policy makers using evidence? Models of research utilisation and local NHS policy making

    PubMed Central

    Elliott, H.; Popay, J.

    2000-01-01

    STUDY OBJECTIVE—This paper is based on a qualitative study that aimed to identify factors that facilitate or impede evidence-based policy making at a local level in the UK National Health Service (NHS). It considers how models of research utilisation drawn from the social sciences map onto empirical evidence from this study.
DESIGN—A literature review and case studies of social research projects that were initiated by NHS health authority managers or GP fundholders in one region of the NHS. In depth interviews and document analysis were used.
SETTING—One NHS region in England.
PARTICIPANTS—Policy makers, GPs and researchers working on each of the social research projects selected as case studies.
MAIN RESULTS—The direct influence of research evidence on decision making was tempered by factors such as financial constraints, shifting timescales and decision makers' own experiential knowledge. Research was more likely to impact on policy in indirect ways, including shaping policy debate and mediating dialogue between service providers and users.
CONCLUSIONS—The study highlights the role of sustained dialogue between researchers and the users of research in improving the utilisation of research-based evidence in the policy process.


Keywords: evidence-based policy making; research/policy interface; research utilisation PMID:10818123

  18. Influence of palm olein on protein utilisation in the growing rat.

    PubMed

    Henry, C J; Ghusain-Choueiri, A; Gurr, M I

    1999-03-01

    In view of our preliminary findings that refined palm oil (RPOL) enhanced protein utilisation, and because of the growing importance of palm oil in human diets, two separate studies were conducted. The first study aimed to investigate the effect of the palm oil source and fraction on protein utilisation, as determined by net protein utilization (NPU) in growing rats. The second study aimed to investigate the influence of the dietary concentration of one particular palm oil fraction, refined palm olein (RPO) on net protein utilisation. The fat source of each of the semi-purified diets was as follows: crude palm oil (CPO), refined palm kernel oil (RKO), refined palm olein (RPO), refined palm stearin (RPS), and refined palm oil (RPOL). A sixth control group was offered an identical diet but with olive oil (OO, control) as the fat source. Both the oil source (P < 0.01) and the oil level (P < 0.05) influenced NPU in rats. NPU values were generally higher for rats given the RPO-containing diets, particularly at the 20% dietary level (P < 0.01) compared to the diets containing ground nut oil (GNO). The results of these two experiments indicate that RPO influences protein metabolism specifically at a concentration of at least 20% in the diet. This may suggest that RPO is superior to GNO as a source of fat for the rehabilitation of malnourished children. Human trials notably during the rehabilitation of malnourished children may therefore be the next step in this line of research.

  19. Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda.

    PubMed

    Musoke, David; Boynton, Petra; Butler, Ceri; Musoke, Miph Boses

    2014-12-01

    The health seeking behaviour of a community determines how they use health services. Utilisation of health facilities can be influenced by the cost of services, distance to health facilities, cultural beliefs, level of education and health facility inadequacies such as stock-out of drugs. To assess the health seeking practices and challenges in utilising health facilities in a rural community in Wakiso district, Uganda. The study was a cross sectional survey that used a structured questionnaire to collect quantitative data among 234 participants. The sample size was obtained using the formula by Leslie Kish. While 89% of the participants were aware that mobile clinics existed in their community, only 28% had received such services in the past month. The majority of participants (84%) did not know whether community health workers existed in their community. The participants' health seeking behaviour the last time they were sick was associated with age (p = 0.028) and occupation (p = 0.009). The most significant challenges in utilising health services were regular stock-out of drugs, high cost of services and long distance to health facilities. There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy.

  20. The impact of the urban resident basic medical insurance on health services utilisation in China.

    PubMed

    Chen, Gang; Liu, Gordon G; Xu, Fei

    2014-03-01

    The Urban Resident Basic Medical Insurance (URBMI), launched in 2007 by the State Council, aims to cover around 420 million urban residents in China. This study aimed to assess the impact of URBMI on health services access (especially inpatient utilisation) in urban China. Data was drawn from the recent four-wave URBMI Survey (2008-2011). Probit and recursive bivariate probit models have been adopted to handle the possible endogeneity of medical insurance in the utilisation equations. Based on the preferred results from the unbalanced four-wave panel data, we found that the URBMI had significantly increased the likelihood of receiving inpatient treatment in the past year. However, the insurance effect on reducing the refused hospitalisation was insignificant. Finally, the URBMI had also increased the probability of using outpatient services in the past 2 weeks, although the insurance reimburses mainly against critical outpatient care. Given that it is still early days for the URBMI scheme, the positive effect on health services utilisation is appreciable.

  1. Utilisation of prey by antlion larvae (Neuroptera: Myrmeleontidae) in terms of energy and nutrients.

    PubMed

    De K Van Der Linde, T C.; Van Der Westhuizen, M C.; Van Zyl, A

    1997-07-01

    Prey utilisation at low prey densities was determined for third instar Cueta sp., Furgella intermedia (Markl) and Palpares annulatus (Stitz) larvae in terms of wet weight, dry weight, energy and nutrients. Prey utilisation was similar to other insects on a wet weight (42-47%), dry weight (46-49%), energetic (40-58%) and nutritive basis (62-79%). Lipids (33-36%) provided energetically the highest contribution of the nutrients ingested. The quantities of water, proteins, nucleic acids, lipids and carbohydrates extracted by the antlion larvae were in proportion to their availability in their prey, the Hodotermes mossambicus larvae. The quantities of nutrients extracted by the antlion larvae at low prey densities were not significantly influenced by the differences in mandible size, antlion body weight or the trapping method (building a pit or not) of the antlion species. It is proposed that a low metabolic rate and the accumulation of fat reserves, and not the extent of prey utilisation, enable P. annulatus larvae to tolerate a 123-d starvation period in which 22.3% of their body weight is lost.

  2. Health service utilisation of rural-to-urban migrants in Guangzhou, China: does employment status matter?

    PubMed

    Song, Xiaolei; Zou, Guanyang; Chen, Wen; Han, Siqi; Zou, Xia; Ling, Li

    2017-01-01

    To describe the self-reported health status and service utilisation of employed, retired and unemployed migrants in Guangzhou, a megacity in southern China. A cross-sectional study adapted from the National Health Service Survey was conducted between September and December in 2014. Based on the distribution of occupation of migrants, multistage sampling was used to recruit individuals. Logistic regression was applied to explore the factors influencing their service utilisation. Of 2906 respondents, 76.6% were employed, 9.2% retired and 14.2% unemployed. Only 8.1% reported having an illness in the previous 2 weeks, and 6.5% reported having been hospitalised in the previous year. Employed migrants had the lowest recent physician consultation rate (3.4%) and the lowest annual hospitalisation rate (4.5%) (P < 0.05); unemployed migrants had the highest rates (6.8% and 14.5% respectively, P < 0.05). Retired migrants were more likely to return to their hometown for health care (8.6%) than employed (1.5%) and unemployed migrants (3.4%) (P < 0.05). After adjusting for age and gender, employment status remained significant in explaining the recent two-week treatment-seeking behaviour of migrants (P < 0.05). Disparity of service utilisation continues to be a problem for migrants due to the poor health awareness, lack of time and inconvenience of medical insurance reimbursement. Employed migrants make the least use of health services. © 2016 John Wiley & Sons Ltd.

  3. How to identify, assess and utilise mobile medical applications in clinical practice.

    PubMed

    Aungst, T D; Clauson, K A; Misra, S; Lewis, T L; Husain, I

    2014-02-01

    There are thousands of medical applications for mobile devices targeting use by healthcare professionals. However, several factors related to the structure of the existing market for medical applications create significant barriers preventing practitioners from effectively identifying mobile medical applications for individual professional use. To define existing market factors relevant to selection of medical applications and describe a framework to empower clinicians to identify, assess and utilise mobile medical applications in their own practice. Resources available on the Internet regarding mobile medical applications, guidelines and published research on mobile medical applications. Mobile application stores (e.g. iTunes, Google Play) are not effective means of identifying mobile medical applications. Users of mobile devices that desire to implement mobile medical applications into practice need to carefully assess individual applications prior to utilisation. Searching and identifying mobile medical applications requires clinicians to utilise multiple references to determine what application is best for their individual practice methods. This can be done with a cursory exploration of mobile application stores and then moving onto other available resources published in the literature or through Internet resources (e.g. blogs, medical websites, social media). Clinicians must also take steps to ensure that an identified mobile application can be integrated into practice after carefully reviewing it themselves. Clinicians seeking to identify mobile medical application for use in their individual practice should use a combination of app stores, published literature, web-based resources, and personal review to ensure safe and appropriate use. © 2014 John Wiley & Sons Ltd.

  4. Donor blood procurement and utilisation at the University of Benin Teaching Hospital, Benin City.

    PubMed

    Enosolease, M E; Imarengiaye, C O; Awodu, O A

    2004-08-01

    Banked blood is a limited resource in Nigeria. We sought to evaluate factors that may further limit the effective utilisation of donor blood in a tertiary hospital in Benin City. The records of the blood transfusion unit of the hospital were studied to identify the methods of blood procurement and utilisation from January 1, 2000 to December 31, 2002. A total of 11,021 units of blood were received in the blood transfusion unit within this period out of which 1491 (13.5%) donor blood samples were found unfit for transfusion and, hence, discarded. Commercial blood donation accounted for 95.3%, compared to 4.7% from replacement and volunteer donors. Commercial blood donation was a major risk factor for likely disposal of donor blood (chi2 = 74.3, p < 0.0001, OR = 21.1. 95% CI = 7.8-56.7). Expired units of blood with low PCV were discarded for lack of infrastructure to fractionate and store them. Over 0.8million naira (US$6000.00) is wasted annually on discarded units of donor blood mainly from commercial donors. A policy on blood procurement to include subgroup selection of donors and improved funding of blood banking services may enhance efficient and effective utilisation of donor blood.

  5. Extreme climatic conditions and health service utilisation across rural and metropolitan New South Wales

    NASA Astrophysics Data System (ADS)

    Jegasothy, Edward; McGuire, Rhydwyn; Nairn, John; Fawcett, Robert; Scalley, Benjamin

    2017-03-01

    Periods of successive extreme heat and cold temperature have major effects on human health and increase rates of health service utilisation. The severity of these events varies between geographic locations and populations. This study aimed to estimate the effects of heat waves and cold waves on health service utilisation across urban, regional and remote areas in New South Wales (NSW), Australia, during the 10-year study period 2005-2015. We divided the state into three regions and used 24 over-dispersed or zero-inflated Poisson time-series regression models to estimate the effect of heat waves and cold waves, of three levels of severity, on the rates of ambulance call-outs, emergency department (ED) presentations and mortality. We defined heat waves and cold waves using excess heat factor (EHF) and excess cold factor (ECF) metrics, respectively. Heat waves generally resulted in increased rates of ambulance call-outs, ED presentations and mortality across the three regions and the entire state. For all of NSW, very intense heat waves resulted in an increase of 10.8% (95% confidence interval (CI) 4.5, 17.4%) in mortality, 3.4% (95% CI 0.8, 7.8%) in ED presentations and 10.9% (95% CI 7.7, 14.2%) in ambulance call-outs. Cold waves were shown to have significant effects on ED presentations (9.3% increase for intense events, 95% CI 8.0-10.6%) and mortality (8.8% increase for intense events, 95% CI 2.1-15.9%) in outer regional and remote areas. There was little evidence for an effect from cold waves on health service utilisation in major cities and inner regional areas. Heat waves have a large impact on health service utilisation in NSW in both urban and rural settings. Cold waves also have significant effects in outer regional and remote areas. EHF is a good predictor of health service utilisation for heat waves, although service needs may differ between urban and rural areas.

  6. Extreme climatic conditions and health service utilisation across rural and metropolitan New South Wales.

    PubMed

    Jegasothy, Edward; McGuire, Rhydwyn; Nairn, John; Fawcett, Robert; Scalley, Benjamin

    2017-03-20

    Periods of successive extreme heat and cold temperature have major effects on human health and increase rates of health service utilisation. The severity of these events varies between geographic locations and populations. This study aimed to estimate the effects of heat waves and cold waves on health service utilisation across urban, regional and remote areas in New South Wales (NSW), Australia, during the 10-year study period 2005-2015. We divided the state into three regions and used 24 over-dispersed or zero-inflated Poisson time-series regression models to estimate the effect of heat waves and cold waves, of three levels of severity, on the rates of ambulance call-outs, emergency department (ED) presentations and mortality. We defined heat waves and cold waves using excess heat factor (EHF) and excess cold factor (ECF) metrics, respectively. Heat waves generally resulted in increased rates of ambulance call-outs, ED presentations and mortality across the three regions and the entire state. For all of NSW, very intense heat waves resulted in an increase of 10.8% (95% confidence interval (CI) 4.5, 17.4%) in mortality, 3.4% (95% CI 0.8, 7.8%) in ED presentations and 10.9% (95% CI 7.7, 14.2%) in ambulance call-outs. Cold waves were shown to have significant effects on ED presentations (9.3% increase for intense events, 95% CI 8.0-10.6%) and mortality (8.8% increase for intense events, 95% CI 2.1-15.9%) in outer regional and remote areas. There was little evidence for an effect from cold waves on health service utilisation in major cities and inner regional areas. Heat waves have a large impact on health service utilisation in NSW in both urban and rural settings. Cold waves also have significant effects in outer regional and remote areas. EHF is a good predictor of health service utilisation for heat waves, although service needs may differ between urban and rural areas.

  7. Extreme climatic conditions and health service utilisation across rural and metropolitan New South Wales

    NASA Astrophysics Data System (ADS)

    Jegasothy, Edward; McGuire, Rhydwyn; Nairn, John; Fawcett, Robert; Scalley, Benjamin

    2017-08-01

    Periods of successive extreme heat and cold temperature have major effects on human health and increase rates of health service utilisation. The severity of these events varies between geographic locations and populations. This study aimed to estimate the effects of heat waves and cold waves on health service utilisation across urban, regional and remote areas in New South Wales (NSW), Australia, during the 10-year study period 2005-2015. We divided the state into three regions and used 24 over-dispersed or zero-inflated Poisson time-series regression models to estimate the effect of heat waves and cold waves, of three levels of severity, on the rates of ambulance call-outs, emergency department (ED) presentations and mortality. We defined heat waves and cold waves using excess heat factor (EHF) and excess cold factor (ECF) metrics, respectively. Heat waves generally resulted in increased rates of ambulance call-outs, ED presentations and mortality across the three regions and the entire state. For all of NSW, very intense heat waves resulted in an increase of 10.8% (95% confidence interval (CI) 4.5, 17.4%) in mortality, 3.4% (95% CI 0.8, 7.8%) in ED presentations and 10.9% (95% CI 7.7, 14.2%) in ambulance call-outs. Cold waves were shown to have significant effects on ED presentations (9.3% increase for intense events, 95% CI 8.0-10.6%) and mortality (8.8% increase for intense events, 95% CI 2.1-15.9%) in outer regional and remote areas. There was little evidence for an effect from cold waves on health service utilisation in major cities and inner regional areas. Heat waves have a large impact on health service utilisation in NSW in both urban and rural settings. Cold waves also have significant effects in outer regional and remote areas. EHF is a good predictor of health service utilisation for heat waves, although service needs may differ between urban and rural areas.

  8. Proposals for Solutions to Problems Related to the Use of F-34 (SFP) and High Sulphur Diesel on Ground Equipment Using Advanced Reduction Emission Technologies (Propositions de solutions aux problemes lies a l’utilisation de F-34 (SFP) et de diesel a haute teneur en soufre pour le materiel terrestre disposant de technologies avancees de reduction des emissions)

    DTIC Science & Technology

    2008-09-01

    technologies avancées de réduction des émissions) Final Report of Exploratory Team AVT-ET-073. ii RTO-TM-AVT-ET-073 The...on board diagnostic system ( OBD ) integrated in the ECU to control the exhaust gas quality. HSF use will negatively impact on ECU and action must be

  9. Factors that influence utilisation of HIV/AIDS prevention methods among university students residing at a selected university campus.

    PubMed

    Ndabarora, Eléazar; Mchunu, Gugu

    2014-01-01

    Various studies have reported that university students, who are mostly young people, rarely use existing HIV/AIDS preventive methods. Although studies have shown that young university students have a high degree of knowledge about HIV/AIDS and HIV modes of transmission, they are still not utilising the existing HIV prevention methods and still engage in risky sexual practices favourable to HIV. Some variables, such as awareness of existing HIV/AIDS prevention methods, have been associated with utilisation of such methods. The study aimed to explore factors that influence use of existing HIV/AIDS prevention methods among university students residing in a selected campus, using the Health Belief Model (HBM) as a theoretical framework. A quantitative research approach and an exploratory-descriptive design were used to describe perceived factors that influence utilisation by university students of HIV/AIDS prevention methods. A total of 335 students completed online and manual questionnaires. Study findings showed that the factors which influenced utilisation of HIV/AIDS prevention methods were mainly determined by awareness of the existing university-based HIV/AIDS prevention strategies. Most utilised prevention methods were voluntary counselling and testing services and free condoms. Perceived susceptibility and perceived threat of HIV/AIDS score was also found to correlate with HIV risk index score. Perceived susceptibility and perceived threat of HIV/AIDS showed correlation with self-efficacy on condoms and their utilisation. Most HBM variables were not predictors of utilisation of HIV/AIDS prevention methods among students. Intervention aiming to improve the utilisation of HIV/AIDS prevention methods among students at the selected university should focus on removing identified barriers, promoting HIV/AIDS prevention services and providing appropriate resources to implement such programmes.

  10. Utilisation of a community-based health facility in a low-income urban community in Ibadan, Nigeria

    PubMed Central

    Asuzu, Michael C.

    2015-01-01

    Background Primary healthcare is established to ensure that people have access to health services through facilities located in their community. However, utilisation of health facilities in Nigeria remains low in many communities. Aim To assess the utilisation of community-based health facility (CBHF) amongst adults in Ibadan, Nigeria Settings A low-income community in Ibadan North West Local Government Area of Oyo State. Methods A cross-sectional survey was conducted using a simple random sampling technique to select one adult per household in all 586 houses in the community. A semi-structured interviewer-administered questionnaire was used to collect information on respondents' sociodemographic characteristics, knowledge and utilisation of the CBHF. Data analysis included descriptive statistics and association testing using the Chi-square test at p = 0.05. Results The mean age of the respondents was 46.5 ± 16.0 years; 46.0% were men and 81.0% married; 26% had no formal education and 38.0% had secondary-level education and above; traders constituted 52.0% of the sample; and 85.2% were of low socioeconomic standing; 90% had patronised the CBHF. The main reasons for non-utilisation were preference for general hospitals (13.8%) and self-medication (12.1%). Respondents who had secondary education and above, were in a higher socioeconomic class, who had good knowledge of the facility and were satisfied with care, utilised the CBHF three months significantly more than their counterparts prior to the study (p < 0.05). However, only satisfaction with care was found to be a significant predictor of utilisation of the CBHF. Conclusion The utilisation of the CBHF amongst adults in the study setting is high, driven mostly by satisfaction with the care received previously. Self-medication, promoted by uncontrolled access to drugs through pharmacies and patent medicine stores, threatens this high utilisation. PMID:26245600

  11. Association between inadequate antenatal care utilisation and severe perinatal and maternal morbidity: an analysis in the PreCARE cohort.

    PubMed

    Linard, M; Blondel, B; Estellat, C; Deneux-Tharaux, C; Luton, D; Oury, J F; Schmitz, T; Mandelbrot, L; Azria, E

    2017-06-20

    Because the effectiveness of antenatal care in reducing pregnancy complications is still discussed despite widespread recommendations of its use, we sought to assess the association between utilisation of recommended antenatal care and severe maternal (SMM) and perinatal morbidity (SPM). Prospective cohort study. Four maternity units around Paris in 2010-2012. 9117 women with singleton pregnancies. Logistic regression models adjusted for maternal social, demographic and medical characteristics. Antenatal care utilisation was assessed by: (1) initiation of care after 14 weeks, (2) < 50% of recommended visits made, according to gestational age, (3) absence of the first, second or third trimester ultrasounds, (4) two modified Adequacy of Prenatal Care Utilisation indexes, combining these components. The two main outcomes were composite variables of SMM and SPM. According to the modified Adequacy of Prenatal Care Utilisation index, 34.6% of women had inadequate antenatal care utilisation; the incidence of severe maternal morbidity (SMM) was 2.9% and severe perinatal morbidity (SPM) 5.5%. A percentage of recommended visits below 50% (2.6% of women) was associated with SMM [adjusted odds ratio (OR) 2.40 (1.38-4.17)] and SPM [aOR 2.27 (1.43-3.59)]. Late initiation of care (17.0% of women) was not associated with SMM or SPM. Failure to undergo the recommended ultrasounds (16, 17 and 22% of women) was associated with SPM. Inadequate antenatal care utilisation according to the index was associated with SPM [aOR 1.37 (1.05-1.80)]. Inadequate antenatal care utilisation is associated with SMM and SPM, to degrees that vary with the component of care and the outcome considered. Inadequate antenatal care utilisation is associated with severe maternal and perinatal morbidity. © 2017 Royal College of Obstetricians and Gynaecologists.

  12. Age of first dental visit and predictors for oral healthcare utilisation in preschool children.

    PubMed

    Ardenghi, Thiago Machado; Vargas-Ferreira, Fabiana; Piovesan, Chaiana; Mendes, Fausto Medeiros

    2012-01-01

    To assess the age the of the first dental visit and the association of self-perceived oral health, socioeconomic and clinical indicators with healthcare utilisation in Brazilian preschool children. An epidemiological survey with 455 5- to 59-month-old children was conducted on National Children's Vaccination Day in Santa Maria, RS, Brazil. Data about age and reasons for the first dental visit, healthcare utilisation, socioeconomic status and self-perceived oral health were collected by means of a parental semi-structured questionnaire. Calibrated examiners evaluated the prevalence of dental caries (WHO) and dental trauma. The assessment of the association used Poisson regression models (prevalence ratio; 95% confidence interval [CI]). A total of 24.2% (95% CI: 20.3% to 28.4%) of the study sample had already had a first dental visit. Older children, those with dental caries and dental trauma and whose mothers had a higher level of education were more likely to have gone to the dentist. Children of low socioeconomic status were more likely to have visited public than private healthcare services. The reasons for the first dental visit were associated with clinical indicators of the sample. The distribution of utilisation of the types of oral healthcare services (public or private) varied across the socioeconomic groups. Non-white children with dental caries and dental trauma tended to visit a dentist only for treatment reasons. Socioeconomic and clinical indicators are associated with the use of dental services, indicating the need for strategies to promote public health and reorientation of services that facilitate dental access for preschool children.

  13. L’utilisation d’objets comme outils: un développement continu

    PubMed Central

    Kahrs, Björn Alexander; Lockman, Jeffrey J.

    2014-01-01

    Le débat autour des origines développementales de la capacité humaine à utiliser des outils de manière souple reste ouvert. Alors que l’approche dominante se focalise sur un changement qualitatif cognitif vers la fin de la première année, la théorie perception-action fournit des indices importants sur la manière dont les comportements exploratoires plus précoces des nourrissons jettent les bases pour l’émergence de cette capacité. En particulier, nous nous intéressons à la manière dont les tentatives des nourrissons de mettre en rapport les objets et les surfaces leur permettent d’apprendre comment les objets peuvent servir d’extension de la main et fournissent l’occasion d’exercer des actions qui seront recrutées plus tard pour l’utilisation d’outils. Dans ce contexte, nous discutons des études comportementales et cinématiques portant sur la manipulation d’objets, qui montrent que les nourrissons font interagir les objets et les surfaces avec discernement et que leur contrôle de la frappe (banging) augmente au cours de leur première année. En conclusion, une perspective perception-action suggère que l’utilisation d’outils émerge de manière plus continue au cours du développement que ce qui a été traditionnellement envisagé. PMID:24511151

  14. Pattern of Utilisation of Dental Health Care Among HIV-positive Adult Nigerians.

    PubMed

    Adedigba, Michael A; Adekanmbi, Victor T; Asa, Sola; Fakande, Ibiyemi

    2016-01-01

    To determine the pattern of dental care utilisation of people living with HIV (PLHIV). A cross-sectional questionnaire survey of 239 PLHIV patients in three care centres was done. Information on sociodemographics, dental visit, risk groups, living arrangement, medical insurance and need of dental care was recorded. The EC Clearinghouse and WHO clinical staging was used to determine the stage of HIV/AIDS infection following routine oral examinations under natural daylight. Multivariate logistic regression models were created after adjusting for all the covariates that were statistically significant at univariate/bivariate levels. The majority of subjects were younger than 50 years, about 93% had not seen a dentist before being diagnosed HIV positive and 92% reported no dental visit after contracting HIV. Among nonusers of dental care, 14.3% reported that they wanted care but were afraid to seek it. Other reasons included poor awareness, lack of money and stigmatisation. Multivariate analysis showed that lack of dental care was associated with employment status, living arrangements, educational status, income per annum and presenting with oral symptoms. The area under the receiver operating curve was 84% for multivariate logistic regression model 1, 70% for model 2, 67% for model 3 and 71% for model 4, which means that the predictive power of the models were good. Contrary to our expectations, dental utilisation among PLHIV was generally poor among this group of patients. There is serious and immediate need to improve the awareness of PLHIVs in African settings and barriers to dental care utilisation should also be removed or reduced.

  15. An exploration of the data collection methods utilised with children, teenagers and young people (CTYPs).

    PubMed

    Flanagan, Sarah M; Greenfield, Sheila; Coad, Jane; Neilson, Susan

    2015-03-01

    The impact of cancer upon children, teenagers and young people can be profound. Research has been undertaken to explore the impacts upon children, teenagers and young people with cancer, but little is known about how researchers can 'best' engage with this group to explore their experiences. This review paper provides an overview of the utility of data collection methods employed when undertaking research with children, teenagers and young people. A systematic review of relevant databases was undertaken utilising the search terms 'young people', 'young adult', 'adolescent' and 'data collection methods'. The full-text of the papers that were deemed eligible from the title and abstract were accessed and following discussion within the research team, thirty papers were included. Due to the heterogeneity in terms of the scope of the papers identified the following data collections methods were included in the results section. Three of the papers identified provided an overview of data collection methods utilised with this population and the remaining twenty seven papers covered the following data collection methods: Digital technologies; art based research; comparing the use of 'paper and pencil' research with web-based technologies, the use of games; the use of a specific communication tool; questionnaires and interviews; focus groups and telephone interviews/questionnaires. The strengths and limitations of the range of data collection methods included are discussed drawing upon such issues as of the appropriateness of particular methods for particular age groups, or the most appropriate method to employ when exploring a particularly sensitive topic area. There are a number of data collection methods utilised to undertaken research with children, teenagers and young adults. This review provides a summary of the current available evidence and an overview of the strengths and limitations of data collection methods employed.

  16. Multiply disadvantaged: Health and service utilisation factors faced by homeless injecting drug consumers in Australia.

    PubMed

    Whittaker, Elizabeth; Swift, Wendy; Roxburgh, Amanda; Dietze, Paul; Cogger, Shelley; Bruno, Raimondo; Sindicich, Natasha; Burns, Lucy

    2015-07-01

    Homelessness status is strongly correlated with higher rates of substance use. Few studies, however, examine the complex relationship between housing status and substance use in people who inject drugs (PWID). This study extends previous research by comparing the physical and mental health status and service utilisation rates between stably housed and homeless PWID. A cross-sectional sample of 923 PWID were recruited for the 2012 Illicit Drug Reporting System. Multivariate models were generated addressing associations between homelessness and the domains of demographics; substance use; and health status, service utilisation and criminal justice system contact, with significant correlates entered into a final multivariate model. Two-thirds of the PWID sample were male. The median age was 39 years and 16% identified as Indigenous. Almost one-quarter (23%) reported that they were homeless. Homeless PWID were significantly more likely to be unemployed [adjusted odds ratio (AOR) 2.83, 95% confidence interval (CI) 1.26, 6.34], inject in public (AOR 2.01, 95% CI 1.38, 3.18), have poorer mental health (AOR 0.98, 95% CI 0.97, 1.00), report schizophrenia (AOR 2.31, 95% CI 1.16, 4.60) and have a prison history (AOR 1.53, 95% CI 1.05, 2.21) than stably housed PWID. Findings highlight the challenge of mental health problems for homeless PWID. Our results demonstrate that further research that evaluates outcomes of housing programs accommodating PWID, particularly those with comorbid mental health disorders, is warranted. Results also emphasise the need to better utilise integrated models of outreach care that co-manage housing and mental health needs. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  17. An international review of the patterns and determinants of health service utilisation by adult cancer survivors

    PubMed Central

    2012-01-01

    Background There is a need to review factors related to health service utilisation by the increasing number of cancer survivors in order to inform care planning and the organisation and delivery of services. Methods Studies were identified via systematic searches of Medline, PsycINFO, CINAHL, Social Science Citation Index and the SEER-MEDICARE library. Methodological quality was assessed using STROBE; and the Andersen Behavioural Model was used as a framework to structure, organise and analyse the results of the review. Results Younger, white cancer survivors were most likely to receive follow-up screening, preventive care, visit their physician, utilise professional mental health services and least likely to be hospitalised. Utilisation rates of other health professionals such as physiotherapists were low. Only studies of health service use conducted in the USA investigated the role of type of health insurance and ethnicity. There appeared to be disparate service use among US samples in terms of ethnicity and socio-demographic status, regardless of type of health insurance provision s- this may be explained by underlying differences in health-seeking behaviours. Overall, use of follow-up care appeared to be lower than expected and barriers existed for particular groups of cancer survivors. Conclusions Studies focussed on the use of a specific type of service rather than adopting a whole-system approach and future health services research should address this shortcoming. Overall, there is a need to improve access to care for all cancer survivors. Studies were predominantly US-based focussing mainly on breast or colorectal cancer. Thus, the generalisability of findings to other health-care systems and cancer sites is unclear. The Andersen Behavioural Model provided an appropriate framework for studying and understanding health service use among cancer survivors. The active involvement of physicians and use of personalised care plans are required in order to ensure

  18. Healthcare Utilisation and Drug Treatment in a Large Cohort of Patients with Inflammatory Bowel Disease

    PubMed Central

    Wettermark, Björn; Löfberg, Robert; Eriksson, Irene; Sundström, Johan; Lördal, Mikael

    2016-01-01

    Background and Aims: Crohn’s disease [CD] and ulcerative colitis [UC] are chronic diseases associated with a substantial utilisation of healthcare resources. We aimed to estimate the prevalence of inflammatory bowel disease [IBD], CD, and UC and to describe and compare healthcare utilisation and drug treatment in CD and UC patients. Methods: This was a cross-sectional study of all patients with a recorded IBD diagnosis in Stockholm County, Sweden. Data on outpatient visits, hospitalisations, surgeries, and drug treatment during 2013 were analysed. Results: A total of 13 916 patients with IBD were identified, corresponding to an overall IBD prevalence of 0.65% [CD 0.27%, UC 0.35%, inflammatory bowel disease unclassified 0.04%]; 49% of all IBD patients were treated with IBD-related drugs. Only 3.6% of the patients received high-dose corticosteroids, whereas 32.4% were treated with aminosalicylates [CD 21.2%, UC 41.0%, p < 0.0001]. More CD patients were treated with biologicals compared with UC patients [CD 9.6%, UC 2.9%, p < 0.0001] and surgery was significantly more common among CD patients [CD 3.0%, UC 0.8%, p < 0.0001]. Conclusions: This study indicates that patients with CD are the group with the highest medical needs. Patients with CD utilised significantly more healthcare resources [including outpatient visits, hospitalisations, and surgeries] than UC patients. Twice as many CD patients received immunomodulators compared with UC patients and CD patients were treated with biologicals three times more often. These results highlight that CD remains a challenge and further efforts are needed to improve care in these patients. PMID:26733406

  19. Radiotherapy access in Belgium: How far are we from evidence-based utilisation?

    PubMed

    Lievens, Y; De Schutter, H; Stellamans, K; Rosskamp, M; Van Eycken, L

    2017-10-01

    Underutilisation of radiotherapy has been observed worldwide. To evaluate the current situation in Belgium, optimal utilisation proportions (OUPs) adopted from the European SocieTy for Radiotherapy and Oncology - Health Economics in Radiation Oncology (ESTRO-HERO) project were compared to actual utilisation proportions (AUPs) and with radiotherapy advised during the multidisciplinary cancer team (MDT) meetings. In addition, the impact of independent variables was analysed. AUPs and advised radiotherapy were calculated overall and by cancer type for 110,810 unique cancer diagnoses in 2009-2010. Radiotherapy utilisation was derived from reimbursement data and distinguished between palliative and curative intent external beam radiotherapy (EBRT) and/or brachytherapy (BT). Sensitivity analyses regarding the influence of the follow-up period, the survival length and patient's age were performed. Advised radiotherapy was calculated based on broad treatment categories as reported at MDT meetings. The overall AUP of 37% (39% including BT) was lower than the OUP of 53%, but in line with advised radiotherapy (35%). Large variations by tumour type were observed: in some tumours (e.g. lung and prostate cancer) AUP was considerably lower than OUP, whereas in others there was reasonable concordance (e.g. breast and rectal cancer). Overall, 84% of treatments started within 9 months following diagnosis. Survival time influenced AUP in a cancer type-dependent way. Elderly patients received less radiotherapy. Although the actually delivered radiotherapy in Belgium aligns well to MDT advices, it is lower than the evidence-based optimum. Further analysis of potential barriers is needed for radiotherapy forecasting and planning, and in order to promote adequate access to radiotherapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Determinants of prenatal health care utilisation by low-risk women: a prospective cohort study.

    PubMed

    Feijen-de Jong, Esther I; Jansen, Danielle E M C; Baarveld, Frank; Boerleider, Agatha W; Spelten, Evelien; Schellevis, François; Reijneveld, Sijmen A

    2015-06-01

    Prenatal health care is pivotal in providing adequate prevention and care to pregnant women. We examined the determinants of inadequate prenatal health care utilisation by low-risk women in primary midwifery-led care in the Netherlands. We used longitudinal data from the population-based DELIVER study with 20 midwifery practices across the Netherlands in 2009 and 2010 as the experimental setting. The participants were 3070 pregnant women starting pregnancy care in primary midwifery care. We collected patient-reported data on potential determinants of prenatal care utilisation derived from the Andersen model. Prenatal health care utilisation was measured by a revised version of the Kotelchuck Index, which measures a combination of care entry and number of visits. Low-risk pregnant women (not referred during pregnancy) were more likely to use prenatal care inadequately if they intended to deliver at a hospital, if they did not use folic acid adequately periconceptionally, or if they were exposed to cigarette smoke during pregnancy. Among those who were referred to secondary care, women reporting a chronic illnesses or disabilities, and women who did not use folic acid periconceptionally were more likely to make inadequate use of prenatal care. Inadequate prenatal health care use in primary midwifery care is more likely in specific groups, and the risk groups differ when women are referred to secondary care. The findings suggest routes that can target interventions to women who are at risk of not adequately using prenatal prevention and care services. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  1. Patterns of service utilisation within Australian hepatology clinics: high prevalence of advanced liver disease.

    PubMed

    El-Atem, N A; Wojcik, K; Horsfall, L; Irvine, K M; Johnson, T; McPhail, S M; Powell, E E

    2016-04-01

    Liver diseases in Australia are estimated to affect 6 million people with a societal cost of $51 billion annually. Information about utilisation of specialist hepatology care is critical in informing policy makers about the requirements for delivery of hepatology-related healthcare. This study examined the aetiology and severity of liver disease seen in a tertiary hospital hepatology clinic, as well as the resource utilisation patterns. A longitudinal cohort study included consecutive patients booked in hepatology outpatient clinics during a 3-month period. Subsequent outpatient appointments for these patients over the following 12 months were then recorded. During the initial 3-month period, 1471 appointments were scheduled with a hepatologist, 1136 of which were attended. Twenty-one per cent of patients were 'new cases'. Hepatitis B virus (HBV) was the most common disease aetiology for new cases (37%). Advanced disease at presentation varied between aetiology; only 5% of HBV cases had advanced liver disease at presentation, in contrast with HCV, NAFLD and ALD, in which advanced disease was identified at presentation in 31%, 46% and 72% of cases, respectively. Most patients (83%) attended multiple hepatology appointments, and a range of referral patterns for procedures, investigations and other specialty assessments were observed. There is a high prevalence of HBV in new case referrals. Patients with HCV infection, NAFLD and ALD have a high prevalence of advanced liver disease at referral, requiring ongoing surveillance for development of decompensated liver disease and liver cancer. These findings that describe the patterns of health service utilisation among patients with liver disease provide useful information for planning sustainable health service provision for this clinical population. © 2016 Royal Australasian College of Physicians.

  2. Comprehensive determinants of health service utilisation for mental health reasons in a canadian catchment area

    PubMed Central

    2012-01-01

    Introduction This study sought to identify factors associated with health service utilisation by individuals with mental disorders in a Canadian catchment area. Methods To be included in the study, participants had to be aged between 15 and 65 and reside in the study location. Data was collected randomly from June to December 2009 by specially trained interviewers. A comprehensive set of variables (including geospatial factors) was studied using the Andersen's behavioural health service model. Univariate, bivariate, and multivariate analyses were carried out. Results Among 406 individuals diagnosed with mental disorders, 212 reported using a mental health service at least once in the 12 months preceding the interviews. Emotional problems and a history of violence victimisation were most strongly associated with such utilisation. Participants who were middle-aged or deemed their mental health to be poor were also more likely to seek mental healthcare. Individuals living in neighbourhoods where rental accommodations were the norm used significantly fewer health services than individuals residing in neighbourhoods where homeownership was preponderant; males were also less likely to use services than females. Conclusions Our study broke new ground by uncovering the impact of longstanding violence victimisation, and the proportion of homeownership on mental health service utilisation among this population. It also confirmed the prominence of some variables (gender, age, emotional problems and self-perceived mental health) as key enabling variables of health-seeking. There should be better promotion of strategies designed to change the attitudes of males and youths and to deal with violence victimisation. There is also a need for initiatives that are targeted to neighbourhoods where there is more rental housing. PMID:22469459

  3. Differences in healthcare service utilisation in elderly, registered in eight districts of five European countries.

    PubMed

    Vadla, Draženka; Božikov, Jadranka; Åkerström, Bengt; Cheung, Wai-Yee; Kovačić, Luka; Masanovic, Maria; Merilainen, Satu; Mihel, Sandra; Nummelin-Niemi, Hanna; Stefanaki, Ioanna; Stencrantz, Bo

    2011-05-01

    The aim of the study was to compare and analyse the differences in self-reported frequencies of visits paid to physicians and hospitalisation rates, as well as their association with socio-demographic factors and health status self-rated by elderly. A cross-sectional study was performed in eight districts of five European countries (Finland, Sweden, Ireland, Croatia, and Greece). A total of 3540 persons aged 70 or more were interviewed by trained interviewers. Healthcare service utilisation and its association with demographic characteristics and self-rated health were analysed using descriptive statistical methods, chi-square test, and logistic regression. Almost 90% of elderly visited a physician in the past year; 50% visited a specialist, while 24% were hospitalised. A visit to a specialist was paid by 70% of the Greek, 50% to 60% of the Croatian, and around 40% of the Irish, the Finnish, and the Swedish elderly. The highest proportion of hospitalisations (32%) was encountered in Greece and the lowest one (20%) in Sweden. Self-rated poor health appears to be the only common denominator associated with increased healthcare utilisation. Younger age stood out as a statistically significant predictor of the likelihood of specialist consults, while older age, male gender, and the synergy of male gender and current single life were disclosed as the predictors of hospitalisation frequency. Healthcare service utilisation exercised by the elderly across European districts was found to be highly variable and showed a clear distinction between north-western and south-eastern Europe; this is in line with differences in self-rated health.

  4. Factors affecting the utilisation of improved ventilated latrines among communities in Mtwara Rural District, Tanzania

    PubMed Central

    Kema, Koronel; Semali, Innocent; Mkuwa, Serafina; Kagonji, Ignatio; Temu, Florence; Ilako, Festus; Mkuye, Martin

    2012-01-01

    Introduction The Tanzania government, working in partnership with other stakeholders implemented a community-based project aimed at increasing access to clean and safe water basic sanitation and promotion of personal hygiene in Mtwara Rural District. Mid-term evaluation revealed that progress had been made towards improved ventilated latrines; however, there was no adequate information on utilisation of these latrines and associated factors. This study was therefore conducted to establish the factors influencing the utilisation of these latrines. Methods A cross-sectional study was conducted among 375 randomly selected households using a pre-tested questionnaire to determine whether the households owned improved ventilated latrines and how they utilised them. Resuls About half (50.5%) of the households had an improved ventilated latrine and households with earnings of more than 50,000 Tanzanian Shillings were two times more likely to own an improved latrine than those that earned less (AOR 2.1, 95% CI=1.1-4.0, p= 0.034). The likelihood of owning an improved latrine was reduced by more than 60 percent for female-headed households (AOR=0.38; 95% CI=0.20-0.71; p=0.002). Furthermore, it was established that all members of a household were more likely to use a latrine if it was an improved ventilated latrine (AOR=2.4; 95% CI=1.1-5.1; p= 0.024). Conclusion Findings suggest adoption of strategies to improve the wellbeing of households and deploying those who had acquired improved ventilated latrines as resource persons to help train others. Furthermore, efforts are needed to increase access to soft loans for disadvantaged members and increasing community participation. PMID:23467697

  5. Novel biphasic separations utilising highly selective molecularly imprinted polymers as biorecognition solvent extraction agents.

    PubMed

    Castell, Oliver K; Allender, Christopher J; Barrow, David A

    2006-10-15

    Molecularly imprinted polymers (MIPs) represent a class of artificial receptors that promise an environmentally robust alternative to naturally occurring biorecognition elements of biosensing devices and systems. However, in general, the performance of conventional MIPs in aqueous environments is poor. In the study reported here, this limitation has been addressed by the novel application of MIPs as a solvent extraction solid phase in a biphasic solvent system. This paper describes a previously unreported use of MIPs as solvent extraction reagents, their successful application to aqueous sample media and the opportunities for utilisation of this unique system in novel biosensing and separation procedures. This study demonstrates the development of a novel biphasic solvent system utilising MIP in the extracting phase to enhance both efficiency and selectivity of a simple two phase liquid extraction. Monodisperse propranolol imprinted polymer microspheres [p(divinylbenzene-co-methacrylic acid)] were prepared by precipitation polymerisation. Initially, the affinity of the polymers for (R,S)-propranolol was assessed by established techniques whereby the MIP demonstrated greater affinity for the template than did the non-imprinted control polymer (NIP). Importantly, MIP performance was also assessed using the novel dual solvent system. The depletion of (R,S)-propranolol from the aqueous phase into the polymer containing organic phase was determined. When compared to control extractions containing no polymer the presence of MIP in the extracting solvent phase resulted in an increased extraction of (R,S)-propranolol from the aqueous phase. Importantly, this extraction was significantly greater in the presence of MIP when compared to NIP. This unique principle generates opportunities for MIP based extractions and chemical enrichments in industrial applications, offering commercial, ecological and practical advantages to traditional solvent extraction techniques. The

  6. Integrating payload design, planning, and control in the Dutch Utilisation Centre

    NASA Technical Reports Server (NTRS)

    Grant, T. J.

    1993-01-01

    Spacecraft payload design, experiment planning and scheduling, and payload control are traditionally separate areas of activity. This paper describes the development of a prototype software tool--the Activity Scheduling System (ASS)--which integrates these activity areas. ASS is part of a larger project to build a Dutch Utilisation Centre (DUC), intended eventually to support all space utilization activities in The Netherlands. ASS has been tested on the High Performance Capillary Electrophoresis payload. The paper outlines the integrated preparation and operations concept embodied in ASS. It describes the ASS prototype, including a typical session. The results of testing are summarized. Possible enhancement of ASS, including integration into DUC, is sketched.

  7. An algorithmic approach for static and dynamic gesture recognition utilising mechanical and biomechanical characteristics.

    PubMed

    Parvini, Farid; Shahabi, Cyrus

    2007-01-01

    We propose a novel approach for recognising static and dynamic hand gestures by analysing the raw data streams generated by the sensors attached to the human hands. We utilise the concept of 'range of motion' in the movement of fingers and exploit this characteristic to analyse the acquired data for recognising hand signs. Our approach for hand gesture recognition addresses two major problems: user-dependency and device-dependency. Furthermore, we show that our approach neither requires calibration nor involves training. We apply our approach for recognising American Sign Language (ASL) signs and show that more than 75% accuracy in sign recognition can be achieved.

  8. Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study.

    PubMed

    Toar, Magzoub; O'Brien, Kirsty K; Fahey, Tom

    2009-06-30

    Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD), depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60) and refugees (n = 28) from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36), presence of PTSD symptoms and anxiety/depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medications. Asylum seekers were significantly more likely than refugees to report symptoms of PTSD (OR 6.3, 95% CI: 2.2-17.9) and depression/anxiety (OR 5.8, 95% CI: 2.2-15.4), while no significant difference was found in self-reported general health. When adjusted by multivariable regression, the presence of more than one chronic disease (OR 4.0, 95%CI: 1.3-12.7; OR 3.4, 95% CI: 1.2-10.1), high levels of pre migration stressors (OR 3.6, 95% CI: 1.1-11.9; OR 3.3, 95% CI: 1.0-10.4) or post migration stressors (OR 17.3, 95% CI: 4.9-60.8; OR 3.9, 95% CI: 1.2-12.3) were independent predictors of self reported PTSD or depression/anxiety symptoms respectively, however, residence status was no longer significantly associated with PTSD or depression/anxiety. Residence status may act as a marker for other explanatory variables; our results show it has a strong relationship with post migration stressors (chi2 = 19.74, df = 1, P < 0.001).In terms of health care utilisation, asylum seekers use GP services more often than refugees, while no significant difference was found between these groups for use of dentists, medication

  9. Utilising Nonlinear Air Damping as a Soft Mechanical Stopper for MEMS Vibration Energy Harvesting

    NASA Astrophysics Data System (ADS)

    Chen, Shao-Tuan; Du, Sijun; Arroyo, Emmanuelle; Jia, Yu; Seshia, Ashwin

    2016-11-01

    This paper reports on the theory and experimental verification of utilising air damping as a soft stopper mechanism for piezoelectric vibration energy harvesting to enhance shock resistance. Experiments to characterise device responsiveness under various vibration conditions were performed at different air pressure levels, and a dimensionless model was constructed with nonlinear damping terms included to model PVEH response. The relationship between the quadratic damping coefficient ζ n and air pressure is empirically established, and an optimal pressure level is calculated to trade off harvestable energy and device robustness for specific environmental conditions.

  10. Impact of delisting ARBs, apart from losartan, on ARB utilisation patterns in Denmark: implications for other countries.

    PubMed

    Hesse, Ulrik; Godman, Brian; Petzold, Max; Martin, Andrew; Malmström, Rickard E

    2013-12-01

    Renin-angiotensin inhibitor drugs have been a target for health authority initiatives across Europe with the potential for substantial savings once generic angiotensin-converting enzyme inhibitors (ACEIs) became available without compromising care. Recently, losartan was the first angiotensin receptor blocker (ARB) to lose its patent. In Denmark, the authorities removed all other ARBs from the reimbursement list, apart from losartan, as they were all seen as essentially similar for the management of hypertension or congestive heart failure at appropriate doses, but more expensive. Similarly, all other ARB fixed-dose combinations (FDCs), apart from losartan, were removed from the reimbursement list. The aims of the study were to (i) assess the impact of these reimbursement changes on the subsequent utilisation of losartan and other ARBs alone or as FDCs; (ii) assess changes in the prices of losartan and other ARBs post-generic losartan to calculate potential savings; and (iii) compare the impact of the policies in Denmark with other European countries to provide guidance. This was a retrospective segmented regression analysis of an interrupted time-series design comparing utilisation patterns before and after the changes in ARB reimbursement status. Utilisation was measured in defined daily doses (DDDs). Changes in total expenditure and expenditure/DDD were also assessed over time. Losartan utilisation grew from 31 to 33 % of total single ARB utilisation before generic losartan, to 93 % by October 2011. There was a corresponding decrease in the utilisation of all other ARBs. Both changes were significant (p < 0.001). Total expenditure on single ARBs in 2011 was 77 % below 2009 levels despite a 16 % increase in utilisation. Estimated savings were 290.5 million Danish Kroner (DKK). A similar trend was seen for losartan FDCs, which was also significant (p < 0.001). Losartan utilisation grew appreciable following the changes. The change was much greater than seen in

  11. Trends in hospital bed utilisation in New Zealand 1989 to 2006: more or less beds in the future?

    PubMed

    Malcolm, Laurence

    2007-10-26

    Reduction in hospital bed utilisation has been a key factor in controlling costs in recent decades in many health systems, including New Zealand's. This paper has the following aims: to analyse trends in hospital bed utilisation from 1988 to 2006; to examine variation between district health boards (DHBs); to consider factors which may explain the trends observed; to compare the results with international trends; and to discuss future need for beds and factors affecting this need, including the integrated DHB system. Ministry of Health Hospital Throughput reports for 1988/89 to 2005/06 were accessed and present standardised, filtered, and truncated data on discharges, average length of stay (ALOS), bed days, and DHB comparisons. Data on beds were also obtained from the Private Surgical Hospitals Association. Rates of utilisation were calculated using Statistics New Zealand and the Ministry of Health population data. Australian, UK, and US comparisons were obtained. The New Zealand data showed a continuing rise in discharge rates, especially case weighted. This was almost entirely due to the increase in day patients. There was a marked downward trend in bed day rates due to a more than 50% decline in the ALOS and a corresponding decline in bed availability. There was a marked variation between DHBs in standardised discharge ratios in 2005/06, with low rates indicating potential benchmarks to which higher utilisation DHBs might aspire. New Zealand was well ahead of both Australia and the UK National Health System (NHS) in reducing bed utilisation but comparisons with Kaiser Permanente indicated that DHBs could potentially, even dramatically, reduce bed utilisation through reducing admissions. The findings point to important progress in New Zealand in containing costs associated with hospital bed utilisation. Future strategies need to focus strongly on reducing hospital admissions through PHO action to provide community alternatives and chronic disease management.

  12. Contraceptive Utilisation Among Mothers of Reproductive Age in Ajman, United Arab Emirates

    PubMed Central

    Kanwal, Naila; Muttappallymyalil, Jayakumary; Al-Sharbatti, Shatha; Ismail, Iman

    2017-01-01

    Objectives This study aimed to determine contraceptive utilisation among mothers aged 18–49 years old in Ajman, United Arab Emirates (UAE). Methods This cross-sectional study was carried out from May to November 2013. A total of 400 participants were recruited from two primary healthcare centres and one private hospital in Ajman. An interviewer-administered validated questionnaire was used for data collection. Results The frequency of previous and current contraceptive use was 68.0% and 61.8%, respectively. Expatriates more frequently used contraceptives in comparison to Emiratis (77.3% versus 54.3%, respectively). Contraceptive use increased significantly with age (75.5% among >35-year-olds versus 57.3% among ≤25-year-olds; P <0.050) and education level (83.3% among postgraduates versus 60.0% among those with primary education; P <0.050). In addition, contraceptive use was significantly higher among those living in a nuclear family system (P <0.050). A univariate analysis indicated significant associations between contraceptive use and age, nationality, education level, type of family system, employment sector, parity, knowledge of birth control measures and source of birth control information (P <0.050 each). However, no significant associations were found via multivariate analysis. Conclusion Healthcare practitioners can play a pivotal role in providing contraceptive advice which could lead to an improvement in contraceptive utilisation. Efforts are recommended to raise awareness regarding newer forms of contraceptives among mothers of reproductive age in the UAE. PMID:28417029

  13. Utilisation of steviol glycosides from Stevia rebaudiana (Bertoni) by lactobacilli and bifidobacteria in in vitro conditions.

    PubMed

    Kunová, Gabriela; Rada, Vojtěch; Vidaillac, Adrien; Lisova, Ivana

    2014-05-01

    In the current study, eight strains of bifidobacteria and seven strains of lactobacilli were tested for their ability to grow in the presence of rebaudioside A and steviol glycosides from the sweetener Natusweet M001 originating from herb Stevia rebaudiana (Bertoni). Stevia is gaining popularity as a natural, non-caloric sugar substitute, and recently, it was allowed as a food additive by European Union too. Utilisation of steviol glycosides by intestinal microbiota suggests that they might have potential prebiotic effect. Based on the evaluation of bacterial density and pH values in our in vitro study, it was found that lactobacilli and bifidobacteria tested were able to utilise steviol glycosides as a carbon source only to a very limited extent. All strains tested showed significantly lower change in the absorbance A540 (P < 0.05) and pH decrease of the growth media as compared with the positive controls (medium containing glucose as a carbon source and de Man Rogosa Sharpe broth). We concluded that a suggested prebiotic effect was not confirmed either in the case of rebaudioside A or in the case of the sweetener Natusweet M001 containing a mixture of steviol glycosides.

  14. Pharmaco-epidcemiology of drugs utilised for cataract surgery in a government medical college and hospital.

    PubMed

    Biswas, Supreeti; Mondal, Kanchan Kumar; Halder, Sujash; Sarkar, Sougat Sourendra; Maiti, Tamoghna; Lahiri, Saibendu Kumar; Haldar, Swaraj

    2010-12-01

    Prescription audit is a powerful tool for rational prescription. To evaluate pharmaco-epidemiology of drugs utilised for cataract surgery, a retrospective study was conducted in the department of pharmacology, RG Kar Medical College, Kolkata. Data from bed head tickets of one year, available in medical record section, were collected in case report forms and analysed. Utilisation pattern of drugs like dosage form, dose, route and frequency of administration and duration of therapy were audited. Drug prescription versus therapeutic indication was also evaluated. Price of the prescribed drugs was evaluated for rationality towards cost-effective prescription. For 848 cases of cataract surgery, drugs were prescribed pre-, per- and post-operatively. Different fluoroquinolone antibiotics, anti-inflammatory and mydriatic-cycloplegic agents were prescribed. High or low cost drugs were prescribed both in generic (52%) and brand (48%) names. Few Latin abbreviations were used in directions. Different parameters and study results were discussed from various aspects to explore their social impacts. Though prescription pattern was almost rational, some parts need improvement. Healthcare provider should be aware of cost-effectiveness of the prescribed drugs for the benefit of patients to provide a rational prescription.

  15. Differences in the utilisation of active power in squat and countermovement jumps.

    PubMed

    Ferraro, Damián; Fábrica, Gabriel

    2017-07-01

    The aim of this article was to understand how active power is used in squat and countermovement jumps. A simple empirical model comprising a mass, a spring, an active element and a damper, together with an optimisation principle, was used to identify the mechanical factors that maximise performance of jumps without countermovement (squat jumps, SJ) and with countermovement (CMJ). Twelve amateur volleyball players performed SJ from two initial positions and CMJ with two degrees of counterbalancing, while kinematic data were collected (jump height, push-off duration and position of the centre of mass). The model adjusted well to real data of SJ through all the impulse phase, and slightly less adequately at the end of this phase for CMJ. Nevertheless, it provides a satisfactory explanation for the generation and utilisation of active power for both type of jumps. On average, the estimated power of the active elements, the spring, and the damper were greater in the SJ. Based upon the result obtained with this model, we suggest that active power is best evaluated with SJ. The reason for this is that, during this kind of jump, the elements associated with the damper consume much of the energy produced by the active elements. The participation of the elements that consume the energy generated by the active elements is less in CMJ than in SJ, allowing for a better utilisation of this energy. In this way it is possible to achieve a better performance in CMJ with less active power.

  16. [Comparative evaluation of methods to determine efficiency potentials in drug utilisation].

    PubMed

    Pfannkuche, M S; Hoffmann, F; Meyer, F; Glaeske, G

    2007-12-01

    Discussions in health-care policy frequently pursue a raising efficiency in drug utilisation. Therefore saving potentials are quantified based on health insurance company claims data. This article is a contribution to methodical discussions about the determination of saving potentials in drug utilisation. Based on claims data from the health insurance company Gmuender ErsatzKasse (GEK) of 2005, four different methods to calculate efficiency potentials in the generic drug market are presented. The different effects are illustrated for the example of Omeprazol. Depending on the used methods, different estimates, abstractions and varied information are required. In the given example the identified increase in efficiency varies between 741,000 Euro and 165,000 Euro (80%). According to the used method, saving potentials range between 2.9% and 13.1% as measured by the total expenditure for Omeprazol. The amount and the pertinence of saving potentials in theory are highly dependent on underlying assumptions and used methods. Calculations on the level of several drugs should, in the best case, occur at the time of prescription under consideration of drug prices. A detailed methods description is required for an appropriate outcome evaluation.

  17. Allele Mining Strategies: Principles and Utilisation for Blast Resistance Genes in Rice (Oryza sativa L.).

    PubMed

    Ashkani, Sadegh; Yusop, Mohd Rafii; Shabanimofrad, Mahmoodreza; Azady, Amin; Ghasemzadeh, Ali; Azizi, Parisa; Latif, Mohammad Abdul

    2015-01-01

    Allele mining is a promising way to dissect naturally occurring allelic variants of candidate genes with essential agronomic qualities. With the identification, isolation and characterisation of blast resistance genes in rice, it is now possible to dissect the actual allelic variants of these genes within an array of rice cultivars via allele mining. Multiple alleles from the complex locus serve as a reservoir of variation to generate functional genes. The routine sequence exchange is one of the main mechanisms of R gene evolution and development. Allele mining for resistance genes can be an important method to identify additional resistance alleles and new haplotypes along with the development of allele-specific markers for use in marker-assisted selection. Allele mining can be visualised as a vital link between effective utilisation of genetic and genomic resources in genomics-driven modern plant breeding. This review studies the actual concepts and potential of mining approaches for the discovery of alleles and their utilisation for blast resistance genes in rice. The details provided here will be important to provide the rice breeder with a worthwhile introduction to allele mining and its methodology for breakthrough discovery of fresh alleles hidden in hereditary diversity, which is vital for crop improvement.

  18. A situational analysis of current antimicrobial governance, regulation and utilisation in South Africa.

    PubMed

    Schellack, Natalie; Benjamin, Deon; Brink, Adrian; Duse, Adriano; Faure, Kim; Goff, Debra; Mendelson, Marc; Meyer, Johanna; Miot, Jacqui; Perovic, Olga; Pople, Troy; Suleman, Fatima; van Vuuren, Moritza; Essack, Sabiha

    2017-09-08

    The Global Action Plan (GAP) on AMR calls for optimising the use of antimicrobial medicines in human and animal health, in tandem with strengthening of the knowledge and evidence base through surveillance and research. However, there is a paucity of consumption data in African countries such as South Africa. Determining antimicrobial consumption data in low resource settings remains a challenge. This paper describes alternative mechanisms of assessing antimicrobial consumption data such as Intercontinental Marketing Services (IMS), and contract data arising from tenders (an open Request for Proposal, RFP) as opposed to the international norms of daily defined doses per 100 patient days, or per 1000 of the population. Despite its limitations, this serves as an indicator of antimicrobial exposure at population level and as an alternate method for ascertaining antimicrobial consumption in human health. Furthermore, South Africa has the largest antiretroviral treatment (ART) programme globally and carries a high burden of tuberculosis (TB). This prompted the inclusion of antiretroviral and anti-TB antibiotic consumption data. Knowledge of antimicrobial utilisation is imperative to make meaningful future interventions. Baseline antimicrobial utilisation data could guide future research initiatives that could provide a better understanding of the different measures of antibiotic use and the level of antibiotic resistance. Copyright © 2017. Published by Elsevier Ltd.

  19. Contraceptive Utilisation Among Mothers of Reproductive Age in Ajman, United Arab Emirates.

    PubMed

    Kanwal, Naila; Muttappallymyalil, Jayakumary; Al-Sharbatti, Shatha; Ismail, Iman

    2017-02-01

    This study aimed to determine contraceptive utilisation among mothers aged 18-49 years old in Ajman, United Arab Emirates (UAE). This cross-sectional study was carried out from May to November 2013. A total of 400 participants were recruited from two primary healthcare centres and one private hospital in Ajman. An interviewer-administered validated questionnaire was used for data collection. The frequency of previous and current contraceptive use was 68.0% and 61.8%, respectively. Expatriates more frequently used contraceptives in comparison to Emiratis (77.3% versus 54.3%, respectively). Contraceptive use increased significantly with age (75.5% among >35-year-olds versus 57.3% among ≤25-year-olds; P <0.050) and education level (83.3% among postgraduates versus 60.0% among those with primary education; P <0.050). In addition, contraceptive use was significantly higher among those living in a nuclear family system (P <0.050). A univariate analysis indicated significant associations between contraceptive use and age, nationality, education level, type of family system, employment sector, parity, knowledge of birth control measures and source of birth control information (P <0.050 each). However, no significant associations were found via multivariate analysis. Healthcare practitioners can play a pivotal role in providing contraceptive advice which could lead to an improvement in contraceptive utilisation. Efforts are recommended to raise awareness regarding newer forms of contraceptives among mothers of reproductive age in the UAE.

  20. Isolation of palm oil-utilising, polyhydroxyalkanoate (PHA)-producing bacteria by an enrichment technique.

    PubMed

    Alias, Zazali; Tan, Irene K P

    2005-07-01

    In early attempts to isolate palm oil-utilising bacteria from palm oil mill effluent (POME), diluted liquid samples of POME were spread on agar containing POME as primary nutrient. 45 purified colonies were screened for intracellular lipids by staining with Sudan Black B. Of these, 10 isolates were positively stained. The latter were grown in a nitrogen-limiting medium with palm olein (a triglyceride) or saponified palm olein (salts of fatty acids) as carbon source. None of the isolates grew in the palm olein medium but all grew well in the saponified palm olein medium. Of the latter however, only one isolate was positively stained with Nile Blue A, indicating the presence of PHA. This method did not successfully generate bacterial isolates which could metabolise palm olein to produce PHA. An enrichment technique was therefore developed whereby a selective medium was designed. The latter comprised minerals and palm olein (1% w/v) as sole carbon source to which POME (2.5% v/v) was added as the source of bacteria. The culture was incubated with shaking at 30 degrees C for 4 weeks. Out of seven isolates obtained from the selective medium, two isolates, FLP1 and FLP2, could utilise palm olein for growth and production of the homopolyester, poly(3-hydroxybutyrate). FLP1 is gram-negative and is identified (BIOLOG) to have 80% similarity to Burkholderia cepacia. When grown with propionate or valerate, FLP1 produced a copolyester, poly(3-hydroxybutyrate-co-3-hydroxyvalerate).

  1. Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review

    PubMed Central

    2014-01-01

    Background Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services. Methods Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement. Results Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse. Conclusions Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base. PMID:25029907

  2. National health insurance subscription and maternal healthcare utilisation across mothers' wealth status in Ghana.

    PubMed

    Ameyaw, Edward Kwabena; Kofinti, Raymond Elikplim; Appiah, Francis

    2017-12-01

    This study is against the backdrop that despite the forty-nine percent decline in Maternal Mortality Rate in Ghana, the situation still remains high averaging 319 per 100,000 live births between 2011 and 2015. To examine the relationship between National Health Insurance and maternal healthcare utilisation across three main wealth quintiles (Poor, Middle and Rich). The study employed data from the 2014 Ghana Demographic and Health Survey. Both descriptive analysis and binary logistic regression were conducted. Descriptively, rich women had high antenatal attendance and health facility deliveries represented by 96.5% and 95.6% respectively. However, the binary logistic regression results revealed that poor women owning NHIS are 7% (CI = 1.76-2.87) more likely to make at least four antenatal care visits compared to women in the middle wealth quintile (5%, CI = 2.12-4.76) and rich women (2%, CI = 1.14-4.14). Similarly, poor women who owned the NHIS are 14% (CI = 1.42-2.13) likely to deliver in health facility than women in the middle and rich wealth quintile. The study has vindicated the claim that NHIS Scheme is pro-poor in Ghana. The Ministry of Health should target women in the rural area to be enrolled on the NHIS to improve maternal healthcare utilisation since poverty is principally a rural phenomenon in Ghana.

  3. Material utilisation when depositing CdTe layers by inline AP-MOCVD

    NASA Astrophysics Data System (ADS)

    Barrioz, V.; Kartopu, G.; Irvine, S. J. C.; Monir, S.; Yang, X.

    2012-09-01

    A study was undertaken to assess the efficiency of precursors' usage during deposition of cadmium telluride (CdTe) layers via atmospheric pressure metal organic chemical vapour deposition (AP-MOCVD) for thin film photovoltaic solar cells. Precursors were released from a showerhead assembly normal to the glass substrate 0.7 mm thick (5×7.5 cm2) being deposited which was kept stationary or moved under the showerhead assembly, with speed of upto 2.25 cm/min. In order to estimate the effective precursor utilisation, the weight deposit (layer) was compared against the theoretical values calculated for ideal molar supply. The layer thickness, composition, morphology, and crystallinity were also measured using profilometry, energy dispersive X-ray (EDX), scanning electron microscopy (SEM), and X-ray diffraction (XRD), respectively. It is shown that over 40% material utilisation can be achieved depending on the deposition parameters of substrate temperature and speed, partial pressure of precursors and total gas flow. The activation energy derived from an Arrhenius plot of deposition rate equals 49 kJ mol-1 and is consistent with previous reports of MOCVD CdTe using a horizontal reactor. This confirms that, despite the very different reactor geometry, the alkyl radical homolysis and reaction mechanism applies in the case of the inline injector geometry in the work presented here. These results demonstrate an alternative path to high throughput processing of CdTe thin film solar cells by inline AP-MOCVD.

  4. Carbon substrate utilisation profile of a high concentration effluent degrading microbial consortium.

    PubMed

    Jena, S; Jeanmeure, L F C; Wichukorn, S D; Wright, P C

    2006-08-01

    This paper presents the carbon substrate utilisation profile of a group of microorganisms responsible for the biodegradation of a highly concentrated industrial effluent. A 1 litre bioreactor was used to study this consortium's biodegradation potential, with the chemical oxygen demand (COD) of the waste being reduced by 90% from 24000 mg l(-1) within 456 hours. This study also demonstrates that the consortium is capable of degrading organic solvents, such as isopropanol, at concentrations of 260 mg l(-1). The population distribution and biochemical behaviour were also characterised using denaturing gradient gel electrophoresis (DGGE) and Biolog Eco Plates at various stages of bioreactor operation. The DGGE results indicated that the dominant bands of the microbial population profile were stable at various operational stages, and that only a few bands varied with time. Moreover, four Biolog Eco plates were inoculated with samples drawn from the bioreactor at 0, 24, 72 and 120 hours after inoculation. Based on this Biolog Eco Plate profiling, a carbon source utilisation analysis was conducted to group the substrates according to their colour development patterns. Patterns were quantified via measurement of well optical density. Subsequently, cross-correlation statistical techniques were used to establish the existence of recurrent behavioural responses from each carbon source to the various wastewater samples. From the cross correlation, an attempt was made to classify the metabolic potential for future biodegradation processes. Carbohydrates, amino acids and carboxylic acids were the most predominant groups of sole carbon substrates showing similar growth behaviour in the consortium.

  5. Wildlife resource utilisation at Moremi Game Reserve and Khwai community area in the Okavango Delta, Botswana.

    PubMed

    Mbaiwa, Joseph E

    2005-10-01

    This paper uses the concept of sustainable development to examine the utilisation of wildlife resources at Moremi Game Reserve (MGR) and Khwai community area (NG 18/19) in the Okavango Delta, Botswana. Using both secondary and primary data sources, results show that the establishment of MGR in 1963 led to the displacement of Khwai residents from their land; affected Basarwa's hunting and gathering economy; marked the beginning of resource conflicts between Khwai residents and wildlife managers; and, led to the development of negative attitudes of Khwai residents towards wildlife conservation. Since the late 1980s, a predominantly foreign owned tourism industry developed in and around MGR, however, Khwai residents derive insignificant benefits from it and hence resource conflicts increased. In an attempt to address problems of resource conflicts and promote sustainable wildlife utilisation, the Botswana Government adopted the Community-Based Natural Resource Management (CBNRM) programme, which started operating at Khwai village in 2000. The CBNRM programme promotes local participation in natural resource management and rural development through tourism. It is beginning to have benefits to Khwai residents such as income generation, employment opportunities and local participation in wildlife management. These benefits from CBNRM are thus having an impact in the development of positive attitudes of Khwai residents towards wildlife conservation and tourism development. This paper argues that if extended to MGR, CBNRM has the potential of minimising wildlife conflicts between Khwai residents and the wildlife-tourism sectors. This approach may in the process promote the sustainable wildlife use in and around MGR.

  6. Environmental-benign utilisation of fly ash as low-cost adsorbents.

    PubMed

    Wang, Shaobin; Wu, Hongwei

    2006-08-25

    Fly ash is a waste substance from thermal power plants, steel mills, etc. that is found in abundance in the world. In recent years, utilisation of fly ash has gained much attention in public and industry, which will help reduce the environmental burden and enhance economic benefit. In this paper, the technical feasibility of utilisation of fly ash as a low-cost adsorbent for various adsorption processes for removal of pollutants in air and water systems has been reviewed. Instead of using commercial activated carbon or zeolites, a lot of researches have been conducted using fly ash for adsorption of NO(x), SO(x), organic compounds, and mercury in air, and cations, anions, dyes and other organic matters in waters. It is recognised that fly ash is a promising adsorbent for removal of various pollutants. Chemical treatment of fly ash will make conversion of fly ash into a more efficient adsorbent for gas and water cleaning. Investigations also revealed that unburned carbon component in fly ash plays an important role in adsorption capacity. Directions for future research are also discussed.

  7. Assessment of utilisation of PMTCT services at Nyanza Provincial Hospital, Kenya.

    PubMed

    Moth, I A; Ayayo, A B C O; Kaseje, D O

    2005-07-01

    The main objective of the study was to assess the utilisation of prevention of mother-to-child transmission (PMTCT) services among mothers registered for services at Nyanza Provincial Hospital in Kenya. A crosssectional exploratory study was conducted, using both quantitative and qualitative approaches to collect primary and secondary data. The study population was 133 clients registered for PMTCT services. The study revealed that 52.4% of clients received PMTCT information at the health facility without prior knowledge about intervention, 96% waited for more than 90 minutes, and 89% took less than 10 minutes for post-test counselling. Knowledge of MTCT and PMTCT was inadequate even after counselling, as participants could not recall the information divulged during counselling. In addition, 80% of clients did not present for follow-up counselling irrespective of HIV status, and 95%, did not disclose positive HIV status to spouses/relatives for fear of stigma, discrimination and violence. Inadequate counselling services delivered to clients affected service utilisation, in that significant dropout occurred at the stages of HIV result (31.5%), enrollment (53.6%), and delivery (80.7%). Reasons for dropout included fear of positive HIV result, chronic illness, stigma and discrimination, unsupportive spouse and inability to pay for the services.

  8. A laser induced fluorescence technique for quantifying transient liquid fuel films utilising total internal reflection

    NASA Astrophysics Data System (ADS)

    Alonso, Mario; Kay, Peter J.; Bowen, Phil J.; Gilchrist, Robert; Sapsford, Steve

    2010-01-01

    This paper describes the development of a laser induced fluorescence (LIF) technique to quantify the thickness and spatial distribution of transient liquid fuel films formed as a result of spray-wall interaction. The LIF technique relies on the principle that upon excitation by laser radiation the intensity of the fluorescent signal from a tracer like 3-pentanone is proportional to the film thickness. A binary solution of 10% (v/v) of 3-pentanone in iso-octane is used as a test fuel with a Nd:YAG laser as the excitation light source (utilising the fourth harmonic at wavelength 266 nm) and an intensified CCD camera is used to record the results as fluorescent images. The propagation of the excitation laser beam through the optical piston is carefully controlled by total internal reflection so that only the fuel film is excited and not the airborne droplets above the film, which had been previously shown to induce significant error. Other known sources of error are also carefully minimised. Calibrated temporally resolved benchmark results of a transient spray from a gasoline direct injector impinging on a flat quartz crown under atmospheric conditions are presented, with observations and discussion of the transient development of the fuel film. The calibrated measurements are consistent with previous studies of this event and demonstrate the applicability of the technique particularly for appraisal of CFD predictions. The potential utilisation of the technique under typical elevated ambient conditions is commented upon.

  9. Progress towards Sustainable Utilisation and Management of Food Wastes in the Global Economy

    PubMed Central

    Ghosh, Purabi R.; Fawcett, Derek; Sharma, Shashi B.

    2016-01-01

    In recent years, the problem of food waste has attracted considerable interest from food producers, processors, retailers, and consumers alike. Food waste is considered not only a sustainability problem related to food security, but also an economic problem since it directly impacts the profitability of the whole food supply chain. In developed countries, consumers are one of the main contributors to food waste and ultimately pay for all wastes produced throughout the food supply chain. To secure food and reduce food waste, it is essential to have a comprehensive understanding of the various sources of food wastes throughout the food supply chain. The present review examines various reports currently in the literature and quantifies waste levels and examines the trends in wastage for various food sectors such as fruit and vegetable, fisheries, meat and poultry, grain, milk, and dairy. Factors contributing to food waste, effective cost/benefit food waste utilisation methods, sustainability and environment considerations, and public acceptance are identified as hurdles in preventing large-scale food waste processing. Thus, we highlight the need for further research to identify and report food waste so that government regulators and food supply chain stakeholders can actively develop effective waste utilisation practices. PMID:27847805

  10. Heating Has No Effect on the Net Protein Utilisation from Egg Whites in Rats

    PubMed Central

    Takahashi, Yayoi; Kimura, Mamoru; Masuda, Yasunobu; Kunou, Masaaki

    2017-01-01

    Egg whites (EW) are a good source of protein; however, they are typically heated prior to consumption. Therefore, we investigated the effects of different heating conditions on the protein utilisation rate of EW. Male Sprague-Dawley rats (n = 36, 198 ± 1 g) were divided into six groups and fed American Institute of Nutrition-76 chow containing unheated EW, soft-boiled EW, boiled EW, milk whey protein, soybean protein, or no protein over a 10-day period using pair-feeding. Urine and faeces were sampled daily beginning on day 5 to measure nitrogen content and the net protein utilisation (NPU) rate. The soybean protein group had a significantly lower level of food intake and was thus excluded from subsequent analyses. The NPU value was similar among the unheated, soft-boiled, and boiled EW groups (97.5 ± 0.4, 96.5 ± 0.1, and 96.5 ± 0.7, resp.). The EW group values were significantly higher than the whey group values (90.5 ± 1.0). These results show that EW serve as a good source of protein, irrespective of heating. PMID:28337477

  11. Utilisation of Mucin Glycans by the Human Gut Symbiont Ruminococcus gnavus Is Strain-Dependent

    PubMed Central

    Crost, Emmanuelle H.; Tailford, Louise E.; Le Gall, Gwenaelle; Fons, Michel; Henrissat, Bernard; Juge, Nathalie

    2013-01-01

    Commensal bacteria often have an especially rich source of glycan-degrading enzymes which allow them to utilize undigested carbohydrates from the food or the host. The species Ruminococcus gnavus is present in the digestive tract of ≥90% of humans and has been implicated in gut-related diseases such as inflammatory bowel diseases (IBD). Here we analysed the ability of two R. gnavus human strains, E1 and ATCC 29149, to utilize host glycans. We showed that although both strains could assimilate mucin monosaccharides, only R. gnavus ATCC 29149 was able to grow on mucin as a sole carbon source. Comparative genomic analysis of the two R. gnavus strains highlighted potential clusters and glycoside hydrolases (GHs) responsible for the breakdown and utilization of mucin-derived glycans. Transcriptomic and functional activity assays confirmed the importance of specific GH33 sialidase, and GH29 and GH95 fucosidases in the mucin utilisation pathway. Notably, we uncovered a novel pathway by which R. gnavus ATCC 29149 utilises sialic acid from sialylated substrates. Our results also demonstrated the ability of R. gnavus ATCC 29149 to produce propanol and propionate as the end products of metabolism when grown on mucin and fucosylated glycans. These new findings provide molecular insights into the strain-specificity of R. gnavus adaptation to the gut environment advancing our understanding of the role of gut commensals in health and disease. PMID:24204617

  12. An environmental analysis of options for utilising wasted food and food residue.

    PubMed

    Oldfield, Thomas L; White, Eoin; Holden, Nicholas M

    2016-12-01

    The potential environmental impact of wasted food minimisation versus its utilisation in a circular bioeconomy is investigated based on a case study of Ireland. The amount of wasted food and food residue (WFFR) produced in 2010 was used for business-as-usual, (a) and four management options were assessed, (b) minimisation, (c) composting, (d) anaerobic digestion and (e) incineration. The environmental impacts Global Warming Potential (GWP), Acidification Potential (AP) and Eutrophication Potential (EP) were considered. A carbon return on investment (CRoI) was calculated for the three processing technologies (c-e). The results showed that a minimisation strategy for wasted food would result in the greatest reduction of all three impacts, -4.5 Mt CO2-e (GWP), -11.4 kt PO4(3)-e (EP) and -43.9 kt SO2-e (AP) compared to business as usual. For WFFR utilisation in the circular bioeconomy, anaerobic digestion resulted in the lowest environmental impact and best CRoI of -0.84 kg CO2-e per Euro. From an economic perspective, for minimisation to be beneficial, 0.15 kg of wasted food would need to be reduced per Euro spent.

  13. Reflective topical autobiography: an under utilised interpretive research method in nursing.

    PubMed

    Johnstone, M J

    1999-01-01

    Reflective topical autobiography (an autobiographical method) belongs to the genre of testimonial research and is located within the postpositivist interpretive research paradigm. Despite the (reflective) topical autobiographical method enjoying a 'rebirth' in recent years and being utilised by a range of researchers in the human and literary disciplines, it remains largely unknown and under utilised in nursing research domains. In this article it is proposed that reflective topical autobiography is an important research method in its own right, and one which promises to make a substantive contribution to the overall project of advancing nursing inquiry and knowledge. This is particularly so where nursing research shares in the affirming projects of interpretive research generally and the relatively new sociology of the emotions in particular apropos: (i) increasing understanding of subjectivity and making subjective experiences more visible and intelligible, (ii) the search for meaning and increasing understanding of the commonality of existential human experience, and (iii) decentring the detached observer and his/her privileging the objectivist illusion in the hierarchy of research discourses, paving the way for the admission of multiple realities and interpretations of lived experience. In this article, a coherent reflective topical autobiographical research method is advanced for use in nursing education and research contexts.

  14. Health care seeking behaviour and utilisation in a multiple health insurance system: does insurance affiliation matter?

    PubMed Central

    2014-01-01

    Background Many countries striving to achieve universal health insurance coverage have done so by means of multiple health insurance funds covering different population groups. However, existence of multiple health insurance funds may also cause variation in access to health care, due to the differential revenue raising capacities and benefit packages offered by the various funds resulting in inequity and inefficiency within the health system. This paper examines how the existence of multiple health insurance funds affects health care seeking behaviour and utilisation among members of the Community Health Fund, the National Health Insurance Fund and non-members in two districts in Tanzania. Methods Using household survey data collected in 2011 with a sample of 3290 individuals, the study uses a multinomial logit model to examine the influence of predisposing, enabling and need characteristics on the probability of seeking care and choice of provider. Results Generally, health insurance is found to increase the probability of seeking care and reduce delays. However, the probability, timing of seeking care and choice of provider varies across the CHF and NHIF members. Conclusions Reducing fragmentation is necessary to provide opportunities for redistribution and to promote equity in utilisation of health services. Improvement in the delivery of services is crucial for achievement of improved access and financial protection and for increased enrolment into the CHF, which is essential for broadening redistribution and cross-subsidisation to promote equity. PMID:24645876

  15. Health care seeking behaviour and utilisation in a multiple health insurance system: does insurance affiliation matter?

    PubMed

    Chomi, Eunice Nahyuha; Mujinja, Phares G M; Enemark, Ulrika; Hansen, Kristian; Kiwara, Angwara Dennis

    2014-03-19

    Many countries striving to achieve universal health insurance coverage have done so by means of multiple health insurance funds covering different population groups. However, existence of multiple health insurance funds may also cause variation in access to health care, due to the differential revenue raising capacities and benefit packages offered by the various funds resulting in inequity and inefficiency within the health system. This paper examines how the existence of multiple health insurance funds affects health care seeking behaviour and utilisation among members of the Community Health Fund, the National Health Insurance Fund and non-members in two districts in Tanzania. Using household survey data collected in 2011 with a sample of 3290 individuals, the study uses a multinomial logit model to examine the influence of predisposing, enabling and need characteristics on the probability of seeking care and choice of provider. Generally, health insurance is found to increase the probability of seeking care and reduce delays. However, the probability, timing of seeking care and choice of provider varies across the CHF and NHIF members. Reducing fragmentation is necessary to provide opportunities for redistribution and to promote equity in utilisation of health services. Improvement in the delivery of services is crucial for achievement of improved access and financial protection and for increased enrolment into the CHF, which is essential for broadening redistribution and cross-subsidisation to promote equity.

  16. Sites of metabolic substitution: investigating metabolite structures utilising ion mobility and molecular modelling.

    PubMed

    Dear, Gordon J; Munoz-Muriedas, Jordi; Beaumont, Claire; Roberts, Andrew; Kirk, Jayne; Williams, Jonathan P; Campuzano, Iain

    2010-11-15

    Drug metabolism is an integral part of the drug development and drug discovery process. It is required to validate the toxicity of metabolites in support of safety testing and in particular provide information on the potential to form pharmacologically active or toxic metabolites. The current methodologies of choice for metabolite structural elucidation are liquid chromatography/tandem mass spectrometry (LC/MS/MS) and nuclear magnetic resonance (NMR) spectroscopy. There are, in certain cases, examples of metabolites whose sites of metabolism cannot be unequivocally identified by MS/MS alone. Utilising commercially available molecular dynamics packages and known quantum chemistry basis sets, an ensemble of lowest energy structures were generated for a group of aromatic hydroxylated metabolites of the model compound ondansetron. Theoretical collision cross-sections were calculated for each structure. Travelling-wave ion mobility (IMS) measurements were also performed on the compounds, thus enabling experimentally derived collision cross-sections to be calculated. A comparison of the theoretical and experimentally derived collision cross-sections were utilised for the accurate assignment of isomeric drug metabolites. The UPLC/IMS-MS method, described herein, demonstrates the ability to measure reproducibly by ion mobility, metabolite structural isomers, which differ in collision cross-section, both theoretical and experimentally derived, by less than 1 Å(2). This application has the potential to supplement and/or complement current methods of metabolite structural characterisation. Copyright © 2010 John Wiley & Sons, Ltd.

  17. Utilisation of short rotation forestry for on-site boiler fuel

    SciTech Connect

    Sims, R.E.H.; Lowe, H.T.

    1995-11-01

    A New Zealand meat processing company has planted 100 ha of land adjacent to its plant in short rotation coppice eucalyptus trees for land treatment of the effluent stream (5000+ m{sup 3}/day). To be effective this necessitates removal of the accumulate biomass from the site at regular intervals (every 3-4 years). Using the biomass for fuelwood on site could offset the cost of effluent treatment if it could substitute for the existing energy supplies bought into the plant. A wide range of harvesting, drying, processing, storage and conversion options were identified with the objective of using the biomass produced on site to partly displace the coal currently fuelling a 4.2 MW boiler to provide process steam. A computer model was developed to identify the optimum biomass utilisation system from the variety of combinations of options possible including use of contractors. The objective was to match the work capacity of the various equipment components and to minimise the investment payback period for the company. Boiler options to convert or replace the current boiler or to purchase an additional wood-fired boiler were also included. The model was based around the specific requirements of this particular meat plant but it could be adapted to suit other similar short rotation forestry, biomass utilisation schemes.

  18. Investigating the accessibility factors that influence antenatal care services utilisation in Mangwe district, Zimbabwe.

    PubMed

    Nyathi, Leoba; Tugli, Augustine K; Tshitangano, Takalani G; Mpofu, Molyn

    2017-06-29

    Maternal and infant mortality remains a huge public health problem in developing countries. One of the strategies to minimise the risks of both maternal and infant mortality is access to and utilisation of antenatal care (ANC) services. This study aimed to investigate the accessibility factors that influence the use of ANC services in Mangwe district. A qualitative approach using explorative design was adopted to target women who have babies under 1 year of age. The study was conducted in Mangwe district, Matabeleland South province, Zimbabwe. Data were collected through semi-structured interviews and observations. Data saturation was reached after 15 women who were conveniently sampled were interviewed. Field notes were analysed thematically using Tech's steps. Lincoln and Guba's criteria ensured trustworthiness of the study findings. Accessibility factors such as lack of transport, high transport costs and long distances to health care facilities, health care workers' attitudes, type and quality of services as well as delays in receiving care influence women's utilisation of ANC services in Mangwe district, Zimbabwe. The study concluded that women were still facing problems of unavailability of nearby clinics; therefore, it was recommended that the government should avail resources for women to use. Mangwe District Health Department should provide mobile clinics rendering ANC services in distant rural areas.

  19. Progress towards Sustainable Utilisation and Management of Food Wastes in the Global Economy.

    PubMed

    Ghosh, Purabi R; Fawcett, Derek; Sharma, Shashi B; Poinern, Gerrard Eddy Jai

    2016-01-01

    In recent years, the problem of food waste has attracted considerable interest from food producers, processors, retailers, and consumers alike. Food waste is considered not only a sustainability problem related to food security, but also an economic problem since it directly impacts the profitability of the whole food supply chain. In developed countries, consumers are one of the main contributors to food waste and ultimately pay for all wastes produced throughout the food supply chain. To secure food and reduce food waste, it is essential to have a comprehensive understanding of the various sources of food wastes throughout the food supply chain. The present review examines various reports currently in the literature and quantifies waste levels and examines the trends in wastage for various food sectors such as fruit and vegetable, fisheries, meat and poultry, grain, milk, and dairy. Factors contributing to food waste, effective cost/benefit food waste utilisation methods, sustainability and environment considerations, and public acceptance are identified as hurdles in preventing large-scale food waste processing. Thus, we highlight the need for further research to identify and report food waste so that government regulators and food supply chain stakeholders can actively develop effective waste utilisation practices.

  20. Nutritional values and bioactive components of under-utilised vegetables consumed by indigenous people in Malaysia.

    PubMed

    Abdul Wahab, Norsuhaila; Ahdan, Rohaina; Ahmad Aufa, Zabidah; Kong, Kin Weng; Johar, Mohd Hafizan; Shariff Mohd, Zalilah; Ismail, Amin

    2015-10-01

    Diverse plants species in the forest remain under-utilised and they are mainly consumed only by local people. However, increasing issues in food security prompted the present study, which explores the nutritional and antioxidant aspects of Malaysian under-utilised vegetables. The studied vegetables were Paku Nyai (Stenochlaena palustris), Cemperai (Champereia manillana), Maman Pasir (Cleome viscose), Dudung (Erechtites valerianifolia) and Semambuk (Ardisia pendula). Overall, these vegetables exhibited a low proximal content but they were high in vitamin C [7.07-1263 mg kg(-1) edible fresh sample (EFS)] and β-carotene content (18.4-43.9 mg kg(-1) kg(-1) EFS). Cemperai had the highest calcium content (565 mg kg(-1) EFS), whereas Semambuk had the highest total phenolic content [28.21 g gallic acid equivalents kg(-1) edible dried sample (EDS)] and antioxidant activity (86.1%) measured using β-carotene bleaching assay. Maman Pasir contained the highest total flavonoid content (39.99 g CE kg(-1) EDS) and 1,1-diphenyl-2-picryl hydrazyl radical scavenging activity (82.2%). The extracts of these vegetables had significantly prevented the oxidation of haemoglobin and low-density lipoprotein, which yielded a reduced production of malondialdehyde. Semambuk and Maman Pasir are potent to be used as new food and functional food sources as they are rich in nutrients and antioxidants. © 2014 Society of Chemical Industry.

  1. Analysis of healthcare financing, supply and utilisation trends in the new EU countries.

    PubMed

    Ruseski, Jane E

    2006-01-01

    The EU expanded in 2004 to include eight transition countries, i.e. Central and Eastern European (CEE) and newly independent states of the former Soviet Union, and two other CEE countries are scheduled to join the EU in 2007. Each of these countries has undertaken substantial healthcare reform efforts over the past 15 years. The paths of healthcare reform are diverse for a number of reasons including differences in initial economic, political and structural conditions. The objective of this article is to evaluate the process and preliminary outcomes of healthcare reform in the new EU and candidate countries by analysing trends in aggregate financing, supply and utilisation indicators using data drawn from the WHO Health for All database. The analysis is done in the context of an analytical framework built around common healthcare reform themes. The key reform measures examined include implementing social insurance systems, implementing payment systems that promote efficiency, and removal of excess capacity. The trend analysis highlights the importance of the economic, political and social context in driving the direction and pace of healthcare reform. For example, the transition to social insurance systems was smoother in countries with stronger economies and political commitment to reform. Policies aimed at improving the efficiency of the healthcare system, reducing utilisation and reducing excess capacity were met with some success in all of the countries. However, the reform effort continues as the countries are still addressing the initial challenges of insufficient funding, informal payments, excess capacity and inefficiencies in the provision of healthcare.

  2. Minimisation and utilisation of waste mineral sludge from sodium perborate production.

    PubMed

    Grilc, Viktor; Jersan, Rok

    2002-10-01

    Various approaches to waste minimisation, waste treatment and recycling or safe disposal of the waste mineral sludge from sodium perborate production are presented and critically discussed. Some most promising actions for waste (or its harmful potential) reduction on the production level are identified. These include: a) use of better raw materials (richer boron ore), b) improvement of the ore leaching process, and c) intensification of sludge washing and dewatering. These source reduction measures have already resulted in 50% reduction of boron content in the sludge. Utilisation of the raw or treated (e.g. dried, compacted) waste sludge could be found in agriculture, civil engineering and construction material production. Agricultural use (as a lime substitute) is based on favourable content of calcium-magnesium minerals and alkali pH value of the sludge, and simultaneous absence of heavy metals. Application in civil engineering (as an aggregate) is possible after calcination, which is costly, or as a cement kiln additive. Stabilisation of sludge before disposal, when no utilisation is available, is possible by small addition of commercial binders (e.g. Portland cement) or larger amounts of pozzolanic wastes (e.g. coal fly ash).

  3. Metabolic specialisation on preferred prey and constraints in the utilisation of alternative prey in an ant-eating spider.

    PubMed

    Líznarová, Eva; Pekár, Stano

    2016-10-01

    Trophic specialists are expected to possess adaptations that increase the efficiency of handling preferred prey. Such adaptations may constrain the ability to utilise alternative prey. Here we tested whether the ant-eating spider Euryopis episinoides possesses metabolic specialisations with increased efficiency in utilising preferred prey and decreased efficiency in utilising alternative prey. In addition, we investigated the contribution of genetic variation via maternal effects. We reared E. episinoides spiders from the first instar on two different diets, either ants (preferred prey) or fruit flies (alternative prey). Spider survival rate and increases in body mass were significantly higher on the ant diet. The total development time did not differ between diet groups, nor did the number of egg sacs per female or the incubation period. However, the number of eggs per egg sac and hatching success were higher on the ant diet. There was a genetic variation in several offspring traits. Our data support the hypothesis that stenophagous ant-eating E. episinoides have a metabolic specialisation on ant utilisation indicated by higher efficiency in utilising ants than fruit flies. While most individuals of E. episinoides were able to capture fruit flies, only very few spiders were able to develop and reproduce on a pure fruit fly diet, suggesting the existence of within-species genetic variation regarding the tolerance to alternative prey. Copyright © 2016 Elsevier GmbH. All rights reserved.

  4. Acceptance and Utilisation of Sulphadoxine-Pyrimethamine and Insecticide-Treated Nets among Pregnant Women in Oyo State, Nigeria.

    PubMed

    Adeola, Aderonke A; Okwilagwe, Eugenia A

    2015-01-01

    The study is an investigation of the acceptance and utilisation of Sulphadoxine-Pyrimethamine (Fansidar), the drug of choice for Intermittent Preventive Treatment in pregnancy, and Insecticide-Treated Nets among pregnant women who access different health facilities in Oyo State, Nigeria. Pregnant women (582) attending government primary healthcare antenatal clinics and 50 attending faith clinics purposively selected responded to structured instruments that were analysed using percentages, t-test correlation, and multiple regression. Acceptance and utilisation of RBM tools were higher in government clinics than faith clinics and in rural areas. Pregnant women in government clinics, 60.8% and 66.8%, and faith clinics, 18% and 38.0%, utilised Roll Back Malaria tools, significant at t (630) = 5.81, p ≤ 0.05, and t (630) = 3.99, p ≤ 0.05, respectively. Pregnant women in rural locations who accessed government clinics utilised Roll Back Malaria tools more than those in urban areas, t (580) = -641, p ≤ 0.05. Number of pregnancies, educational qualification of the pregnant women, and marital status significantly and consistently influenced acceptance and utilisation of these tools. To ensure that set targets are met, the utilization of RBM tools among the two categories of pregnant women can be improved by increasing the supply of the tools and ensuring that treatment is free.

  5. Utilisation of joint movement range in arboreal primates compared with human subjects: an evolutionary frame for primary osteoarthritis.

    PubMed Central

    Alexander, C J

    1994-01-01

    OBJECTIVE--To determine whether an arboreal lifestyle required full use of movement ranges underutilised in nine joint groups in humans, because under-utilisation of available movement range may be associated with susceptibility to primary osteoarthritis. METHODS--Utilisation of the nine joint groups was studied in two species of primate exercising in a simulated arboreal environment, using 'focal animal' observation techniques supplemented by telephoto photography and by review of archival material from other sources. Fifteen apes were observed over a total observation period of 20.2 man-hours and 152 films were analysed for utilisation of movement range. RESULTS--With one exception, all the movement ranges reported to be under-utilised in humans were fully utilised by the apes in climbing activities. The exception, metacarpophalangeal extension, was an essential component of the chimpanzee ground progression mode of knuckle walking. CONCLUSIONS--The underused movement range in several human joints is explicable as residual capacity from a semiarboreal lifestyle. If the correlation with primary osteoarthritis is confirmed, it suggests that the disease may reflect a disparity between inherited capacity and current need. The significance of the result lies in its implication that primary osteoarthritis may be preventable. Images PMID:7826133

  6. The impact of frailty on healthcare utilisation in Ireland: evidence from the Irish longitudinal study on ageing.

    PubMed

    Roe, Lorna; Normand, Charles; Wren, Maev-Ann; Browne, John; O'Halloran, Aisling M

    2017-09-05

    To examine the impact of frailty on medical and social care utilisation among the Irish community-dwelling older population to inform strategies of integrated care for older people with complex needs. Participants aged ≥65 years from the Irish Longitudinal Study on Ageing (TILDA) representative of the Irish community-dwelling older population were analysed (n = 3507). The frailty index was used to examine patterns of utilisation across medical and social care services. Multivariate logistic and negative binomial regression models were employed to examine the impact of frailty on service utilisation outcomes after controlling for other factors. The prevalence of frailty and pre-frailty was 24% (95% CI: 23, 26%) and 45% (95% CI: 43, 47%) respectively. Frailty was a significant predictor of utilisation of most social care and medical care services after controlling for the main correlates of frailty and observed individual effects. Frailty predicts utilisation of many different types of healthcare services rendering it a useful risk stratification tool for targeting strategies of integrated care. The pattern of care is predominantly medical as few of the frail older population use social care prompting questions about sub-groups of the frail older population with unmet care needs.

  7. Acceptance and Utilisation of Sulphadoxine-Pyrimethamine and Insecticide-Treated Nets among Pregnant Women in Oyo State, Nigeria

    PubMed Central

    Adeola, Aderonke A.; Okwilagwe, Eugenia A.

    2015-01-01

    The study is an investigation of the acceptance and utilisation of Sulphadoxine-Pyrimethamine (Fansidar), the drug of choice for Intermittent Preventive Treatment in pregnancy, and Insecticide-Treated Nets among pregnant women who access different health facilities in Oyo State, Nigeria. Pregnant women (582) attending government primary healthcare antenatal clinics and 50 attending faith clinics purposively selected responded to structured instruments that were analysed using percentages, t-test correlation, and multiple regression. Acceptance and utilisation of RBM tools were higher in government clinics than faith clinics and in rural areas. Pregnant women in government clinics, 60.8% and 66.8%, and faith clinics, 18% and 38.0%, utilised Roll Back Malaria tools, significant at t(630) = 5.81, p ≤ 0.05, and t(630) = 3.99, p ≤ 0.05, respectively. Pregnant women in rural locations who accessed government clinics utilised Roll Back Malaria tools more than those in urban areas, t(580) = −641, p ≤ 0.05. Number of pregnancies, educational qualification of the pregnant women, and marital status significantly and consistently influenced acceptance and utilisation of these tools. To ensure that set targets are met, the utilization of RBM tools among the two categories of pregnant women can be improved by increasing the supply of the tools and ensuring that treatment is free. PMID:26839732

  8. The effect of health-related quality of life (HRQOL) on health service utilisation of a Chinese population.

    PubMed

    Lam, Cindy L K; Fong, Daniel Y T; Lauder, Ian J; Lam, Tai-Pong D

    2002-11-01

    This study was designed to find out whether health-related quality of life (HRQOL) was an independent determinant of health service utilisation of a Chinese population and to determine whether the addition of HRQOL data to sociodemographic and morbidity factors could significantly increase the explanatory power of risk-adjustment models. A cross-sectional random telephone survey of the general adult Chinese population in Hong Kong was conducted among 2410 Chinese aged 18-88yr old, 52% were females and 38% had one or more chronic diseases. Health service utilisation was measured by annual consultation, monthly consultation and hospitalisation rates. HRQOL was measured by the SF-36. Multivariate regressions were used to test the dependence of service utilisation rates on sociodemographic factors, chronic morbidity and the SF-36 scores. Structured multiphase regression analyses were used to determine the magnitude of the effect of the SF-36 scores, in addition to those of sociodemographic and chronic morbidity factors, on service utilisation. Five of eight SF-36 scores were independent determinants of consultation rates. They doubled and tripled the percentages of variance explained for annual and monthly consultation rates, respectively. Role limitation by physical problems and bodily pain scores had a significant effect on hospitalisation rates. This was the first study showing a linear relationship between HRQOL and service utilisation on a Chinese population. It confirmed the clinical relevance of the SF-36 to a culture and health care system that is different from that of the United States where the instrument originated.

  9. Bed utilisation and increased risk of Clostridium difficile infections in acute hospitals in England in 2013/2014.

    PubMed

    Vella, Venanzio; Aylin, Paul P; Moore, Luke; King, Alice; Naylor, Nichola R; Birgand, Gabriel J C; Lishman, Hannah; Holmes, Alison

    2017-06-01

    The study aimed to identify thresholds for hospital bed utilisation which are independently associated with significantly higher risks for Clostridium difficile infections (CDI) in acute hospitals in England. A retrospective analysis was carried out on reported data from the English National Health Service (NHS) for the financial year 2013/2014. Reported rates of CDI were used as a proxy for hospital infection rates in acute NHS hospital trusts. Multivariate linear regression was used to assess the relationship between bed utilisation values and CDI controlling for confounding factors. Hospitals were finally plotted in a Pabon Lasso graph according to their average bed occupancy rate (BOR) and bed turnover rate (BTR) per year to visualise the relationship between bed utilisation and CDI. Among English hospital NHS trusts, increasing BTR and decreasing BOR were associated with a decrease in CDI. However, this effect was not large, and patient mix had a larger impact on CDI rates than bed utilisation. While policymakers and managers wishing to target healthcare providers with high CDI rates should look at bed utilisation measures, focusing on these alone is unlikely to have the desired impact. Instead, strategies to combat CDI must take a wider perspective on contributory factors at the institutional level. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Impact of Nutritional Status and Sleep Quality on Hospital Utilisation in the Oldest Old with Heart Failure.

    PubMed

    Selan, S; Hellström, A; Fagerström, C

    2016-02-01

    To describe three-year trends in nutritional status and sleep quality and their impact on hospital utilisation in the oldest old (80 +) with heart failure (HF). Single-centred longitudinal observational study. South-eastern Sweden. 90 elderly (80+) with objectively verified HF. Baseline data from the Mini Nutritional Assessment (MNA) and on sleep quality were collected through structured interviews following the HF diagnosis (n=90) and at a three-year follow-up (n=41). Data on hospital utilisation during the three years following the HF diagnosis were also collected. Nineteen percent of the participants were found to have impaired nutritional status, a condition that increased hospital utilisation by four bed days per year. A majority (85%) had impaired sleep quality, but no impact on hospital utilisation was found. Nutritional status and sleep quality were stable over the three-year period. In the oldest old with HF, impaired nutritional status and impaired sleep quality are already common at HF diagnosis. Impaired nutritional status increases hospital utilisation significantly. Therefore, it is of supreme importance to systematically evaluate nutritional status and sleep quality in the oldest old when they are diagnosed with HF, as well as to take action if impairments are present.

  11. Identification des objets et detection de leur alignement en utilisant la technologie RFID

    NASA Astrophysics Data System (ADS)

    Rahma, Zayoud

    De nos jours, les vehicules motorises sont essentiels dans notre vie quotidienne, d'ou la necessite de leur approvisionnement en carburant. L'approvisionnement en carburant peut entrainer certains inconvenients, tels que: les files d'attente, la disponibilite non-continuelle du carburant et les fraudes. Les problemes d'attente et de disponibilite non-continuelle du carburant peuvent etre facilement resolus en allant a une autre station d'essence aux alentours si disponibles. Par contre le probleme de fraudes est plus difficile a resoudre. De ce fait, decoule notre solution qui consiste a developper un systeme intelligent pour la gestion d'approvisionnement en carburant afin de remedier a ce probleme de fraudes. Pour des raisons de surete, il faut eviter les risques d'etincelles dans l'environnement du carburant. En particulier, il convient de ne pas utiliser un systeme utilisant 1'electricite proche de la pompe, du tuyau ou du reservoir du carburant du vehicule. Nous avons choisi la technologie RFID (Radio Frequency IDentification) et avons opte pour l'utilisation des etiquettes passives, etant donne que les etiquettes semi-passives ou actives contiennent une batterie electrique et sont nettement plus cheres. Un vehicule motorise sera identifie avec une etiquette RFID passive collee au-dessus du goulot de son reservoir. Deux autres etiquettes RFID seront placees sur le pistolet de sorte que le flux du carburant ne sera autorise que lorsque les trois etiquettes sont alignees. Notre travail etait a la demande d'une entreprise petroliere ayant une chaine internationale de stations de carburant. Le travail consiste en la conception, par la recherche, du systeme requis et s'articule sur l'optimisation de la topologie des antennes et des etiquettes de sorte que le systeme juge qu'il y a alignement lorsque le bec du pistolet est fonce dans le goulot du reservoir, et par consequent autorise le versement du carburant. Dans tous les autres cas, le systeme doit juger qu'il n

  12. Design and utilisation of protocols to characterise dynamic PET uptake of two tracers using basis pursuit

    NASA Astrophysics Data System (ADS)

    Bell, Christopher; Puttick, Simon; Rose, Stephen; Smith, Jye; Thomas, Paul; Dowson, Nicholas

    2017-06-01

    Imaging using more than one biological process using PET could be of great utility, but despite previously proposed approaches to dual-tracer imaging, it is seldom performed. The alternative of performing multiple scans is often infeasible for clinical practice or even in research studies. Dual-tracer PET scanning allows for multiple PET radiotracers to be imaged within the same imaging session. In this paper we describe our approach to utilise the basis pursuit method to aid in the design of dual-tracer PET imaging experiments, and later in separation of the signals. The advantage of this approach is that it does not require a compartment model architecture to be specified or even that both signals are distinguishable in all cases. This means the method for separating dual-tracer signals can be used for many feasible and useful combinations of biology or radiotracer, once an appropriate scanning protocol has been decided upon. Following a demonstration in separating the signals from two consecutively injected radionuclides in a controlled experiment, phantom and list-mode mouse experiments demonstrated the ability to test the feasibility of dual-tracer imaging protocols for multiple injection delays. Increases in variances predicted for kinetic macro-parameters V D and K I in brain and tumoral tissue were obtained when separating the synthetically combined data. These experiments confirmed previous work using other approaches that injections delays of 10-20 min ensured increases in variance were kept minimal for the test tracers used. On this basis, an actual dual-tracer experiment using a 20 min delay was performed using these radio tracers, with the kinetic parameters (V D and K I) extracted for each tracer in agreement with the literature. This study supports previous work that dual-tracer PET imaging can be accomplished provided certain constraints are adhered to. The utilisation of basis pursuit techniques, with its removed need to specify a model

  13. Tracing diatom utilisation, and its fate, in Lake Baikal, Siberia: the application of silicon isotope geochemistry

    NASA Astrophysics Data System (ADS)

    Panizzo, V. N.; Swann, G. E. A.; Mackay, A. W.; Roberts, S.; Vologina, E.; Sturm, M.; Horstwood, M. S.

    2014-12-01

    The global biogeochemical cycling of silicon (Si) is intrinsically linked to the fate of CO2 in the earth's atmosphere. To date, most research has focused on the oceanic cycling of Si over glacial/interglacial timescales although, the importance of continental Si cycling (via abiotic and biotic processes) is now being addressed. Especially as the significant potential for Si sequestration in continental lake systems has been recently highlighted [1]. We present the first large-scale silicon isotope (δ30SiDSi) profiles of Lake Baikal's water column, where a comparison between both pre- and post-diatom growing season δ30SiDSi signatures are made. Samples were collected along a water profile (surface to 180 m) at numerous sites across Lake Baikal, with deep-water endmembers at 400 m and c. 1,500 m. All isotopic analyses were conducted on a Neptune + Multi-Collector ICP-MS at NIGL, UK, using wet plasma mode with Mg doping of samples and standard-sample-standard bracketing. Analytical reproducibility is 0.12‰ (2σ) and blanks are <1% of signal intensity. DSi concentrations of March water surface samples (South Basin only) range between c. 0.74 and 1.23 ppm while those collected in August are all <0.70 ppm, following seasonal biological utilisation. In turn Chlorophyll a values from South Basin profiles in August are greater (between c. 1.46 to 3.18 mg l-1) than March surface values (<0.70 mg l-1). Indeed, March δ30SiDSi surface values range between c. +2.16 and +2.45‰ while summer surface values range between c. +2.20 and +2.84‰, reflecting residual pool depletion after summer biological utilisation. δ30SiDSi values are >1‰ more enriched than dominant lake water inflows again reflecting diatom Si uptake. Annual open sediment traps deployed down Lake Baikal's water column yield δ30Sidiatom signatures of +1.25‰, which suggests that down-column diatom dissolution is minimal. Applying the diatom fractionation factor of -1.1‰[2] and adopting a closed system

  14. Design and utilisation of protocols to characterise dynamic PET uptake of two tracers using basis pursuit.

    PubMed

    Bell, Christopher Michael; Puttick, Simon; Rose, Stephen; Smith, Jye; Thomas, Paul; Dowson, Nicholas

    2017-04-04

    Imaging using more than one biological process using PET could be of great utility, but despite previously proposed approaches to dual-tracer imaging, it is seldom performed. The alternative of performing multiple scans is often infeasible for clinical practice or even in research studies. Dual-tracer PET scanning allows for multiple PET radiotracers to be imaged within the same imaging session. In this paper we describe our approach to utilise the basis pursuit method to aid in the R2.9 design of dual-tracer PET imaging experiments, and later in separation of the signals. The advantage of this approach is that it does not require a compartment model architecture to be specified or even that both signals are distinguishable in all cases. This means the R2.16 method for separating dual-tracer signals can be used for many feasible and useful combinations of biology or radiotracer, once an appropriate scanning protocol has been decided upon. Following a demonstration in separating the signals from two consecutively injected radionuclides in a controlled experiment, phantom and list-mode mouse experiments demonstrated the ability to test the R2.13feasibility of dual-tracer imaging protocols for multiple injection delays. Increases in variances predicted for kinetic macro-parameters VD and KI in brain and tumoral tissue were obtained when R2.14 separating the synthetically combined data. R2.2 These experiments confirmed previous work using other approaches that injections delays of 10-20 minutes ensured increases in variance were kept minimal for the test tracers used. On this basis, an actual dual-tracer experiment using a 20-minute delay was performed using these radio tracers, with the kinetic parameters (VD and KI) extracted for each tracer in agreement with the literature. This R2.4, 2.8 study supports previous work that dual-tracer PET imaging can be accomplished provided certain constraints are adhered to. The utilisation of basis pursuit techniques, with its

  15. Spatial modelling of healthcare utilisation for treatment of fever in Namibia

    PubMed Central

    2012-01-01

    Background Health care utilization is affected by several factors including geographic accessibility. Empirical data on utilization of health facilities is important to understanding geographic accessibility and defining health facility catchments at a national level. Accurately defining catchment population improves the analysis of gaps in access, commodity needs and interpretation of disease incidence. Here, empirical household survey data on treatment seeking for fever were used to model the utilisation of public health facilities and define their catchment areas and populations in northern Namibia. Method This study uses data from the Malaria Indicator Survey (MIS) of 2009 on treatment seeking for fever among children under the age of five years to characterize facility utilisation. Probability of attendance of public health facilities for fever treatment was modelled against a theoretical surface of travel times using a three parameter logistic model. The fitted model was then applied to a population surface to predict the number of children likely to use a public health facility during an episode of fever in northern Namibia. Results Overall, from the MIS survey, the prevalence of fever among children was 17.6% CI [16.0-19.1] (401 of 2,283 children) while public health facility attendance for fever was 51.1%, [95%CI: 46.2-56.0]. The coefficients of the logistic model of travel time against fever treatment at public health facilities were all significant (p < 0.001). From this model, probability of facility attendance remained relatively high up to 180 minutes (3 hours) and thereafter decreased steadily. Total public health facility catchment population of children under the age five was estimated to be 162,286 in northern Namibia with an estimated fever burden of 24,830 children. Of the estimated fevers, 8,021 (32.3%) were within 30 minutes of travel time to the nearest health facility while 14,902 (60.0%) were within 1 hour. Conclusion This study

  16. Utilisation and costs of nursing agencies in the South African public health sector, 2005–2010

    PubMed Central

    Rispel, Laetitia C.; Angelides, George

    2014-01-01

    Background Globally, insufficient information exists on the costs of nursing agencies, which are temporary employment service providers that supply nurses to health establishments and/or private individuals. Objective The aim of the study was to determine the utilisation and direct costs of nursing agencies in the South African public health sector. Design A survey of all nine provincial health departments was conducted to determine utilisation and management of nursing agencies. The costs of nursing agencies were assumed to be equivalent to expenditure. Provincial health expenditure was obtained for five financial years (2005/6–2009/10) from the national Basic Accounting System database, and analysed using Microsoft Excel. Each of the 166,466 expenditure line items was coded. The total personnel and nursing agency expenditure was calculated for each financial year and for each province. Nursing agency expenditure as a percentage of the total personnel expenditure was then calculated. The nursing agency expenditure for South Africa is the total of all provincial expenditure. The 2009/10 annual government salary scales for different categories of nurses were used to calculate the number of permanent nurses who could have been employed in lieu of agency expenditure. All expenditure is expressed in South African rands (R; US$1 ∼ R7, 2010 prices). Results Only five provinces reported utilisation of nursing agencies, but all provinces showed agency expenditure. In the 2009/10 financial year, R1.49 billion (US$212.64 million) was spent on nursing agencies in the public health sector. In the same year, agency expenditure ranged from a low of R36.45 million (US$5.20 million) in Mpumalanga Province (mixed urban-rural) to a high of R356.43 million (US$50.92 million) in the Eastern Cape Province (mixed urban-rural). Agency expenditure as a percentage of personnel expenditure ranged from 0.96% in KwaZulu-Natal Province (mixed urban-rural) to 11.96% in the Northern Cape

  17. Development and evaluation of the R-I-CAM-Q as a brief summative measure of CAM utilisation.

    PubMed

    Bryden, Gabrielle M; Browne, Matthew

    2016-08-01

    This study evaluates a revised version of the I-CAM-Q, the R-I-CAM-Q, which is a shorter scale, and suitable for use as a brief, summative measure of CAM utilisation. Online survey with an Australian sample (n=2697). The psychometric properties of the I-CAM-Q were analysed using Mokken Scaling Analysis and Structural Equation Modelling. A subset of items were identified as having an adequate uni-dimensional structure that can be aggregated to yield a scalar measure of CAM utilisation. Certain items, including prayer for health purposes, and chiropractic, were not indicative of general CAM use. The R-I-CAM-Q provides a unitary, aggregate measure of CAM utilisation that provides scope for replicable research into the determinants of CAM use. It is the first quantitative and summative measure of general CAM use, developed and tested using modern psychometric methods. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. [High utilisers with affective and schizophrenic disorders in the psychiatric health care system: a comparison between Eastern and Western Germany].

    PubMed

    von Rad, Kathrin; Puschner, Bernd; Spießl, Hermann; Grempler, Julia; Janssen, Birgit; Becker, Thomas; Freyberger, Harald

    2014-10-01

    High utilisers of psychiatric services are defined as a group of patients showing a great amount of service use, especially inpatient care, consequently causing immense costs. There is a lack of studies investigating differences between East and West Germany. Service use and psychopathology were examined in 350 high utilisers receiving inpatient treatment in one East German and three West German psychiatric hospitals. Whereas current length of stay was higher in participants from West Germany, readmissions were more frequent in the East German participants who also exhibited higher psychopathology. Presumably, the deficient situation of outpatient health care in East Germany is compensated by increased stationary admission, consequently leading to a structural promotion of high utilisation. © Georg Thieme Verlag KG Stuttgart · New York.

  19. The use of secure anonymised data linkage to determine changes in healthcare utilisation following severe open tibial fractures.

    PubMed

    Page, Piers R J; Trickett, Ryan W; Rahman, Shakeel M; Walters, Angharad; Pinder, Leila M; Brooks, Caroline J; Hutchings, Hayley; Pallister, Ian

    2015-07-01

    Severe open fractures of the lower limbs are complex injuries requiring expert multidisciplinary management in appropriate orthoplastic centres. This study aimed to assess the impact of open fractures on healthcare utilisation and test the null hypotheses that there is no difference in healthcare utilisation between the year before and year after injury, and that there is no difference in healthcare utilisation in the year post-injury between patients admitted directly to an orthoplastic centre in keeping with the joint BOA/BAPRAS standards and those having initial surgery elsewhere. This retrospective cohort study utilising secure anonymised information linkage (SAIL), a novel databank of anonymised nationally pooled health records, recruited patients over 18 years of age sustaining severe open lower limb fractures managed primarily or secondarily at our centre and who had data available in the SAIL databank. 101 patients met inclusion criteria and 90 of these had records in the SAIL databank. The number of days in hospital, number of primary care attendances, number of outpatient attendances and number of emergency department attendances in the years prior and subsequent to injury were recorded. Patients sustaining open fractures had significantly different healthcare utilisation in the year after injury when compared with the year before, in terms of days spent in hospital (23.42 vs. 1.70, p=0.000), outpatient attendances (11.98 vs. 1.05, p=0.000), primary care attendances (29.48 vs. 11.99, p=0.000) and emergency department presentations (0.2 vs. 0.01, p=0.025). Patients admitted directly to orthoplastic centres had significantly fewer operations (1.78 vs. 3.31) and GP attendances (23.6 vs. 33.52) than those transferred in subsequent to initial management in other units. There is a significant increase in healthcare utilisation after open tibial fracture. Adherence to national standards minimises the impact of this on both patients and health services.

  20. Explanatory factors for first and second-generation non-western women's inadequate prenatal care utilisation: a prospective cohort study.

    PubMed

    Boerleider, Agatha W; Manniën, Judith; van Stenus, Cherelle M V; Wiegers, Therese A; Feijen-de Jong, Esther I; Spelten, Evelien R; Devillé, Walter L J M

    2015-04-21

    Little research into non-western women's prenatal care utilisation in industrialised western countries has taken generational differences into account. In this study we examined non-western women's prenatal care utilisation and its explanatory factors according to generational status. Data from 3300 women participating in a prospective cohort of primary midwifery care clients (i.e. women with no complications or no increased risk for complications during pregnancy, childbirth and the puerperium who receive maternity care by autonomous midwives) in the Netherlands (the DELIVER study) was used. Gestational age at entry and the total number of prenatal visits were aggregated into an index. The extent to which potential factors explained non-western women's prenatal care utilisation was assessed by means of blockwise logistic regression analyses and percentage changes in odds ratios. The unadjusted odds of first and second-generation non-western women making inadequate use of prenatal care were 3.26 and 1.96 times greater than for native Dutch women. For the first generation, sociocultural factors explained 43% of inadequate prenatal care utilisation, socioeconomic factors explained 33% and demographic and pregnancy factors explained 29%. For the second generation, sociocultural factors explained 66% of inadequate prenatal care utilisation. Irrespective of generation, strategies to improve utilisation should focus on those with the following sociocultural characteristics (not speaking Dutch at home, no partner or a first-generation non-Dutch partner). For the first generation, strategies should also focus on those with the following demographic, pregnancy and socioeconomic characteristics (aged ≤ 19 or ≥ 36, unplanned pregnancies, poor obstetric histories (extra-uterine pregnancy, molar pregnancy or abortion), a low educational level, below average net household income and no supplementary insurance.

  1. Utilisation of maternal health services by adolescent mothers in Kenya: analysis of the demographic health survey 2008-2009.

    PubMed

    Banke-Thomas, Oluwasola; Banke-Thomas, Aduragbemi; Ameh, Charles Anawo

    2016-10-12

    Many Kenyan adolescents die following pregnancy and childbirth complications. Maternal health services (MHS) utilisation is key to averting such poor outcomes. Our objectives were to understand the characteristics of adolescent mothers in Kenya, describe their MHS utilisation pattern and explore factors that influence this pattern. We collected demographic and MHS utilisation data of all 301 adolescent mothers aged 15-19 years included in the Kenya Demographic Health Survey 2008/2009 (KDHS). Descriptive statistics were used to characterise them and their MHS utilisation patterns. Bivariate and multivariate analyses were used to test associations between selected predictor variables and MHS utilisation. Eighty-six percent, 48% and 86% of adolescent mothers used ante-natal care (ANC), skilled birth attendance (SBA) and post-natal care (PNC), respectively. Adolescent mothers from the richest quintile were nine (CI=2.00-81.24, p=0.001) and seven (CI=3.22-16.22, p<0.001) times more likely to use ANC and SBA, respectively, compared to those from the poorest. Those with primary education were four (CI=1.68-9.64, p<0.001) and two (CI=0.97-4.81, p=0.043) times more likely to receive ANC and SBA, respectively, compared to uneducated mothers, with similar significant findings amongst their partners. Urban adolescent mothers were six (CI=1.89-32.45, p=0.001) and four (CI=2.00-6.20, p<0.001) times more likely to use ANC and SBA, respectively, compared to their rural counterparts. The odds of Maasai adolescent mothers using ANC was 90% (CI=0.02-0.93, p=0.010) lower than that of Kalenjin mothers. Adolescent MHS utilisation in Kenya is an inequality issue. To address this, focus should be on the poorest, least educated, rural-dwelling adolescent mothers living in the most disadvantaged communities.

  2. Utilisation of Pangolin (Manis sps) in traditional Yorubic medicine in Ijebu province, Ogun State, Nigeria

    PubMed Central

    2009-01-01

    Background Concern about the use of endangered and threatened species in traditional medicine escalated as populations of many species plummeted because of poaching for the medicinal trade. Nigeria is known for a long and valued tradition of using wild animals and plants for medicinal purposes. Despite this, studies on medicinal animals are still scarce when compared to those focusing on medicinal plants. Utilisation of wild animals in traditional Yorubic medical practices was indiscriminate as it involved threatened species. By touting the medicinal properties of these species, traditional medicine fuel continuing demand, thereby subjecting such species to further threats. This paper examined the use and commercialisation of pangolins for traditional medicinal purposes amongst the Ijebus, South-western Nigeria, and the implications of this utilisation for the conservation of this species. Methods Traditional Yorubic medical practitioners (tymps) (16) and dealers in traditional medicinal ingredients (56) in public markets in Ijebu province, Nigeria, were interviewed using open-ended questionnaires. The dynamic stock movement of pangolins in the stalls of dealers was also monitored to determine quantity of pangolins sold into the traditional Yorubic medicinal practices. Specific conditions treated and the parts required were also documented. Results A total of 178 whole pangolin carcasses were sold into traditional medical practices. Above 55% of respondents had just primary education, over 90% of respondents were not aware of either the conservation status of this species or the existence of any legal machinery regulating its trade and utilisation, while 14% admitted to giving contracts to hunters for deliberate search for this animal when needed. More than 98% of respondents have no other means of livelihood. The trade was female dominated while the healing practice had more males. Pangolins were used in various preparations to treat a total of 42 conditions

  3. Utilisation of inorganic salts in fungal crop disease management in the U.K.

    PubMed

    Deliopoulos, T; Kettlewell, P S; Hare, M C

    2009-01-01

    The overaLl aim of the study described in this communication was to utilise the findings of a global scientific and technical literature survey on the use of inorganic salts against crop fungal diseases in order to assess the potential of using these substances to reduce the reliance of UK growers on conventional fungicides. A summary of the main findings of the Literature survey is provided followed by information on the current commercial use of inorganic salt-based products in fungal disease management. Finally, the scope of potential use of inorganic salts on high disease risk crops in the UK is assessed and specific crop/pathogen combinations are prioritised for further research.

  4. Détermination du courant d'arc par utilisation de fibres optiques fluorescentes

    NASA Astrophysics Data System (ADS)

    Melouki, B.; Lieutier, M.; Lefort, A.

    1997-02-01

    In this paper, we develop a method of determination of the arc current in a circuit breaker during the interruption. This method is based on the use of an optoelectronic system using a fluorescent optical fibre coupled with a photodetector. The current wave is obtained from the light wave detected by the detection system. Dans cet article, nous développons une méthode permettant de déterminer le courant traversant un disjoncteur lors d'une coupure. Cette méthode utilise un système optoélectronique constitué d'une fibre optique fluorescente couplée à un photodétecteur. L'onde du courant d'arc est obtenue à partir de l'onde lumineuse reçue par le système de détection.

  5. Utilisation of Pangolin (Manis sps) in traditional Yorubic medicine in Ijebu province, Ogun State, Nigeria.

    PubMed

    Soewu, Durojaye A; Ayodele, Ibukun A

    2009-12-04

    Concern about the use of endangered and threatened species in traditional medicine escalated as populations of many species plummeted because of poaching for the medicinal trade. Nigeria is known for a long and valued tradition of using wild animals and plants for medicinal purposes. Despite this, studies on medicinal animals are still scarce when compared to those focusing on medicinal plants. Utilisation of wild animals in traditional Yorubic medical practices was indiscriminate as it involved threatened species. By touting the medicinal properties of these species, traditional medicine fuel continuing demand, thereby subjecting such species to further threats. This paper examined the use and commercialisation of pangolins for traditional medicinal purposes amongst the Ijebus, South-western Nigeria, and the implications of this utilisation for the conservation of this species. Traditional Yorubic medical practitioners (tymps) (16) and dealers in traditional medicinal ingredients (56) in public markets in Ijebu province, Nigeria, were interviewed using open-ended questionnaires. The dynamic stock movement of pangolins in the stalls of dealers was also monitored to determine quantity of pangolins sold into the traditional Yorubic medicinal practices. Specific conditions treated and the parts required were also documented. A total of 178 whole pangolin carcasses were sold into traditional medical practices. Above 55% of respondents had just primary education, over 90% of respondents were not aware of either the conservation status of this species or the existence of any legal machinery regulating its trade and utilisation, while 14% admitted to giving contracts to hunters for deliberate search for this animal when needed. More than 98% of respondents have no other means of livelihood. The trade was female dominated while the healing practice had more males. Pangolins were used in various preparations to treat a total of 42 conditions. These include infertility

  6. Numerical system utilising a Monte Carlo calculation method for accurate dose assessment in radiation accidents.

    PubMed

    Takahashi, F; Endo, A

    2007-01-01

    A system utilising radiation transport codes has been developed to derive accurate dose distributions in a human body for radiological accidents. A suitable model is quite essential for a numerical analysis. Therefore, two tools were developed to setup a 'problem-dependent' input file, defining a radiation source and an exposed person to simulate the radiation transport in an accident with the Monte Carlo calculation codes-MCNP and MCNPX. Necessary resources are defined by a dialogue method with a generally used personal computer for both the tools. The tools prepare human body and source models described in the input file format of the employed Monte Carlo codes. The tools were validated for dose assessment in comparison with a past criticality accident and a hypothesized exposure.

  7. Influence of spices on protein utilisation of winged bean (Psophocarpus tetragonolobus) and horsegram (Dolichos biflorus).

    PubMed

    Pradeep, K U; Geervani, P

    1994-10-01

    The influence of a mixture of eleven spices commonly consumed in India on the utilisation of protein from boiled winged bean (Psophocarpus tetragonolobus) and horsegram (Dolichos biflorus) was studied at 10 and 20 percent level of protein intake in experimental rats. Spices used in the mixture include red chillies (Capsicum annum), black pepper (Piper nigrum), coriander (Coriandrum sativum), cumin (Cuminum cyminum), garlic (Allium sativum), ajowan (Carum copticum), turmeric (Curcuma longa), caraway seeds (Carum carui) and fennel seeds (Foeniculum vulgare). Addition of this spice mixture at 1.5% level of the diet decreased the TD of both legumes, significantly only in the case of horsegram. A significant increase was observed in the BV of both the legumes at both levels of protein tested.

  8. Impact of caprock permeability on vertical ground surface displacements in geological underground utilisation

    NASA Astrophysics Data System (ADS)

    Kempka, Thomas; Tillner, Elena

    2015-04-01

    Geological underground utilisation inducing pore pressure changes in underground reservoirs is generally accompanied by hydro-mechanical processes. Thereby, pore pressure increase due to fluid injection may trigger ground surface uplift, while a decrease in pore pressure due to reservoir fluid production is known to induce ground subsidence. Different coupled hydro-mechanical simulation studies (e.g. Klimkowski et al., 2015, Kempka et al., 2014, Tillner et al., 2014) indicate that ground surface displacements can achieve a magnitude of several decimetres, if storage or production operations are being carried out at an industrial scale. Consequently, detailed knowledge on the parameters impacting ground surface uplift or subsidence is of major interest for the success of any geological underground utilisation in order to avoid surface infrastructure damage by spatially varying deformations. Furthermore, ground subsidence may result increased groundwater levels as experienced in different underground coal mining districts. In the present study, we carried out coupled hydro-mechanical simulations to account for the impact of caprock permeability on ground surface displacements resulting from geological underground utilisation. Thereto, different simulation scenarios were investigated using a synthetic 3D coupled numerical simulation model with varying caprock permeability and vertical location of the open well section in the target reservoir. Material property ranges were derived from available literature, while a normal faulting stress state was applied in all simulation scenarios. Our simulation results demonstrate that caprock permeability has a significant impact on the pressure development, and thus on vertical displacements at the ground surface as well as at the reservoir top. An increase in caprock permeability from 1 x 10-20 m2 by two orders of magnitude doubles vertical displacements at the ground surface, whereas vertical displacements at the reservoir top

  9. Detailed Analysis of Wheat Straw Node and Internode for their Prospective Efficient Utilisation.

    PubMed

    Ghaffar, Seyed Hamidreza; Fan, Mizi; Zhou, Yonghui; AboMadyan, Omar

    2017-09-27

    In order to efficiently utilise wheat straw, the systematic examination of their cell wall components, chemical structures, morphology and relation to the physicochemical and mechanical properties is necessary. Detailing of node and internode signifies their different features and characteristics which can ultimately lead to their separated processing for enhanced efficiency and higher added-value bio-refinery. In this study, distinct variations were found amongst characteristics of node and internode, inner and outer surface. It was revealed that node has more extractives, Klason lignin and ash content than internode, higher contents of extractives and ash in the node are related to the thicker epidermis tissue. Hot-water followed by mild steam pre-treatment was used to examine the effects on the characteristics of wheat straw. The results showed: 1) reduced level of waxes and Si (weight %) from the outer surface, and 2) significantly lower (P < 0.05) extractives content in both internode and node.

  10. The possibilities of utilisation of heat from Tattapani Geothermal field, India

    SciTech Connect

    Sarolkar, P.B.; Pitale, U.L.

    1996-12-31

    The Tattapani Geothermal field produces + 1800 1pm thermal water of 100{degrees}C from five production wells. The hot water production can sustain electricity production of 300 kWe by using a binary cycle power plant. The heat energy of effluent water from power plant can be utilized for direct heat utilization on horticulture, aquaculture, cold storage, silviculture etc; to augment the economics of the power plant be spot can be developed as a centre for tourist attraction by constructing botanical park, greenhouse, geyser show and crocodile farm. The direct heat utilization shemes can be planned in cascading order to achieve maximum utility of thermal water. Additional deep drilling is essential for optimum commercial utilization of the Geothermal energy. The direct heat utilisation shemes along with binary cycle power plant may help in development of the geothermal energy and boosting the economy of this region.

  11. Dekkera and Brettanomyces growth and utilisation of hydroxycinnamic acids in synthetic media.

    PubMed

    Harris, Victoria; Ford, Christopher M; Jiranek, Vladimir; Grbin, Paul R

    2008-04-01

    Dekkera and Brettanomyces yeast are important spoilage organisms in a number of food and beverage products. Isolates of both genera were cultured in a defined medium and supplemented with hydroxycinnamic acids and vinylphenols to investigate their influence on growth and the formation of ethyl phenol derivatives. The growth rate of Brettanomyces species in the presence of acids was reduced, and no significant conversion to vinyl or ethyl derivatives was observed. The growth rate and substrate utilisation rates of Dekkera anomala and Dekkera bruxellensis yeast differed depending on strain and the acid precursor present. Growth of D. bruxellensis was slowed by the presence of ferulic acid with the addition of 1 mM ferulic acid completely inhibiting growth. This study provides an insight into the spoilage potential of these organisms and possible control strategies involving hydroxycinnamic acids.

  12. The effect of Ghana's National Health Insurance Scheme on health care utilisation.

    PubMed

    Blanchet, N J; Fink, G; Osei-Akoto, I

    2012-06-01

    The study investigates the effect of Ghana's National Health Insurance Scheme (NHIS) on health care utilisation. We provide a short history of health insurance in Ghana, and briefly discuss general patterns of enrolment in Ghana as well as in Accra in a first step. In a second step, we use data from the Women's Health Study of Accra wave II to evaluate the effect of insurance on health seeking behaviour using propensity score matching. We find that on average individuals enrolled in the insurance scheme are significantly more likely to obtain prescriptions, visit clinics and seek formal health care when sick. These results suggest that the government's objective to increase access to the formal health care sector through health insurance has at least partially been achieved.

  13. The utilisation of engineered invert traps in the management of near bed solids in sewer networks.

    PubMed

    Ashley, R M; Tait, S J; Stovin, V R; Burrows, R; Framer, A; Buxton, A P; Blackwood, D J; Saul, A J; Blanksby, J R

    2003-01-01

    Large existing sewers are considerable assets which wastewater utilities will require to operate for the foreseeable future to maintain health and the quality of life in cities. Despite their existence for more than a century there is surprisingly little guidance available to manage these systems to minimise problems associated with in-sewer solids. A joint study has been undertaken in the UK, to refine and utilise new knowledge gained from field data, laboratory results and Computational Fluid Dynamics (CFD) simulations to devise cost beneficial engineering tools for the application of small invert traps to localise the deposition of sediments in sewers at accessible points for collection. New guidance has been produced for trap siting and this has been linked to a risk-cost-effectiveness assessment procedure to enable system operators to approach in-sewer sediment management pro-actively rather than reactively as currently happens.

  14. Investigating public perceptions of carbon dioxide utilisation (CDU) technology: a mixed methods study.

    PubMed

    Jones, C R; Kaklamanou, D; Stuttard, W M; Radford, R L; Burley, J

    2015-01-01

    Carbon dioxide utilisation (CDU) technologies hold promise for helping to limit atmospheric releases of CO2 while generating saleable products. However, while there is growing investment in the research and development required to bring CDU to the market, to date there has been very little systematic research into public perceptions of the technology. The current research reports upon the findings of a series of six qualitative focus groups (and an associated questionnaire) held with members of the UK public in order to discuss the perceived benefits and risks of CDU technology. The findings reveal that public awareness of CDU is currently very low and that there is a desire to learn more about the technology. While our participants did, on average, appear to develop an overall positive attitude towards CDU, this attitude was tentative and was associated with a number of caveats. The implications for the findings in terms of the development of communication and broader strategies of public engagements are outlined.

  15. Inter-comparison of safety culture within selected practices in Ghana utilising ionising radiation.

    PubMed

    Faanu, A; Schandorf, C; Darko, E O; Boadu, M; Emi-Reynolds, G; Awudu, A R; Gyekye, P K; Kpeglo, D O

    2010-12-01

    The safety culture of selected practices and facilities in Ghana utilising radiation sources or radiation emitting devices has been assessed using a performance indicator, which provided status information on management and operating staff commitment to safety. The questionnaire was based on the following broad areas: general safety considerations, safety policy at the facility level, safety practices at the facility level, definition of responsibility, staff training, safety of the physical structure of the facility and the emergency plans. The analysis showed that the percentage levels of commitment to safety for the respective practices are as follows: conventional radiography, 23.3-90.0%; research reactor, 73.3%; gamma irradiation facility, 53.3%; radiotherapy, 76.7%; X-ray scanner, 80.0%; gamma scanner, 76.7%; industrial radiography 86.7% and nuclear density practice, 78%. None of the practices or facilities was able to satisfy all the requirements that will ensure a 100% level of safety culture.

  16. Improved sugar co-utilisation by encapsulation of a recombinant Saccharomyces cerevisiae strain in alginate-chitosan capsules

    PubMed Central

    2014-01-01

    Background Two major hurdles for successful production of second-generation bioethanol are the presence of inhibitory compounds in lignocellulosic media, and the fact that Saccharomyces cerevisiae cannot naturally utilise pentoses. There are recombinant yeast strains that address both of these issues, but co-utilisation of glucose and xylose is still an issue that needs to be resolved. A non-recombinant way to increase yeast tolerance to hydrolysates is by encapsulation of the yeast. This can be explained by concentration gradients occuring in the cell pellet inside the capsule. In the current study, we hypothesised that encapsulation might also lead to improved simultaneous utilisation of hexoses and pentoses because of such sugar concentration gradients. Results In silico simulations of encapsulated yeast showed that the presence of concentration gradients of inhibitors can explain the improved inhibitor tolerance of encapsulated yeast. Simulations also showed pronounced concentration gradients of sugars, which resulted in simultaneous xylose and glucose consumption and a steady state xylose consumption rate up to 220-fold higher than that found in suspension culture. To validate the results experimentally, a xylose-utilising S. cerevisiae strain, CEN.PK XXX, was constructed and encapsulated in semi-permeable alginate-chitosan liquid core gel capsules. In defined media, encapsulation not only increased the tolerance of the yeast to inhibitors, but also promoted simultaneous utilisation of glucose and xylose. Encapsulation of the yeast resulted in consumption of at least 50% more xylose compared with suspended cells over 96-hour fermentations in medium containing both sugars. The higher consumption of xylose led to final ethanol titres that were approximately 15% higher. In an inhibitory dilute acid spruce hydrolysate, freely suspended yeast cells consumed the sugars in a sequential manner after a long lag phase, whereas no lag phase was observed for the

  17. A compilation of research working groups on drug utilisation across Europe

    PubMed Central

    2014-01-01

    Background The assessment of the benefit-risk of medicines needs careful consideration concerning their patterns of utilization. Systems for the monitoring of medicines consumption have been established in many European countries, and several international groups have identified and described them. No other compilation of European working groups has been published. As part of the PROTECT project, as a first step in searching for European data sources on the consumption of five selected groups of medicines, we aimed to identify and describe the main characteristics of the existing collaborative European working groups. Findings Google and bibliographic searches (PubMed) of articles containing information on databases and other sources of drug consumption data were conducted. For each working group the main characteristics were recorded. Nineteen selected groups were identified, focusing on: a) general drug utilisation (DU) research (EuroDURG, CNC, ISPE’S SIG-DUR, EURO-MED-STAT, PIPERSKA Group, NorPEN, ENCePP, DURQUIM), b) specific DU research: b.1) antimicrobial drugs (ARPAC, ESAC, ARPEC, ESGAP, HAPPY AUDIT), b.2) cardiovascular disease (ARITMO, EUROASPIRE), b.3) paediatrics (TEDDY), and b.4) mental health/central nervous system effects (ESEMeD, DRUID, TUPP/EUPoMMe). Information on their aims, methods and activities is presented. Conclusions We assembled and updated information on European working groups in DU research and in the utilisation of five selected groups of drugs for the PROTECT project. This information should be useful for academic researchers, regulatory and health authorities, and pharmaceutical companies conducting and interpreting post-authorisation and safety studies. European health authorities should encourage national research and collaborations in this important field for public health. PMID:24625054

  18. Resource utilisation and health care costs in patients diagnosed with fibromyalgia in Spain.

    PubMed

    Rivera, J; Rejas, J; Esteve-Vives, J; Vallejo, M A

    2009-01-01

    Fibromyalgia (FM) patients have been regarded as great utilizers of health resources, with important related costs. The aim of this study is to describe health care resource utilisation and related costs of FM from the perspective of the National Health System in Spain. A cross-sectional multicenter study was conducted on FM patients based on a patient interview. Data about demographic and clinical variables, physical examination, self-perceived health, psychosocial variables and health resource utilisation, were collected. Direct and indirect costs were calculated, and a correlational study between costs and clinical variables was performed. Three-hundred and one patients were studied. During the year 2006 the mean total cost per patient per year was 9,982 Euros, of which 3,245.8 (32.5%) corresponded to health care costs and 6,736.2 (67.5%) to indirect costs attributable to productivity losses. Non-drug therapies accounted for the largest proportion of the health care costs, three times greater than the drug treatment. Patients with higher total costs showed the greatest disease involvement. The variables associated to the total health care costs were functional capacity, depression, comorbidities and age. Patients with permanent working disability were the greatest resource utilizers. FM patients with higher costs show the greatest disease involvement. Direct and indirect costs are well correlated to disease severity. The indirect costs account for most of the economic burden of FM and approximately double the health care costs. Patients with permanent working disability present more severe disease and generate greater health care costs.

  19. Measurement of changes in antihypertensive drug utilisation following primary care educational interventions.

    PubMed

    Horn, Fiona E; Mandryk, John A; Mackson, Judith M; Wutzke, Sonia E; Weekes, Lynn M; Hyndman, Rob J

    2007-03-01

    To measure changes in drug utilisation following a national general practice education program aimed at improving prescribing for hypertension. A series of nationally implemented, multifaceted educational interventions using social marketing principles focusing on prescribing for hypertension, was commenced in October 1999, and repeated in September 2001 and August 2003. The target group was all primary care prescribers in Australia and interventions were both active (voluntary) and passive. Newsletter and prescribing feedback was mailed in October 1999, September 2001 (newsletter only) and August 2003. Approximately a third of general practitioners (GPs) in Australia undertook at least one active educational activity (clinical audit, educational visit or case study) during the period October 1999-April 2004. National dispensing data from 1996 to 2004 were analysed using time series methodology with a decay term for intervention effect, to assess trends in prescribing of various classes of antihypertensives. In particular, the program aimed to increase the prescribing of thiazide diuretics and beta blockers. Consistent with key intervention messages, the program achieved an increase in low-dose thiazide and beta blocker prescribing. The rate of prescribing of low-dose thiazides doubled from 1.1 per 1000 consultations in October 1999 to 2.4 per 1000 in October 2003. Beta-blocker utilisation showed a more modest but significant increase over the time of the study, with the change in observed versus expected rate of prescribing increasing by 8% by April 2004. Therapeutic options for treating hypertension changed markedly in the time of the study with the advent of ACE inhibitor/Angiotensin II receptor antagonists and thiazide combination products. It is important, therefore, to interpret the results in light of these changes. A national education program aimed at GPs was successful in improving prescribing for hypertension. Lessons learned will be applied in

  20. How residents and interns utilise and perceive the personal digital assistant and UpToDate

    PubMed Central

    Phua, Jason; Lim, Tow Keang

    2008-01-01

    Background In this era of evidence-based medicine, doctors are increasingly using information technology to acquire medical knowledge. This study evaluates how residents and interns utilise and perceive the personal digital assistant (PDA) and the online resource UpToDate. Methods This is a questionnaire survey of all residents and interns in a tertiary teaching hospital. Results Out of 168 doctors, 134 (79.8%) responded to the questionnaire. Only 54 doctors (40.3%) owned a PDA. Although these owners perceived that the PDA was most useful for providing drug information, followed by medical references, scheduling and medical calculators, the majority of them did not actually have medical software applications downloaded on their PDAs. The greatest concerns highlighted for the PDA were the fear of loss and breakage, and the preference for working with desktop computers and paper. Meanwhile, only 76 doctors (56.7%) used UpToDate, even though the hospital had an institutional subscription for it. Although 93.4% of these users would recommend UpToDate to a colleague, only 57.9% stated that the use of UpToDate had led to a change in their management of patients. Conclusion Although UpToDate and various PDA software applications were deemed useful by some of the residents and interns in our study, both digital tools were under-utilised. More should be done to facilitate the use of medical software applications on PDAs, to promote awareness of tools for evidence-based medicine such as UpToDate, and to facilitate the application of evidence-based medicine in daily clinical practice. PMID:18625038

  1. Primary care physician supply and other key determinants of health care utilisation: the case of Switzerland

    PubMed Central

    Busato, André; Künzi, Beat

    2008-01-01

    Background The Swiss government decided to freeze new accreditations for physicians in private practice in Switzerland based on the assumption that demand-induced health care spending may be cut by limiting care offers. This legislation initiated an ongoing controversial public debate in Switzerland. The aim of this study is therefore the determination of socio-demographic and health system-related factors of per capita consultation rates with primary care physicians in the multicultural population of Switzerland. Methods The data were derived from the complete claims data of Swiss health insurers for 2004 and included 21.4 million consultations provided by 6564 Swiss primary care physicians on a fee-for-service basis. Socio-demographic data were obtained from the Swiss Federal Statistical Office. Utilisation-based health service areas were created and were used as observational units for statistical procedures. Multivariate and hierarchical models were applied to analyze the data. Results Models within the study allowed the definition of 1018 primary care service areas with a median population of 3754 and an average per capita consultation rate of 2.95 per year. Statistical models yielded significant effects for various geographical, socio-demographic and cultural factors. The regional density of physicians in independent practice was also significantly associated with annual consultation rates and indicated an associated increase 0.10 for each additional primary care physician in a population of 10,000 inhabitants. Considerable differences across Swiss language regions were observed with reference to the supply of ambulatory health resources provided either by primary care physicians, specialists, or hospital-based ambulatory care. Conclusion The study documents a large small-area variation in utilisation and provision of health care resources in Switzerland. Effects of physician density appeared to be strongly related to Swiss language regions and may be rooted

  2. A feasibility study of municipal solid waste incineration fly ash utilisation in Estonia.

    PubMed

    Berber, Hakan; Frey, Ruedi; Voronova, Viktoria; Koroljova, Arina

    2017-09-01

    The purpose of this paper is to discuss the alternative environmental management options for the utilisation of municipal solid waste (MSW) incineration fly ash (FA), which is generated at Iru Power Plant where MSW is incinerated in Estonia. To determine sustainable and economically feasible environmental management options for MSW incineration FA in Estonia, CO2 sequestration with a further carbonation process was examined. A partial Cost & Benefit Analysis has been conducted to compare the carbonation process to the current situation. Two carbonation options were developed. Option 1 is to use carbonated FA in any other processes based on the waste-to-product principle. Option 2 is to send carbonated FA to the non-hazardous landfill in Tallinn, Estonia. Important parameters, such as Net Present Value (NPV), Internal Rate of Return (IRR), Benefit-Cost Ratio (BCR) and Break Even Point (BEP), have been calculated for carbonation options and the current case. In addition, a sensitivity analysis has been conducted to examine its robustness. The results showed that the best option is carbonation Option 1 with NPV of 9,209,662 EUR, IRR of 43%, BCR of 2.63 and BEP between 2018 and 2019. Both Options 1 and 2 constitute more sustainable and environmentally friendly management options compared to the current situation. It can be concluded that this preliminary feasibility study showed that running a carbonation plant may be profitable and sustainable for Estonia. Currently, there is no treatment technology for MSW incineration FA in Estonia and FA is sent to a neighbouring country for further utilisation. This is the first study to demonstrate FA management options with economic and environmental benefits.

  3. Utilisation of sexual health services by female sex workers in Nepal

    PubMed Central

    2011-01-01

    Background The Nepal Demographic Health Survey (NDHS) in 2006 showed that more than half (56%) of the women with sexually transmitted infections (STIs), including HIV, in Nepal sought sexual health services. There is no such data for female sex workers (FSWs) and the limited studies on this group suggest they do not even use routine health services. This study explores FSWs use of sexual health services and the factors associated with their use and non-use of services. Methods This study aimed to explore the factors associated with utilisation of sexual health services by FSWs in the Kathmandu Valley of Nepal, and it used a mixed-method approach consisting of an interviewer administered questionnaire-based survey and in-depth interviews. Results The questionnaire survey, completed with 425 FSWs, showed that 90% FSWs self-reported sickness, and (30.8%) reported symptoms of STIs. A quarter (25%) of those reporting STIs had never visited any health facilities especially for sexual health services preferring to use non-governmental clinics (72%), private clinics (50%), hospital (27%) and health centres (13%). Multiple regression analysis showed that separated, married and street- based FSWs were more likely to seek health services from the clinics or hospitals. In- depth interviews with 15 FSWs revealed that FSWs perceived that personal, structural and socio-cultural barriers, such as inappropriate clinic opening hours, discrimination, the judgemental attitude of the service providers, lack of confidentiality, fear of public exposure, and higher fees for the services as barriers to their access and utilisation of sexual health services. Conclusion FSWs have limited access to information and to health services, and operate under personal, structural and socio-cultural constraints. The 'education' to change individual behaviour, health worker and community perceptions, as well as the training of the health workers, is necessary. PMID:21501473

  4. Health insurance and maternal, newborn services utilisation and under-five mortality.

    PubMed

    Bosomprah, Samuel; Ragno, Peter Luigi; Gros, Clemens; Banskota, Hari

    2015-01-01

    Ghana's National Health Insurance Scheme (NHIS) was introduced in 2005 as a demand side intervention to remove financial barriers to accessing health services. After almost a decade of implementation, this study aims to investigate the association of NHIS membership with antenatal visits (ANC), postnatal visits (PNC) and under-five mortality, using data from the most recent Multiple Indicator Cluster Survey (MICS). The survey was nationally representative and used a two-stage sample design to produce separate estimates for key indicators for each of the ten regions in Ghana. A generalised linear model (GLM) with binomial-family logit-link was used to estimate the effect of NHIS membership on each of the MNCH service utilisation indicators, adjusting for relevant confounding factors. Using birth history data, the Cox proportional hazard regression model was used to estimate the effect of NHIS membership on the incidence of under-five deaths, adjusted for wealth quintiles and other potential confounders. The results support the role of health insurance membership in improving access to maternal and child health services, including antenatal care (ANC4+ adjusted OR = 1.94; 95 % CI = [1.28, 2.95]; P < 0.01), and content of antenatal care (adjusted OR = 2.05; 95 % CI = (1.46, 2.90); P < 0.0001). However, the study failed to show evidence of association of NHIS membership and under-five mortality (adjusted hazard rate = 0.86; 95 % CI = [0.64, 1.14]; P = 0.30). National health insurance membership is associated with increased access to and utilisation of health care but not with under-five mortality.

  5. New perspectives on nutritional interventions to augment lipid utilisation during exercise.

    PubMed

    Gonzalez, Javier T; Stevenson, Emma J

    2012-02-01

    The enhancement of fat oxidation during exercise is an aim for both recreational exercising individuals and endurance athletes. Nutritional status may explain a large part of the variation in maximal rates of fat oxidation during exercise. This review reveals novel insights into nutritional manipulation of substrate selection during exercise, explaining putative mechanisms of action and evaluating the current evidence. Lowering the glycaemic index of the pre-exercise meal can enhance lipid utilisation by up to 100 % through reduced insulin concentrations, although its application may be restricted to specific training sessions rather than competition. Chronic effects of dietary glycaemic index are less clear and warrant future study before firm recommendations can be made. A flurry of recent advances has overthrown the conventional view of l-carnitine supplementation, with skeletal muscle uptake possible under certain dietary conditions and providing a strategy to influence energy metabolism in an exercise intensity-dependent manner. Use of non-carbohydrate nutrients to stimulate muscle l-carnitine uptake may prove more beneficial for optimising lipid utilisation, but this requires more research. Studies investigating fish oil supplementation on fat oxidation during exercise are conflicting. In spite of some strong putative mechanisms, the only crossover trial showed no significant effect on lipid use during exercise. Ca may increase NEFA availability although it is not clear whether these effects occur. Ca and caffeine can increase NEFA availability under certain circumstances which could theoretically enhance fat oxidation, yet strong experimental evidence for this effect during exercise is lacking. Co-administration of nutrients to maximise their effectiveness needs further investigation.

  6. Persisting stigma reduces the utilisation of HIV-related care and support services in Viet Nam.

    PubMed

    Thanh, Duong Cong; Moland, Karen Marie; Fylkesnes, Knut

    2012-11-25

    Seeking and utilisation of HIV prevention, treatment, care, and support services for people living with HIV is often hampered by HIV-related stigma. The study aimed to explore the perceptions and experiences regarding treatment, care, and support amongst people living with HIV in Viet Nam, where the HIV epidemic is concentrated among injecting drug users, sex workers, and men who have sex with men. In-depth interviews and focus group discussions were conducted during September 2007 in 6 districts in Hai Phong with a very high HIV prevalence among injecting drug users. The information obtained was analysed and merged within topic areas. Illustrative quotes were selected. Stigma and discrimination against people living with HIV in the community and healthcare settings was commonly reported, and substantially hampered the seeking and the utilisation of HIV-related services. The informants related the high level of stigma to the way the national HIV preventive campaigns played on fear, by employing a "scare tactic" mainly focusing on drug users and sex workers, who were defined as "social evils" in the anti-drug and anti-prostitution policy. There was a strong exclusion effect caused by the stigma, with serious implications, such as loss of job opportunities and isolation. The support and care provided by family members was experienced as vital for the spirit and hope for the future among people living with HIV. A comprehensive care and support programme is needed. The very high levels of stigma experienced seem largely to have been created by an HIV preventive scare tactic closely linked to the "social evil" approach in the national policy on drug and prostitution. In order to reduce the stigma and create more effective interventions, this tactic will have to be replaced with approaches that create better legal and policy environments for drug users and sex workers.

  7. Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

    PubMed Central

    2011-01-01

    Background There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®). Results The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix. Conclusions Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain. PMID:21645335

  8. Surface Nutrient Utilisation and Productivity During Glacial-Interglacial Periods from the Equatorial Indian Ocean

    NASA Astrophysics Data System (ADS)

    R, C. K.; Bhushan, R.; Agnihotri, R.; Sawlani, R.; Jull, A. J. T.

    2016-12-01

    Seawaters and underlying sediments off Sri Lanka provide a unique marine realm affected by both branches of Northern Indian Ocean i.e. Arabian Sea (AS) and Bay of Bengal (BOB). AS and BOB are known for their distinct response to southwest monsoon. AS experiencing mainly winds and upwelling while BOB receives precipitation driven surface runoff from the Indian sub-continent. Multiple proxies were measured on a radiocarbon dated sediment core raised off Sri Lanka; their down core variations were used to understand oceanic history (nutrient utilisation, surface productivity, nature of organic matter) spanning last glacial-interglacial cycle ( 26 to 2.5 ka BP). Variations in CaCO3, biogenic silica (BSi) and δ15N from 26 ka to 12.5 ka BP indicate the region was experiencing high surface productivity with probably reduced surface nutrient utilisation efficiency. Sedimentary δ15N depth profile is decoupled from down core variations of major productivity indices (e.g. CaCO3, OC), hinting plausibly partial utilization of nutrients in the mixed layer (photic zone). δ13C of OC and C/N (wt. ratio) clearly reveal the terrestrial origin of organic matter at 15 ka BP, a period known for witnessing onset of deglaciation in northern hemisphere. δ13C minimum at 9 ka BP indicates intense monsoonal activity during this time coinciding well with solar insolation (June) maximum of the northern hemisphere. With the onset of Holocene ( 11 ka BP), δ15N variations appear to correlate with BSi and Ba/Ti indicating enhanced utilization of available nutrients at surface. Suggesting surface productivity over the region was probably micro-nutrient limited. The increased inventory of terrestrial runoff in Holocene probably demonstrates enhanced carbon sequestration capability of the region.

  9. Utilisation of chemical signals by inquiline wasps in entering their host figs.

    PubMed

    Gu, Ding; Yang, Da-Rong

    2013-10-01

    The fig tree, Ficus curtipes, hosts an obligate pollinating wasp, an undescribed Eupristina sp., but can also be pollinated by two inquiline (living in the burrow, nest, gall, or other habitation of another animal) wasps, Diaziella yangi and an undescribed Lipothymus sp. The two inquilines are unable to independently induce galls and depend on the galls induced by the obligate pollinator for reproduction and, therefore, normally enter receptive F. curtipes figs colonised by the obligate pollinators. However, sometimes the inquilines also enter figs that are not colonised by the pollinators, despite consequent reproductive failure. It is still unknown which signal(s) the inquilines use in entering the colonised and non-colonised figs. We conducted behavioural experiments to investigate several possible signals utilised by the inquilines in entering their host receptive figs. Our investigation showed that both inquiline species enter the receptive F. curtipes figs in response to the body odours of the obligate wasps and one of the main compounds emitted by the figs, 6-methyl-5-hepten-2-one. The compound was not found in the pollinator body odours, suggesting that the two inquiline wasps can utilise two signals to enter their host figs, which is significant for the evolution of the fig-fig wasp system. These inquilines could evolve to become mutualists of the figs if they evolve the ability to independently gall fig flowers; there is, however, another possibility that a monoecious Ficus species hosting such inquilines may evolve into a dioecious one if these inquilines cannot evolve the above-mentioned ability. Additionally, this finding provides evidence for the evolution of chemical communication between plants and insects. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Utilisation and Satisfaction with Rehabilitation Services in Children with Primary Language Impairment Transitioning to School: Parents' Perspective

    ERIC Educational Resources Information Center

    Mazer, Barbara; Dion, Karyne; Moryoussef, Aguy

    2017-01-01

    Children with disabilities require coordinated services to optimise transition into school. This study compared type, frequency and approach to service utilisation for children with primary language impairment transitioning from rehabilitation to the educational system, and examined parent satisfaction. Parents responded to a telephone…

  11. Utilisation and Impact of the Essential Electronic Agricultural Database (TEEAL) on Library Services in a Nigerian University of Agriculture

    ERIC Educational Resources Information Center

    Oduwole, A. A.; Sowole, A. O.

    2006-01-01

    Purpose: This study examined the utilisation of the Essential Electronic Agricultural Library database (TEEAL) at the University of Agriculture Library, Abeokuta, Nigeria. Design/methodology/approach: Data collection was by questionnaire following a purposive sampling technique. A total of 104 out 150 (69.3 per cent) responses were received and…

  12. Teachers' Perceptions of the Utilisation of Emotional Intelligence by Their School Principals to Manage Mandated Curriculum Change Processes

    ERIC Educational Resources Information Center

    Grobler, Bennie; Moloi, Connie; Thakhordas, Sunita

    2017-01-01

    This quantitative study investigates teachers' perceptions of how Emotional Intelligence (EI) was utilised by their school principals to manage mandated curriculum change processes in schools in the Johannesburg North district of Gauteng in South Africa. Research shows that EI consists of a range of fundamental skills that could enable school…

  13. Utilisation and Satisfaction with Rehabilitation Services in Children with Primary Language Impairment Transitioning to School: Parents' Perspective

    ERIC Educational Resources Information Center

    Mazer, Barbara; Dion, Karyne; Moryoussef, Aguy

    2017-01-01

    Children with disabilities require coordinated services to optimise transition into school. This study compared type, frequency and approach to service utilisation for children with primary language impairment transitioning from rehabilitation to the educational system, and examined parent satisfaction. Parents responded to a telephone…

  14. Motivational Strategies and Utilisation of Internet Resources as Determinants of Research Productivity of Lecturers in Universities of Agriculture in Nigeria

    ERIC Educational Resources Information Center

    Ajegbomogun, Fredrick Olatunji; Popoola, Sunday Olarenwaju

    2013-01-01

    This study examined motivational strategies and utilisation of Internet resources as determinants of research productivity of lecturers in universities of agriculture in Nigeria. One thousand, one hundred and thirty two (1,132) copies of the questionnaire were administered on the lecturers in universities of agriculture in Nigeria. Eight hundred…

  15. Impediments to Effective Utilisation of Information and Communication Technology Tools in Selected Universities in the North-Eastern Nigeria

    ERIC Educational Resources Information Center

    Momoh, Mustapha

    2010-01-01

    This study examined the impediments to effective use of Information and Communication Technology (ICT) tools in Nigerian universities. Series of research conducted on the factors militating against computerisation indicated that, there were impediments to effective utilisation of ICT tools in most developing countries. In the light of this, the…

  16. Teachers' Perceptions of the Utilisation of Emotional Intelligence by Their School Principals to Manage Mandated Curriculum Change Processes

    ERIC Educational Resources Information Center

    Grobler, Bennie; Moloi, Connie; Thakhordas, Sunita

    2017-01-01

    This quantitative study investigates teachers' perceptions of how Emotional Intelligence (EI) was utilised by their school principals to manage mandated curriculum change processes in schools in the Johannesburg North district of Gauteng in South Africa. Research shows that EI consists of a range of fundamental skills that could enable school…

  17. The Effect of Children's Rights Training on Primary School Students' Utilisation and Knowledge Level about Children's Rights

    ERIC Educational Resources Information Center

    Ozmen, Suna Kaymak; Ocal, Tugba; Ozmen, Ahmet

    2014-01-01

    Recently, children's rights issue has taken attention. In this study, main purpose was to investigate the utilisation and knowledge level of 4th and 5th grade primary school students after children's rights training. The participants of this survey study were selected randomly from 10 schools. Results indicated that students had the chance to…

  18. Socioeconomic inequalities in dental services utilisation in a Norwegian county: the third Nord-Trondelag Health Survey.

    PubMed

    Vikum, Eirik; Krokstad, Steinar; Holst, Dorthe; Westin, Steinar

    2012-11-01

    To assess the level of socioeconomic inequity in dental care utilisation in Norway and enable comparison with recent international comparative studies. We studied dental care utilisation among 17,136 men and 21,414 women in the third Nord-Trøndelag Health Survey (2006-08). Respondents aged 20 years and above were included in the study, and analyses were also performed within subgroups of age and gender (20-39, 40-59, and ≥60 years). Income-related horizontal inequity was estimated by means of concentration indices. Education-related inequity was estimated as relative risks. We found consistent pro-rich income inequity among men and women of all ages. The level of income inequity was highest among men and women ≥60 years, and in this group the income gradient was steepest between the poorest and the middle quintiles. Pro-educated inequity was found exclusively among men and women ≥60 years. General attendance was high (77%). The overall level of income-related inequity in dental services utilisation was low compared to other European countries as reported in two recent international studies of socioeconomic inequalities in dental care utilisation. Pro-rich and pro-educated inequity is a public health challenge mainly in the older part of the population.

  19. Impediments to Effective Utilisation of Information and Communication Technology Tools in Selected Universities in the North-Eastern Nigeria

    ERIC Educational Resources Information Center

    Momoh, Mustapha

    2010-01-01

    This study examined the impediments to effective use of Information and Communication Technology (ICT) tools in Nigerian universities. Series of research conducted on the factors militating against computerisation indicated that, there were impediments to effective utilisation of ICT tools in most developing countries. In the light of this, the…

  20. Utilisation and Impact of the Essential Electronic Agricultural Database (TEEAL) on Library Services in a Nigerian University of Agriculture

    ERIC Educational Resources Information Center

    Oduwole, A. A.; Sowole, A. O.

    2006-01-01

    Purpose: This study examined the utilisation of the Essential Electronic Agricultural Library database (TEEAL) at the University of Agriculture Library, Abeokuta, Nigeria. Design/methodology/approach: Data collection was by questionnaire following a purposive sampling technique. A total of 104 out 150 (69.3 per cent) responses were received and…

  1. Motivational Strategies and Utilisation of Internet Resources as Determinants of Research Productivity of Lecturers in Universities of Agriculture in Nigeria

    ERIC Educational Resources Information Center

    Ajegbomogun, Fredrick Olatunji; Popoola, Sunday Olarenwaju

    2013-01-01

    This study examined motivational strategies and utilisation of Internet resources as determinants of research productivity of lecturers in universities of agriculture in Nigeria. One thousand, one hundred and thirty two (1,132) copies of the questionnaire were administered on the lecturers in universities of agriculture in Nigeria. Eight hundred…

  2. Ethnic Factors in Mental Health Service Utilisation among People with Intellectual Disability in High-Income Countries: Systematic Review

    ERIC Educational Resources Information Center

    Dura-Vila, G.; Hodes, M.

    2012-01-01

    Background: An emerging literature suggests that ethnic and cultural factors influence service utilisation among people with intellectual disability (ID), but this has not previously been reviewed. Aims: To investigate possible ethnic variation in uptake of mental health services in children, adolescents and adults with ID in high-income…

  3. The Effect of Children's Rights Training on Primary School Students' Utilisation and Knowledge Level about Children's Rights

    ERIC Educational Resources Information Center

    Ozmen, Suna Kaymak; Ocal, Tugba; Ozmen, Ahmet

    2014-01-01

    Recently, children's rights issue has taken attention. In this study, main purpose was to investigate the utilisation and knowledge level of 4th and 5th grade primary school students after children's rights training. The participants of this survey study were selected randomly from 10 schools. Results indicated that students had the chance to…

  4. Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data.

    PubMed

    Browne, Joyce L; Kayode, Gbenga A; Arhinful, Daniel; Fidder, Samuel A J; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin

    2016-03-18

    This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care. A population-based cross-sectional study. We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status. Utilisation of antenatal, skilled delivery and postnatal care. Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care. After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01). This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Demystifying the Rubric: A Five-Step Pedagogy to Improve Student Understanding and Utilisation of Marking Criteria

    ERIC Educational Resources Information Center

    Jones, Lorraine; Allen, Bill; Dunn, Peter; Brooker, Lesley

    2017-01-01

    Marking-criteria rubrics are commonly used to judge the quality of student work, but few students receive instruction to effectively use and apply rubrics. This study investigates an intervention designed to encourage effective utilisation of rubrics. The study, completed over two years (2011: n = 189 respondents; 2012: n = 464 respondents) in a…

  6. Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data

    PubMed Central

    Browne, Joyce L; Kayode, Gbenga A; Arhinful, Daniel; Fidder, Samuel A J; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin

    2016-01-01

    Objective This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care. Design A population-based cross-sectional study. Setting and participants We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status. Primary outcomes Utilisation of antenatal, skilled delivery and postnatal care. Statistical analyses Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care. Results After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01). Conclusions This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service. PMID:26993621

  7. Experiences in the Dissemination and Utilisation of Information and Communication Technology (ICT) Research Findings from Three Southern African Universities

    ERIC Educational Resources Information Center

    Kaino, Luckson M.; Mtetwa, David; Kasanda, Choshi

    2014-01-01

    The dissemination and utilisation of research knowledge produced at universities has been debated in recent times. Recent changes and developments at universities suggest an entrepreneurial model of academic research production in which universities have the responsibility not only to carry out research and teaching but also to disseminate…

  8. [Day hospitals--predictors for utilisation and quality expectations from the perspective of family caregivers of dementia patients].

    PubMed

    Donath, Carolin; Bleich, Stefan; Grässel, Elmar

    2009-05-01

    To relieve the burden on family caregivers of dementia patients, the utilisation of day hospitals should be increased. Therefore, the predictive variables for utilisation as well as family caregivers' views regarding the quality of day hospitals must be investigated. The cross-sectional study was carried out as an anonymous, written survey of family caregivers of dementia patients in four regions of Germany. Quantitative and qualitative data from 404 family caregivers was analysed using binary logistic regression analysis and qualitative content analysis, respectively. In addition, 11 day hospital managers were interviewed concerning their quality concepts. The only significant predictor for the utilisation of day hospitals is the estimate of how helpful this support is for the family caregiver's situation. Those who have already had experiences with a day hospital expressed a wish for medical and psychiatric care by "well-trained" staff and a reasonable form of occupation for the dementia patient. In order to increase utilisation, family caregivers must be convinced of the advantages of using day hospitals. A day hospital that combines both activating occupational therapy and medical care by well-trained staff is what family caregivers wish most for their care-receivers.

  9. Ethnic disparities in utilisation of maternal health care services in Ghana: evidence from the 2007 Ghana Maternal Health Survey.

    PubMed

    Ganle, John Kuumuori

    2016-01-01

    Disparities in utilisation of maternal health care remain a challenge to attainment of the maternal health-related Millennium Development Goals. The objective of this descriptive study was to examine disparities in utilisation of maternal health care among ethnic groups in Ghana. Data from the 2007 Ghana Maternal Health Survey were analysed for disparities in antenatal care (ANC) visit, utilisation of tetanus toxoid immunisation and iron tablets/syrup intake during pregnancy, place of delivery, skilled birth attendance, caesarean section (CS) and post-natal care (PNC) among different ethnic groups. Findings show that the proportion of women who received any form of skilled antenatal, delivery and PNC in the five years (2003-2007) preceding the survey was 96%, 55% and 55%, respectively. Despite the incremental progress Ghana made in improving access to skilled maternal health care services, large gradients of disparities exist. The ethnic difference in utilisation of institutional prenatal care was small; however, fewer births to women from majority ethnic groups such as the Akan (21%) took place at home compared with births to women from minority ethnic groups such as the Ewe (58.8%), Guan (42.7%), Grusi (53.4%), Mole-Dagbani (74.7%) and Gruma (58.8%). The rate of consultation of a skilled health care provider for delivery among the different ethnic groups also ranged from a low of 27% for births to Mole-Dagbani women to a high of 68.8% among births to Akan women. Minority ethnic groups reported lower utilisation levels for most of the components of skilled maternity care in Ghana. However, ethnic disparities in utilisation of all the components of ANC in Ghana were less compared to delivery in health facilities, skilled attendance at birth, use of CS and PNC. Therefore, efforts to promote universal access to skilled maternity care not only should target those sub-populations with significantly low utilisation levels but also must focus on those components of

  10. Formal home-care utilisation by older adults in Ireland: evidence from the Irish Longitudinal Study on Ageing (TILDA).

    PubMed

    Murphy, Catriona M; Whelan, Brendan J; Normand, Charles

    2015-07-01

    The aim of this study was to provide a population-based estimate of the utilisation of publicly financed formal home care by older adults in Ireland and to identify the principal characteristics of those utilising formal home care. Data were collected through computer-aided personal interviews from a representative sample of community living older adults in Ireland. The interviews were conducted between 2009 and 2011 as part of the first wave of the Irish Longitudinal Study on Ageing (TILDA). The study is cross-sectional in design and limited to participants aged 65 years and older (n = 3507). Results reveal that 8.2% (95% CI 7.1%-9.3%) of participants utilised publicly financed formal home care in the form of home help and/or personal care. Key determinants of formal home-care utilisation were Instrumental Activity of Daily Living (IADL) difficulty (Adj OR 3.8, 95% CI 2.7-5.3), older age (Adj OR 3.4, 95% CI 2.4-4.8) and living alone (Adj OR 2.6, 95% CI 1.9-3.8). Almost half of those utilising formal care did not self-report an Activity of Daily Living (ADL) difficulty or an IADL difficulty. Government policy aims to reduce the need for long-term residential care by providing formal home care for older adults with low to moderate levels of dependency. This requires an increasing emphasis on personal care provision in the home. No evidence was found in this study to suggest that a shift in emphasis from formal domestic to personal care is taking place in Ireland. The absence of standardised assessment and eligibility criteria are deemed to be barriers to reorientation of the system. From a health services perspective, the current situation is not sustainable into the future and requires a focused policy response.

  11. Muscle glycogen utilisation during Rugby match play: Effects of pre-game carbohydrate.

    PubMed

    Bradley, Warren J; Morehen, James C; Haigh, Julian; Clarke, Jon; Donovan, Timothy F; Twist, Craig; Cotton, Caroline; Shepherd, Sam; Cocks, Matthew; Sharma, Asheesh; Impey, Samuel G; Cooper, Robert G; Maclaren, Don P M; Morton, James P; Close, Graeme L

    2016-12-01

    Although the physical demands of Rugby League (RL) match-play are well-known, the fuel sources supporting energy-production are poorly understood. We therefore assessed muscle glycogen utilisation and plasma metabolite responses to RL match-play after a relatively high (HCHO) or relatively low CHO (LCHO) diet. Sixteen (mean±SD age; 18±1 years, body-mass; 88±12kg, height 180±8cm) professional players completed a RL match after 36-h consuming a non-isocaloric high carbohydrate (n=8; 6gkgday(-1)) or low carbohydrate (n=8; 3gkgday(-1)) diet. Muscle biopsies and blood samples were obtained pre- and post-match, alongside external and internal loads quantified using Global Positioning System technology and heart rate, respectively. Data were analysed using effects sizes ±90% CI and magnitude-based inferences. Differences in pre-match muscle glycogen between high and low carbohydrate conditions (449±51 and 444±81mmolkg(-1)d.w.) were unclear. High (243±43mmolkg(-1)d.w.) and low carbohydrate groups (298±130mmolkg(-1)d.w.) were most and very likely reduced post-match, respectively. For both groups, differences in pre-match NEFA and glycerol were unclear, with a most likely increase in NEFA and glycerol post-match. NEFA was likely lower in the high compared with low carbohydrate group post-match (0.95±0.39mmoll(-1) and 1.45±0.51mmoll(-1), respectively), whereas differences between the 2 groups for glycerol were unclear (98.1±33.6mmoll(-1) and 123.1±39.6mmoll(-1)) in the high and low carbohydrate groups, respectively. Professional RL players can utilise ∼40% of their muscle glycogen during a competitive match regardless of their carbohydrate consumption in the preceding 36-h. Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  12. Utilisation of malaria preventive measures during pregnancy and birth outcomes in Ibadan, Nigeria

    PubMed Central

    2011-01-01

    Background Malaria remains a major public health problem in sub Saharan Africa and the extent of utilisation of malaria preventive measures may impact on the burden of malaria in pregnancy. This study sought to determine the association between malaria preventive measures utilized during pregnancy and the birth outcomes of birth weight and preterm delivery. Methods This cross sectional survey involved 800 mothers who delivered at the University College Hospital, and Adeoyo Maternity Hospital, Ibadan. Data obtained included obstetric information, gestational age, birth weight and self reported use of malaria prevention strategies in index pregnancy. Results Most (95.6%) mothers used one or more malaria control measures. The most commonly used vector control measures were window net (84.0%), insecticide spray (71.5%) and insecticide treated bed nets (20.1%), while chemoprophylactic agents were pyrimethamine (23.5%), Intermittent Preventive Treatments with Sulphadoxine-Pyrimethamine (IPTsp) (18.5%) and intermittent chloroquine (9.5%) and 21.7% used herbal medications. The mean ± SD birthweight and gestational age of the babies were 3.02 kg ± 0.56 and 37.9 weeks ± 2.5 respectively. Preterm delivery rate was 19.4% and 9% had low birth weight. Comparing babies whose mothers had IPTsp with those who did not, mean birth weight was 3.13 kg ± 0.52 versus 3.0 kg ± 0.56 (p = 0.016) and mean gestational age was 38.5 weeks ± 2.1 versus 37.8 weeks ± 2.5 (p = 0.002). The non-use of IPTsp was associated with increased risk of having low birth weight babies (AOR: 2.27, 95% CI: 0.98; 5.28) and preterm birth (AOR: 1.93, 95% CI: 1.08, 3.44). The non use of herbal preparations (AOR: 0.55, 95% CI: 0.36, 0.85) was associated with reduced risk of preterm birth. The mean ± SD birth weight and gestational ages of babies born to mothers who slept under ITNs were not significantly different from those who did not (p = 0.07 and 0.09 respectively). Conclusions There is a need for

  13. The Impact of Severe Obesity on Healthcare Resource Utilisation in Spain.

    PubMed

    Espallardo, Olga; Busutil, Rafael; Torres, Antonio; Zozaya, Néboa; Villoro, Renata; Hidalgo-Vega, Álvaro

    2017-08-01

    Obesity is not only a health problem but also a source of increased monetary expenditures. The objectives of this study were to analyse the use of healthcare resources in the Spanish adult population with class II obesity and above (BMI ≥35 kg/m(2)) and to compare it with other BMI groups. We used the Spanish National Health Survey, a longitudinal population-based survey (n = 18,682), to analyse healthcare resource utilisation by BMI groups. Adjusted and unadjusted logistic regression models were used to calculate odds ratios (OR) for healthcare use among class II and over obese subjects versus normal BMI. Persons with BMI ≥35 are more likely to attend general practitioner (GP)'s consultations (17%), to visit the emergency department (26%), to consume medications (36%), to be hospitalised (49%), to require nursing consultations (61%) and to require psychology consultations (83%). The proportion of obese people receiving home visits is 2.6 times higher than among normal BMI. After controlling for sex and age groups, people with severe obesity (BMI ≥35 kg/m(2)) were more prone to requiring home care visits (OR 2.3; CI [1.3; 4.2]), GP visits (OR 2.1; CI [1.5; 3.0]), psychologist visits (OR 1.96; CI [1.3; 2.99]), emergency service visits (OR 1.5; CI [1.2; 1.8]), nurse visits (OR 1.46; CI [1.2; 1.9]) and hospitalisations (OR 1.43; CI [1.1; 1.9]) and after also adjusting for relevant comorbidities like hypertension, diabetes and cardiovascular diseases: GP visits (OR 1.85; CI [1.3; 2.7]), psychologist visits (OR 1.8; CI [1.2; 2.7]), specialised care visits (OR 0.92; CI [0.7; 1.2]) and physiotherapist visits (OR 0.7; CI [0.5; 1.0]). Severe obesity significantly increases healthcare resource utilisation in Spain. The results shed light on the real magnitude of the burden of obesity in Spain.

  14. Determining the dimensions of essential medical coverage required by military body armour plates utilising Computed Tomography.

    PubMed

    Breeze, J; Lewis, E A; Fryer, R

    2016-09-01

    Military body armour is designed to prevent the penetration of ballistic projectiles into the most vulnerable structures within the thorax and abdomen. Currently the OSPREY and VIRTUS body armour systems issued to United Kingdom (UK) Armed Forces personnel are provided with a single size front and rear ceramic plate regardless of the individual's body dimensions. Currently limited information exists to determine whether these plates overprotect some members of the military population, and no method exists to accurately size plates to an individual. Computed Tomography (CT) scans of 120 male Caucasian UK Armed Forces personnel were analysed to measure the dimensions of internal thoraco-abdominal anatomical structures that had been defined as requiring essential medical coverage. The boundaries of these structures were related to three potential anthropometric landmarks on the skin surface and statistical analysis was undertaken to validate the results. The range of heights of each individual used in this study was comparable to previous anthropometric surveys, confirming that a representative sample had been used. The vertical dimension of essential medical coverage demonstrated good correlation to torso height (suprasternal notch to iliac crest) but not to stature (r(2)=0.53 versus 0.04). Horizontal coverage did not correlate to either measure of height. Surface landmarks utilised in this study were proven to be reliable surrogate markers for the boundaries of the underlying anatomical structures potentially requiring essential protection by a plate. Providing a range of plate sizes, particularly multiple heights, should optimise the medical coverage and thus effectiveness of body armour for UK Armed Forces personnel. The results of this work provide evidence that a single width of plate if chosen correctly will provide the essential medical coverage for the entire military population, whilst recognising that it still could overprotect the smallest individuals

  15. Utilisation, Reliability and Validity of Clinical Evaluation Exercise in Otolaryngology Training.

    PubMed

    Awad, Z; Hayden, L; Muthuswamy, K; Tolley, N S

    2015-10-01

    To investigate the utilisation, reliability and validity of clinical evaluation exercise (CEX) in otolaryngology training. Retrospective database analysis. Online assessment database. We analysed all CEXs submitted by north London core (CT) and speciality trainees (ST) in otolaryngology from 2010 to 2013. Internal consistency of the 7 CEX items rated as either O: outstanding, S: satisfactory or D: development required. Overall performance rating (pS) of 1-4 assessed against completion of training level. Receiver operating characteristic was used to describe CEX sensitivity and specificity. Overall score (cS), pS and the number of 'D'-rated items were used to investigate construct validity. One thousand one hundred and sixty CEXs from 45 trainees were included. CEX showed good internal consistency (Cronbach's alpha= 0.85). CEX was highly sensitive (99%), yet not specific (6%). cS and pS for ST was higher than CT (99.1% ± 0.4 versus 96.6% ± 0.8 and 3.06 ± 0.05 versus 1.92 ± 0.04, respectively P < 0.001). pS showed a significant stepwise increase from CT1 to ST6 (P < 0.001). In contrast, cS only showed improvement up to ST4 (P = 0.025). The most frequently utilised item 'management and follow-up planning' was found to be the best predictor of cS and pS (rs  = +0.69 and +0.21, respectively). CEX is reliable in assessing early years otolaryngology trainees in clinical examination, but not at higher level. It has the potential to be used in a summative capacity in selecting trainees for ST positions. This would also encourage trainees to master all domains of otolaryngology clinical examination by end of CT. © 2015 John Wiley & Sons Ltd.

  16. Enhanced Aircraft Platform Availability Through Advanced Maintenance Concepts and Technologies (Amelioration de la Disponibilite des Plateformes D’Aeronefs par L’Utilisation des Technologies et des Concepts Evolues de Maintenance)

    DTIC Science & Technology

    2011-06-01

    David Elford MOD DPA-DLO United Kingdom Mr. Richard Eustace Defence Science and Technology Organisation (DSTO) Australia Oberstleut nant Dirk...d’équipements de soutien qui peuvent être utilisées pour réduire le besoin en maintenance et les immobilisations associées. Le courant dominant de la R&D en...Defence Materiel in Operational Condition). In a statement to the Defence Commission of the French National Assembly in 2005 [12], General Richard

  17. Learning preferences of first year nursing and midwifery students: utilising VARK.

    PubMed

    James, Santhamma; D'Amore, Angelo; Thomas, Theda

    2011-05-01

    The diversity of first year students is increasing with new schemes promoting access to higher education courses. It is important to assess the learning styles of students in order to cater for their differing learning needs. The aim of this study was to profile first year nursing/midwifery students at two campuses of Australian Catholic University, to investigate their learning preferences and the effect demographic background has on these preferences. We designed a survey to collect demographic data and incorporated the VARK (visual, aural, read-write and kinaesthetic) questionnaire to investigate the students' preferred learning modes. The kinaesthetic score of our students was the highest (7.34 ± 2.67), significantly differing from the other three modes (p<0.001). Demographic factors such as gender and age group did not influence mean scores of each sensory modality. The predominant preference was quadmodal utilising all four learning styles. The distribution of students preferring to learn by unimodal, bimodal, trimodal and quadmodal styles varied between demographic groupings. The rural students had significantly higher visual and kinaesthetic scores compared to their metropolitan counterparts. Students attending the rural campus had higher visual and read-write scores. Visual and aural scores were significantly lower for students from non-English speaking backgrounds. These findings have significant teaching and research implications. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Breast cancer screening in England and the United States: a comparison of provision and utilisation.

    PubMed

    Williams, Joseph; Garvican, Linda; Tosteson, Anna N A; Goodman, David C; Onega, Tracy

    2015-12-01

    Comparing breast cancer screening across countries within the context of some of the benefits and harms offers the opportunity to improve effectiveness through mutual learning. This paper describes the provision of breast cancer screening in England and the United States. The various recommendations for accessing breast cancer screening in the two countries are set out and the organisation of services including quality assurance, incentives and performance mechanisms considered. In the United States, younger women are routinely screened; they are less likely to benefit and more likely to be harmed. The utilisation of breast cancer screening amongst eligible women is broadly comparable in the two countries. However, there are differences in technical performance; the reasons for these including radiological reading procedures and cultural factors are explored. Despite a well-functioning screening programme, breast cancer mortality and survival in England are poor relative to other countries. Emphasis for American improvement should be on reducing false-positive recall rates, while the English NHS could supplement existing efforts to understand and improve comparatively poor survival and mortality.

  19. Relationship between Health Insurance Status and the Pattern of Traditional Medicine Utilisation in Ghana

    PubMed Central

    Gyasi, Razak Mohammed

    2015-01-01

    This paper examines the relationship between national health insurance status and the pattern of traditional medicine (TRM) use among the general population in Ghana. A retrospective cross-sectional survey of randomly sampled adults, aged ≥18 years (N = 324), was conducted. The results indicate that TRM use was high with prevalence of over 86%. The study found no statistically significant association between national health insurance status and TRM utilisation (P > 0.05). Paradoxically, major sources of TRM, frequency of TRM use, comedical administration, and disclosure of TRM use to health care professionals differed significantly between the insured and uninsured subgroups (P < 0.001). Whereas effectiveness of TRM predicted its use for both insured [odds ratio (OR) = 4.374 (confidence interval (CI): 1.753–10.913; P = 0.002)] and uninsured [OR = 3.383 CI: 0.869–13.170; P = 0.039)], work experience predicted TRM use for the insured [OR = 1.528 (95% CI: 1.309–1.900; P = 0.019)]. Cultural specific variables and health philosophies rather than health insurance status may influence health care-seeking behaviour and TRM use. The enrollment of herbal-based therapies on the national health insurance medicine plan is exigent to ensure monitoring and rational use of TRM towards intercultural health care system in Ghana. PMID:26347791

  20. Utilising polymorphisms to achieve allele-specific genome editing in zebrafish

    PubMed Central

    Capon, Samuel J.; Baillie, Gregory J.; Bower, Neil I.; da Silva, Jason A.; Paterson, Scott; Hogan, Benjamin M.; Simons, Cas

    2017-01-01

    ABSTRACT The advent of genome editing has significantly altered genetic research, including research using the zebrafish model. To better understand the selectivity of the commonly used CRISPR/Cas9 system, we investigated single base pair mismatches in target sites and examined how they affect genome editing in the zebrafish model. Using two different zebrafish strains that have been deep sequenced, CRISPR/Cas9 target sites containing polymorphisms between the two strains were identified. These strains were crossed (creating heterozygotes at polymorphic sites) and CRISPR/Cas9 complexes that perfectly complement one strain injected. Sequencing of targeted sites showed biased, allele-specific editing for the perfectly complementary sequence in the majority of cases (14/19). To test utility, we examined whether phenotypes generated by F0 injection could be internally controlled with such polymorphisms. Targeting of genes bmp7a and chordin showed reduction in the frequency of phenotypes in injected ‘heterozygotes’ compared with injecting the strain with perfect complementarity. Next, injecting CRISPR/Cas9 complexes targeting two separate sites created deletions, but deletions were biased to selected chromosomes when one CRISPR/Cas9 target contained a polymorphism. Finally, integration of loxP sequences occurred preferentially in alleles with perfect complementarity. These experiments demonstrate that single nucleotide polymorphisms (SNPs) present throughout the genome can be utilised to increase the efficiency of in cis genome editing using CRISPR/Cas9 in the zebrafish model. PMID:27895053

  1. Hypertension, cardiovascular risk factors and antihypertensive medication utilisation among HIV-infected individuals in Rakai, Uganda.

    PubMed

    Sander, Laura D; Newell, Kevin; Ssebbowa, Paschal; Serwadda, David; Quinn, Thomas C; Gray, Ronald H; Wawer, Maria J; Mondo, George; Reynolds, Steven

    2015-03-01

    To assess the prevalence of hypertension, elevated blood pressure and cardiovascular risk factors among HIV-positive individuals in rural Rakai District, Uganda. We assessed 426 HIV-positive individuals in Rakai, Uganda from 2007 to 2010. Prevalence of hypertension and elevated blood pressure assessed by clinical measurement was compared to clinician-recorded hypertension in case report forms. Multiple logistic regression and z-tests were used to examine the association of hypertension and elevated blood pressure with age, sex, body mass index (BMI), CD4 cell count and antiretroviral treatment (ART) use. For individuals on antihypertensives, medication utilisation was reviewed. The prevalence of hypertension (two elevated blood pressure readings at different time points) was 8.0% (95% CI: 5.4-10.6%), and that of elevated blood pressure (one elevated blood pressure reading) was 26.3% (95% CI: 22.1-30.5%). Age ≥50 years and higher BMI were positively associated with elevated blood pressure. ART use, time on ART and CD4 cell count were not associated with hypertension. Eighty-three percent of subjects diagnosed with hypertension were on antihypertensive medications, most commonly beta-blockers and calcium channel blockers. Hypertension is common among HIV-positive individuals in rural Uganda. © 2014 John Wiley & Sons Ltd.

  2. Reference amounts utilised in front of package nutrition labelling; impact on product healthfulness evaluations.

    PubMed

    Raats, M M; Hieke, S; Jola, C; Hodgkins, C; Kennedy, J; Wills, J

    2015-05-01

    The research question addressed in this paper is how different reference amounts utilised in front of package nutrition labelling influence evaluation of product healthfulness. A total of 13,117 participants from six European countries (Germany, UK, Spain, France, Poland and Sweden) were recruited via online panels. A mixed between/within-subject factorial design was employed with food (biscuits, sandwiches, yogurts), healthfulness and presence of Guideline Daily Amounts as within-subjects factors and reference amount ('per 100 g', 'typical portion', 'half portion') and country as between-subjects factors. Overall, people correctly ranked foods according to their objective healthfulness as defined by risk nutrients alone, and could distinguish between more and less healthful variants of foods. General healthfulness associations with the three product categories do not appear to have had a strong influence on product ratings. This study shows that where the reference amount of 'per 100 g' is very different from the 'typical' portion size, as was the case for biscuits, products with a 'per 100 g' label are rated significantly less healthful than the 'typical' or 'half typical' portions. The results indicate that across the three food categories, consumers do factor the reference amount, that is, the quantity of food for which the nutritional information is being presented, into their judgements of healthfulness. Therefore, appropriate reference amounts are also of importance for the effective presentation of nutritional information.

  3. Sustainable management and utilisation of concrete slurry waste: A case study in Hong Kong.

    PubMed

    Hossain, Md Uzzal; Xuan, Dongxing; Poon, Chi Sun

    2017-03-01

    With the promotion of environmental protection in the construction industry, the mission to achieve more sustainable use of resources during the production process of concrete is also becoming important. This study was conducted to assess the environmental sustainability of concrete slurry waste (CSW) management by life cycle assessment (LCA) techniques, with the aim of identifying a resource-efficient solution for utilisation of CSW in the production of partition wall blocks. CSW is the dewatered solid residues deposited in the sedimentation tank after washing out over-ordered/rejected fresh concrete and concrete trucks in concrete batching plants. The reuse of CSW as recycled aggregates or a cementitious binder for producing partition wall blocks, and the life cycle environmental impact of the blocks were assessed and compared with the conventional one designed with natural materials. The LCA results showed that the partition wall blocks prepared with fresh CSW and recycled concrete aggregates achieved higher sustainability as it consumed 59% lower energy, emitted 66% lower greenhouse gases, and produced lesser amount of other environmental impacts than that of the conventional one. When the mineral carbonation technology was further adopted for blocks curing using CO2, the global warming potential of the corresponding blocks production process was negligible, and hence the carbonated blocks may be considered as carbon neutral eco-product.

  4. Towards zero industrial waste: Utilisation of brick dust waste in sustainable construction.

    PubMed

    Kinuthia, J M; Nidzam, R M

    2011-08-01

    Laboratory investigations were carried out to establish the potential utilisation of brick dust (BD) in construction. The dust is a waste material from the cutting of fired clay bricks. Currently, the disposal of the dust is a problem to the brick fabrication company, and hence an environmental pollution concern. The dust was stabilised either used on its own or in combination with Pulverised Fuel Ash (PFA), a by-product material from coal combustion. The traditional stabilisers of lime and/or Portland Cement (PC) were used as controls. The main aim was to use a sustainable stabiliser material, where these stabilisers were partially replaced with Ground Granulated Blastfurnace Slag (GGBS), a by-product material from steel manufacture. Compacted cylinder test specimens were made at typical stabiliser contents and moist cured for up to 56 days prior to testing for compressive and California Bearing Ratio (CBR) strength tests, and to linear expansion during moist curing and subsequent soaking in water. The results obtained showed that partial substitution of the dust with PFA resulted in stronger material compared to using it on its own. The blended stabilisers achieved better performance. These results suggest technological, economic as well as environmental advantages of using the brick dust and similar industrial by-products to achieve sustainable infrastructure development with near zero industrial waste.

  5. Novel utilisation of a circular multi-reflection cell applied to materials ageing experiments

    NASA Astrophysics Data System (ADS)

    Knox, D. A.; King, A. K.; McNaghten, E. D.; Brooks, S. J.; Martin, P. A.; Pimblott, S. M.

    2015-04-01

    We report on the novel utilisation of a circular multi-reflection (CMR) cell applied to materials ageing experiments. This enabled trace gas detection within a narrow interfacial region located between two sample materials and remotely interrogated with near-infrared sources combined with fibre-optic coupling. Tunable diode laser absorption spectroscopy was used to detect water vapour and carbon dioxide at wavelengths near 1,358 and 2,004 nm, respectively, with corresponding detection limits of 7 and 1,139 ppm m Hz-0.5. The minimum detectable absorption was estimated to be 2.82 × 10-3 over a 1-s average. In addition, broadband absorption spectroscopy was carried out for the detection of acetic acid, using a super-luminescent light emitting diode centred around 1,430 nm. The 69 cm measurement pathlength was limited by poor manufacturing tolerances of the spherical CMR mirrors and the consequent difficulty of collecting all the cell output light.

  6. Utilisation of biomass gasification by-products for onsite energy production.

    PubMed

    Vakalis, S; Sotiropoulos, A; Moustakas, K; Malamis, D; Baratieri, M

    2016-06-01

    Small scale biomass gasification is a sector with growth and increasing applications owing to the environmental goals of the European Union and the incentivised policies of most European countries. This study addresses two aspects, which are at the centre of attention concerning the operation and development of small scale gasifiers; reuse of waste and increase of energy efficiency. Several authors have denoted that the low electrical efficiency of these systems is the main barrier for further commercial development. In addition, gasification has several by-products that have no further use and are discarded as waste. In the framework of this manuscript, a secondary reactor is introduced and modelled. The main operating principle is the utilisation of char and flue gases for further energy production. These by-products are reformed into secondary producer gas by means of a secondary reactor. In addition, a set of heat exchangers capture the waste heat and optimise the process. This case study is modelled in a MATLAB-Cantera environment. The model is non-stoichiometric and applies the Gibbs minimisation principle. The simulations show that some of the thermal energy is depleted during the process owing to the preheating of flue gases. Nonetheless, the addition of a secondary reactor results in an increase of the electrical power production efficiency and the combined heat and power (CHP) efficiency.

  7. Utilisation of three-dimensional printed heart models for operative planning of complex congenital heart defects.

    PubMed

    Olejník, Peter; Nosal, Matej; Havran, Tomas; Furdova, Adriana; Cizmar, Maros; Slabej, Michal; Thurzo, Andrej; Vitovic, Pavol; Klvac, Martin; Acel, Tibor; Masura, Jozef

    2017-01-01

    To evaluate the accuracy of the three-dimensional (3D) printing of cardiovascular structures. To explore whether utilisation of 3D printed heart replicas can improve surgical and catheter interventional planning in patients with complex congenital heart defects. Between December 2014 and November 2015 we fabricated eight cardiovascular models based on computed tomography data in patients with complex spatial anatomical relationships of cardiovascular structures. A Bland-Altman analysis was used to assess the accuracy of 3D printing by comparing dimension measurements at analogous anatomical locations between the printed models and digital imagery data, as well as between printed models and in vivo surgical findings. The contribution of 3D printed heart models for perioperative planning improvement was evaluated in the four most representative patients. Bland-Altman analysis confirmed the high accuracy of 3D cardiovascular printing. Each printed model offered an improved spatial anatomical orientation of cardiovascular structures. Current 3D printers can produce authentic copies of patients` cardiovascular systems from computed tomography data. The use of 3D printed models can facilitate surgical or catheter interventional procedures in patients with complex congenital heart defects due to better preoperative planning and intraoperative orientation.

  8. Space resource utilisation: a novel indicator to quantify species competitive ability for light

    PubMed Central

    Zhang, Pengfei; Zhou, Xiaolong; Li, Junyong; Guo, Zhi; Du, Guozhen

    2015-01-01

    Species richness and productivity are two fundamental aspects of ecosystems. As a result, the relationship between species richness and productivity has been widely studied. A series of fertilisation experiments in an alpine meadow on the Tibetan Plateau were performed to study the relationship between species richness and productivity. In this paper, we present a novel indicator, i.e., space resource utilisation (SRU), which is calculated by a volume formula (Vi  =  hi · Si; hi = plant height of species i, Si = quadrat area × percent cover of species i). SRU more fully reflected species competitive ability for light in both horizontal and vertical dimensions compared with plant height and cover. We used this novel indicator to investigate the effects of SRU on the changes in species richness and productivity following fertilisation. We found that the SRU of the community was correlated with increasing productivity and decreasing species richness following fertilisation and was a better predictor of species richness than productivity. The changes in SRU following fertilisation vary among species. These results demonstrate that SRU can be a more useful tool in explaining plant biodiversity loss and predicting the fate of different species than each of height, cover and productivity. PMID:26593068

  9. Deposition of nano-hydroxyapatite particles utilising direct and transitional electrohydrodynamic processes.

    PubMed

    Ahmad, Z; Thian, E S; Huang, J; Edirisinghe, M J; Best, S M; Jayasinghe, S N; Bonfield, W; Brooks, R A; Rushton, N

    2008-09-01

    Electrohydrodynamic spraying is a well established process used to deposit, coat, analyse and synthesise materials within the biomedical remit. Recently, electrohydrodynamic printing has been developed to afford structures for potential applications in the biomedical and medical engineering fields. Both of these processes rely on the formation of an electrically-induced jet, however the resulting products can be made strikingly different and offer potential in broader applications. Here we show how spraying and printing are linked by elucidating the ease of transition between the processes. Changes in the deposition distance can result in either spray (>10 mm) or print formation (<3 mm), with an overlap of the two in between this range. For the optimal printing distance of 0.5 mm, gradual changes in the applied voltage (0-4.5 kV) encounters transitional printing modes (dripping, micro-dripping, rapid micro-dripping, unstable and stable jetting) which can be utilised for patterning. The results indicate the robustness of the electrohydrodynamic route in the nano-materials processing arena, with emphasis on biomedical materials.

  10. Utilisation and Safety of Deferasirox: Results from an Observational Cohort Study in England.

    PubMed

    Osborne, Vicki; Davies, Miranda; Layton, Deborah; Shakir, Saad A W

    2017-10-10

    Deferasirox (EXJADE(®), Novartis, UK) is an oral iron-chelating agent primarily used to reduce chronic iron overload in patients receiving blood transfusions for various chronic anaemias and some non-transfusion dependant anaemias. The aim of this study was to examine the utilisation and safety of deferasirox used in general practice in England. A single exposure observational cohort study design was used. Patients were identified from dispensed prescriptions for deferasirox between September 2006 and September 2014. Outcome data were collected via postal questionnaires sent to prescribers ≥ 6 months after first dispensed prescription for an individual patient. Summary descriptive statistics were calculated. The evaluable cohort consisted of 122 patients, of which 41.8% were aged 2-17 years. Frequent reasons for prescribing were sickle cell anaemia (27/103 where specified, 26.2%) and beta thalassaemia (26, 25.2%). The majority of patients (43/51, 84.3%) were prescribed the licensed doses of 10 or 20 mg/kg/day at start. Prior measurements of serum creatinine were only reported for a small proportion this study (18/122, 14.8%). In total, 91 incident events were reported, including two of raised serum creatinine. These results show that deferasirox is largely being prescribed for its licensed indications in general practice in England and events reported were consistent with the known safety profile.

  11. Passively cooled 405 W ytterbium fibre laser utilising a novel metal coated active fibre

    NASA Astrophysics Data System (ADS)

    Daniel, Jae M. O.; Simakov, Nikita; Hemming, Alexander; Clarkson, W. Andrew; Haub, John

    2016-03-01

    We present a novel metal coated triple clad active fibre design, utilising an all glass inner cladding structure and aluminium outer coating. This metal coated active fibre enables a number of benefits to high power laser design, such as increase robustness and extended operating temperature range. As a demonstration of the advantages of this design a passively cooled ytterbium fibre laser is presented. A 20 m length of active fibre was coiled into a planar arrangement and mounted onto a high emissivity heatsink. Up to 405 W of output power was achieved without the need for active water or forced air cooling. The slope efficiency of this source was 74 % and maximum outer heat sink temperature was ~140°C. This arrangement allowed for significant weight and size savings to be achieved with the active fibre laser head weighing less than 100 g. We will discuss the design choices and trade-offs of metal coated active fibre on high power fibre laser systems as well as the prospects for further power scaling to the kW level.

  12. Utilisation of single added fatty acids by consortia of digester sludge in batch culture

    SciTech Connect

    Wagner, Andreas Otto; Gstrauntaler, Gudrun; Illmer, Paul

    2010-10-15

    Inocula derived from an anaerobic digester were used to study (i) their potential for methane production and (ii) the utilisation rates of different short chain fatty acids (SCFAs) by the microbial community in defined media with mono-carbon sources (formic-, acetetic-, propionic-, butyric acid) in batch culture. It could be demonstrated that the microbial reactor population could be transferred successfully to the lab, and its ability to build up methane was present even with deteriorating biogas plant performance. Therefore, this reduction in performance of the biogas plant was not due to a decrease in abundance, but due to an inactivity of the microbial community. Generally, the physico-chemical properties of the biogas plant seemed to favour hydrogenotrophic methanogens, as seen by the high metabolisation rates of formate compared with all other carbon sources. In contrast, acetoclastic methanogenesis could be shown to play a minor role in the methane production of the investigated biogas plant, although the origin of up to 66% of methane is generally suggested to be generated through acetoclastic pathway.

  13. The evolution and provision of expert knowledge and its effective utilisation

    NASA Astrophysics Data System (ADS)

    Sammonds, Peter

    2017-04-01

    The specific aims of increasing Resilience to Natural Hazards in China programme are (i) to improve hazard forecasting, risk mitigation and preparedness based upon reliable knowledge of the fundamental processes involved and underpinned by basic science and, (ii) to improve the uptake of and responses to scientific advice, by developing risk-based approaches to natural hazards in collaboration with the communities at risk. One of the programme's principal goals is to integrate natural and social science research to increase the benefits for those affected by natural hazards. To that end a co-productive approach to research is expected, involving a framework for sharing knowledge and values between natural and social scientists and consultation with policy makers, civil society and other stakeholders. This paper explore knowledge relationships and reflective learning across disciplines. There is commonly a disjunction between the evolution and provision of expert knowledge and its effective utilisation. Building on experience as Strategic Advisor to the Increasing Resilience to Natural Hazards programme, this paper addresses the research needs to assess how scientific knowledge and risk reduction strategies can be most effectively developed and communicated.

  14. High-throughput genotyping of hop (Humulus lupulus L.) utilising diversity arrays technology (DArT).

    PubMed

    Howard, E L; Whittock, S P; Jakše, J; Carling, J; Matthews, P D; Probasco, G; Henning, J A; Darby, P; Cerenak, A; Javornik, B; Kilian, A; Koutoulis, A

    2011-05-01

    Implementation of molecular methods in hop (Humulus lupulus L.) breeding is dependent on the availability of sizeable numbers of polymorphic markers and a comprehensive understanding of genetic variation. However, use of molecular marker technology is limited due to expense, time inefficiency, laborious methodology and dependence on DNA sequence information. Diversity arrays technology (DArT) is a high-throughput cost-effective method for the discovery of large numbers of quality polymorphic markers without reliance on DNA sequence information. This study is the first to utilise DArT for hop genotyping, identifying 730 polymorphic markers from 92 hop accessions. The marker quality was high and similar to the quality of DArT markers previously generated for other species; although percentage polymorphism and polymorphism information content (PIC) were lower than in previous studies deploying other marker systems in hop. Genetic relationships in hop illustrated by DArT in this study coincide with knowledge generated using alternate methods. Several statistical analyses separated the hop accessions into genetically differentiated North American and European groupings, with hybrids between the two groups clearly distinguishable. Levels of genetic diversity were similar in the North American and European groups, but higher in the hybrid group. The markers produced from this time and cost-efficient genotyping tool will be a valuable resource for numerous applications in hop breeding and genetics studies, such as mapping, marker-assisted selection, genetic identity testing, guidance in the maintenance of genetic diversity and the directed breeding of superior cultivars.

  15. Semi-active control of magnetorheological elastomer base isolation system utilising learning-based inverse model

    NASA Astrophysics Data System (ADS)

    Gu, Xiaoyu; Yu, Yang; Li, Jianchun; Li, Yancheng

    2017-10-01

    Magnetorheological elastomer (MRE) base isolations have attracted considerable attention over the last two decades thanks to its self-adaptability and high-authority controllability in semi-active control realm. Due to the inherent nonlinearity and hysteresis of the devices, it is challenging to obtain a reasonably complicated mathematical model to describe the inverse dynamics of MRE base isolators and hence to realise control synthesis of the MRE base isolation system. Two aims have been achieved in this paper: i) development of an inverse model for MRE base isolator based on optimal general regression neural network (GRNN); ii) numerical and experimental validation of a real-time semi-active controlled MRE base isolation system utilising LQR controller and GRNN inverse model. The superiority of GRNN inverse model lays in fewer input variables requirement, faster training process and prompt calculation response, which makes it suitable for online training and real-time control. The control system is integrated with a three-storey shear building model and control performance of the MRE base isolation system is compared with bare building, passive-on isolation system and passive-off isolation system. Testing results show that the proposed GRNN inverse model is able to reproduce desired control force accurately and the MRE base isolation system can effectively suppress the structural responses when compared to the passive isolation system.

  16. Influence of phenolic substrates utilised by yeast Trichosporon cutaneum on the degradation kinetics

    PubMed Central

    Gerginova, Maria; Zlateva, Plamena; Peneva, Nadejda; Alexieva, Zlatka

    2014-01-01

    The degradation kinetics of different phenolic substrates utilised by Trichosporon cutaneum R57 was studied. The following compounds were used as substrates: phenol, resorcinol, hydroquinone, 3-nitrophenol, 2,6-dinitrophenol, 3-chloro phenol and p-cresol. The specific degradation rates (Qs) were described by a Haldane kinetic model. The unknown model parameters were estimated using the mathematical optimisation procedure for direct search. The results obtained demonstrated that Qs varied greatly in the experiments carried out. The level of biodegradability depended on the different structure and toxicity of compounds used as carbon substrates. The highest Qs values were observed for less toxic hydroxylated phenols (0.77–0.85 h−1), while the most toxic chlorinated phenols were characterised with the lowest Qs values (0.224 h−1). The results obtained with different concentrations of resorcinol (from 0.2 to 0.8 g L−1) and 2,6-dinitrophenol (from 0.2 to 0.7 g L−1) demonstrated a growing inhibitory effect directly correlating with the extended time necessary for complete degradation of both compounds. PMID:26692781

  17. Effects of thermal treatments on the characterisation and utilisation of red mud with sawdust additive.

    PubMed

    Liu, Yanju; Naidu, Ravi; Ming, Hui; Dharmarajan, Rajarathnam; Du, Jianhua

    2016-06-01

    Extremely large amounts of red mud (bauxite residue) are generated globally every year from alumina refining industries, which are being disposed of on engineered landfills. The objective of this study is to investigate the effects of thermal treatments on red mud for development of utilisation strategies. Thermal treatments of red mud samples and their characterisations were investigated under inert (N2) and oxidative (air) conditions with and without sawdust addition at 200-600°C. After calcination, the resulting samples were analysed using thermogravimetric-infrared spectroscopy (TG-IR) for functional group transformations, thermogravimetric analysis (TGA) for thermal loss profiles and X-ray diffraction (XRD) for mineral transformations. The characterisation results showed that in N2 environment, boehmite in red mud was transferred to transition alumina at around 400°C while losing water from structural components. The addition of sawdust for incubation and calcination of red mud in air increased the surface area, whereas that in nitrogen atmosphere lead to reduction of hematite to magnetite at around 500°C. The incorporated carbon materials played a major role in increasing the surface area especially for pore size less than 2.5 nm. This treated red mud with altered mineral composition and improved properties for binding contaminants can be used for environmental remediation and in the process of metal recovery such as iron. © The Author(s) 2016.

  18. An immunoenzymatic assay for the diagnosis of hepatitis A utilising immunoglobulin Y.

    PubMed

    Silva, Alexandre dos Santos da; Vasconcelos, Gentil Arthur Lins Bentes Mendonça de; Kappel, Livia Abud; Pinto, Marcelo Alves; Paula, Vanessa Salete de

    2012-11-01

    The detection of anti-hepatitis A virus (HAV) antibody levels by diagnostic kits in the convalescent period of disease generally use immunoglobulin G (IgG), which is expensive. An alternative to IgG is immunoglobulin Y (IgY), an immunoglobulin antibody encountered in birds and reptiles. The aim of this study was to develop a competitive immunoenzymatic assay to measure total anti-HAV antibody levels using anti-HAV IgY as the capture and conjugated immunoglobulins. For this purpose, anti-HAV IgY was conjugated to horseradish peroxidase (HRP) and the optimal dilution of HRP-conjugated antibodies was evaluated to establish the competitive immuneenzymatic assay. The results obtained from our "in-house" assay were plotted on a receiver operator curve, which showed a sensitivity of 95% and a specificity of 98.8%, demonstrating that a competitive anti-HAV IgY immunoenzymatic assay developed "in house" could be used as an alternative to commercial assays that utilise IgG.

  19. Utilisation of optimisation solutions to control active suspension for decreased braking distance

    NASA Astrophysics Data System (ADS)

    Edrén, Johannes; Jonasson, Mats; Jerrelind, Jenny; Stensson Trigell, Annika; Drugge, Lars

    2015-02-01

    This work deals with how to utilise active suspension on individual vehicle wheels in order to improve the vehicle performance during straight-line braking. Through numerical optimisation, solutions have been found as regards how active suspension should be controlled and coordinated with friction brakes to shorten the braking distance. The results show that, for the studied vehicle, the braking distance can be shortened by more than 1 m when braking from 100 km/h. The applicability of these results is studied by investigating the approach for different vehicle speeds and actuator stroke limitations. It is shown that substantial improvements in the braking distance can also be found for lower velocities, and that the actuator strokes are an important parameter. To investigate the potential of implementing these findings in a real vehicle, a validated detailed vehicle model equipped with active struts is analysed. Simplified control laws, appropriate for on-board implementation and based on knowledge of the optimised solution, are proposed and evaluated. The results show that substantial improvements of the braking ability, and thus safety, can be made using this simplified approach. Particle model simulations have been made to explain the underlying physical mechanisms and limitations of the approach. These results provide valuable guidance on how active suspension can be used to achieve significant improvements in vehicle performance with reasonable complexity and energy consumption.

  20. Carbon dioxide utilisation of Dunaliella tertiolecta for carbon bio-mitigation in a semicontinuous photobioreactor.

    PubMed

    Farrelly, Damien J; Brennan, Liam; Everard, Colm D; McDonnell, Kevin P

    2014-04-01

    Bio-fixation of carbon dioxide (CO2) by microalgae has been recognised as an attractive approach to offset anthropogenic emissions. Biological carbon mitigation is the process whereby autotrophic organisms, such as microalgae, convert CO2 into organic carbon and O2 through photosynthesis; this process through respiration produces biomass. In this study Dunaliella tertiolecta was cultivated in a semicontinuous culture to investigate the carbon mitigation rate of the system. The algae were produced in 1.2-L Roux bottles with a working volume of 1 L while semicontinuous production commenced on day 4 of cultivation when the carbon mitigation rate was found to be at a maximum for D. tertiolecta. The reduction in CO2 between input and output gases was monitored to predict carbon fixation rates while biomass production and microalgal carbon content are used to calculate the actual carbon mitigation potential of D. tertiolecta. A renewal rate of 45 % of flask volume was utilised to maintain the culture in exponential growth with an average daily productivity of 0.07 g L(-1) day(-1). The results showed that 0.74 g L(-1) of biomass could be achieved after 7 days of semicontinuous production while a total carbon mitigation of 0.37 g L(-1) was achieved. This represented an increase of 0.18 g L(-1) in carbon mitigation rate compared to batch production of D. tertiolecta over the same cultivation period.

  1. Bismuth oxybromide-based photocatalysts for solar energy utilisation and environmental remediation

    NASA Astrophysics Data System (ADS)

    Kong, Liang

    This thesis reports the investigation of Bismuth oxybromide (BiOBr) semiconductor material as an efficient photocatalyst for the sunlight harvesting as well as environmental cleanup. I have utilised different synthetic methodologies to obtain BiOBr and its derivatives, such as co-precipitation, ultrasonification, and photo-deposition; and have studied their structural and optical properties by X-ray diffraction and surface analysis techniques. I report the synthesis and characterisation of two new p-n heterojunction systems, AgBr-BiOBr and BiOBr-ZnFe2O4, and have performed initial studies on photocatalytic reaction and their catalytic decomposition mechanisms. I have also reported the surface modification method including the deposition of noble metal on BiOBr to investigate the role played by the noble metal and the interactions between semiconductor and metal using various characterisation measurements. Furthermore, a continuous series of BiOBr-BiOI solid solutions were synthesised, characterised and the photocatalytic degradation was performed on the as-obtained semiconductors, to study the band structure properties of the solid solutions..

  2. The effects of increasing exercise intensity on muscle fuel utilisation in humans

    PubMed Central

    van Loon, Luc J C; Greenhaff, Paul L; Constantin-Teodosiu, D; Saris, Wim H M; Wagenmakers, Anton J M

    2001-01-01

    Contemporary stable isotope methodology was applied in combination with muscle biopsy sampling to accurately quantify substrate utilisation and study the regulation of muscle fuel selection during exercise.Eight cyclists were studied at rest and during three consecutive 30 min stages of exercise at intensities of 40, 55 and 75 % maximal workload (Wmax). A continuous infusion of [U-13C]palmitate and [6,6-2H2]glucose was administered to determine plasma free fatty acid (FFA) oxidation and estimate plasma glucose oxidation, respectively. Biopsy samples were collected before and after each exercise stage.Muscle glycogen and plasma glucose oxidation rates increased with every increment in exercise intensity. Whole-body fat oxidation increased to 32 ± 2 kJ min−1 at 55 % Wmax, but declined at 75 % Wmax (19 ± 2 kJ min−1). This decline involved a decrease in the oxidation rate of both plasma FFA and triacylglycerol fat sources (sum of intramuscular plus lipoprotein-derived triacylglycerol), and was accompanied by increases in muscle pyruvate dehydrogenase complex activation and acetylation of the carnitine pool, resulting in a decline in muscle free carnitine concentration.We conclude that the most likely mechanism for the reduction in fat oxidation during high-intensity exercise is a downregulation of carnitine palmitoyltransferase I, either by this marked decline in free carnitine availability or by a decrease in intracellular pH. PMID:11579177

  3. The impact on hospital resource utilisation of treatment of hepatic encephalopathy with rifaximin-α.

    PubMed

    Orr, James G; Currie, Craig J; Berni, Ellen; Goel, Anurag; Moriarty, Kieran J; Sinha, Ashish; Gordon, Fiona; Dethier, Anne; Dillon, John F; Clark, Katie; Richardson, Paul; Middleton, Paul; Patel, Vishal; Shawcross, Debbie; Preedy, Helen; Aspinall, Richard J; Hudson, Mark

    2016-09-01

    Rifaximin-α reduces the risk of recurrence of overt hepatic encephalopathy. However, there remain concerns regarding the financial cost of the drug. We aimed to study the impact of treatment with rifaximin-α on healthcare resource utilisation using data from seven UK liver treatment centres. All seven centres agreed a standardised data set and data characterising clinical, demographic and emergency hospital admissions were collected retrospectively for the time periods 3, 6 and 12 months before and following initiation of rifaximin-α. Admission rates and hospital length of stay before and during therapy were compared. Costs of admissions and drug acquisition were estimated using published sources. Multivariate analyses were carried out to assess the relative impact of various factors on hospital length of stay. Data were available from 326 patients. Following the commencement of rifaximin, the total hospital length of stay reduced by an estimated 31-53%, equating to a reduction in inpatient costs of between £4858 and £6607 per year. Taking into account drug costs of £3379 for 1-year treatment with rifaximin-α, there was an estimated annual mean saving of £1480-£3228 per patient. Initiation of treatment with rifaximin-α was associated with a marked reduction in the number of hospital admissions and hospital length of stay. These data suggest that treatment of patients with rifaximin-α for hepatic encephalopathy was generally cost saving. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Differential utilisation of health facilities and services for childbirth in Peninsula Malaysia--the ethnic factor.

    PubMed

    Arhsat, H; Tan Boon Ann; Tey Nai Peng

    1985-12-01

    The ethnic factor in the differential utilization of the health facilities in Peninsular Malaysia is examined. Data from the Malaysian Population and Family Survey 1984/85 show that about 45% of the births were delivered in the government hospitals, 15% in the private hospitals/clinics and the remaining 40% were delivered at home. Utilisation of these facilities varies greatly by ethnicity. The Malays have the greatest tendency to choose home delivery (60%), as opposed to institutional delivery (40%). Although urbanization and better socioeconomic conditions have led to an increase in institutional delivery, social customs continue to exert an influence on their behavior in favor of home delivery. Almost all Chinese babies are delivered in hospitals or clinics, with those from the higher social class showing a tendency to resort to the use of private hospitals/clinics for delivery. Indians were the most frequent users of government hospital across nearly all the social strata. While institutional deliveries were all attended by trained personnel, about 71% of the home deliveries were attended by government midwives and 24% by village midwives or other untrained persons, and only 5% were delivered by a doctor or a nurse.

  5. Morphometric study on the development of magnocellular neurons of the supraoptic nucleus utilising immunohistochemical methods.

    PubMed Central

    Lazcano, M A; Bentura, M L; Toledano, A

    1990-01-01

    Vasopressin (VP)- and oxytocin (OXY)-producing neurons, components of the rat supraoptic nucleus, have been located with immunohistochemical methods, with the purpose of studying their morphofunctional characteristics during different phases of life (embryonic, juvenile, adult and senile). To carry out this study, an IBAS I (Kontron) computerised image analyser has been utilised. The hormone VP is first detected in the neuronal cytoplasm of 21 days old rat embryos and the hormone OXY appears in the neuronal cytoplasm later, in the newborn phase. The neuronal area with a positive reaction for the two neurohormones has been evaluated and it has been found that the quantity of reaction substance is proportional to the age. In the adult period, VP neurons possess a reaction area (198 microns 2) greater than that of OXY neurons (153 microns 2). In the SON, there are two neuronal shapes, fusiform and round; these shapes coexist in both hormonal types of neurons. Until Day 15 of postnatal development, the SON neurons are intermixed in the interior of the nucleus but in this period a neuronal redistribution is initiated. In the adult phase, OXY neurons are situated preferentially in the anterior, posterior and dorsal parts and VP neurons in the ventral and posterior parts, with both neurons being present in the intermediate part of the SON. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Figs. 12-14 Fig. 15 Fig. 16 PMID:2182586

  6. Tolerance of pentose utilising yeast to hydrogen peroxide-induced oxidative stress

    PubMed Central

    2014-01-01

    Background Bioethanol fermentations follow traditional beverage fermentations where the yeast is exposed to adverse conditions such as oxidative stress. Lignocellulosic bioethanol fermentations involve the conversion of pentose and hexose sugars into ethanol. Environmental stress conditions such as osmotic stress and ethanol stress may affect the fermentation performance; however, oxidative stress as a consequence of metabolic output can also occur. However, the effect of oxidative stress on yeast with pentose utilising capabilities has yet to be investigated. Results Assaying for the effect of hydrogen peroxide-induced oxidative stress on Candida, Pichia and Scheffersomyces spp. has demonstrated that these yeast tolerate hydrogen peroxide-induced oxidative stress in a manner consistent with that demonstrated by Saccharomyces cerevisiae. Pichia guillermondii appears to be more tolerant to hydrogen peroxide-induced oxidative stress when compared to Candida shehatae, Candida succiphila or Scheffersomyces stipitis. Conclusions Sensitivity to hydrogen peroxide-induced oxidative stress increased in the presence of minimal media; however, addition of amino acids and nucleobases was observed to increase tolerance. In particular adenine increased tolerance and methionine reduced tolerance to hydrogen peroxide-induced oxidative stress. PMID:24636079

  7. Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries.

    PubMed

    Devaux, Marion

    2015-01-01

    A key policy objective in OECD countries is to achieve adequate access to health care for all people on the basis of need. Previous studies have shown that there are inequities in health care services utilisation (HCSU) in the OECD area. In recent years, measures have been taken to enhance health care access. This paper re-examines income-related inequities in doctor visits among 18 selected OECD countries, updating previous results for 12 countries with 2006-2009 data, and including six new countries. Inequalities in preventive care services are also considered for the first time. The indirect standardisation procedure is used to estimate the need-adjusted HCSU and concentration indexes are derived to gauge inequalities and inequities. Overall, inequities in HCSU remain present in OECD countries. In most countries, for the same health care needs, people with higher incomes are more likely to consult a doctor than those with lower incomes. Pro-rich inequalities in dental visits and cancer screening uptake are also found in nearly all countries, although the magnitude of these varies among countries. These findings suggest that further monitoring of inequalities is essential in order to assess whether country policy objectives are achieved on a regular basis.

  8. Income-based disparities in health care utilisation under universal health coverage in Brazil, 2002-2003.

    PubMed

    Cataife, Guido; Courtemanche, Charles

    2014-01-01

    Since Brazil's adoption of universal health care in 1988, the country's health care system has consisted of a mix of private providers and free public providers. We test whether income-based disparities in medical visits and medications remain in Brazil despite universal coverage using a nationally representative sample of over 48,000 households. Additional income is associated with less public sector utilisation and more private sector utilisation, both using simple correlations and regressions controlling for household characteristics and local area fixed effects. Importantly, the increase in private care use is greater than the drop in public care use. Also, income and unmet medical needs are negatively associated. These results suggest that access limitations remain for low-income households despite the availability of free public care.

  9. Utilisation of oral health services, oral health needs and oral health status in a peri-urban informal settlement.

    PubMed

    Westaway, M S; Viljoen, E; Rudolph, M J

    1999-04-01

    Interviews were conducted with 294 black residents (155 females and 138 males) of a peri-urban informal settlement in Gauteng to ascertain utilisation of oral health services, oral health needs and oral health status. Only 37 per cent of the sample had consulted a dentist or medical practitioner, usually for extractions. Teenagers and employed persons were significantly less likely to utilise dentists than the older age groups and unemployed persons. Forty per cent were currently experiencing oral health problems such as a sore mouth, tooth decay and bleeding/painful gums. Two hundred and twelve (73 per cent) interviewees wanted dental treatment or advice. Residents who rated their oral health status as fair or poor appeared to have the greatest need for oral health services. The use of interviews appears to be a cost-effective method of determining oral morbidity.

  10. Investigation of Matlab® as Platform in Navigation and Control of an Automatic Guided Vehicle Utilising an Omnivision Sensor

    PubMed Central

    Kotze, Ben; Jordaan, Gerrit

    2014-01-01

    Automatic Guided Vehicles (AGVs) are navigated utilising multiple types of sensors for detecting the environment. In this investigation such sensors are replaced and/or minimized by the use of a single omnidirectional camera picture stream. An area of interest is extracted, and by using image processing the vehicle is navigated on a set path. Reconfigurability is added to the route layout by signs incorporated in the navigation process. The result is the possible manipulation of a number of AGVs, each on its own designated colour-signed path. This route is reconfigurable by the operator with no programming alteration or intervention. A low resolution camera and a Matlab® software development platform are utilised. The use of Matlab® lends itself to speedy evaluation and implementation of image processing options on the AGV, but its functioning in such an environment needs to be assessed. PMID:25157548

  11. Investigation of Matlab® as platform in navigation and control of an Automatic Guided Vehicle utilising an omnivision sensor.

    PubMed

    Kotze, Ben; Jordaan, Gerrit

    2014-08-25

    Automatic Guided Vehicles (AGVs) are navigated utilising multiple types of sensors for detecting the environment. In this investigation such sensors are replaced and/or minimized by the use of a single omnidirectional camera picture stream. An area of interest is extracted, and by using image processing the vehicle is navigated on a set path. Reconfigurability is added to the route layout by signs incorporated in the navigation process. The result is the possible manipulation of a number of AGVs, each on its own designated colour-signed path. This route is reconfigurable by the operator with no programming alteration or intervention. A low resolution camera and a Matlab® software development platform are utilised. The use of Matlab® lends itself to speedy evaluation and implementation of image processing options on the AGV, but its functioning in such an environment needs to be assessed.

  12. Accuracy analysis of direct georeferenced UAV images utilising low-cost navigation sensors

    NASA Astrophysics Data System (ADS)

    Briese, Christian; Wieser, Martin; Verhoeven, Geert; Glira, Philipp; Doneus, Michael; Pfeifer, Norbert

    2014-05-01

    control points should be used to improve the estimated values, especially to decrease the amount of systematic errors. For the bundle block adjustment the calibration of the camera and their temporal stability must be determined additionally. This contribution presents next to the theory a practical study on the accuracy analysis of direct georeferenced UAV imagery by low-cost navigation sensors. The analysis was carried out within the research project ARAP (automated (ortho)rectification of archaeological aerial photographs). The utilized UAS consists of the airplane "MAJA", manufactured by "Bormatec" (length: 1.2 m, wingspan: 2.2 m) equipped with the autopilot "ArduPilot Mega 2.5". For image acquisition the camera "Ricoh GR Digital IV" is utilised. The autopilot includes a GNSS receiver capable of DGPS (EGNOS), an inertial measurement system (INS), a barometer, and a magnetometer. In the study the achieved accuracies for the estimated position and orientation of the images are presented. The paper concludes with a summary of the remaining error sources and their possible corrections by applying further improvements on the utilised equipment and the direct georeferencing process.

  13. Increased iron level in phytase-supplemented diets reduce performance and nutrient utilisation in broiler chickens.

    PubMed

    Akter, M; Iji, P A; Graham, H

    2017-04-11

    1. The effect of different levels of dietary iron on phytase activity and its subsequent effect on broiler performance was investigated in a 3 x 2 factorial arrangement. A total of 360 day-old Ross 308 male broiler chicks were distributed to 6 experimental diets, formulated with three levels of Fe (60, 80 and 100 mg/kg) and two levels of phytase (0, 500 FTU/kg). 2. Phytase supplemented to mid-Fe diets increased feed consumption more than the non-supplemented diet at d 24. From hatch to d 35, Fe x phytase interaction significantly influenced the FI, BWG and FCR. The high-Fe diet supplemented with phytase significantly reduced FI and BWG of broilers than those supplemented with low or mid-Fe diets. The overall FCR was significantly better in birds fed on the mid-Fe diets with phytase supplementation. 3. A significant improvement in ileal digestibility of N, P, Mg and Fe was observed in birds feed diets containing 60 mg Fe/kg, with significant interaction between Fe and phytase. 4. Phytase improved the bone breaking strength when supplemented to low or mid-Fe diets, compared to the non-supplemented diets. There was a significant Fe x phytase interaction effect. Tibia Fe content was higher in birds fed on phytase-free diets with high Fe but the reverse was the case when phytase was added and their interaction was significant. High dietary Fe significantly increased the accumulation of Fe in liver. 5. Phytase improved Ca-Mg-ATPase, Ca-ATPase and Mg-ATPase activities in jejunum when supplemented to the diet containing 80 mg Fe/kg. 6. This study indicates that high (100 mg/kg) dietary Fe inhibited phytase efficacy and subsequently reduced the overall performance and nutrient utilisation of broilers.

  14. Can silicon isotopes be used to assess anthropogenic impacts and nutrient utilisation in Lake Baikal, Siberia?

    NASA Astrophysics Data System (ADS)

    Swann, G. E. A.; Panizzo, V. N.; Mackay, A. W.; Roberts, S.; Vologina, E.; Horstwood, M. S.

    2014-12-01

    Silicon isotope geochemistry (28Si, 29Si, 30Si) represents a growing field in Earth Sciences providing information to constrain and understand biogeochemical cycling on land and in oceans. Here we present records of δ30Si (30Si/28Si) from the Lake Baikal drainage basin in central Siberia to understand silicon cycling through the dominant river tributaries and into Lake Baikal itself, the world's deepest and most voluminous lake containing one fifth of all freshwater not stored in glaciers and ice caps.Waters were collected along an upstream transect for the five dominant Lake Baikal inflows as well as from the Selenga Delta which account for >50% of the annual riverine flow to the lake. Samples for dissolved silicon (DSi) concentrations and silicon isotopic signatures (δ30SiDSi) were filtered and acidified in the field with isotopic analyses conducted on a Neptune + Multi-Collector ICP-MS using wet plasma mode with Mg doping of samples and standard-sample-standard bracketing. Analytical reproducibility is 0.11‰ (2σ) and blanks are <1% of signal intensity. The DSi concentration of all river inflow samples varies from c. 2.5-6.3 ppm, which contrasts with concentrations of < 1ppm from the Angara River, the lake's only outflow. Combined with river δ30SiDSi values of c. + 0.94 to +1.52‰ and lake water and outflow values of c. +2.50‰, the results show significant (up to 60%) biological utilisation of silicon entering the lake.With the Lake Baikal having been designated a World Heritage Site since 1996, due to its high level of biological endemicity, the work in combination with sediment cores from the lake provides an insight into the transportation and fate of silicon in the basin and an assessment of how climate change and expanding anthropogenic activities in the region including urbanisation, deforestation, agriculture and mining have impacted biogeochemical cycling.

  15. Healthcare Resource Utilisation Associated with Herpes Zoster in a Prospective Cohort of Older Australian Adults.

    PubMed

    Karki, Surendra; Newall, Anthony T; MacIntyre, C Raina; Heywood, Anita E; McIntyre, Peter; Banks, Emily; Liu, Bette

    2016-01-01

    Herpes zoster (HZ) is a common condition that increases in incidence with older age but vaccines are available to prevent the disease. However, there are limited data estimating the health system burden attributable to herpes zoster by age. In this study, we quantified excess healthcare resource usage associated with HZ during the acute/sub-acute period of disease (21days before to 90 days after onset) in 5952 cases and an equal number of controls matched on age, sex, and prior healthcare resource usage. Estimates were adjusted for potential confounders in multivariable regression models. Using population-based estimates of HZ incidence, we calculated the age-specific excess number of health service usage events attributable to HZ in the population. Per HZ case, there was an average of 0.06 (95% CI 0.04-0.08) excess hospitalisations, 1.61 (95% CI 1.51-1.69) excess general practitioner visits, 1.96 (95% CI 1.86-2.15) excess prescriptions filled and 0.11 (95% CI 0.09-0.13) excess emergency department visits. The average number of healthcare resource use events, and the estimated excess per 100,000 population increased with increasing age but were similar for men and women, except for higher rates of hospitalisation in men. The excess annual HZ associated burden of hospitalisations was highest in adults ≥80 years (N = 2244, 95%CI 1719-2767); GP visits was highest in those 60-69 years (N = 50567, 95%CI 39958-61105), prescriptions and ED visits were highest in 70-79 years (N = 50524, 95%CI 40634-60471 and N = 2891, 95%CI 2319-3449 respectively). This study provides important data to establish the healthcare utilisation associated with HZ against which detailed cost-effectiveness analyses of HZ immunisation in older adults can be conducted.

  16. Availability, utilisation and quality of basic and comprehensive emergency obstetric care services in Malawi.

    PubMed

    Kongnyuy, Eugene J; Hofman, Jan; Mlava, Grace; Mhango, Chisale; van den Broek, Nynke

    2009-09-01

    To establish a baseline for the availability, utilisation and quality of maternal and neonatal health care services for monitoring and evaluation of a maternal and neonatal morbidity/mortality reduction programme in three districts in the Central Region of Malawi. Survey of all the 73 health facilities (13 hospitals and 60 health centres) that provide maternity services in the three districts (population, 2,812,183). There were 1.6 comprehensive emergency obstetric care (CEmOC) facilities per 500,000 population and 0.8 basic emergency obstetric care (BEmOC) facilities per 125,000 population. About 23% of deliveries were conducted in emergency obstetric care (EmOC) facilities and the met need for emergency obstetric complications was 20.7%. The case fatality rate for emergency obstetric complications treated in health facilities was 2.0%. Up to 86.7% of pregnant women attended antenatal clinic at least once and only 12.0% of them attend postnatal clinic at least once. There is a shortage of qualified staff and unequal distribution with more staff in hospitals leaving health centres severely understaffed. The total number of CEmOC facilities is adequate but the distribution is unequal, leaving some rural areas with poor access to CEmOC services. There are no functional BEmOC facilities in the three districts. In order to reduce maternal mortality in Malawi and countries with similar socio-economic profile, there is a need to upgrade some health facilities to at least BEmOC level by training staff and providing equipment and supplies.

  17. Healthcare Resource Utilisation Associated with Herpes Zoster in a Prospective Cohort of Older Australian Adults

    PubMed Central

    Karki, Surendra; Newall, Anthony T.; MacIntyre, C. Raina; Heywood, Anita E.; McIntyre, Peter; Banks, Emily; Liu, Bette

    2016-01-01

    Background Herpes zoster (HZ) is a common condition that increases in incidence with older age but vaccines are available to prevent the disease. However, there are limited data estimating the health system burden attributable to herpes zoster by age. Methods In this study, we quantified excess healthcare resource usage associated with HZ during the acute/sub-acute period of disease (21days before to 90 days after onset) in 5952 cases and an equal number of controls matched on age, sex, and prior healthcare resource usage. Estimates were adjusted for potential confounders in multivariable regression models. Using population-based estimates of HZ incidence, we calculated the age-specific excess number of health service usage events attributable to HZ in the population. Results Per HZ case, there was an average of 0.06 (95% CI 0.04–0.08) excess hospitalisations, 1.61 (95% CI 1.51–1.69) excess general practitioner visits, 1.96 (95% CI 1.86–2.15) excess prescriptions filled and 0.11 (95% CI 0.09–0.13) excess emergency department visits. The average number of healthcare resource use events, and the estimated excess per 100,000 population increased with increasing age but were similar for men and women, except for higher rates of hospitalisation in men. The excess annual HZ associated burden of hospitalisations was highest in adults ≥80 years (N = 2244, 95%CI 1719–2767); GP visits was highest in those 60–69 years (N = 50567, 95%CI 39958–61105), prescriptions and ED visits were highest in 70–79 years (N = 50524, 95%CI 40634–60471 and N = 2891, 95%CI 2319–3449 respectively). Conclusions This study provides important data to establish the healthcare utilisation associated with HZ against which detailed cost-effectiveness analyses of HZ immunisation in older adults can be conducted. PMID:27483007

  18. Swarm Utilisation Analysis: LEO satellite observations for the ESA's SSA Space Weather network

    NASA Astrophysics Data System (ADS)

    Kervalishvili, Guram; Stolle, Claudia; Rauberg, Jan; Olsen, Nils; Vennerstrøm, Susanne; Gullikstad Johnsen, Magnar; Hall, Chris

    2017-04-01

    ESA's (European Space Agency) constellation mission Swarm was successfully launched on 22 November 2013. The three satellites achieved their final constellation on 17 April 2014 and since then Swarm-A and Swarm-C orbiting the Earth at about 470 km (flying side-by-side) and Swarm-B at about 520 km altitude. Each of Swarm satellite carries instruments with high precision to measure magnetic and electric fields, neutral and plasma densities, and TEC (Total Electron Content) for which a dual frequency GPS receiver is used. SUA (Swarm Utilisation Analysis) is a project of the ESA's SSA (Space Situational Awareness) SWE (Space Weather) program. Within this framework GFZ (German Research Centre for Geosciences, Potsdam, Germany) and DTU (National Space Institute, Kongens Lyngby, Denmark) have developed two new Swarm products ROT (Rate Of change of TEC) and PEJ (Location and intensity level of Polar Electrojets), respectively. ROT is derived as the first time derivative from the Swarm measurements of TEC at 1 Hz sampling. ROT is highly relevant for users in navigation and communications: strong plasma gradients cause GPS signal degradation or even loss of GPS signal. Also, ROT is a relevant space weather asset irrespective of geomagnetic activity, e.g., high amplitude values of ROT occur during all geomagnetic conditions. PEJ is derived from the Swarm measurements of the magnetic field strength at 1 Hz sampling. PEJ has a high-level importance for power grid companies since the polar electrojet is a major cause for ground-induced currents. ROT and PEJ together with five existing Swarm products TEC, electron density, IBI (Ionospheric Bubble Index), FAC (Field-Aligned Current), and vector magnetic field build the SUA service prototype. This prototype will be integrated into ESA's SSA Space Weather network as a federated service and will be available soon from ESA's SSA SWE Ionospheric Weather and Geomagnetic Conditions Expert Service Centres (ESCs).

  19. Culture environment regulates amino acid turnover and glucose utilisation in human ES cells.

    PubMed

    Rathjen, Joy; Yeo, Christine; Yap, Charlotte; Tan, Boon Siang Nicholas; Rathjen, Peter D; Gardner, David K

    2014-06-01

    Human embryonic stem (ES) cells have been proposed as a renewable source of pluripotent cells that can be differentiated into various cell types for use in research, drug discovery and in the emerging area of regenerative medicine. Exploitation of this potential will require the development of ES cell culture conditions that promote pluripotency and a normal cell metabolism, and quality control parameters that measure these outcomes. There is, however, relatively little known about the metabolism of pluripotent cells or the impact of culture environment and differentiation on their metabolic pathways. The effect of two commonly used medium supplements and cell differentiation on metabolic indicators in human ES cells were examined. Medium modifications and differentiation were compared in a chemically defined and feeder-independent culture system. Adding serum increased glucose utilisation and altered amino acid turnover by the cells, as well as inducing a small proportion of the cells to differentiate. Cell differentiation could be mitigated by inhibiting p38 mitogen-activated protein kinase (p38 MAPK activity). The addition of Knockout Serum Replacer also increased glucose uptake and changed amino acid turnover by the cells. These changes were distinct from those induced by serum and occurred in the absence of detectable differentiation. Induction of differentiation by bone morphogenetic protein 4 (BMP4), in contrast, did not alter metabolite turnover. Deviations from metabolite turnover by ES cells in fully defined medium demonstrated that culture environment can alter metabolite use. The challenge remains to understand the impact of metabolic changes on long-term cell maintenance and the functionality of derived cell populations.

  20. Prevalence and pattern of traditional medical therapy utilisation in Kumasi Metropolis and Sekyere South District, Ghana.

    PubMed

    Gyasi, Razak Mohammed; Siaw, Lawrencia Pokuah; Mensah, Charlotte Monica

    2015-02-23

    Whilst over three-quarters of the world׳s population continues to use traditional medicine (TRM) with an increasing trend globally, limited data exist in the Ashanti Region regarding TRM utilisation. This study espoused a retrospective cross-sectional quantitative approach to examine the prevalence and pattern of TRM use among the general population in the Kumasi Metropolis and Sekyere South District, Ghana. A sample of 324, drawn through systematic random sampling was used. The main instrument for data collection was formal face-to-face interviewer-administered questionnaire. Data were analysed using Chi-square and Fisher's exact tests from the PASW (V.17.0) with p ≤ 0.05 as significant. The survey found that TRM use alongside conventional medicines was pervasive with prevalence of 86.1%. Biologically-based therapies (88.5%) and distant prayer interventions (58.4%) were commonly used modalities through the influence of families (50.3%), friends (19.4%) and the mass media (18.0%). Whilst self-administration and purchases from pharmacy shops remained important sources of TRM, TMPs׳ consultation was less credible (p<0.005). The disclosure rate of TRM use to health care professionals remained low (12.2%; p<0.001). Concomitant TRM use with conventional therapies without disclosure may interfere with the potency of treatment regimen and result in drug interactions. Inclusion of alternative medicines on the National Health Insurance Scheme's drug plan will fortify monitoring and professional administration of TRM. Information as regards TRM use needs to be incorporated into clinical and medical practice, hence the need to prioritise patient-physician communication. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Light Levels Affect Carbon Utilisation in Tropical Seagrass under Ocean Acidification

    PubMed Central

    2016-01-01

    Under future ocean acidification (OA), increased availability of dissolved inorganic carbon (DIC) in seawater may enhance seagrass productivity. However, the ability to utilise additional DIC could be regulated by light availability, often reduced through land runoff. To test this, two tropical seagrass species, Cymodocea serrulata and Halodule uninervis were exposed to two DIC concentrations (447 μatm and 1077 μatm pCO2), and three light treatments (35, 100, 380 μmol m-2 s-1) for two weeks. DIC uptake mechanisms were separately examined by measuring net photosynthetic rates while subjecting C. serrulata and H. uninervis to changes in light and addition of bicarbonate (HCO3-) use inhibitors (carbonic anhydrase inhibitor, acetazolamide) and TRIS buffer (pH 8.0). We observed a strong dependence on energy driven H+-HCO3- co-transport (TRIS, which disrupts H+ extrusion) in C. serrulata under all light levels, indicating greater CO2 dependence in low light. This was confirmed when, after two weeks exposure, DIC enrichment stimulated maximum photosynthetic rates (Pmax) and efficiency (α) more in C. serrulata grown under lower light levels (36–60% increase) than for those in high light (4% increase). However, C. serrulata growth increased with both DIC enrichment and light levels. Growth, NPP and photosynthetic responses in H. uninervis increased with higher light treatments and were independent of DIC availability. Furthermore, H. uninervis was found to be more flexible in HCO3- uptake pathways. Here, light availability influenced productivity responses to DIC enrichment, via both carbon fixation and acquisition processes, highlighting the role of water quality in future responses to OA. PMID:26938454

  2. Nutrient utilisation and methane emissions in Sahiwal calves differing in residual feed intake.

    PubMed

    Sharma, Vimlesh C; Mahesh, Munnurpal S; Mohini, Madhu; Datt, Chander; Nampoothiri, Vinu M

    2014-01-01

    The presented study aimed at investigating the residual feed intake (RFI) of Sahiwal calves, nutrient utilisation as affected by RFI and its relationship with methane (CH4) emissions and some blood metabolites. Eighteen male Sahiwal calves (10-18 months of age; mean body weight 133 kg) were fed ad libitum with a total mixed ration. After calculating RFI for individual calves (-0.40 to +0.34 kg DM/d), they were divided into three groups with low, medium and high RFI, respectively. Dry matter intake (DMI) was higher (p < 0.05) in Group High RFI, whereas digestibility of all nutrients except crude protein and ether extract was significantly higher in Group Low RFI. Nitrogen balance was also significantly higher in Group Low RFI (20.2 g/d) than in Group High RFI (17.0 g/d). Average daily gain and feed conversion ratio were similar among the groups. With exception of glucose, concentrations of all measured blood metabolites were higher in Group High RFI (p < 0.05). Compared with Group High RFI, the CH4 emission of Group Low RFI was significantly lower (on the basis g/d and g/kg DMI by 11% and 19%, respectively). Furthermore, the CH4 emission [g/d] was significantly correlated with RFI (r = 0.77). Because higher feed efficiency and less CH4 production were observed in Group Low RFI, it was concluded that RFI can be used as a measure of feed efficiency, which has a potential to select Sahiwal calves for lowered CH4 emissions.

  3. Increased utilisation of PEPFAR-supported laboratory services by non-HIV patients in Tanzania

    PubMed Central

    Gwynn, Charon; Rabkin, Miriam; Antelman, Gretchen; Wu, Yingfeng; Alemayehu, Bereket; Lim, Travis; Imtiaz, Rubina; Mosha, Fausta; Mwasekaga, Michael; Othman, Asha A.; Justman, Jessica

    2016-01-01

    Background It is unknown to what extent the non-HIV population utilises laboratories supported by the President’s Emergency Plan for AIDS Relief (PEPFAR). Objectives We aimed to describe the number and proportion of laboratory tests performed in 2009 and 2011 for patients referred from HIV and non-HIV services (NHSs) in a convenience sample collected from 127 laboratories supported by PEPFAR in Tanzania. We then compared changes in the proportions of tests performed for patients referred from NHSs in 2009 vs 2011. Methods Haematology, chemistry, tuberculosis and syphilis test data were collected from available laboratory registers. Referral sources, including HIV services, NHSs, or lack of a documented referral source, were recorded. A generalised linear mixed model reported the odds that a test was from a NHS. Results A total of 94 132 tests from 94 laboratories in 2009 and 157 343 tests from 101 laboratories in 2011 were recorded. Half of all tests lacked a documented referral source. Tests from NHSs constituted 42% (66 084) of all tests in 2011, compared with 31% (29 181) in 2009. A test in 2011 was twice as likely to have been referred from a NHS as in 2009 (adjusted odds ratio: 2.0 [95% confidence interval: 2.0–2.1]). Conclusion Between 2009 and 2011, the number and proportion of tests from NHSs increased across all types of test. This finding may reflect increased documentation of NHS referrals or that the laboratory scale-up originally intended to service the HIV-positive population in Tanzania may be associated with a ‘spillover effect’ amongst the general population. PMID:26962475

  4. Prescription monitoring of anti-hypertensive drug utilisation at the Panjab University Health Centre in India.

    PubMed

    Tiwari, H; Kumar, A; Kulkarni, S K

    2004-03-01

    The present pilot study was conducted in order to establish the drug-prescribing trend of anti-hypertensive agents at the Panjab University Health Centre in India. A pilot study of six-month duration was conducted at the Panjab University Health Centre. The information was collected from the patients attending the outpatient department through a random sample method. World Health Organisation-based prescription-auditing proforma was used for data collection. This study revealed that most of the male patients were on monotherapy (60 percent). In the monotherapy category, four classes of drugs were used. These were calcium channel blockers (48.1 percent), beta-blockers (46.2 percent), ACE inhibitors (3.9 percent) and diuretics (1.9 percent). Among monotherapy drugs, calcium channel blockers were prescribed most whereas diuretics were least used. Among those who were treated with drug combinations, 92.1% received two drugs and 7.9 percent received three drugs. In combination therapy, a two-drug combination consisting of beta-blockers and calcium channel blockers was given to the majority of the patients. Overall, 57.8 percent patients were treated with a single anti-hypertensive drug and 42.2 percent were treated with anti-hypertensive drug combinations. The present study represents the current prescribing trend for anti-hypertensive agents and it highlights certain shortcomings in the existing prescribing practice. There is a considerable scope for improvement, particularly the under-utilisation of diuretics in the present prescribing pattern of anti-hypertensive drugs.

  5. Waste generation and utilisation in micro-sized furniture-manufacturing enterprises in Turkey.

    PubMed

    Top, Y

    2015-01-01

    The number of small-scale businesses within most national economies is generally high, especially in developing countries. Often these businesses have a weak economic status and limited environmental awareness. The type and amount of waste produced, and the recycling methods adopted by these businesses during their operation can have negative effects on the environment. This study investigated the types of waste generated and the recycling methods adopted in micro-sized enterprises engaged in the manufacture of furniture. An assessment was also made of whether the characteristics of the enterprise had any effect on the waste recycling methods that were practised. A survey was conducted of 31 enterprises in the furniture industry in Gumushane province, Turkey, which is considered a developing economy. Surveys were undertaken via face-to-face interviews. It was found that medium-density fibreboard (MDF), and to a lesser extent, chipboard, were used in the manufacture of furniture, and two major types of waste in the form of fine dust and small fragments of board are generated during the cutting of these boards. Of the resulting composite board waste, 96.9% was used for heating homes and workplaces, where it was burnt under conditions of incomplete combustion. Enterprises were found to have adopted other methods to utilise their wastes in addition to using them as fuel. Such enterprises include those operating from a basement or first floor of a building in the cities, those continuing production throughout the year, those in need for capital and those enterprises not operating a dust-collection system. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

  6. Impact of utilisation of uncompleted handouts on power point presentations (PPT) in rural Indian medical institute

    PubMed Central

    BHAISARE, ROSHAN; KAMBLE, BHAVNA

    2016-01-01

    Introduction Note taking while attending a PPT requires high activity of memory and writing process which ultimately leads to what is called “death by power point” referring to boredom and fatigue.  To overcome this we planned to evaluate the impact of utilisation of uncompleted handouts given prior to PPT presentations. Methods Final year MBBS students were divided in 2 batches, batch A and batch B.  For a set of lectures one batch was provided with handouts before lecture while the other batch was given lectures only. Crossover was done to avoid bias, all the lectures being given by the same presenter.  At the end of each lecture, a short questionnaire of 10 Multiple Choice Question (MCQ) was provided to the students. Mean scores were calculated for lectures with handouts and without handouts. Results For a set of lectures, when batch A was provided with handouts, the mean score was 28.2; for batch B to which no handouts were given the mean score was 23.4. Similarly, for batch B when provided with handouts the mean score was 29.1, for batch A which was not provided with handouts the mean score was 24. There was an average increase of 4.2 marks. Actual gain when handouts were provided was 1.2 marks per lecture.  It was more for the batch comprising of repeater students as compared to the batch of fresher students. Increase in attendance was also noted. Conclusion Providing uncompleted handouts before a didactic lecture definitely results in increase in knowledge gain; repeater students benefit more with uncompleted handouts, PMID:27382583

  7. Utilising reinforcement learning to develop strategies for driving auditory neural implants

    NASA Astrophysics Data System (ADS)

    Lee, Geoffrey W.; Zambetta, Fabio; Li, Xiaodong; Paolini, Antonio G.

    2016-08-01

    Objective. In this paper we propose a novel application of reinforcement learning to the area of auditory neural stimulation. We aim to develop a simulation environment which is based off real neurological responses to auditory and electrical stimulation in the cochlear nucleus (CN) and inferior colliculus (IC) of an animal model. Using this simulator we implement closed loop reinforcement learning algorithms to determine which methods are most effective at learning effective acoustic neural stimulation strategies. Approach. By recording a comprehensive set of acoustic frequency presentations and neural responses from a set of animals we created a large database of neural responses to acoustic stimulation. Extensive electrical stimulation in the CN and the recording of neural responses in the IC provides a mapping of how the auditory system responds to electrical stimuli. The combined dataset is used as the foundation for the simulator, which is used to implement and test learning algorithms. Main results. Reinforcement learning, utilising a modified n-Armed Bandit solution, is implemented to demonstrate the model’s function. We show the ability to effectively learn stimulation patterns which mimic the cochlea’s ability to covert acoustic frequencies to neural activity. Time taken to learn effective replication using neural stimulation takes less than 20 min under continuous testing. Significance. These results show the utility of reinforcement learning in the field of neural stimulation. These results can be coupled with existing sound processing technologies to develop new auditory prosthetics that are adaptable to the recipients current auditory pathway. The same process can theoretically be abstracted to other sensory and motor systems to develop similar electrical replication of neural signals.

  8. Impact of utilisation of uncompleted handouts on power point presentations (PPT) in rural Indian medical institute.

    PubMed

    Bhaisare, Roshan; Kamble, Bhavna

    2016-07-01

    Note taking while attending a PPT requires high activity of memory and writing process which ultimately leads to what is called "death by power point" referring to boredom and fatigue.  To overcome this we planned to evaluate the impact of utilisation of uncompleted handouts given prior to PPT presentations. Final year MBBS students were divided in 2 batches, batch A and batch B.  For a set of lectures one batch was provided with handouts before lecture while the other batch was given lectures only. Crossover was done to avoid bias, all the lectures being given by the same presenter.  At the end of each lecture, a short questionnaire of 10 Multiple Choice Question (MCQ) was provided to the students. Mean scores were calculated for lectures with handouts and without handouts. For a set of lectures, when batch A was provided with handouts, the mean score was 28.2; for batch B to which no handouts were given the mean score was 23.4. Similarly, for batch B when provided with handouts the mean score was 29.1, for batch A which was not provided with handouts the mean score was 24. There was an average increase of 4.2 marks. Actual gain when handouts were provided was 1.2 marks per lecture.  It was more for the batch comprising of repeater students as compared to the batch of fresher students. Increase in attendance was also noted. Providing uncompleted handouts before a didactic lecture definitely results in increase in knowledge gain; repeater students benefit more with uncompleted handouts.

  9. Detection of copy number variations in melanocytic lesions utilising array based comparative genomic hybridisation.

    PubMed

    Mesbah Ardakani, Nima; Thomas, Carla; Robinson, Cleo; Mina, Kym; Harvey, Nathan Tobias; Amanuel, Benhur; Wood, Benjamin Andrew

    2017-04-01

    Distinction between melanocytic naevi and melanoma occasionally poses a diagnostic challenge in ambiguous cases showing overlapping histological features. Melanomas are characterised by the presence of multiple genomic copy number variants (CNVs), while this is not a feature of naevi. We assessed the feasibility and utility of array-based comparative genomic hybridisation (aCGH) to assess CNVs in melanocytic lesions. DNA was extracted from formalin fixed, paraffin embedded (FFPE) sections of unambiguous naevi (n=19) and melanomas (n=19). The test DNA and gender mismatched human reference DNA were differentially labelled with fluorophores. Equal quantities of the two DNA samples were mixed and co-hybridised to a SurePrint G3 Human CGH 8x60K array, and digitally scanned to capture and quantify the relative fluorescence intensities. The ratio of the fluorescence intensities was analysed by Cytogenomics software (Agilent). Frequent large CNVs were identified in 94.7% of melanoma samples, including losses of 9p (73.6%), 9q (52.6%), 10q (36.8%), 11q (36.8%), 3p (21%), and 10p (21%), and gains of 6p (42.1%), 7p (42.1%), 1q (36.8%), 8q (31.5%) and 20q (21%). Only one naevus showed two large copy number changes. Overall aCGH showed a specificity and sensitivity of 94.7% in separating naevi from melanomas. Based on our results, aCGH can be successfully used to analyse CNVs of melanocytic lesions utilising FFPE derived biopsy samples, providing a potentially useful adjunctive test for the classification of diagnostically challenging melanocytic proliferations. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  10. Effects of glyceryl polyethylene glycol ricinoleate on nutrient utilisation and performance of broiler chickens.

    PubMed

    Kaczmarek, Sebastian Andrzej; Bochenek, Maciej; Samuelsson, Anne-Cathrine; Rutkowski, Andrzej

    2015-01-01

    A completely randomised design study with a 2 × 2 factorial arrangement was conducted to observe effects of an emulsifier (glyceryl polyethylene glycol ricinoleate (GPR)) on nutrient utilisation and performance of broiler chickens. A total of 384 male broiler chickens were used to determine the influence of GPR (without addition or added at 0.04% of diet) and two levels of apparent metabolisable energy (AMEN) (according to standard requirements (Diets SE) or energy reduced by 0.4 MJ/kg diet (Diets LE)) on birds' performance and apparent total tract digestibility (ATTD). ATTD of ether extract (EE) and AMEN were measured on d 14 and 35, and ATTD of neutral detergent fibre (NDF) was measured on d 35. All diets were based on wheat-maize-soybean meal with rapeseed oil and lard (blend of 50:50) as fat sources. During the grower period and the whole trial, birds fed Diets supplemented with GPR were characterised by higher body weight gain (BWG) and lower feed conversion ratio (FCR) compared to chicken receiving diets without GPR (p < 0.05). At the end of experiment, birds fed Diet LE without GPR were characterised by lower BWG and higher FCR (p < 0.05). Supplementation with GPR caused a higher ATTD of EE for diets SE and LE at d 14 and 35 (p < 0.05). Moreover, the GPR addition to Diet LE improved ATTD of NDF at d 35 (p < 0.05). In conclusion, the findings suggest that GPR effects the digestion of a blend of animal fat/rapeseed oil positively, even in a practical maize-wheat-based broiler diet with decreased AMEN level.

  11. Agricultural waste utilisation strategies and demand for urban waste compost: Evidence from smallholder farmers in Ethiopia.

    PubMed

    Nigussie, Abebe; Kuyper, Thomas W; de Neergaard, Andreas

    2015-10-01

    The use of agricultural waste for soil amendment is limited in developing countries. Competition between fuel and feed is the major cause for the insufficient application of agricultural waste on cropland. The aims of this study were therefore (i) to investigate variation in agricultural waste allocation between groups of farmers with different livelihood strategies and link this allocation with the nutrient balances of their production systems, (ii) to identify farm characteristics that influence utilisation of agricultural waste for soil amendment, and (iii) to assess demand for urban waste compost. A total of 220 farmers were selected randomly and interviewed using standardised semi-structured questionnaires. Four groups of farmers, namely (i) field crop farmers, (ii) vegetable producers, (iii) ornamental-plant growers, and (iv) farmers practising mixed farming, were identified using categorical principal component and two-step cluster analyses. Field crop farmers produced the largest quantity of agricultural waste, but they allocated 80% of manure to fuel and 85% of crop residues to feed. Only <10% of manure and crop residues were applied on soils. Farmers also sold manure and crop residues, and this generated 5-10% of their annual income. Vegetable and ornamental-plant growers allocated over 40% of manure and crop residues to soil amendment. Hence, nutrient balances were less negative in vegetable production systems. Education, farm size, land tenure and access to extension services were the variables that impeded allocation of agricultural waste to soil amendment. Replacement of fuel and feed through sustainable means is a viable option for soil fertility management. Urban waste compost should also be used as alternative option for soil amendment. Our results showed variation in compost demand between farmers. Education, landownership, experience with compost and access to extension services explained variation in compost demand. We also demonstrated that

  12. Working with Persistent Pain: An Exploration of Strategies Utilised to Stay Productive at Work.

    PubMed

    Oakman, Jodi; Kinsman, Natasha; Briggs, Andrew M

    2017-03-01

    Purpose Maintaining productive employment for people with persistent pain conditions is challenging. This study aims to explore supports-work and non-work- used by employees to assist them in maintaining productive employment. Methods An exploratory, mixed-methods study comprising a questionnaire battery followed by semi-structured interviews to collect in-depth qualitative data was undertaken. The questionnaires measured descriptive variables used to select participants for interviews based on maximum heterogeneity sampling. Thirty-five semi-structured interviews were undertaken (14 males; 21 females). The interview schedule covered: employment situation, workplace challenges, workplace supports, coping strategies, motivations, future employment options and any other resources utilised. Inductive content analysis was undertaken using a grounded theory approach to systematically explore the data. Results Three key themes were identified: barriers to working productively, enablers to working productively, disclosing my condition at work. A key determinant of maintaining productive employment was a supportive employer. In addition, flexibility in the work organisation was also pivotal in maintaining sustainable, productive employment. An important issue emerged with regard to disclosure of one's condition to an employer. For some, this was a significant barrier to employment. Conclusions To ensure sustainable employment is attainable for those with persistent pain conditions, a good match is required between an employee and their work. Workplace accommodations may assist with improving job fit but this requires disclosure of a condition to an employer. Weighing up the risks and benefits of disclosure is difficult, and may be assisted by knowledge of available supports to assist with maintaining ongoing employment.

  13. The POPPY Research Programme protocol: investigating opioid utilisation, costs and patterns of extramedical use in Australia

    PubMed Central

    Degenhardt, Louisa; Blanch, Bianca; Gisev, Natasa; Larance, Briony; Pearson, Sallie

    2015-01-01

    Introduction Opioid prescribing is increasing in many countries. In Australia, there is limited research on patterns of prescribing and access, or the outcomes associated with this use. The aim of this research programme is to use national dispensing data to estimate opioid use and costs, including problematic or extramedical use in the Australian population. Methods and analysis In a cohort of persons dispensed at least one opioid in 2013, we will estimate monthly utilisation and costs of prescribed opioids, overall and according to individual opioid formulations and strengths. In a cohort of new opioid users, commencing therapy between 1 July 2009 and 31 December 2013, we will examine patterns of opioid use including initiation of therapy, duration of treatment and concomitant use of opioids and other prescribed medicines. We will also examine patterns of extramedical opioid use based on indicators including excess dosing, use of more than one opioid concomitantly, doctor/pharmacy shopping and accelerated time to prescription refill. Ethics and dissemination This protocol was approved by the NSW Population and Health Services Ethics Committee (March 2014) and data access approved by the Department of Human Services External Review Evaluation Committee (June 2014). This will be one of the first comprehensive Australian studies with the capability to investigate individual patterns of use and track extramedical use. In the first instance our analysis will be based on 5 years of dispensing data but will be expanded with ongoing annual data updates. This research has the capability to contribute significantly to pharmaceutical policy within Australia and globally. In particular, the trajectory of extramedical prescription-opioid use has been the subject of limited research to date. The results of this research will be published widely in general medical, pharmacoepidemiology, addiction and psychiatry journals. PMID:25631315

  14. Light Levels Affect Carbon Utilisation in Tropical Seagrass under Ocean Acidification.

    PubMed

    Ow, Yan X; Uthicke, Sven; Collier, Catherine J

    2016-01-01

    Under future ocean acidification (OA), increased availability of dissolved inorganic carbon (DIC) in seawater may enhance seagrass productivity. However, the ability to utilise additional DIC could be regulated by light availability, often reduced through land runoff. To test this, two tropical seagrass species, Cymodocea serrulata and Halodule uninervis were exposed to two DIC concentrations (447 μatm and 1077 μatm pCO2), and three light treatments (35, 100, 380 μmol m(-2) s(-1)) for two weeks. DIC uptake mechanisms were separately examined by measuring net photosynthetic rates while subjecting C. serrulata and H. uninervis to changes in light and addition of bicarbonate (HCO3-) use inhibitors (carbonic anhydrase inhibitor, acetazolamide) and TRIS buffer (pH 8.0). We observed a strong dependence on energy driven H+-HCO3- co-transport (TRIS, which disrupts H+ extrusion) in C. serrulata under all light levels, indicating greater CO2 dependence in low light. This was confirmed when, after two weeks exposure, DIC enrichment stimulated maximum photosynthetic rates (Pmax) and efficiency (α) more in C. serrulata grown under lower light levels (36-60% increase) than for those in high light (4% increase). However, C. serrulata growth increased with both DIC enrichment and light levels. Growth, NPP and photosynthetic responses in H. uninervis increased with higher light treatments and were independent of DIC availability. Furthermore, H. uninervis was found to be more flexible in HCO3- uptake pathways. Here, light availability influenced productivity responses to DIC enrichment, via both carbon fixation and acquisition processes, highlighting the role of water quality in future responses to OA.

  15. Effectiveness of a five-level Paediatric Triage System: an analysis of resource utilisation in the emergency department in Taiwan

    PubMed Central

    Chang, Yu-Che; Ng, Chip-Jin; Wu, Chang-Teng; Chen, Li-Chin; Chen, Jih-Chang; Hsu, Kuang-Hung

    2013-01-01

    Objectives To examine the effectiveness of a five-level Paediatric Triage and Acuity System (Ped-TTAS) by comparing the reliability of patient prioritisation and resource utilisation with the four-level Paediatric Taiwan Triage System (Ped-TTS) among non-trauma paediatric patients in the emergency department (ED). Methods The study design used was a retrospective longitudinal analysis based on medical chart review and a computer database. Except for a shorter list of complaints and some abnormal vital sign criteria modifications, the structure and triage process for applying Ped-TTAS was similar to that of the Paediatric Canadian Emergency Triage and Acuity Scale. Non-trauma paediatric patients presenting to the ED were triaged by well-trained triage nurses using the four-level Ped-TTS in 2008 and five-level Ped-TTAS in 2010. Hospitalisation rates and medical resource utilisation were analysed by acuity levels between the contrasting study groups. Results There was a significant difference in patient prioritisation between the four-level Ped-TTS and five-level Ped-TTAS. Improved differentiation was observed with the five-level Ped-TTAS in predicting hospitalisation rates and medical costs. Conclusions The five-level Ped-TTAS is better able to discriminate paediatric patients by triage acuity in the ED and is also more precise in predicting resource utilisation. The introduction of a more accurate acuity and triage system for use in paediatric emergency care should provide greater patient safety and more timely utilisation of appropriate ED resources. PMID:22983978

  16. A qualitative study on barriers to utilisation of institutional delivery services in Moroto and Napak districts, Uganda: implications for programming.

    PubMed

    Wilunda, Calistus; Quaglio, Gianluca; Putoto, Giovanni; Lochoro, Peter; Dall'Oglio, Giovanni; Manenti, Fabio; Atzori, Andrea; Lochiam, Rose Miligan; Takahashi, Risa; Mukundwa, Aline; Oyerinde, Koyejo

    2014-08-04

    Skilled attendance at delivery is critical in prevention of maternal deaths. However, many women in low- and middle-income countries still deliver without skilled assistance. This study was carried out to identify perceived barriers to utilisation of institutional delivery in two districts in Karamoja, Uganda. Data were collected through participatory rural appraisal (PRA) with 887 participants (459 women and 428 men) in 20 villages in Moroto and Napak districts. Data were analysed using deductive content analysis. Notes taken during PRA session were edited, triangulated and coded according to recurring issues. Additionally, participants used matrix ranking to express their perceived relative significance of the barriers identified. The main barriers to utilisation of maternal health services were perceived to be: insecurity, poverty, socio-cultural factors, long distances to health facilities, lack of food at home and at health facilities, lack of supplies, drugs and basic infrastructure at health facilities, poor quality of care at health facilities, lack of participation in planning for health services and the ready availability of traditional birth attendants (TBAs). Factors related to economic and physical inaccessibility and lack of infrastructure, drugs and supplies at health facilities were highly ranked barriers to utilisation of institutional delivery. A comprehensive approach to increasing the utilisation of maternal health care services in Karamoja is needed. This should tackle both demand and supply side barriers using a multi-sectorial approach since the main barriers are outside the scope of the health sector. TBAs are still active in Karamoja and their role and influence on maternal health in this region cannot be ignored. A model for collaboration between skilled health workers and TBAs in order to increase institutional deliveries is needed.

  17. Effects of drug price reduction and prescribing restrictions on expenditures and utilisation of antihypertensive drugs in Korea

    PubMed Central

    Yoo, Ki-Bong; Lee, Sang Gyu; Park, Sohee; Kim, Tae Hyun; Ahn, Jeonghoon; Cho, Mee-Hyun; Park, Eun-Cheol

    2015-01-01

    Objectives To evaluate the quantitative effects of the drug price reduction on pharmaceutical expenditures and the new guidelines to restrict prescribing on drug utilisation for antihypertensive drugs. Design We used an interrupted time series design with the National patient sample data of Health Insurance Review and Assessment Service in South Korea. Methods 54 295 participants who were with primary hypertension from the National patient sample data of Health Insurance Review and Assessment Service were included. The study period was from March 2011 to December 2013. The dependent variables were antihypertensive drug costs, antihypertensive drug cost per prescribing day, daily drug utilisation, average number of drugs per month, percentage of original drugs per prescription, drug overutilisation and prohibited combinations. Segmented regression analysis was used. Results The drug price reduction reduced expenditure (US$−1.51, −10.2%), and the new guidelines reduced expenditures even more (US$−2.13; −16.2%). These policies saved US$4.22 (28%) of antihypertensive drug costs per patient in December 2013 compared to March 2012. Drug price reduction policy was introduced in April 2012. We established the policy effect by comparing it before (March 2012) with after(21 months later-December 2012). The effects of the guidelines decreased expenditures, daily drug utilisation and the average number of drugs per month more than did the drug price reduction. Conclusions Both policies saved money. The guidelines were more effective over time and had fewer side effects such as increasing daily drug utilisation and number of drugs than the effects of drug price reduction. PMID:26179644

  18. Utilisation of health services and the poor: deconstructing wealth-based differences in facility-based delivery in the Philippines.

    PubMed

    Hodge, Andrew; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez-Soto, Eliana

    2016-07-06

    Despite achieving some success, wealth-related disparities in the utilisation of maternal and child health services persist in the Philippines. The aim of this study is to decompose the principal factors driving the wealth-based utilisation gap. Using national representative data from the 2013 Philippines Demographic and Health Survey, we examine the extent overall differences in the utilisation of maternal health services can be explained by observable factors. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect of differences in measurable characteristics on the wealth-based coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was respectively 41.1 % and 74.6 % for poor and non-poor households. Between 67 and 69 % of the wealth-based coverage gap was explained by differences in observed characteristics. After controlling for factors characterising the socioeconomic status of the household (i.e. the mothers' and her partners' education and occupation), the birth order of the child was the major factor contributing to the disparity. Mothers' religion and the subjective distance to the health facility were also noteworthy. This study has found moderate wealth-based disparities in the utilisation of institutional delivery in the Philippines. The results confirm the importance of recent efforts made by the Philippine government to implement equitable, pro-poor focused health programs in the most deprived geographic areas of the country. The importance of addressing the social determinants of health, particularly education, as well as developing and implementing effective strategies to encourage institutional delivery for higher order births, should be prioritised.

  19. Changes in utilisation of antiepileptic drugs in epilepsy and non-epilepsy disorders-a pharmacoepidemiological study and clinical implications.

    PubMed

    Baftiu, Arton; Johannessen Landmark, Cecilie; Rusten, Ida Rudberg; Feet, Silje Andrea; Johannessen, Svein I; Larsson, Pål G

    2016-10-01

    The purpose of this study was to investigate changes in utilisation of antiepileptic drugs (AEDs) in epilepsy and non-epilepsy disorders in Norway and furthermore to study the retention rates of the most commonly used AEDs in these indications in long-term use. The data consisted of all prescriptions of AEDs from Norwegian pharmacies in the Norwegian Prescription Database (NorPD) (2004-2012). Variables included anonymous data regarding age, gender, diagnosis specific reimbursement codes and utilisation of AEDs. In recent years (2008-2012), the utilisation of AEDs in non-epilepsy disorders accounted for 45-53 % of the total use. In epilepsy, the most commonly used AED was lamotrigine, followed by levetiracetam, carbamazepine and valproate. Lamotrigine was also the predominant AED used in psychiatry, while pregabalin and gabapentin were mostly used in neuropathic pain. In migraine, topiramate predominated but accounted for <1 % of the total utilisation of AEDs. The majority of prescriptions were by general practitioners and only 20 % by specialists. Regardless of indication, newer AEDs had higher retention rates (34-48 %) and were used for a longer period before discontinuation. The use of AEDs in non-epilepsy disorders is increasing and accounted for 53 % in 2012. Newer AEDs were predominantly used and demonstrated higher retention rates than older AEDs in all indications. This nationwide study demonstrates an increased exposure to AEDs in new patient groups, and details in prescription patterns and clinical and safety considerations should be closely monitored. This contributes to long-term post-marketing data of AED and accordingly improved pharmacovigilance.

  20. Inhibition of chorismate-utilising enzymes by 2-amino-4-carboxypyridine and 4-carboxypyridone and 5-carboxypyridone analogues.

    PubMed

    Payne, Richard J; Bulloch, Esther M M; Kerbarh, Olivier; Abell, Chris

    2010-08-07

    Several 2-amino-4-carboxypyridine, 4- and 5-carboxypyridone-based compounds were prepared and tested against three members of the chorismate-utilising enzyme family, anthranilate synthase, isochorismate synthase and salicylate synthase. Most compounds exhibited low micromolar inhibition of these three enzymes. The most potent inhibitor was a 4-carboxypyridone analogue bearing a lactate side chain on the pyridyl nitrogen which exhibited inhibition constants of 5, 91 and 54 muM against anthranilate synthase, isochorismate synthase and salicylate synthase respectively.

  1. Challenging the perceptions of cancer service provision for the disadvantaged: evaluating utilisation of cancer support services in Western Australia.

    PubMed

    Moorin, Rachael; Gibson, David; Bulsara, Caroline E; Holman, C D J

    2012-08-01

    The main aim of the study was to evaluate the distributive utilisation of services provided by the Cancer Council of Western Australia according to age, social disadvantage and geographic location. Results were used to determine if social justice principles in terms of service provision were upheld. Cross-sectional study design to evaluate utilisation of cancer support services over a 12-week period in 2007 using administrative records. Service utilisation incidence rates (population information obtained from de-identified cancer registry data) and incidence rate ratios were calculated by gender, age group, cancer type, socioeconomic status and location. The Information services (52%, n = 4,932) were the most popular Cancer Council of Western Australia (CCWA) services followed by Emotional Support services (21%, n = 2,045). All CCWA services were more likely to be accessed by those with a lower socioeconomic status, except for Clinical Services. The rate of utilisation for patients with cancer in the 65+ years age group was found to be under-serviced relative to the 40-64 years age group. Overall, the study has shown that CCWA services are not provided uniformly (horizontal equity) across strata of socio-economic status. Given that the prevalence of cancer generally increases with socio-economic advantage, the findings were notable in regard to one particular outcome. Results for age indicate that there may be some underlying accessibility issues for the aged population. The findings are consistent with current literature highlighting issues of disadvantage in regard to the ability of elderly persons with cancer to access services and support.

  2. The Effect of Urban Basic Medical Insurance on Health Service Utilisation in Shaanxi Province, China: A Comparison of Two Schemes

    PubMed Central

    Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang

    2014-01-01

    Background Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Methods Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Results Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Conclusion Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services. PMID:24740282

  3. The effect of urban basic medical insurance on health service utilisation in Shaanxi Province, China: a comparison of two schemes.

    PubMed

    Zhou, Zhongliang; Zhou, Zhiying; Gao, Jianmin; Yang, Xiaowei; Yan, Ju'e; Xue, Qinxiang; Chen, Gang

    2014-01-01

    Urban population in China is mainly covered by two medical insurance schemes: the Urban Employee Basic Medical Insurance (UEBMI) for urban employees in formal sector and the Urban Resident Basic Medical Insurance (URBMI) for the left urban residents, mainly the unemployed, the elderly and children. This paper studies the effects of UEBMI and URBMI on health services utilisation in Shaanxi Province, Western China. Cross-sectional data from the 4th National Health Services Survey - Shaanxi Province was studied. The propensity score matching and the coarsened exact matching methods have been used to estimate the average medical insurance effect on the insured. Compared to the uninsured, robust results suggest that UEBMI had significantly increased the outpatient health services utilisation in the last two weeks (p<0.10), whilst the significant effect on hospitalisation was evident in the CEM method (p<0.10). The effect of URBMI was limited in that although being insured was associated with higher health services utilisation, compared with the uninsured, none of the improvement was statistically significant (p>0.10). It was also found that compared with the uninsured, basic medical insurance enrollees were more likely to purchase inpatient treatments in lower levels of hospitals, consistent with the incentive of the benefit package design. Basic Medical insurance schemes have shown a positive but limited effect on increasing health services utilisation in Shaanxi Province. The benefit package design of higher reimbursement rates for lower level hospitals has induced the insured to use medical services in lower level hospitals for inpatient services.

  4. Low utilisation of diabetes medicines in Iran, despite their affordability (2000–2012): a time-series and benchmarking study

    PubMed Central

    Sarayani, Amir; Rashidian, Arash; Gholami, Kheirollah

    2014-01-01

    Objectives Diabetes is a major public health concern worldwide, particularly in low-income and middle-income countries (LMICs). Limited data exist on the status of access to diabetes medicines in LMICs. We assessed the utilisation and affordability of diabetes medicines in Iran as a middle-income country. Design We used a retrospective time-series design (2000–2012) and assessed national diabetes medicines’ utilisation using pharmaceuticals wholesale data. Methods We calculated defined daily dose consumptions per population days (DDDs/1000 inhabitants/day; DIDs) indicator. Findings were benchmarked with data from Organization for Economic Co-operation and Development (OECD) countries. We also employed Drug Utilization-90% (DU-90) method to compare DU-90s with the Essential Medicines List published by the WHO. We measured affordability using number of minimum daily wage required to purchase a treatment course for 1 month. Results Diabetes medicines’ consumption increased from 4.47 to 33.54 DIDs. The benchmarking showed that medicines’ utilisation in Iran in 2011 was only 54% of the median DIDs of 22 OECD countries. Oral hypoglycaemic agents consisted over 80% of use throughout the study period. Regular and isophane insulin (NPH), glibenclamide, metformin and gliclazide were the DU-90 drugs in 2012. Metformin, glibenclamide and regular/NPH insulin combination therapy were affordable throughout the study period (∼0.4, ∼0.1, ∼0.3 of minimum daily wage, respectively). While the affordability of novel insulin preparations improved over time, they were still unaffordable in 2012. Conclusions The utilisation of diabetes medicines was relatively low, perhaps due to underdiagnosis and inadequate management of patients with diabetes. This had occurred despite affordability of essential diabetes medicines in Iran. Appropriate policies are required to address the underutilisation of diabetes medicines in Iran. PMID:25324322

  5. Self-reported illnesses and service utilisation among migrants working in small-to medium sized enterprises in Guangdong, China.

    PubMed

    Zou, G; Zeng, Z; Chen, W; Ling, L

    2015-07-01

    As one of the most vulnerable populations in China, many migrants work in the small-to-medium-sized enterprises (SMEs). This study aims to describe the self-reported illnesses and service utilization of the migrants working in the SMEs in Pearl River Delta Areas (PRDA) of Guangdong province, China. Cross-sectional survey. We interviewed 856 migrants working in the SMEs of different manufacturing industries in 2012. Descriptive analysis was employed to report self-reported illnesses and service utilisation among migrants in the last two weeks and in the last year. Statistical tests such as χ2 test were used to explore factors influencing their service utilisation. In the last two weeks, 91(11%) of the respondents reported having any illness. The most reported illness was respiratory problem (69%), while 9.9%, 7.7% and 13% reported having digestive, skin and other problems respectively. The most important symptom was cough (39%). Thirty-seven percent of the respondents who reported any illness had visited health facilities. The lower income group were more likely to visit health facilities than the higher income group (P = 0.006). The most reported reason for not visiting health facilities was 'feeling not serious' (65%). In the last year, 13% reported having respiratory problems and 7.8% reported accidental injuries. Less than 3% received hospitalization care. The proportion of those without hospitalization to those who should have been hospitalized was 31%. Underuse of the health service among migrants working in the SMEs could be associated with the 'healthy migrant' effect. However, when assessed among the ill migrants in the SMEs, the utilisation rate was still low mainly due to their poor health awareness. Improving their risk perception and integration of occupational and general health service is crucial to improve the health conditions and utilisation of service among migrants in the SMES. Copyright © 2015 The Royal Society for Public Health. Published

  6. Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study

    PubMed Central

    Gerritsen, Annette AM; Bramsen, Inge; Devillé, Walter; van Willigen, Loes HM; Hovens, Johannes E; van der Ploeg, Henk M

    2004-01-01

    Background This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. Methods/Design The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees. PMID:15070416

  7. Accessibility to and utilisation of schistosomiasis-related health services in a rural area of state of Minas Gerais, Brazil.

    PubMed

    Reis, Dener Carlos dos; Kloos, Helmut; King, Charles; Quites, Humberto Ferreira Oliveira; Matoso, Leonardo Ferreira; Coelho, Kellen Rosa; Gazzinelli, Andrea

    2010-07-01

    The objective of the present paper was to compare accessibility and utilisation of schistosomiasis diagnostic and treatment services in a small village and the surrounding rural area in northern part of the state of Minas Gerais Brazil. The study included 1,228 individuals: 935 central village residents and 293 rural residents of São Pedro do Jequitinhonha. Schistosoma mansoni infection rates were significantly higher in the central village than in the rural area during a survey in 2007 (44.3% and 23.5%, respectively) and during the 2002 schistosomiasis case-finding campaign (33.1% and 26.5%, respectively) (p < 0.001). However, during the 2002-2006 period, only 23.7% of the villagers and 27% of the rural residents obtained tests on their own from health centres, hospitals and private clinics in various nearby towns. In 2007, 63% of the villagers and 70.5% of the rural residents reported never having received treatment for schistosomiasis. This paper reveals considerable variation in the accessibility and utilisation of schistosomiasis-related health services between the central village and the rural area. A combination of low utilisation rates between 2002-2006 and persistently high S. mansoni infection rates suggest that the schistosomiasis control program must be more rapidly incorporated into the primary health services.

  8. Caregiver perceptions of mental health problems and treatment utilisation in siblings of children with mental health problems.

    PubMed

    Ma, Nylanda; Furber, Gareth; Roberts, Rachel; Winefield, Helen

    2016-01-01

    Siblings of children with mental health problems (MHPs) have been found to have higher rates of psychopathology and impaired psychosocial functioning compared to control children. It is not yet known how these siblings are managed within the clinical service context (e.g., are they assessed for mental health problems? Do they receive appropriate psychological treatment?). The following brief report describes a pilot study which aimed to explore (a) the rate of caregiver-identified MHPs in siblings and (b) the proportion of siblings receiving psychiatric or psychosocial treatment or support (i.e., treatment utilisation). Eighty-five caregivers of children receiving treatment at CAMHS were interviewed about the mental health and treatment utilisation of their siblings. The findings revealed a high rate of caregiver-identified MHPs in siblings (34.1%) and a high rate of treatment utilisation (85.7%). The findings suggest that, for the vast majority, when siblings of children with MHPs are identified by their caregivers as having MHPs, they are receiving some kind of support and treatment. Implications for mental health service costs are discussed and recommendations for future research are outlined.

  9. Impact of health insurance status changes on healthcare utilisation patterns: a longitudinal cohort study in South Korea

    PubMed Central

    Kim, Jae-Hyun; Lee, Sang Gyu; Lee, Kwang-Soo; Jang, Sung-In; Cho, Kyung-Hee; Park, Eun-Cheol

    2016-01-01

    Objectives The study examined medical care utilisation by health insurance status changes. Setting The Korean Welfare Panel Study (KoWePs) was used. Participants This study analysed 14 267 participants at baseline (2006). Interventions The individuals were categorised into four health insurance status groups: continuous health insurance, change from health insurance to Medical Aid, change from Medical Aid to health insurance, or continuous Medical Aid. Primary and secondary outcome measures Three dependent variables were also analysed: days spent in hospital; number of outpatient visits; and hospitalisations per year. Longitudinal data analysis was used to determine whether changes in health insurance status were associated with healthcare utilisation. Results The number of outpatient visits per year was 0.1.363 times higher (p<0.0001) in the continuous Medical Aid than in the continuous health insurance group. The number of hospitalisations per year was 1.560 times higher (p<0.001) in new Medical Aid and −0.636 times lower (p<0.001) in new health insurance than in continuous health insurance group. The number of days spent in hospital per year was −0.567 times lower (p=0.021) in the new health insurance than in the continuous health insurance group. Conclusions Health insurance beneficiaries with a coverage level lower than Medical Aid showed lower healthcare utilisation, as measured by the number of hospitalisations and days spent in hospital per year. PMID:27036140

  10. The relationships between sulphate reduction and COD/VFA utilisation using grass cellulose as carbon and energy sources.

    PubMed

    Mulopo, Jean; Greben, Harma; Sigama, Julia; Radebe, Vivian; Mashego, Mlawule; Burke, Lisa

    2011-02-01

    The release of mine effluents can have a damaging impact on receiving water bodies. Therefore, treatment of mine waters before discharge is imperative. A novel biological SO²⁻₄ removal technology has been developed whereby the degradation/fermentation products of grass cellulose, volatile fatty acids (VFA), function as the electron donors and SO²⁻₄ as the electron acceptor. The aim of the study presented here was to elucidate the interactions between the cellulose degradation rate, the chemical oxygen demand (COD), VFA production and its/utilisation rate as well as the sulphate reduction rate. To this end, two stirred batch reactors were operated: a test and a control reactor. The results showed that high COD and VFA concentrations were achieved after cellulose degradation, which resulted in a rapid decrease in the SO²⁻₄ concentration in the test reactor. The VFA results indicated that propionic and butyric acids were preferentially utilised, producing acetate. In the control reactor, the VFA and the COD production increased initially at the same rate, followed later by a decrease at a similar rate. These results suggest that the degradation products formed were utilised by the methanogenic bacteria to produce methane rather than by the sulphate-reducing bacteria, since the control reactor contained no sulphate (Visser 1995). Furthermore, these results showed a clear relationship between the COD/VFA production and the SO²⁻₄reduction in the test reactor and between the COD and VFA pattern in the control reactor.

  11. Self-management support interventions to reduce health care utilisation without compromising outcomes: a systematic review and meta-analysis.

    PubMed

    Panagioti, Maria; Richardson, Gerry; Small, Nicola; Murray, Elizabeth; Rogers, Anne; Kennedy, Anne; Newman, Stanton; Bower, Peter

    2014-08-27

    There is increasing interest in the role of 'self-management' interventions to support the management of long-term conditions in health service settings. Self-management may include patient education, support for decision-making, self-monitoring and psychological and social support. Self-management support has potential to improve the efficiency of health services by reducing other forms of utilisation (such as primary care or hospital use), but a shift to self-management may lead to negative outcomes, such as patients who feel more anxious about their health, are less able to cope, or who receive worse quality of care, all of which may impact on their health and quality of life. We sought to determine which models of self-management support are associated with significant reductions in health services utilisation without compromising outcomes among patients with long-term conditions. We used systematic review with meta-analysis. We included randomised controlled trials in patients with long-term conditions which included self-management support interventions and reported measures of service utilisation or costs, as well as measures of health outcomes (standardized disease specific quality of life, generic quality of life, or depression/anxiety).We searched multiple databases (CENTRAL, CINAHL, Econlit, EMBASE, HEED, MEDLINE, NHS EED and PsycINFO) and the reference lists of published reviews. We calculated effects sizes for both outcomes and costs, and presented the results in permutation plots, as well as conventional meta-analyses. We included 184 studies. Self-management support was associated with small but significant improvements in health outcomes, with the best evidence of effectiveness in patients with diabetic, respiratory, cardiovascular and mental health conditions. Only a minority of self-management support interventions reported reductions in health care utilisation in association with decrements in health. Evidence for reductions in utilisation

  12. Phytase effects on the efficiency of utilisation and blood concentrations of phosphorus and calcium in Pekin ducks.

    PubMed

    Rodehutscord, M; Hempel, R; Wendt, P

    2006-06-01

    1. The objective was to study the effects of a supplementation of a 6-phytase derived from the Peniophora lycii gene in the White Pekin duck. 2. In two balance studies, low-phosphorus (P) diets consisting mainly of maize, solvent extracted soybean meal and solvent extracted sunflower meal were supplemented with phytase up to concentrations of 1500 U/kg (Study 1) or 2000 U/kg (Study 2). Each diet (phytase level) was fed to 8 to 10 individually penned ducks. The intake and excretion of each animal was measured for 5 consecutive days when ducks were in their third week of life. Responses were described by nonlinear regression. 3. Although the basal diets from the two studies were similar in ingredient composition, efficiencies of P utilisation (P accretion/P intake x 100) for the unsupplemented basal diets were 39% in Study 1 and 30% in Study 2. Phytase supplementation significantly improved P utilisation up to levels of about 55% in both studies. A plateau in P utilisation with an increase in phytase supplementation was achieved in Study 2, but not in Study 1. The enzyme was more efficient in Study 2 than in Study 1 at low rates of supplementation. Utilisation of calcium (Ca) was significantly improved by phytase supplementation. Accretions of P and Ca increased at a constant ratio. 4. In a 5-week growth study, diets with an intentionally marginal P level were used. Diets were fed either unsupplemented or supplemented with 1000 or 10,000 U/kg of phytase. Eight pens of 10 sex-separated ducks each (4 pens per sex) were allocated to each dietary treatment. 5. Phytase significantly improved the growth of ducks of both sexes between d 1 and 21, but not between d 22 and 35. Feed conversion rate was not affected by treatment. Blood serum phosphate concentrations, but not calcium, were significantly increased by phytase supplementation. Blood concentrations of creatinine, aspartate aminotransferase and lactate dehydrogenase remained unaffected while alanine aminotransferase

  13. Univariate and multivariate spatial models of health facility utilisation for childhood fevers in an area on the coast of Kenya.

    PubMed

    Ouma, Paul O; Agutu, Nathan O; Snow, Robert W; Noor, Abdisalan M

    2017-09-18

    Precise quantification of health service utilisation is important for the estimation of disease burden and allocation of health resources. Current approaches to mapping health facility utilisation rely on spatial accessibility alone as the predictor. However, other spatially varying social, demographic and economic factors may affect the use of health services. The exclusion of these factors can lead to the inaccurate estimation of health facility utilisation. Here, we compare the accuracy of a univariate spatial model, developed only from estimated travel time, to a multivariate model that also includes relevant social, demographic and economic factors. A theoretical surface of travel time to the nearest public health facility was developed. These were assigned to each child reported to have had fever in the Kenya demographic and health survey of 2014 (KDHS 2014). The relationship of child treatment seeking for fever with travel time, household and individual factors from the KDHS2014 were determined using multilevel mixed modelling. Bayesian information criterion (BIC) and likelihood ratio test (LRT) tests were carried out to measure how selected factors improve parsimony and goodness of fit of the time model. Using the mixed model, a univariate spatial model of health facility utilisation was fitted using travel time as the predictor. The mixed model was also used to compute a multivariate spatial model of utilisation, using travel time and modelled surfaces of selected household and individual factors as predictors. The univariate and multivariate spatial models were then compared using the receiver operating area under the curve (AUC) and a percent correct prediction (PCP) test. The best fitting multivariate model had travel time, household wealth index and number of children in household as the predictors. These factors reduced BIC of the time model from 4008 to 2959, a change which was confirmed by the LRT test. Although there was a high correlation of the

  14. Utilisation and Off-Label Prescriptions of Respiratory Drugs in Children

    PubMed Central

    Schmiedl, Sven; Fischer, Rainald; Ibáñez, Luisa; Fortuny, Joan; Klungel, Olaf H.; Reynolds, Robert; Gerlach, Roman; Tauscher, Martin; Thürmann, Petra; Hasford, Joerg; Rottenkolber, Marietta

    2014-01-01

    Respiratory drugs are widely used in children to treat labeled and non-labeled indications but only some data are available quantifying comprehensively off-label usage. Thus, we aim to analyse drug utilisation and off-label prescribing of respiratory drugs focusing on age- and indication-related off-label use. Patients aged ≤18 years documented in the Bavarian Association of Statutory Health Insurance Physicians database (approx. 2 million children) between 2004 and 2008 were included in our study. Annual period prevalence rates (PPRs) per 10,000 children and the proportion of age- and indication-related off-label prescriptions were calculated and stratified by age and gender. Within the study period, highest PPRs were found for the fixed combination of clenbuterol/ambroxol (between 374–575 per 10,000 children) and the inhaled short acting beta-2-agonist salbutamol (between 378–527 per 10,000 children). Highest relative PPR increase was found for oral salbutamol (approx. 39-fold) whereas the most distinct decrease was found for oral long-acting beta-2-agonist clenbuterol (−97%). Compound classes most frequently involved in off-label prescribing were inhaled bronchodilative compounds (91,402; 37.3%) and oral beta-2-agonists (26,850; 22.5%). The highest absolute number of off-label prescriptions were found for inhaled salbutamol (n = 67,084; 42.0%) and oral clenbuterol/ambroxol (fixed combination, n = 18,897; 20.7%). Off-label prescribing due to indication was of much greater relevance than age-related off-label use. Most frequently, bronchodilative compounds were used off-label to treat respiratory tract infections. Highest off-label prescription rates were found in the youngest patients without relevant gender-related differences. Off-label prescribing of respiratory drugs is common especially in young children. Bronchodilative drugs were most frequently used off-label for treating acute bronchitis or upper respiratory tract infections underlining

  15. Changes to radiotherapy utilisation in Western NSW after the opening of a local service.

    PubMed

    Butler, Sally M

    2017-02-03

    In 2011, the first radiotherapy centre in Western NSW Local Health District (WNSWLHD) was opened in the city of Orange. Prior to this, patients travelled outside the health service, primarily to Sydney, to receive treatment. The aim of this study was to investigate if the establishment of the new rural radiotherapy service has changed the demographic profile, cancer type, treatment intent and number of patients treated. Data were collected on WNSWLHD patients, 17 years of age and above, who received radiotherapy in either 2010 or 2012 in New South Wales (NSW) or Australian Capital Territory (ACT). The age, gender, treatment intent, cancer type and residential town were recorded. The number of patients who accessed radiation increased from 573 to 667 between 2010 and 2012. The corresponding radiotherapy utilisation (RTU) rates were 29.3% in 2010 and 33.4% in 2012, an improvement of 4.1% (P = 0.01, 95% CI 1-7%). Patients travelled 128.5 km less for treatment in 2012 than in 2010 (338.7 km vs. 210.2 km, CI 111-145.5 km, P > 0.0001). All regions had an improvement in the RTU rates apart from the Remote region which decreased by 9% (31-20% in 2012). The number of palliative treatments increased significantly only within the Orange region. The number of male patients for treatments also significantly increased as there were 81 additional treatments (292 vs. 373) as did patients with a respiratory cancer (66 vs. 97). A new radiotherapy service in a sparsely populated health district significantly changed the pattern of radiotherapy use for those who lived only in the Orange region. Treatment capacity at the Orange radiotherapy centre has doubled with the opening of a second linear accelerator since this study was conducted. Thus, a follow-up study is recommended to ascertain if radiotherapy rates remain low in the regions beyond Orange. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society

  16. Benthic macroinfaunal community structure, resource utilisation and trophic relationships in two Canadian Arctic Archipelago polynyas.

    PubMed

    Mäkelä, Anni; Witte, Ursula; Archambault, Philippe

    2017-01-01

    Climate change driven alterations to patterns of Arctic marine primary production, with increasing phytoplankton- and decreasing ice algal production, have the potential to change the resource utilisation and trophic structure of the benthic communities relying on the algae for food. To predict the benthic responses to dietary changes, we studied the macroinfaunal community compositions, and used the faunal δ13C and δ15N signatures to investigate their main food sources and trophic positions in North Water (NOW) and Lancaster Sound (LS) polynyas in the Canadian Arctic Archipelago. Macroinfaunal density (10 952 ind. m-2) and biomass (3190 mg C m-2) recorded in NOW were higher than previously found in the Arctic at depths >500m, and significantly higher than in LS (8355 ind. m-2 and 2110 mg C m-2). This was attributed to higher particulate organic matter fluxes to seafloor in NOW. Polychaetes were significant taxa at both sites in terms of density and biomass, and in addition crustacean density in NOW and bivalve density in LS were high. Facultative filter and surface deposit feeders were highly prevalent at both sites, suggesting feeding plasticity is a successful strategy for accessing different food sources. The macrofaunal δ13C signatures reflected the signatures of pelagic particulate organic matter at the sites, and an isotope mixing model confirmed phytoplankton as the main food source for most taxa and feeding guilds. The food web length in LS was longer than in NOW (3.2 vs. 2.8 trophic levels). This was attributed to a larger reliance on reworked organic matter by the benthic community in LS, whereas the high export fluxes at the highly productive NOW resulted in higher rates of selective consumption of fresh algal matter. Despite studies suggesting that loss of ice algae from consumer diets in the Arctic might have a negative impact on the benthos, this study suggests that Arctic macrobenthic communities thrive using phytoplankton as their main food

  17. A prospective study of health care resource utilisation and selected costs of schizophrenia in France

    PubMed Central

    2012-01-01

    Background Schizophrenia is among the most burdensome and costly illnesses worldwide. To estimate the cost of schizophrenia in France, a longitudinal study was carried out between 1998 and 2002. The main objective of this study was to describe and update the cost of schizophrenia in a longitudinal, representative sample of French patients. The second objective was to identify cost drivers in the treatment of schizophrenia. Methods Based on a cohort of 288 French schizophrenic patients during 2 years of prospective follow-up, this study collected clinical, patient reported outcomes, quality of life, functioning, patient management, care giver involvement and resource utilisation data every 6 months. For each service, information was collected on the type of service, the frequency of attendance and type of intervention provided to the patient. Unit costs were based on available French databases. Mean service use and costs over the five time points were estimated using between-effects regression models. Results In the total sample of 288 patients aged 18-64 years, the mean total cost (€ 3 534) was mainly accounted for by the cost of inpatient treatment (€ 1 390) and day care (€ 1 331). The estimate of the annual cost for direct medical health care for all French schizophrenic patients was € 1 581 million, including € 621 million for inpatient treatment and € 595 million for day care (77%). The costs for medication accounted for 16.1% of total annual costs. The remaining costs (6.9%) included visits to psychiatrists, general practitioners, other physicians and psychologists. The direct resource allocation showed inpatient treatment as the main direct cost. Unemployment was identified as a major indirect cost of schizophrenia treatment. Positive and depressive schizophrenia symptoms at baseline and relapse occurrence during the follow-up period were associated with a higher cost of treatment. Health satisfaction or negative symptoms of schizophrenia at

  18. Acute effects of the beta 3-adrenoceptor agonist, BRL 35135, on tissue glucose utilisation.

    PubMed

    Liu, Y L; Stock, M J

    1995-02-01

    1. The acute effects of BRL 35135 (BRL) on tissue glucose utilisation index (GUI) in vivo were investigated in anaesthetized rats by use of 2-deoxy-[3H]-glucose. 2. Intravenous injection of BRL caused a dose-dependent increase in GUI in skeletal muscle, and white and brown adipose tissue; plasma insulin and fatty acid concentrations were also increased. Chronic treatment with BRL added to the diet caused a 34 fold increase in basal GUI of brown adipose tissue (BAT), but had no effect on GUI in other tissues. After chronic treatment, the acute tissue response to an intravenous maximal dose of BRL had disappeared completely in all tissues apart from the soleus muscle. 3. A high dose (20 mg kg-1) of the non-selective beta-antagonist, propranolol, inhibited the acute effect of BRL on GUI in BAT, but failed to affect GUI in muscle. A lower dose (1 mg kg-1) of the antagonist also inhibited the BAT response, but had little or no effect on the response in Type I (working) muscles such as soleus and adductor longus (ADL), and potentiated the response in Type II (non-working) muscles such as tibialis and extensor digitorium longus (EDL). 4. A low dose (1 mg kg-1) of the selective beta 1-antagonist, atenolol, had no effect on the BRL response but the same dose of the selective beta 2-antagonist, ICI 118551, potentiated significantly the effect of BRL on GUI in most muscles without altering plasma insulin levels. 5. It is concluded that: (i) the heterogeneous tissue responses of different muscle fibre types in the presence of P-antagonists indicates that BRL affects muscle GUI directly, in addition to effects mediated by increases in plasma insulin concentration; (ii) the resistance of the BRL response to conventional P-adrenoceptor antagonists implicates an atypical adrenoceptor mediating the GUI response in skeletal muscle, but this may not be identical to the adipose tissue P3-adrenoceptor; (iii) the potentiation of BRL responses by ICI 118551 indicates an inhibitory P2

  19. Clinical outcomes and resource utilisation in Medicare patients with chronic liver disease: a historical cohort study.

    PubMed

    Younossi, Zobair M; Zheng, Li; Stepanova, Maria; Venkatesan, Chapy; Mishra, Alita

    2014-05-16

    The aim of this study is to assess recent trends in health resource utilisation and patient outcomes of Medicare beneficiaries with chronic liver disease (CLD). Liver-related mortality is the 10th leading cause of death in the USA, and hepatitis C virus (HCV) and obesity-related non-alcoholic fatty liver disease are the major causes of CLD. As the US population ages and becomes more obese, the impact of CLD is expected to become more prominent for the Medicare population. This is a retrospective cohort study of Medicare beneficiaries with a diagnosis of CLD based on inpatient (N=21 576; 14 977 unique patients) and outpatient (N=515 990; 244 196 patients) claims from 2005 to 2010. The study outcomes included hospital length of stay (LOS) and inpatient mortality as well as inpatient and outpatient inflation-adjusted payments. Between 2005 and 2010, there was an annual decrease in LOS of 3.17% for CLD-related hospitalisations. Risk-adjusted in-hospital mortality decreased (OR 0.90, 95% CI 0.87 to 0.94), while short-term postdischarge mortality remained stable (1.00, 0.98 to 1.03). Inpatient per-claim payment increased from $11 769 in 2005 to $12 347 in 2010 (p=0.0006). Similarly, the average yearly payments for outpatient care increased from $366 to $404 (p<0.0001). This change in payment was observed together with a consistent decrease in the proportion of beneficiary-paid amount (25.4-20%, p<0.0001) as opposed to Medicare-paid amount (73.1-80%, p<0.0001). The major predictors of higher outpatient payments were younger age, Asian race or Hispanic ethnicity, living in California, and having more diagnoses and outpatient procedures per claim. The predictors of inpatient spending also included younger age, location and the number of inpatient procedures. Length of inpatient stay and inpatient mortality among Medicare beneficiaries with CLD decreased, while inpatient and outpatient spending increased. Published by the BMJ Publishing Group Limited. For

  20. Rapakivi Granite: An architectural emblem of St Petersburg and its utilisation in other world cities

    NASA Astrophysics Data System (ADS)

    Bulakh, Andrey; Gavrilenko, Vladimir; Panova, Helen

    2015-04-01

    The wide-ranging utilisation of Rapakivi Granite in St Petersburg is typified by the the famous Alexander Column, and 114 stone columns of St Isaac's Cathedralas well as the pedestal of the Nicholas I monument, and portals and basements of buildings of the Admiralty, General Staff, Senate and Synod. The stone is also frequently seen among pavement slabs and in parapets of embankments and bridges around the city. This list of examples where Rapakivi Granite has been used could be expanded further. All Rapakivi Granites used in the buildings of St.Petersburg were quarried from the so-called Vyborg massif. At present it has been found that the massif occupies an area of about 18 000 km2. In the past granite of the Vyborg massif was worked from several quarries in the vicinity of Fredrikshamn (Hamina) in Finland for use in St Peterburg. The best known granite quarries are at Piterlaks (Piuterlahti) and Gimmekyul (Hämeenkylä). Sometimes Rapakivi Granite form Finland differs in appearance from typical varieties. Thus columns of a classical portal in the house at N 7 in Pochtamtskaya Street are hewn from this greyish variety. Other examples are the plinth of the General Staff and Trade Store buildings. After the 1960s varieties from the Leningrad district, and Korosten (Ukraine) massifs were used in St Petersburg. Today it is possible to find examples of Rapakivi Granite from Finland in cities in the USA, South Africa, United Kingdom and Germany. It is a long used stone as demonstrated by its cultural heritage. It is also used as an ornamental or decorative stone in modern architecture. References: 1) Bulakh, A.G., Abakumova, N.B., and Romanovsky, J.V. St Petersburg: a History in Stone. 2010. Print House of St Petersburg State University. 173 p. (In English). 2) Tutakova, A.Ya., Romanovskiy, A.Z., Bulakh, A.G., and Leer, V.I. Dimension Stone of the Leningrad Region. Granites of the Karelia Isthmus in Architecture of the Modern St Petersburg. 2011. St Petersburg. 78 p

  1. Benthic macroinfaunal community structure, resource utilisation and trophic relationships in two Canadian Arctic Archipelago polynyas

    PubMed Central

    Witte, Ursula; Archambault, Philippe

    2017-01-01

    Climate change driven alterations to patterns of Arctic marine primary production, with increasing phytoplankton- and decreasing ice algal production, have the potential to change the resource utilisation and trophic structure of the benthic communities relying on the algae for food. To predict the benthic responses to dietary changes, we studied the macroinfaunal community compositions, and used the faunal δ13C and δ15N signatures to investigate their main food sources and trophic positions in North Water (NOW) and Lancaster Sound (LS) polynyas in the Canadian Arctic Archipelago. Macroinfaunal density (10 952 ind. m-2) and biomass (3190 mg C m-2) recorded in NOW were higher than previously found in the Arctic at depths >500m, and significantly higher than in LS (8355 ind. m-2 and 2110 mg C m-2). This was attributed to higher particulate organic matter fluxes to seafloor in NOW. Polychaetes were significant taxa at both sites in terms of density and biomass, and in addition crustacean density in NOW and bivalve density in LS were high. Facultative filter and surface deposit feeders were highly prevalent at both sites, suggesting feeding plasticity is a successful strategy for accessing different food sources. The macrofaunal δ13C signatures reflected the signatures of pelagic particulate organic matter at the sites, and an isotope mixing model confirmed phytoplankton as the main food source for most taxa and feeding guilds. The food web length in LS was longer than in NOW (3.2 vs. 2.8 trophic levels). This was attributed to a larger reliance on reworked organic matter by the benthic community in LS, whereas the high export fluxes at the highly productive NOW resulted in higher rates of selective consumption of fresh algal matter. Despite studies suggesting that loss of ice algae from consumer diets in the Arctic might have a negative impact on the benthos, this study suggests that Arctic macrobenthic communities thrive using phytoplankton as their main food

  2. Silages containing buckwheat and chicory: quality, digestibility and nitrogen utilisation by lactating cows.

    PubMed

    Kälber, Tasja; Kreuzer, Michael; Leiber, Florian

    2012-02-01

    The suitability of silages containing buckwheat (Fagopyrum esculentum) and chicory (Cichorium intybus) for the nutrition of dairy cows was determined. Buckwheat and chicory were sown in mixture with ryegrass (Lolium multilorum), and a pure ryegrass culture served as a control forage. Swards were harvested 55 d after sowing and were ensiled after wilting, without additives in small round bales. Finally, buckwheat and chicory made up the dietary dry matter (DM) proportions of 0.46 and 0.34, respectively. Concentrates were restricted to 2 kg/d. Diets were fed to 3 x 6 late-lactating cows for 15 d at ad libitum access. During the collection period (days 10-15) amounts of feed intake and faeces, urine and milk were recorded and samples were taken. Ensilability was good for buckwheat and ryegrass swards, but was so less for the chicory sward, which was rich in total ash. The buckwheat silage was rich in acid detergent fibre (445 g/kg DM) and lignin (75.7 g/kg DM) and contained less crude protein (135 g/kg DM) and ether extract (15.8 g/kg DM) than the other silages. Consistent with that, the apparent digestibility of the organic matter and fibre were lowest when feeding this silage. The potassium concentrations in the chicory and ryegrass silages were high (61 g/ kg) and lower in buckwheat (47 g/kg). No significant treatment effects on intake, body weight, milk yield or milk composition as well as plasma beta-hydroxybutyrate and non-esterified fatty acids occurred. Being lowest in nitrogen (N) content, the buckwheat silage resulted in the lowest urine N losses and the most efficient N utilisation for milk protein synthesis, but this at cost of body N retention. The results show that silages containing buckwheat and chicory may be used as components of the forage part of dairy cows' diets even though they were found to have a lower feeding value than ryegrass silage.

  3. Utilisation of hospital services in Italy: a comparative analysis of immigrant and Italian citizens.

    PubMed

    Baglio, Giovanni; Saunders, Catherine; Spinelli, Angela; Osborn, John

    2010-08-01

    In Italy, immigrants from Less Developed Countries (LDCs) have doubled every 10 years since the 1970s and this number grew to 330,000 at the end of 1981, and to more than 1,300,000 in 2001. As the presence of immigrants increases, it becomes ever more important to assess their health needs and utilisation of health services, in order to promote adequate programmes and policies. This study was aimed to compare the patterns of hospital use by immigrants from LDCs living in the Lazio Region, Italy, with those of the resident Italians. The study was based on the hospital discharge data collected by the Lazio Region Hospital Information System. Discharges of immigrants from acute hospitals in Lazio during 2005 were compared with discharges of resident Italians. Age- and sex-specific hospitalisation rates (per 1,000) were also calculated for legal immigrants and Italians aged 18 years and over. Of 56,610 foreign patients from LCDs admitted to hospitals in Lazio during 2005, 88% were legally residing in the region. The immigrants were younger than the Italians (mean age 30.6 and 51.7 years, respectively), more than half were female and single, and about 1/3 had studied for 9 or more years. Among males, a similar pattern of hospital use by age was observed for foreigners and Italians, with the rates for foreigners in acute care being higher among young people (due to traumatic accidents) and lower among the oldest. Differently, among foreign females, the admission rates for both acute and day care settings varied with women's age, the pattern of hospital use being strongly influenced by reproductive events. The main reason for hospitalisation of foreign males in acute care was injuries (approximately 1/4 of all discharges), and in day care was neoplasms; among females, more than half of the admissions were for childbirth in acute or induced abortions in day care. Injuries for males and induced abortions for females were identified as critical areas for migrants' health, in

  4. GPU-based Space Situational Awareness Simulation utilising Parallelism for Enhanced Multi-sensor Management

    NASA Astrophysics Data System (ADS)

    Hobson, T.; Clarkson, V.

    2012-09-01

    As a result of continual space activity since the 1950s, there are now a large number of man-made Resident Space Objects (RSOs) orbiting the Earth. Because of the large number of items and their relative speeds, the possibility of destructive collisions involving important space assets is now of significant concern to users and operators of space-borne technologies. As a result, a growing number of international agencies are researching methods for improving techniques to maintain Space Situational Awareness (SSA). Computer simulation is a method commonly used by many countries to validate competing methodologies prior to full scale adoption. The use of supercomputing and/or reduced scale testing is often necessary to effectively simulate such a complex problem on todays computers. Recently the authors presented a simulation aimed at reducing the computational burden by selecting the minimum level of fidelity necessary for contrasting methodologies and by utilising multi-core CPU parallelism for increased computational efficiency. The resulting simulation runs on a single PC while maintaining the ability to effectively evaluate competing methodologies. Nonetheless, the ability to control the scale and expand upon the computational demands of the sensor management system is limited. In this paper, we examine the advantages of increasing the parallelism of the simulation by means of General Purpose computing on Graphics Processing Units (GPGPU). As many sub-processes pertaining to SSA management are independent, we demonstrate how parallelisation via GPGPU has the potential to significantly enhance not only research into techniques for maintaining SSA, but also to enhance the level of sophistication of existing space surveillance sensors and sensor management systems. Nonetheless, the use of GPGPU imposes certain limitations and adds to the implementation complexity, both of which require consideration to achieve an effective system. We discuss these challenges and

  5. Mise à jour sur l’utilisation clinique de la buprénorphine

    PubMed Central

    Ducharme, Simon; Fraser, Ronald; Gill, Kathryn

    2012-01-01

    Résumé Objectif Examiner les données scientifiques actuelles sur la buprénorphine-naloxone pour le traitement des troubles liés aux opioïdes, en insistant sur le contexte des soins primaires. Qualité des données On a fait une recension dans MEDLINE et la base de données Cochrane des synthèses critiques. Les données probantes sont surtout de niveau I. Message principal La buprénorphine est un agoniste partiel des récepteurs μ des opioïdes et un antagoniste des récepteurs κ des opioïdes ayant une longue demi-vie et un potentiel moins grand que la méthadone d’entraîner un usage abusif. Pour une désintoxication, la buprénorphine est au moins équivalente à la méthadone et supérieure à la clonidine. Comme thérapie de substitution, la buprénorphine est clairement supérieure au placebo. La méthadone comporte de légers avantages en ce qui a trait à la rétention en thérapie, mais une approche par étape en utilisant initialement la buprénorphine-naloxone est aussi efficace. Il est possible, sécuritaire et efficace de recourir à la buprénorphine en milieu de soins primaires. On peut obtenir l’autorisation de prescrire de la buprénorphine après avoir suivi une formation en ligne. Conclusion La buprénorphine est un agent sécuritaire et efficace pour la désintoxication en cas de dépendance aux opioïdes. Elle peut servir d’agent de première intention dans les programmes de thérapie de substitution, en raison de son potentiel plus faible d’usage abusif en comparaison d’autres opioïdes. Son efficacité en milieux de soins primaires en fait un outil thérapeutique utile pour les médecins de famille.

  6. Cohort study of Western Australia computed tomography utilisation patterns and their policy implications.

    PubMed

    Gibson, David A J; Moorin, Rachael E; Holman, C D'Arcy J

    2014-11-05

    Computed tomography (CT) scanning is a relatively high radiation dose diagnostic imaging modality with increasing concerns about radiation exposure burden at the population level in scientific literature. This study examined the epidemiology of adult CT utilisation in Western Australia (WA) in both the public hospital and private practice settings, and the policy implications. Retrospective cohort design using aggregate adult CT data from WA public hospitals and Medical Benefits Schedule (MBS) (mid-2006 to mid-2012). CT scanning trends by sex, age, provider setting and anatomical areas were explored using crude CT scanning rates, age-standardised CT scanning rates and Poisson regression modelling. From mid-2006 to mid-2012 the WA adult CT scanning rate was 129 scans per 1,000 person-years (PY). Females were consistently scanned at a higher rate than males. Patients over 65 years presented the highest scanning rates (over 300 scans per 1,000 PY). Private practice accounted for 73% of adult CT scans, comprising the majority in every anatomical area. In the private setting females predominately held higher age-standardised CT scanning rates than males. This trend reversed in the public hospital setting. Patients over 85 years in the public hospital setting were the most likely age group CT scanned in nine of ten anatomical areas. Patients in the private practice setting aged 85+ years were relatively less prominent across every anatomical area, and the least likely age group scanned in facial bones and multiple areas CT scans. In comparison to the public hospital setting, the MBS subsidised private sector tended to service females and relatively younger patients with a more diverse range of anatomical areas, constituting the majority of CT scans performed in WA. Patient risk and subsequent burden is greater for females, lower ages and some anatomical areas. In the context of a national health system, Australia has various avenues to monitor radiation exposure levels

  7. The ingestion of protein with a maltodextrin and fructose beverage on substrate utilisation and exercise performance.

    PubMed

    Tarpey, Michael D; Roberts, Justin D; Kass, Lindsy S; Tarpey, Richard J; Roberts, Michael G

    2013-12-01

    The study investigated the ingestion of maltodextrin, fructose, and protein on exogenous carbohydrate oxidation (CHOEXO) and exercise performance. Seven trained cyclists and (or) triathletes (maximal oxygen consumption, 59.20 ± 9.00 mL · kg(-1) · min(-1)) performed 3 exercise trials that consisted of 150 min of cycling at 50% maximal power output (160 ± 11 W), followed by a 60-km time trial. One of 3 beverages were randomly assigned during each trial and consumed at 15-min intervals: (i) 0.84 g · min(-1) maltodextrin + 0.52 g · min(-1) fructose + 0.34 g · min(-1) protein (MD+F+P); (ii) 1.10 g · min(-1) maltodextrin + 0.60 g · min(-1) fructose (MD+F); or (iii) 1.70 g · min(-1) maltodextrin (MD). CHO(EXO) and fuel utilisation were assessed via measurement of expired air (13)C content and indirect calorimetry, respectively. Mean total CHO oxidation (CHOTOT) rates were 2.35 ± 0.18, 2.76 ± 0.08, and 2.61 ± 0.17 g · min(-1) with MD, MD+F, and MD+F+P, respectively, although not significantly different. Peak CHO(EXO) rates with MD+F were significantly greater by 41.4% (p = 0.001) and 45.4% (p = 0.0001) compared with MD+F+P and MD, respectively (1.57 ± 0.22 g · min(-1), 1.11 ± 0.08 g · min(-1), and 1.08 ± 0.11 g · min(-1), respectively). Performance times were 2.2% and 5.0% faster with MD+F compared with MD+F+P and MD, respectively; however, they were not statistically significant. Ingestion of an MD-fructose-protein commercial sports beverage significantly reduced peak and mean CHO(EXO) rates compared with MD+F, but did not significantly influence CHOTOT. The addition of protein to an MD+F beverage did not enhance performance times.

  8. Safety Evaluation - Radioactive Components of Materiel

    DTIC Science & Technology

    1982-12-02

    materials such as radium dials of compasses have been used for many years by the Arrny. Others such as depleted uranium , krypton, proamethium, and tritium...arises when the radioisotope decays and emits a radioactive gas such as radon gas from radiumi. The hazards of radioactive gases accumulating in...contamination tests once each week until a suitable evaluation has been attained. Because of the large variety of radioactive sources stored and used and

  9. Materiel requirements for airborne minefield detection system

    NASA Astrophysics Data System (ADS)

    Bertsche, Karl A.; Huegle, Helmut

    1997-07-01

    Within the concept study, Material Requirements for an airborne minefield detection systems (AMiDS) the following topics were investigated: (i) concept concerning airborne minefield detection technique sand equipment, (ii) verification analysis of the AMiDS requirements using simulation models and (iii) application concept of AMiDS with regard o tactics and military operations. In a first approach the problems concerning unmanned airborne minefield detection techniques within a well-defined area were considered. The complexity of unmanned airborne minefield detection is a result of the following parameters: mine types, mine deployment methods, tactical requirements, topography, weather conditions, and the size of the area to be searched. In order to perform the analysis, a simulation model was developed to analyze the usability of the proposed remote controlled air carriers. The basic flight patterns for the proposed air carriers, as well as the preparation efforts of military operations and benefits of such a system during combat support missions were investigated. The results of the conceptual study showed that a proposed remote controlled helicopter drone could meet the stated German MOD scanning requirements of mine barriers. Fixed wing air carriers were at a definite disadvantage because of their inherently large turning loops. By implementing a mine detection system like AMiDS minefields can be reconnoitered before an attack. It is therefore possible either to plan, how the minefields can be circumvented or where precisely breaching lanes through the mine barriers are to be cleared for the advancing force.

  10. Air Force Materiel Command Reorganization Analysis

    DTIC Science & Technology

    2012-01-01

    Gen Judith Fedder, Deputy Chief of Staff for Logistics, Installations, and Mission Support (AF/A4/7); Patricia Young, Assistant Deputy Chief of...Bruce Carlson as AFMC Commander on November 21, 2008. Lt Gen Terry L. Gabreski and Steven Butler continued on as Vice Commander and Executive

  11. Defense Materiel Acquisition - OSHA’s Impact

    DTIC Science & Technology

    1977-05-01

    This report examines the 1970 Occupational Safety and Health Act, the general workplace safety requirements stipulated in the Act and the agencies...created to enforce the requirements. The report discusses the organization of the Occupational Safety and Health Agency, OSHA, and how it functions. The...the 1970 Act are examined. The report can serve as a point of departure for future research on the Occupational Safety and Health Administration by DSMC students.

  12. Materiel Readiness Support System (MARS). Revision

    DTIC Science & Technology

    1988-12-01

    aveas IwMAGE MIllS WIT NMI* Of 11ACK- 11 RESPONSE 1111401 3 R s Bmoom USD WITH pmlei OF 11ACK- 3105950 maCGW 1PO 005&isS DEMND Dunes fE US 5 TIEt OATS...Location Variable Definition From KOMOD Commodity Code 1 1 NSN National Stock Number 2 14 UP Unit Price 15 23 NSSC Supply Status Code 24 24 SOH Stock On

  13. United States Army Medical Materiel Development Activity

    DTIC Science & Technology

    1989-03-10

    environment, biting insects), or acquired by deliberate exposure to aerosols . Product Managers exploit domestic and foreign medical technology to remedy...Japanese encephalitis; hemorrhagic fevers and other diseases spread by aerosol (and rapid methods to identify the cause of illness); schistosomiasis...Center is contrasting for the first production run. 19 /, I • I 0 Rift Valley Fever Vaccine was prepared by growing the virus in cultured monkey kidney

  14. Product Assurance. Materiel Deterioration Prevention and Control.

    DTIC Science & Technology

    1979-10-16

    702-24 Appendix A--Continued I1.8.6.9 Handling will be avoided or, when handling, gloves will be worn. .* 1.8.7 Hydrogen embrittlement . Closely...is not stress-relieved immediately after plating, fracture can occur almost immediately. Titanium is pcrticularly subject to hydrogen embrittlement ...821740 or higher). To reduce the possibility of hydrogen embrittlement , the following will be cons i ece rcd : 1.8.7.1 Avoid acid cleaning, pickling, and

  15. The BLSTs Role in the Materiel Enterprise

    DTIC Science & Technology

    2016-05-17

    stock in the bri- gade’s supply support activity. Performance-based logistics ( PBL ) was introduced almost a decade ago as an effective tool to...influence read- iness through predictive analysis. PBL is geared toward PM efforts to manage life cycle costs while balanc- ing supply system performance...which AMC manag- ers can mitigate supply problems as- sociated with both home-station and deployed ASL- or PBL -supported systems. Other BLSTs may expe

  16. Energy System Emissions and Materiel Requirements

    SciTech Connect

    1989-02-01

    This report compares a central station solar photovoltaic plant to two coal plants, one gas plant, and a nuclear plant. It is of interest to geothermal energy studies only as source materials for comparisons on material requirements. This contains 48 references / citations. (DJE 2005)

  17. Forecasting Medical Materiel Requirements for Contingency Operations

    DTIC Science & Technology

    2007-11-02

    the Marine Corps’ BAS AMAL required to treat notional patient stream Figure 6. RSVP output for acetaminophen tablets for a fictitious scenario with...supreme test of all armies: to rapidly adapt to circumstances which it could not foresee.” (p. 3) This includes planning for medical support in a...patient requirements. This can be seen in Figure 6 below. Here, RSVP projected in this example, the quantity of acetaminophen tablets needed over six

  18. DoD Materiel Management Regulation

    DTIC Science & Technology

    1998-05-01

    NIMSR NSN NUIT 0ASD(C3I) OL OSD OST OSTL PICA PLT PMRP POD POE Government Industry Data Exchange Program Government Furnished Equipment...Unique Item Tracking ( NUIT ) programs shall be established when visibility of selected items is required throughout a Component’s organization or that of...local level for a specific process, operation, or function. C6.3.2.5. The DoD Small Arms Serialization Program (DoDSASP) is the recognized NUIT

  19. Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review

    PubMed Central

    Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

    2016-01-01

    Objective This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Setting Early prehospital phase of a major incident. Design Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and ‘major incidents’ to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. Results The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. Conclusions HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. Trial registration number CRD42013004473. PMID:26861938

  20. Utilisation of helicopter emergency medical services in the early medical response to major incidents: a systematic literature review.

    PubMed

    Johnsen, Anne Siri; Fattah, Sabina; Sollid, Stephen J M; Rehn, Marius

    2016-02-09

    This systematic review identifies, describes and appraises the literature describing the utilisation of helicopter emergency medical services (HEMS) in the early medical response to major incidents. Early prehospital phase of a major incident. Systematic literature review performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Web of Science, PsycINFO, Scopus, Cinahl, Bibsys Ask, Norart, Svemed and UpToDate were searched using phrases that combined HEMS and 'major incidents' to identify when and how HEMS was utilised. The identified studies were subjected to data extraction and appraisal. The database search identified 4948 articles. Based on the title and abstract, the full text of 96 articles was obtained; of these, 37 articles were included in the review, and an additional five were identified by searching the reference lists of the 37 articles. HEMS was used to transport medical and rescue personnel to the incident and to transport patients to the hospital, especially when the infrastructure was damaged. Insufficient air traffic control, weather conditions, inadequate landing sites and failing communication were described as challenging in some incidents. HEMS was used mainly for patient treatment and to transport patients, personnel and equipment in the early medical management of major incidents, but the optimal utilisation of this specialised resource remains unclear. This review identified operational areas with improvement potential. A lack of systematic indexing, heterogeneous data reporting and weak methodological design, complicated the identification and comparison of incidents, and more systematic reporting is needed. CRD42013004473. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Analysis of the Diversity of Substrate Utilisation of Soil Bacteria Exposed to Cd and Earthworm Activity Using Generalised Additive Models

    PubMed Central

    Muñiz, Selene; Lacarta, Juan; Pata, María P.; Jiménez, Juan José; Navarro, Enrique

    2014-01-01

    Biolog EcoPlates™ can be used to measure the carbon substrate utilisation patterns of microbial communities. This method results in a community-level physiological profile (CLPP), which yields a very large amount of data that may be difficult to interpret. In this work, we explore a combination of statistical techniques (particularly the use of generalised additive models [GAMs]) to improve the exploitation of CLPP data. The strength of GAMs lies in their ability to address highly non-linear relationships between the response and the set of explanatory variables. We studied the impact of earthworms (Aporrectodea caliginosa Savigny 1826) and cadmium (Cd) on the CLPP of soil bacteria. The results indicated that both Cd and earthworms modified the CLPP. GAMs were used to assess time-course changes in the diversity of substrate utilisation (DSU) using the Shannon-Wiener index. GAMs revealed significant differences for all treatments (compared to control -S-). The Cd exposed microbial community presented very high metabolic capacities on a few substrata, resulting in an initial acute decrease of DSU (i.e. intense utilization of a few carbon substrata). After 54 h, and over the next 43 h the increase of the DSU suggest that other taxa, less dominant, reached high numbers in the wells containing sources that are less suitable for the Cd-tolerant taxa. Earthworms were a much more determining factor in explaining time course changes in DSU than Cd. Accordingly, Ew and EwCd soils presented similar trends, regardless the presence of Cd. Moreover, both treatments presented similar number of bacteria and higher than Cd-treated soils. This experimental approach, based on the use of DSU and GAMs allowed for a global and statistically relevant interpretation of the changes in carbon source utilisation, highlighting the key role of earthworms on the protection of microbial communities against the Cd. PMID:24416339

  2. Effects of feeding raw or reconstituted high tannin red sorghum on nutrient utilisation and certain welfare parameters of broiler chickens.

    PubMed

    Kumar, V; Elangovan, A V; Mandal, A B; Tyagi, P K; Bhanja, S K; Dash, B B

    2007-04-01

    1. A feeding trial was conducted on 360 1-d-old chicks from 0 to 6 weeks of age to assess the effect of processed high tannin red sorghum in the diet of broiler chickens on nutrient utilisation and certain welfare parameters. 2. Each of 9 dietary treatments was allotted to 4 groups (replicates) of chicks in a completely randomised design. The treatments were a maize-soy based standard broiler diet (control, RS(0)) and eight test diets formulated by incorporating either raw red sorghum (RS(25), RS(50), RS(75), RS(100)) or reconstituted red sorghum (RS(25)(R), RS(50)(R), RS(75)(R), RS(100)(R)) replacing 25, 50, 75 or 100% of maize from the control diet. 3. The tannin content was reduced from 23 to 16 g/kg in reconstituted red sorghum. 4. Utilisations of nitrogen, calcium and phosphorus retention were similar in all the dietary groups. 5. The cell-mediated immune response measured as footpad index (FPI) value of birds given raw red sorghum was significantly higher than in control and reconstituted red sorghum groups. Similarly, comparatively better humoral response measured as HA titre value was observed in raw red sorghum based groups than in reconstituted ones. 6. Plasma albumin, globulin, protein, glucose, calcium, phosphorus, SGOT, SGPT and uric acid levels did not differ significantly due to dietary treatments. 7. Mild histopathological changes were observed in liver and kidney tissues of birds given raw red sorghum. 8. From the present study, it is concluded that (1) the reconstitution of high tannin red sorghum resulted in about 30% reduction in its tannin concentration; (2) the feeding of reconstituted sorghum based diets to broiler chickens did not exert any appreciable influence on nutrient utilisation, blood biochemicals and enzymes and gross pathological changes; and (3) the birds fed on raw red sorghum exhibited higher immuno-responsiveness in comparison to their reconstituted counterparts.

  3. Health Care Utilisation and Transitions between Health Care Settings in the Last 6 Months of Life in Switzerland

    PubMed Central

    Bähler, Caroline; Signorell, Andri; Reich, Oliver

    2016-01-01

    Background Many efforts are undertaken in Switzerland to enable older and/or chronically ill patients to stay home longer at the end-of-life. One of the consequences might be an increased need for hospitalisations at the end-of-life, which goes along with burdensome transitions for patients and higher health care costs for the society. Aim We aimed to examine the health care utilisation in the last six months of life, including transitions between health care settings, in a Swiss adult population. Methods The study population consisted of 11'310 decedents of 2014 who were insured at the Helsana Group, the leading health insurance in Switzerland. Descriptive statistics were used to analyse the health care utilisation by age group, taking into account individual and regional factors. Zero-inflated Poisson regression model was used to predict the number of transitions. Results Mean age was 78.1 in men and 83.8 in women. In the last six months of life, 94.7% of the decedents had at least one consultation; 61.6% were hospitalised at least once, with a mean length of stay of 28.3 days; and nursing home stays were seen in 47.4% of the decedents. Over the same time period, 64.5% were transferred at least once, and 12.9% experienced at least one burdensome transition. Main predictors for transitions were age, sex and chronic conditions. A high density of home care nurses was associated with a decrease, whereas a high density of ambulatory care physicians was associated with an increase in the number of transitions. Conclusions Health care utilisation was high in the last six months of life and a considerable number of decedents were being transferred. Advance care planning might prevent patients from numerous and particularly from burdensome transitions. PMID:27598939

  4. An evaluation of resource utilisation of single stage porcine acellular dermal matrix assisted breast reconstruction: A comparative study.

    PubMed

    Kilchenmann, Ashley J R; Lardi, Alessia M; Ho-Asjoe, Mark; Junge, Klaus; Farhadi, Jian

    2014-12-01

    To evaluate resource utilization of single stage porcine acellular dermal matrix (ADM) assisted breast reconstruction compared with tissue expander (TE), latissimus dorsi flap and implant (LD/I) and latissimus dorsi flap and TE (LD/TE) reconstructive techniques. Clinical data was collected for length of stay, operative time, additional hospitalisations and operative procedures, and outpatient appointments for 101 patients undergoing unilateral implant based breast reconstruction. Resources utilised by ADM (Strattice Reconstructive Tissue Matrix™) patients were analysed and compared to the resource usage of traditional techniques. 25 patients undergoing single stage ADM (ADM/I) were compared with 27 having TE, 32 having LD/I and 17 having LD/TE reconstructions. Follow up was 24 months. Compared to TE, ADM/I had similar length of stay and operative time, lower rate and number of additional procedures, fewer, shorter re-admissions (p < 0.05) and fewer appointments (p < 0.05). Compared to LD/TE, ADM/I had shorter length of stay and operative time (p < 0.05), lower rate and number of additional procedures, fewer, shorter re-admissions (p < 0.05) and fewer appointments (p < 0.05). Compared to LD/I, ADM/I had shorter length of stay (p < 0.05) and operative time (p < 0.05), fewer appointments, similar rate and number of additional procedures but required more and longer re-admissions. In our experience, unilateral single stage ADM/I was associated with fewer resources utilised in comparison with two staged TE and LD/TE reconstructions in both complication-free and complicated settings over a 24-month period, despite requiring aesthetic revision in 60.9% of patients. Compared to LD/I, resource utilisation was commensurate in complication-free and complicated settings. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Effect of partial replacement of oats with sugar beet pulp and maize oil on nutrient utilisation in horses.

    PubMed

    Lindberg, J E; Karlsson, C P

    2001-11-01

    The objective of the present work was to assess the influence of partial replacement of oats with dried unmolassed sugar beet pulp (SBP) and/or maize oil on nutrient utilisation in horses fed a traditional hay and concentrate diet. The total tract digestibility of nutrients, urinary excretion and plasma parameters were studied in a 4 x 4 Latin-square design experiment with purebred Arabian geldings. Horses fed the SBP diets responded with a reduced (P<0.05) apparent digestibility of crude protein and feeding of maize oil resulted in an increased (P<0.05) apparent digestibility of crude fat. The apparent energy digestibility was unaffected by the replacement of oats with SBP, but increased (P<0.05) when maize oil replaced part of the oats. The urinary excretion of nitrogen increased (P<0.05) when maize oil replaced oats and the excretion of energy was higher (P<0.05) on the diets where oats were replaced by maize oil and SBP. There was a significant (P<0.05) effect across treatments of postprandial blood sampling time on plasma glucose and insulin concentrations. Also, plasma concentrations of glucose and insulin tended to be higher on the oats than on the SBP diets. In conclusion, the limited effects on the digestibility of nutrients and energy suggest that it should be possible to partially replace oats with maize oil and/or SBP in diets for horses without any impairing effects on the overall nutrient utilisation. However, the dietary-induced changes in the urinary excretion of energy and on plasma glucose and insulin levels, indicate a possible influence of dietary carbohydrate composition on nutrient utilisation at the organ level, which requires further study.

  6. The role and utilisation of public health evaluations in Europe: a case study of national hand hygiene campaigns

    PubMed Central

    2014-01-01

    Background Evaluations are essential to judge the success of public health programmes. In Europe, the proportion of public health programmes that undergo evaluation remains unclear. The European Centre for Disease Prevention and Control sought to determine the frequency of evaluations amongst European national public health programmes by using national hand hygiene campaigns as an example of intervention. Methods A cohort of all national hand hygiene campaigns initiated between 2000 and 2012 was utilised for the analysis. The aim was to collect information about evaluations of hand hygiene campaigns and their frequency. The survey was sent to nominated contact points for healthcare-associated infection surveillance in European Union and European Economic Area Member States. Results Thirty-six hand hygiene campaigns in 20 countries were performed between 2000 and 2012. Of these, 50% had undergone an evaluation and 55% of those utilised the WHO hand hygiene intervention self-assessment tool. Evaluations utilised a variety of methodologies and indicators in assessing changes in hand hygiene behaviours pre and post intervention. Of the 50% of campaigns that were not evaluated, two thirds reported that both human and financial resource constraints posed significant barriers for the evaluation. Conclusion The study identified an upward trend in the number of hand hygiene campaigns implemented in Europe. It is likely that the availability of the internationally-accepted evaluation methodology developed by the WHO contributed to the evaluation of more hand hygiene campaigns in Europe. Despite this rise, hand hygiene campaigns appear to be under-evaluated. The development of simple, programme-specific, standardised guidelines, evaluation indicators and other evidence-based public health materials could help promote evaluations across all areas of public health. PMID:24507086

  7. Early nutritional intervention can improve utilisation of vegetable-based diets in diploid and triploid Atlantic salmon (Salmo salar L.).

    PubMed

    Clarkson, Michael; Migaud, Herve; Metochis, Christoforos; Vera, Luisa M; Leeming, Daniel; Tocher, Douglas R; Taylor, John F

    2017-07-01

    The present study investigated nutritional programming in Atlantic salmon to improve utilisation of a vegetable-based diet. At first exogenous feeding, fry were fed either a marine-based diet (Diet Mstimulus, 80% fishmeal (FM)/4% fish oil (FO)) or a vegetable-based diet (Diet Vstimulus, 10% FM/0% FO) for 3 weeks. Subsequently, all fish were then fed under the same conditions with a commercial, marine-based, diet for 15 weeks and thereafter challenged with a second V diet (Diet Vchallenge, 10% FM/0% FO) for 6 weeks. Diploid and triploid siblings were run in parallel to examine ploidy effects. Growth performance, feed intake, nutrient utilisation and intestinal morphology were monitored. Fish initially given Diet Vstimulus (V-fish) showed 24 % higher growth rate and 23 % better feed efficiency compared with M-fish when later challenged with Diet Vchallenge. There was no difference in feed intake between nutritional histories, but increased nutrient retentions highlighted the improved utilisation of a V diet in V-fish. There were generally few significant effects of nutritional history or ploidy on enteritis scores in the distal intestine after the challenge phase as only V-triploids showed a significant increase (P<0·05) in total score. The data highlighted that the positive effects were most likely a result of nutritional programming and the ability to respond better when challenged later in life may be attributed to physiological and/or metabolic changes induced by the stimulus. This novel study showed the potential of nutritional programming to improve the use of plant raw material ingredients in feeds for Atlantic salmon.

  8. Impact of health insurance status changes on healthcare utilisation patterns: a longitudinal cohort study in South Korea.

    PubMed

    Kim, Jae-Hyun; Lee, Sang Gyu; Lee, Kwang-Soo; Jang, Sung-In; Cho, Kyung-Hee; Park, Eun-Cheol

    2016-04-01

    The study examined medical care utilisation by health insurance status changes. The Korean Welfare Panel Study (KoWePs) was used. This study analysed 14,267 participants at baseline (2006). The individuals were categorised into four health insurance status groups: continuous health insurance, change from health insurance to Medical Aid, change from Medical Aid to health insurance, or continuous Medical Aid. Three dependent variables were also analysed: days spent in hospital; number of outpatient visits; and hospitalisations per year. Longitudinal data analysis was used to determine whether changes in health insurance status were associated with healthcare utilisation. The number of outpatient visits per year was 0.1.363 times higher (p<0.0001) in the continuous Medical Aid than in the continuous health insurance group. The number of hospitalisations per year was 1.560 times higher (p<0.001) in new Medical Aid and -0.636 times lower (p<0.001) in new health insurance than in continuous health insurance group. The number of days spent in hospital per year was -0.567 times lower (p=0.021) in the new health insurance than in the continuous health insurance group. Health insurance beneficiaries with a coverage level lower than Medical Aid showed lower healthcare utilisation, as measured by the number of hospitalisations and days spent in hospital per year. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. A longitudinal cohort study evaluating the impact of a geriatrician-led residential care outreach service on acute healthcare utilisation.

    PubMed

    Hutchinson, A F; Parikh, S; Tacey, M; Harvey, P A; Lim, W K

    2015-05-01

    over the last decade, high demand for acute healthcare services by long-term residents of residential care facilities (RCFs) has stimulated interest in exploring alternative models of care. The Residential Care Intervention Program in the Elderly (RECIPE) service provides expert outreach services to RCFs residents, interventions include comprehensive care planning, management of inter-current illness and rapid access to acute care substitution services. to evaluate whether the RECIPE service decreased acute healthcare utilisation. a retrospective cohort study using interrupted time series analysis to analyse change in acute healthcare utilisation before and after enrolment. a 300-bed metropolitan teaching hospital in Australia and 73 RCFs within its catchment. there were 1,327 patients enrolled in the service with a median age of 84 years; 61% were female. data were collected prospectively on all enrolled patients from 2004 to 2011 and linked to the acute health service administrative data set. Primary outcomes change in admission rates, length of stay and bed days per quarter. in the 2 years prior to enrolment, the mean number of acute care admissions per patient per year was 3.03 (SD 2.9) versus post 2.4 (SD 3.3), the service reducing admissions by 0.13 admissions per patient per quarter (P = 0.046). Prior to enrolment, the mean length of stay was 8.6 (SD 11.0) versus post 3.5 (SD 5.0), a reduction of 1.5 days per patient per quarter (P = 0.003). this study suggests that an outreach service comprising a geriatrician-led multidisciplinary team can reduce acute hospital utilisation rates. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Research utilisation and critical thinking among newly graduated nurses: predictors for research use. A quantitative cross-sectional study.

    PubMed

    Wangensteen, Sigrid; Johansson, Inger S; Björkström, Monica E; Nordström, Gun

    2011-09-01

    The aim was to describe research utilisation among newly graduated nurses and to explore critical thinking dispositions and other individual and contextual factors as possible predictors for research use. Nurses are expected to be research users, and variations in research utilisation are explained by individual and contextual factors. To our knowledge, critical thinking dispositions have not earlier been explored as predictors for research use. A cross-sectional design was chosen. Data collection was carried out from October 2006 to April 2007 using the Research Utilization Questionnaire (RUQ) and the California Critical Thinking Disposition Inventory (CCTDI). The response rate was 33% (n =617). Pearson's chi-square test and regression analyses were used for statistical calculations. The respondents reported a positive attitude towards research, but only 24% (n = 148) were defined as research users. A significantly higher proportion of research users reported high critical thinking scores. Critical thinking explained 20% of the variance in attitude towards research and 11% of the variance in research use. Availability and support to implement research findings was the second strongest predictor for research use. Critical thinking, a significant predictor for attitude towards research and for the use of research, should be recognised and strengthened in nursing education and clinical practice. Contextual factors seem to be important for newly graduated nurses' use of research. Nurse leaders play an important role in nurturing newly graduated nurses' critical thinking and assisting them in transferring their positive attitude towards research into research use. Nurse educators play a significant role in supporting, challenging and supervising nursing students to be critical thinkers and strong believers in research utilisation. © 2011 Blackwell Publishing Ltd.

  11. Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study.

    PubMed

    Kwambai, Titus K; Dellicour, Stephanie; Desai, Meghna; Ameh, Charles A; Person, Bobbie; Achieng, Florence; Mason, Linda; Laserson, Kayla F; Ter Kuile, Feiko O

    2013-06-21

    Poor utilisation of facility-based antenatal and delivery care services in Kenya hampers reduction of maternal mortality. Studies suggest that the participation of men in antenatal and delivery care is associated with better health care seeking behaviour, yet many reproductive health programs do not facilitate their involvement. This qualitative study conducted in rural Western Kenya, explored men's perceptions of antenatal and delivery care services and identified factors that facilitated or constrained their involvement. Eight focus group discussions were conducted with 68 married men between 20-65 years of age in May 2011. Participants were of the Luo ethnic group residing in Asembo, western Kenya. The area has a high HIV-prevalence and polygamy is common. A topic guide was used to guide the discussions and a thematic framework approach for data analysis. Overall, men were positive in their views of antenatal and delivery care, as decision makers they often encouraged, some even 'forced', their wives to attend for antenatal or delivery care. Many reasons why it was beneficial to accompany their wives were provided, yet few did this in practice unless there was a clinical complication. The three main barriers relating to cultural norms identified were: 1) pregnancy support was considered a female role; and the male role that of provider; 2) negative health care worker attitudes towards men's participation, and 3) couple unfriendly antenatal and delivery unit infrastructure. Although men reported to facilitate their wives' utilisation of antenatal and delivery care services, this does not translate to practice as adherence to antenatal-care schedules and facility based delivery is generally poor. Equally, reasons proffered why they should accompany their wives are not carried through into practice, with barriers outweighing facilitators. Recommendations to improve men involvement and potentially increase services utilisation include awareness campaigns targeting

  12. Inequalities in health and health service utilisation among reproductive age women in St. Petersburg, Russia: a cross-sectional study.

    PubMed

    Dubikaytis, Tatiana; Larivaara, Meri; Kuznetsova, Olga; Hemminki, Elina

    2010-11-11

    Russian society has faced dramatic changes in terms of social stratification since the collapse of the Soviet Union. During this time, extensive reforms have taken place in the organisation of health services, including the development of the private sector. Previous studies in Russia have shown a wide gap in mortality between socioeconomic groups. There are just a few studies on health service utilisation in post-Soviet Russia and data on inequality of health service use are limited. The aim of the present study was to analyse health (self-rated health and self-reported chronic diseases) and health care utilisation patterns by socioeconomic status (SES) among reproductive age women in St. Petersburg. The questionnaire survey was conducted in 2004 (n = 1147), with a response rate of 67%. Education and income were used as dimensions of SES. The association between SES and health and use of health services was assessed by logistic regression, adjusting for age. As expected low SES was associated with poor self-rated health (education: OR = 1.48; personal income: OR = 1.42: family income: OR = 2.31). University education was associated with use of a wider range of outpatient medical services and increased use of the following examinations: Pap smear (age-adjusted OR = 2.06), gynaecological examinations (age-adjusted OR = 1.62) and mammography among older (more than 40 years) women (age-adjusted OR = 1.98). Personal income had similar correlations, but family income was related only to the use of mammography among older women. Our study suggests a considerable inequality in health and utilisation of preventive health service among reproductive age women. Therefore, further studies are needed to identify barriers to health promotion resources.

  13. Distance and utilisation of out-of-hours services in a Norwegian urban/rural district: an ecological study

    PubMed Central

    2013-01-01

    Background Long travel distances limit the utilisation of health services. We wanted to examine the relationship between the utilisation of a Norwegian out-of-hours service and the distance from the municipality population centroid to the associated casualty clinic. Methods All first contacts from ten municipalities in Arendal out-of-hours district were registered from 2007 through 2011. The main outcomes were contact and consultation rates for each municipality for each year. The associations between main outcomes and distance from the population centroid of the participating municipalities to the casualty clinic and were examined by linear regression. Demographic and socioeconomic factors were included in multivariate linear regression. Secondary endpoints include association between distance and rates of different first actions taken and priority grades assessed by triage nurses. Age and gender specific subgroup analyses were performed. Results 141 342 contacts were included in the analyses. Increasing distance was associated with marked lower rates of all contact types except telephone consultations by doctor. Moving 43 kilometres away from the casualty clinic led to a 50 per cent drop in the rate of face-to-face consultations with a doctor. Availability of primary care doctors and education level contributed to a limited extent to the variance in consultation rate. The rates of all priority grades decreased significantly with increasing distance. The rate of acute events was reduced by 22 per cent when moving 50 kilometres away. The proportion of patients above 66 years increased with increasing distance, while the proportion of 13- to 19 year olds decreased. The proportion of female patients decreased with increasing distance. Conclusions The results confirm that increasing distance is associated with lower utilisation of out-of-hours services, even for the most acute cases. Extremely long distances might compromise patient safety. This must be taken into

  14. Out-of-Pocket Payments, Health Care Access and Utilisation in South-Eastern Nigeria: A Gender Perspective

    PubMed Central

    Onah, Michael N.; Govender, Veloshnee

    2014-01-01

    Out-of-pocket (OOP) payments have severe consequences for health care access and utilisation and are especially catastrophic for the poor. Although women comprise the majority of the poor in Nigeria and globally, the implications of OOP payments for health care access from a gender perspective have received little attention. This study seeks to fill this gap by using a combination of quantitative and qualitative analysis to investigate the gendered impact of OOPs on healthcare utilisation in south-eastern Nigeria. 411 households were surveyed and six single-sex Focus Group Discussions conducted. This study confirmed the socioeconomic and demographic vulnerability of female-headed households (FHHs), which contributed to gender-based inter-household differences in healthcare access, cost burden, choices of healthcare providers, methods of funding healthcare and coping strategies. FHHs had higher cost burdens from seeking care and untreated morbidity than male-headed households (MHHs) with affordability as a reason for not seeking care. There is also a high utilisation of patent medicine vendors (PMVs) by both households (PMVs are drug vendors that are unregulated, likely to offer very low-quality treatment and do not have trained personnel). OOP payment was predominantly the means of healthcare payment for both households, and households spoke of the difficulties associated with repaying health-related debt with implications for the medical poverty trap. It is recommended that the removal of user fees, introduction of prepayment schemes, and regulating PMVs be considered to improve access and provide protection against debt for FHHs and MHHs. The vulnerability of widows is of special concern and efforts to improve their healthcare access and broader efforts to empower should be encouraged for them and other poor households. PMID:24728103

  15. Analysis of the diversity of substrate utilisation of soil bacteria exposed to Cd and earthworm activity using generalised additive models.

    PubMed

    Muñiz, Selene; Lacarta, Juan; Pata, María P; Jiménez, Juan José; Navarro, Enrique

    2014-01-01

    Biolog EcoPlates™ can be used to measure the carbon substrate utilisation patterns of microbial communities. This method results in a community-level physiological profile (CLPP), which yields a very large amount of data that may be difficult to interpret. In this work, we explore a combination of statistical techniques (particularly the use of generalised additive models [GAMs]) to improve the exploitation of CLPP data. The strength of GAMs lies in their ability to address highly non-linear relationships between the response and the set of explanatory variables. We studied the impact of earthworms (Aporrectodea caliginosa Savigny 1826) and cadmium (Cd) on the CLPP of soil bacteria. The results indicated that both Cd and earthworms modified the CLPP. GAMs were used to assess time-course changes in the diversity of substrate utilisation (DSU) using the Shannon-Wiener index. GAMs revealed significant differences for all treatments (compared to control -S-). The Cd exposed microbial community presented very high metabolic capacities on a few substrata, resulting in an initial acute decrease of DSU (i.e. intense utilization of a few carbon substrata). After 54 h, and over the next 43 h the increase of the DSU suggest that other taxa, less dominant, reached high numbers in the wells containing sources that are less suitable for the Cd-tolerant taxa. Earthworms were a much more determining factor in explaining time course changes in DSU than Cd. Accordingly, Ew and EwCd soils presented similar trends, regardless the presence of Cd. Moreover, both treatments presented similar number of bacteria and higher than Cd-treated soils. This experimental approach, based on the use of DSU and GAMs allowed for a global and statistically relevant interpretation of the changes in carbon source utilisation, highlighting the key role of earthworms on the protection of microbial communities against the Cd.

  16. Juvenile obesity and its association with utilisation and costs of pharmaceuticals--results from the KiGGS study.

    PubMed

    Wenig, Christina M; Knopf, Hildtraud; Menn, Petra

    2011-12-16

    According to a national reference, 15% of German children and adolescents are overweight (including obese) and 6.3% are obese. An earlier study analysed the impact of childhood overweight and obesity on different components of direct medical costs (physician, hospital and therapists). To complement the existing literature for Germany, this study aims to explore the association of body mass index (BMI) with utilisation of pharmaceuticals and related costs in German children and adolescents. Based on data from 14, 836 respondents aged 3-17 years in the German Interview and Examination Survey for Children and Adolescents (KiGGS), drug intake and associated costs were estimated using a bottom-up approach. To investigate the association of BMI with utilisation and costs, univariate analyses and multivariate generalised mixed models were conducted. There was no significant difference between BMI groups regarding the probability of drug utilisation. However, the number of pharmaceuticals used was significantly higher (14%) for obese children than for normal weight children. Furthermore, there was a trend for more physician-prescribed medication in obese children and adolescents. Among children with pharmaceutical intake, estimated costs were 24% higher for obese children compared with the normal weight group. This is the first study to estimate excess drug costs for obesity based on a representative cross-sectional sample of the child and adolescent population in Germany. The results suggest that obese children should be classified as a priority group for prevention. This study complements the existing literature and provides important information concerning the relevance of childhood obesity as a health problem.

  17. Juvenile obesity and its association with utilisation and costs of pharmaceuticals - results from the KiGGS study

    PubMed Central

    2011-01-01

    Background According to a national reference, 15% of German children and adolescents are overweight (including obese) and 6.3% are obese. An earlier study analysed the impact of childhood overweight and obesity on different components of direct medical costs (physician, hospital and therapists). To complement the existing literature for Germany, this study aims to explore the association of body mass index (BMI) with utilisation of pharmaceuticals and related costs in German children and adolescents. Methods Based on data from 14, 836 respondents aged 3-17 years in the German Interview and Examination Survey for Children and Adolescents (KiGGS), drug intake and associated costs were estimated using a bottom-up approach. To investigate the association of BMI with utilisation and costs, univariate analyses and multivariate generalised mixed models were conducted. Results There was no significant difference between BMI groups regarding the probability of drug utilisation. However, the number of pharmaceuticals used was significantly higher (14%) for obese children than for normal weight children. Furthermore, there was a trend for more physician-prescribed medication in obese children and adolescents. Among children with pharmaceutical intake, estimated costs were 24% higher for obese children compared with the normal weight group. Conclusions This is the first study to estimate excess drug costs for obesity based on a representative cross-sectional sample of the child and adolescent population in Germany. The results suggest that obese children should be classified as a priority group for prevention. This study complements the existing literature and provides important information concerning the relevance of childhood obesity as a health problem. PMID:22176689

  18. Multimorbidity and healthcare utilisation among high-cost patients in the US Veterans Affairs Health Care System

    PubMed Central

    Zulman, Donna M; Pal Chee, Christine; Wagner, Todd H; Yoon, Jean; Cohen, Danielle M; Holmes, Tyson H; Ritchie, Christine; Asch, Steven M

    2015-01-01

    Objectives To investigate the relationship between multimorbidity and healthcare utilisation patterns among the highest cost patients in a large, integrated healthcare system. Design In this retrospective cross-sectional study of all patients in the U.S. Veterans Affairs (VA) Health Care System, we aggregated costs of individuals’ outpatient and inpatient care, pharmacy services and VA-sponsored contract care received in 2010. We assessed chronic condition prevalence, multimorbidity as measured by comorbidity count, and multisystem multimorbidity (number of body systems affected by chronic conditions) among the 5% highest cost patients. Using multivariate regression, we examined the association between multimorbidity and healthcare utilisation and costs, adjusting for age, sex, race/ethnicity, marital status, homelessness and health insurance status. Setting USA VA Health Care System. Participants 5.2 million VA patients. Measures Annual total costs; absolute and share of costs generated through outpatient, inpatient, pharmacy and VA-sponsored contract care; number of visits to primary, specialty and mental healthcare; number of emergency department visits and hospitalisations. Results The 5% highest cost patients (n=261 699) accounted for 47% of total VA costs. Approximately two-thirds of these patients had chronic conditions affecting ≥3 body systems. Patients with cancer and schizophrenia were less likely to have documented comorbid conditions than other high-cost patients. Multimorbidity was generally associated with greater outpatient and inpatient utilisation. However, increased multisystem multimorbidity was associated with a higher outpatient share of total costs (1.6 percentage points per affected body system, p<0.01) but a lower inpatient share of total costs (−0.6 percentage points per affected body system, p<0.01). Conclusions Multisystem multimorbidity is common among high-cost VA patients. While some patients might benefit from disease

  19. Utilisation of Healthcare and Associated Services in Huntington’s disease: a data mining study

    PubMed Central

    Busse, Monica; Al-Madfai, Dr. Hasan; Kenkre, Joyce; Landwehrmeyer, G. Bernhard; Bentivoglio, AnnaRita; Rosser, Anne

    2011-01-01

    Background: People with Huntington’s disease (HD) often require tailored healthcare and support packages that develop as the disease progresses. The Client Service Receipt Inventory (CSRI) gathers retrospective information on service utilization. This study investigated the use of formal services and informal care as measured by the CSRI and explored associations between informal care, disease severity and functional ability as measured by the Unified Huntington’s Disease Rating Scale Total Motor Score (UHDRS-TMS) and functional scales. Methods: All monitored longitudinal data from annual clinical assessments of UHDRS-TMS and functional assessments and CSRI collected under the auspices of the European Huntington’s Disease Network (EHDN) REGISTRY study between the years 2004 and 2009 were utilised in the analyses. Disease severity was reflected by UHDRS-TMS. Functional ability was measured using the UHDRS functional scales. CSRI data were analysed according to percentage use of individual formal services and total estimated hours per week of informal care. Regression analyses were conducted to identify any associations between disease severity, functional ability and hours of informal care. Results: 451 HD patients (212 female; 239 male) completed one visit; 105 patients (54 females; 51 males) completed two visits and 47 patients (20 females; 27 males) completed three visits in total over the 5 year period. The mean time between visits was 1.2 years. At visit one, 74% of the participants reported being in receipt of at least one formal hospital-based service in the previous six months, and 89% reported receipt of formal primary and community care services. In contrast, at the third visit, 62% of people had used hospital based services and 94% formal community based services in the previous six months. Fifty % of individuals required some form of informal care in the home at visit 1; this increased to 68% at visits 2 and 3. The mean (SD) estimated weekly total

  20. Utilisation of theoretical models and frameworks in the process of evidence synthesis.

    PubMed

    Godfrey, Christina M; Harrison, Margaret B; Graham, Ian D; Ross-White, Amanda

    2010-01-01

    A systematic review is a comprehensive enquiry or study of secondary data sources. There is a research question, an a priori articulation of methods and a set of procedures to focus the investigation. Despite these rigorous structures to guide the review, synthesising evidence is a challenging, resource intense and time consuming process. Large volumes of information complicate not only the search functions, but also the conceptualisation of the evidence needed to create the concise and integrated results. Use of a theoretical model or framework could serve as an essential element in effectively focusing the review and designing the methods to respond to the knowledge question. This scoping review sought to confirm the value of models or frameworks used by authors working within traditional methodologies for evidence synthesis. Types of participants The focus of this review was on the context of health care.Types of intervention(s)/phenomena of interest All studies that discussed models or frameworks used specifically to address the process of synthesis were included.Types of studies Discussion, scholarship or methodology papers and reviews were included.Types of outcome All theoretical models or frameworks were described, with specific attention to the purpose of the framework for each study, and the contribution of the framework to the process of synthesis. The search strategy aimed to find both published and unpublished studies. A three-step search strategy was utilised. The databases for published material included CINAHL; Medline; EMBASE; PsycINFO; AMED; Cochrane; Biomed Central; Scirus; and Mednar. Databases for unpublished material included Dissertation Abstracts; Sociological Abstracts; Conference proceedings. The review was a focused scoping review to locate and describe the contribution of theoretical models or frameworks to the process of synthesis. The methodological quality of the discussion papers was therefore not assessed. Data was extracted from

  1. The utilisation of municipal waste compost for the reclamation of anthropogenic soils: implications on C dynamics.

    NASA Astrophysics Data System (ADS)

    Said-Pullicino, D.; Bol, R.; Gigliotti, G.

    2009-04-01

    samples show that even after 10 years, amended topsoils were significantly enriched in compost-derived organic matter, confirming that the utilisation of such organic inputs in land reclamation activities has the potential to enhance the C stocks of degraded areas. The addition of compost to the superficial layer also resulted in a significant input of soluble organic compounds subject to leaching along the soil profile. Sorption isotherms for compost-derived water-extractable organic matter onto mineral materials used for landfill covering suggest that sorptive preservation was primarily responsible for the increase in C content and the shift in the C isotopic signature to values similar to that of the applied compost, in the deeper soil horizons over the 10 year experimental period. This was also confirmed by the accumulation of lignin-derived phenolic compounds. Nevertheless, analysis for non-cellulosic carbohydrates in soils samples and their respective water-extractable fractions suggest that a proportion of compost-derived, labile organic matter fraction is leached through the soil profile and potentially lost from the soil system, particularly in the years immediately after compost application.

  2. Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries

    PubMed Central

    Ruktanonchai, Nick W.; Nove, Andrea; Lopes, Sofia; Pezzulo, Carla; Bosco, Claudio; Alegana, Victor A.; Burgert, Clara R.; Ayiko, Rogers; Charles, Andrew SEK; Lambert, Nkurunziza; Msechu, Esther; Kathini, Esther; Matthews, Zoë; Tatem, Andrew J.

    2016-01-01

    Background Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH) services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery throughout five East African countries. Methods We calculated a geographic inaccessibility score to the nearest health facility at 300 x 300 m using a dataset of 9,314 facilities throughout Burundi, Kenya, Rwanda, Tanzania and Uganda. Using Demographic and Health Surveys data, we utilised hierarchical mixed effects logistic regression to examine the odds of: 1) skilled birth attendance, 2) receiving 4+ antenatal care visits at time of delivery, and 3) receiving a postnatal health check-up within 48 hours of delivery. We applied model results onto the accessibility surface to visualise the probabilities of obtaining MNH care at both high-resolution and sub-national levels after adjusting for live births in 2015. Results Across all outcomes, decreasing wealth and education levels were associated with lower odds of obtaining MNH care. Increasing geographic inaccessibility scores were associated with the strongest effect in lowering odds of obtaining care observed across outcomes, with the widest disparities observed among skilled birth attendance. Specifically, for each increase in the inaccessibility score to the nearest health facility, the odds of having skilled birth attendance at delivery was reduced by over 75% (0.24; CI: 0.19–0.3), while the odds of receiving antenatal care decreased by nearly 25% (0.74; CI: 0.61–0.89) and 40% for obtaining postnatal care (0.58; CI: 0.45–0.75). Conclusions Overall, these results suggest decreasing accessibility to the nearest health facility significantly deterred utilisation of all

  3. Effect of dietary calcium level and source on mineral utilisation by piglets fed diets containing exogenous phytase.

    PubMed

    Schlegel, P; Gutzwiller, A

    2016-11-21

    Calcium and phosphorus are essential minerals, closely linked in digestive processes and metabolism. With widespread use of low P diets containing exogenous phytase, the optimal dietary Ca level was verified. The 40-day study evaluated the effects of Ca level (4, 7 and 10 g/kg diet) and Ca source (Ca from CaCO3 and from Lithothamnium calcareum) on mineral utilisation in 72 piglets (7.9 ± 1.0 kg BW) fed an exogenous phytase containing diet with 2.9 g digestible P/kg. Measured parameters were growth performance, stomach mineral solubility, bone breaking strength and urinary, serum and bone mineral concentration. The apparent total tract digestibility of minerals was also assessed in the two diets with 7 g Ca/kg, using 12 additional pigs. Regardless of Ca source, increasing dietary Ca impaired feed conversion ratio, increased urinary pH, increased serum and urinary Ca, decreased serum and urinary P, decreased serum Mg and increased urinary Mg, increased serum AP activity, decreased bone Mg increased bone Zn. Bone breaking strength was improved with 7 compared to 4 g Ca/kg. Compared to CaCO3 , Ca from Lithothamnium calcareum increased serum Mg and with, 10 g Ca/kg, it limited body weight gain. The dose response of Ca in a diet with 2.9 g digestible P/kg and including exogenous phytase indicated that: (i) a low dietary Ca was beneficial for piglet growth, but was limiting the metabolic use of P; (ii) a high dietary Ca level impaired P utilisation; (iii) the optimal P utilisation and bone breaking strength was obtained with a dietary Ca-to-digestible P ratio of 2.1 to 2.4:1; (iv). Increasing dietary Ca reduced Mg utilisation, but not Zn status, when fed at adequate level. Finally, Ca from Lithothamnium calcareum had similar effects on Ca and P metabolism as CaCO3 , but impaired growth when fed at the highest inclusion level.

  4. Equality in Maternal and Newborn Health: Modelling Geographic Disparities in Utilisation of Care in Five East African Countries.

    PubMed

    Ruktanonchai, Corrine W; Ruktanonchai, Nick W; Nove, Andrea; Lopes, Sofia; Pezzulo, Carla; Bosco, Claudio; Alegana, Victor A; Burgert, Clara R; Ayiko, Rogers; Charles, Andrew Sek; Lambert, Nkurunziza; Msechu, Esther; Kathini, Esther; Matthews, Zoë; Tatem, Andrew J

    2016-01-01

    Geographic accessibility to health facilities represents a fundamental barrier to utilisation of maternal and newborn health (MNH) services, driving historically hidden spatial pockets of localized inequalities. Here, we examine utilisation of MNH care as an emergent property of accessibility, highlighting high-resolution spatial heterogeneity and sub-national inequalities in receiving care before, during, and after delivery throughout five East African countries. We calculated a geographic inaccessibility score to the nearest health facility at 300 x 300 m using a dataset of 9,314 facilities throughout Burundi, Kenya, Rwanda, Tanzania and Uganda. Using Demographic and Health Surveys data, we utilised hierarchical mixed effects logistic regression to examine the odds of: 1) skilled birth attendance, 2) receiving 4+ antenatal care visits at time of delivery, and 3) receiving a postnatal health check-up within 48 hours of delivery. We applied model results onto the accessibility surface to visualise the probabilities of obtaining MNH care at both high-resolution and sub-national levels after adjusting for live births in 2015. Across all outcomes, decreasing wealth and education levels were associated with lower odds of obtaining MNH care. Increasing geographic inaccessibility scores were associated with the strongest effect in lowering odds of obtaining care observed across outcomes, with the widest disparities observed among skilled birth attendance. Specifically, for each increase in the inaccessibility score to the nearest health facility, the odds of having skilled birth attendance at delivery was reduced by over 75% (0.24; CI: 0.19-0.3), while the odds of receiving antenatal care decreased by nearly 25% (0.74; CI: 0.61-0.89) and 40% for obtaining postnatal care (0.58; CI: 0.45-0.75). Overall, these results suggest decreasing accessibility to the nearest health facility significantly deterred utilisation of all maternal health care services. These results

  5. Dimensionnement par FDTD d'éléments optiques diffractifs utilisant le principe du milieu effectif

    NASA Astrophysics Data System (ADS)

    Aubry, S.; Gérard, P.; Flury, M.; Rockstuhl, C.; Herzig, H. P.; Fontaine, J.

    2004-11-01

    Une méthodologie utilisant l'outil rigoureux FDTD (Finite Difference Time Domain) est proposée et validée à l'aide d'une méthode modale rigoureuse, la FMM (Fourier Modal Method). C'est une première étape pour le calcul de réseaux de diffraction sub-longueur d'onde devant permettre la réalisation d'EOD à 4 niveaux de phase et fonctionnant en réflexion.

  6. Effect of dietary mineral level and inulin inclusion on phosphorus, calcium and nitrogen utilisation, intestinal microflora and bone development.

    PubMed

    Varley, Patrick F; McCarney, Catherine; Callan, James J; O'Doherty, John V

    2010-11-01

    An experiment was conducted to investigate the interaction between dietary phosphorus (P) level (4 vs 6 g total P kg(-1)) and inulin inclusion (0 vs 20 g kg(-1)) on coefficients of total tract apparent digestibility, nitrogen (N), P and calcium (Ca) utilisation, bone mineralisation, selected gastrointestinal microflora, intestinal volatile fatty acid concentrations and digesta pH in the ileum, caecum and proximal colon. Owing to the design of the experiment, as dietary P level increased, there was also an increase in dietary Ca level in order to maintain a sustainable dietary Ca/P ratio. Entire male finisher pigs (n = 10 per treatment) with a similar initial body weight (51 kg, standard deviation 2.4 kg) were used. Inulin inclusion lowered (P < 0.01) Enterobacteriaceae populations in the proximal colon compared with pigs offered diets without added inulin. However, intestinal bacterial populations of Lactobacillus and Bifidobacterium spp. were unaffected. Inulin inclusion had no effect on mineral digestibility or bone mineralisation. Pigs offered low P and Ca diets had lower (P < 0.01) bone mineralisation than pigs offered high P and Ca diets. Intestinal bacterial populations of Enterobacteriaceae in the proximal colon were lowered by inulin inclusion. Inulin inclusion did not affect P, Ca or N utilisation or bone mineralisation in the finisher pig when offered either a low or a high P diet. Increasing the P and Ca content of the diet led to an increase in bone mineralisation. 2010 Society of Chemical Industry

  7. Differences in carbon source utilisation by orchid mycorrhizal fungi from common and endangered species of Caladenia (Orchidaceae).

    PubMed

    Mehra, S; Morrison, P D; Coates, F; Lawrie, A C

    2017-02-01

    Terrestrial orchids depend on orchid mycorrhizal fungi (OMF) as symbionts for their survival, growth and nutrition. The ability of OMF from endangered orchid species to compete for available resources with OMF from common species may affect the distribution, abundance and therefore conservation status of their orchid hosts. Eight symbiotically effective OMF from endangered and more common Caladenia species were tested for their ability to utilise complex insoluble and simple soluble carbon sources produced during litter degradation by growth with different carbon sources in liquid medium to measure the degree of OMF variation with host conservation status or taxonomy. On simple carbon sources, fungal growth was assessed by biomass. On insoluble substrates, ergosterol content was assessed using ultra-performance liquid chromatography (UPLC). The OMF grew on all natural materials and complex carbon sources, but produced the greatest biomass on xylan and starch and the least on bark and chitin. On simple carbon sources, the greatest OMF biomass was measured on most hexoses and disaccharides and the least on galactose and arabinose. Only some OMF used sucrose, the most common sugar in green plants, with possible implications for symbiosis. OMF from common orchids produced more ergosterol and biomass than those from endangered orchids in the Dilatata and Reticulata groups but not in the Patersonii and Finger orchids. This suggests that differences in carbon source utilisation may contribute to differences in the distribution of some orchids, if these differences are retained on site.

  8. Reconnaissance optique des formes en parallele utilisant des reseaux de neurones et une mire de reduction de dimensions

    NASA Astrophysics Data System (ADS)

    Gagne, Philippe

    Cette recherche vise à la mise en OEuvre optique de la reconnaissance des images en utilisant une mire d'anneaux afin de générer des vecteurs caractéristiques qui seront ensuite classifiés par un réseau de neurones. On proposera deux architectures originales: une qui permettra la reconnaissance invariante sous rotation en utilisant un corrélateur conjoint; l'autre montage permettra une classification en parallèle de plusieurs images grâce à la capacité des mires d'anneaux de compresser l'information. Ce dernier montage est basé sur un corrélateur 4F. On présentera des résultats optiques expérimentaux pour ces deux montages. Pour arriver à des résultats concluants on analysera le comportement des vecteurs obtenus à partir d'une mire d'anneaux, on introduira une règle d'apprentissage optimisant le pic de corrélation en réduisant les pics parasites et on corrigera à l'aide d'un algorithme génétique les modulations de phases générées par le modulateur spatial à cristaux liquides.

  9. A simple solution to the problem of effective utilisation of the target material for pulsed laser deposition of thin films

    SciTech Connect

    Kuzanyan, A S; Kuzanyan, A A; Petrosyan, V A; Pilosyan, S Kh; Grasiuk, A Z

    2013-12-31

    The factors determining the efficiency of the target material utilisation for pulsed laser deposition of films are considered. The target volume is calculated, which is evaporated in the ablation process by the focused laser radiation having a rectangular form. The new device is suggested and developed for obtaining thin films by the method of laser deposition, which is specific in the employment of a simple optical system mounted outside a deposition chamber that comprises two lenses and the diaphragm and focuses the laser beam onto a target in the form of a sector-like spot. Thin films of CuO and YBaCuO were deposited with this device. Several deposition cycles revealed that the target material is consumed uniformly from the entire surface of the target. A maximal spread of the target thickness was not greater than ±2% both prior to deposition and after it. The device designed provides a high coefficient of the target material utilisation efficiency. (laser deposition of thin films)

  10. Assistive devices utilisation in activities of everyday life--a proposed framework of understanding a user perspective.

    PubMed

    Krantz, Oskar

    2012-05-01

    This theoretical article proposes a framework of understanding a user perspective of assistive devices utilisation in everyday life. Utilising the MPT model (Matching Person and Technology) and the ValMO model (Values and Meaning in Human Occupations), a framework of understanding is proposed. Main components are person, assistive device, and activity, connected by the person's expectations and experiences concerning the doability/doworthiness (possible to do/worth doing) of an activity, and the usability/useworthiness (possible to use/worth using) of an assistive device. Expectations may differ based on not only earlier experiences (habitus), but also situational and environmental variations, and result in differing experiences. In general, the purpose of an assistive device is to increase a person's repertoire of doable activities. For a person, this can be a function of the evaluation of possible gains, in terms of correlation between investments (in terms of time and energy), and the (expected) result of the activity. The only person able to estimate the useworthiness/usability of a device and the doworthiness/doability of an activity is the user her/himself, assessing the degree at which a specific assistive device enhances the value of an activity, in turn affecting the habitus of the (presumptive) user. [Box: see text].

  11. Discovery, utilisation and analysis of credible threats for 2×2 incomplete information games in the Theory of Moves framework

    NASA Astrophysics Data System (ADS)

    Olsen, Jolie; Sen, Sandip

    2014-04-01

    Steven Brams's [(1994). Theory of moves. Cambridge University Press] Theory of Moves (TOM) is an alternative to traditional game theoretic treatment of real-life interactions, in which players choose strategies based on analysis of future moves and counter-moves that arise if game play commences at a specified start state and either player can choose to move first. In repeated play, players using TOM rationality arrive at nonmyopic equilibria. One advantage of TOM is its ability to model scenarios in which power asymmetries exist between players. In particular, threat power, i.e. the ability of one player to threaten and sustain immediate, globally disadvantageous outcomes to force a desirable result long term, can be utilised to induce Pareto optimal states in games such as Prisoner's Dilemma which result in Pareto-dominated outcomes using traditional methods. Unfortunately, prior work on TOM is limited by an assumption of complete information. This paper presents a mechanism that can be used by a player to utilise threat power when playing a strict, ordinal 2×2 game under incomplete information. We also analyse the benefits of threat power and support in this analysis with empirical evidence.

  12. Increased biohydrogen yields, volatile fatty acid production and substrate utilisation rates via the electrodialysis of a continually fed sucrose fermenter.

    PubMed

    Jones, Rhys Jon; Massanet-Nicolau, Jaime; Mulder, Martijn J J; Premier, Giuliano; Dinsdale, Richard; Guwy, Alan

    2017-04-01

    Electrodialysis (ED) removed volatile fatty acids (VFAs) from a continually-fed, hydrogen-producing fermenter. Simultaneously, electrochemical removal and adsorption removed gaseous H2 and CO2, respectively. Removing VFAs via ED in this novel process increased H2 yields by a factor of 3.75 from 0.24molH2mol(-1)hexose to 0.90molH2mol(-1)hexose. VFA production and substrate utilisation rates were consistent with the hypothesis that end product inhibition arrests H2 production. The methodology facilitated the recovery of 37g of VFAs, and 30L H2 that was more than 99% pure, both of which are valuable, energy dense chemicals. Typically, short hydraulic and solid retention times, and depressed pH levels are used to suppress methanogenesis, but this limits H2 production. To produce H2 from real world, low grade biomass containing complex carbohydrates, longer hydraulic retention times (HRTs) are required. The proposed system increased H2 yields via increased substrate utilisation over longer HRTs.

  13. Individual utilisation thresholds and exploring how GPs' knowledge of their patients affects diagnosis: a qualitative study in primary care.

    PubMed

    Michiels-Corsten, Matthias; Bösner, Stefan; Donner-Banzhoff, Norbert

    2017-05-01

    One of the tenets of general practice is that continuity of care has a beneficial effect on patient care. However, little is known about how continuity can have an impact on the diagnostic reasoning of GPs. To explore GPs' diagnostic strategies by examining GPs' reflections on their patients' individual thresholds for seeking medical attention, how they arrive at their estimations, and which conclusions they draw. Qualitative study with 12 GPs in urban and rural practices in Germany. After each patient consultation GPs were asked to reflect on their diagnostic reasoning for that particular case. Qualitative and quantitative analyses of consultations and interview content were undertaken. A total of 295 primary care consultations were recorded, 134 of which contained at least one diagnostic episode. When elaborating on known patients, GPs frequently commented on how 'early' or 'late' in an illness progression a patient tended to consult. The probability of serious disease was accordingly regarded as high or low. This influenced GPs' behaviour regarding further investigations or referrals, as well as reassurance and watchful waiting. GPs' explanations for a patient's utilisation threshold comprised medical history, the patient's characteristics, family background, the media, and external circumstances. The concept of an individual threshold for the utilisation of primary care would explain how GPs use their knowledge of individual patients and their previous help-seeking behaviour for their diagnostic decision making. Whether the assumption behind this concept is valid, and whether its use improves diagnostic accuracy, remains to be investigated. © British Journal of General Practice 2017.

  14. Hospital bed utilisation in the NHS, Kaiser Permanente, and the US Medicare programme: analysis of routine data.

    PubMed

    Ham, Chris; York, Nick; Sutch, Steve; Shaw, Rob

    2003-11-29

    To compare the utilisation of hospital beds in the NHS in England, Kaiser Permanente in California, and the Medicare programme in the United States and California. Analysis of routinely available data from 2000 and 2001 on inpatient admissions, lengths of stay, and bed days in populations aged over 65 for 11 leading causes of use of acute beds. Comparison of NHS data with data from Kaiser Permanente in California and the Medicare programme in California and the United States; interviews with Kaiser Permanente staff and visits to Kaiser facilities. Bed day use in the NHS for the 11 leading causes is three and a half times that of Kaiser's standardised rate, almost twice that of the Medicare California's standardised rate, and more than 50% higher than the standardised rate in Medicare in the United States. Kaiser achieves these results through a combination of low admission rates and relatively short stays. The lower use of bed days in Medicare in California compared with Medicare in the United States suggests there is a "California effect" as well as a "Kaiser effect" in hospital utilisation. The NHS can learn from Kaiser's integrated approach, the focus on chronic diseases and their effective management, the emphasis placed on self care, the role of intermediate care, and the leadership provided by doctors in developing and supporting this model of care.

  15. Impact of cancer anorexia-cachexia syndrome on health-related quality of life and resource utilisation: A systematic review.

    PubMed

    Tarricone, Rosanna; Ricca, Giada; Nyanzi-Wakholi, Barbara; Medina-Lara, Antonieta

    2016-03-01

    Cancer anorexia-cachexia syndrome (CACS) negatively impacts patients' quality of life (QoL) and increases the burden on healthcare resources. To review published CACS data regarding health-related QOL (HRQoL) and its economic impact on the healthcare system. Searches were conducted in MEDLINE, EMBASE, DARE, and NHS EED databases. A total of 458 HRQoL and 189 healthcare resources utilisation abstracts were screened, and 42 and 2 full-text articles were included, respectively. The EORTC QLQ-C30 and FAACT instruments were most favoured for assessing HRQOL but none of the current tools cover all domains affected by CACS. Economic estimates for managing CACS are scarce, with studies lacking a breakdown of healthcare resource utilisation items. HRQoL instruments that can better assess and incorporate all the domains affected by CACS are required. Rigorous assessment of costs and benefits of treatment are needed to understand the magnitude of the impact of CACS. Copyright © 2016. Published by Elsevier Ireland Ltd.

  16. Utilisation of health services and geography: deconstructing regional differences in barriers to facility-based delivery in Nepal.

    PubMed

    Hodge, Andrew; Byrne, Abbey; Morgan, Alison; Jimenez-Soto, Eliana

    2015-03-01

    While established that geographical inaccessibility is a key barrier to the utilisation of health services, it remains unknown whether disparities are driven only by limited access to these services, or are also attributable to health behaviour. Significant disparities exist in health outcomes and the coverage of many critical health services between the mountains region of Nepal and the rest of the country, yet the principal factors driving these regional disparities are not well understood. Using national representative data from the 2011 Nepal Demographic and Health Survey, we examine the extent to which observable factors explain the overall differences in the utilisation of maternal health services. We apply nonlinear Blinder-Oaxaca-type decomposition methods to quantify the effect that differences in measurable characteristics have on the regional coverage gap in facility-based delivery. The mean coverage of facility-based deliveries was 18.6 and 36.3 % in the mountains region and the rest of Nepal, respectively. Between 54.8 and 74.1 % of the regional coverage gap was explained by differences in observed characteristics. Factors influencing health behaviours (proxied by mothers' education, TV viewership and tobacco use, and household wealth) and subjective distance to the health facility were the major factors, contributing between 52.9 and 62.5 % of the disparity. Mothers' birth history was also noteworthy. Policies simultaneously addressing access and health behaviours appear necessary to achieve greater coverage and better health outcomes for women and children in isolated areas.

  17. Utilising E-on Vue and Unity 3D scenes to generate synthetic images and videos for visible signature analysis

    NASA Astrophysics Data System (ADS)

    Madden, Christopher S.; Richards, Noel J.; Culpepper, Joanne B.

    2016-10-01

    This paper investigates the ability to develop synthetic scenes in an image generation tool, E-on Vue, and a gaming engine, Unity 3D, which can be used to generate synthetic imagery of target objects across a variety of conditions in land environments. Developments within these tools and gaming engines have allowed the computer gaming industry to dramatically enhance the realism of the games they develop; however they utilise short cuts to ensure that the games run smoothly in real-time to create an immersive effect. Whilst these short cuts may have an impact upon the realism of the synthetic imagery, they do promise a much more time efficient method of developing imagery of different environmental conditions and to investigate the dynamic aspect of military operations that is currently not evaluated in signature analysis. The results presented investigate how some of the common image metrics used in target acquisition modelling, namely the Δμ1, Δμ2, Δμ3, RSS, and Doyle metrics, perform on the synthetic scenes generated by E-on Vue and Unity 3D compared to real imagery of similar scenes. An exploration of the time required to develop the various aspects of the scene to enhance its realism are included, along with an overview of the difficulties associated with trying to recreate specific locations as a virtual scene. This work is an important start towards utilising virtual worlds for visible signature evaluation, and evaluating how equivalent synthetic imagery is to real photographs.

  18. Spirometry utilisation among Danish adults initiating medication targeting obstructive lung disease.

    PubMed

    Koefoed, Mette Marie

    2015-02-01

    This PhD thesis was written during my employment at the Research Unit of General Practice in Odense, University of Southern Denmark. It comprises an overview and three papers, all published or submitted for publication in international peer-reviewed scientific journals.   Non-infectious dyspnoea, chronic cough and wheezing are common symptoms in the population. Patients often present with these symptoms in general practice and have a high probability of having obstructive lung diseases. However, there is an indication that the majority of these patients are treated empirically with pharmacotherapy targeting obstructive lung disease and only few have additional tests conducted, although the predictive value of respiratory symptoms for diagnosing obstructive lung disease has proven to be low. Spirometry is recommended as the gold standard for confirming obstructive lung disease, and testing can also rule out airway obstruction in patients with respiratory symptoms caused by other illnesses, such as heart failure or lung cancer. Initiating medication for obstructive lung disease without spirometry entails the risk of these patients experiencing unnecessary delay in the diagnostic process and being exposed to unnecessary economic costs and medication risks. The literature has indicated that many users of medication targeting obstructive lung medication have not had spirometry performed and do not actually have obstructive lung disease. This potential quality gap needs to be assessed. Also, in order to target interventions enhancing earlier spirometry utilisation among patients initiating medication targeting obstructive lung disease, improved knowledge on patient and practice factors associated with spirometry testing is needed.   Among first time users of obstructive lung medication we aimed: - To assess to what extent spirometry was performed within the first year of medication use (Study I) - To assess if patient characteristics like socioeconomic and demographic

  19. Dietary Prebiotics and Probiotics Influence the Growth Performance, Feed Utilisation, and Body Indices of Snakehead (Channa striata) Fingerlings

    PubMed Central

    Munir, Mohammad Bodrul; Hashim, Roshada; Abdul Manaf, Mohammad Suhaimee; Nor, Siti Azizah Mohd

    2016-01-01

    This study used a two-phase feeding trial to determine the influence of selected dietary prebiotics and probiotics on growth performance, feed utilisation, and morphological changes in snakehead (Channa striata) fingerlings as well as the duration of these effects over a post-experimental period without supplementation. Triplicate groups of fish (22.46 ±0.17 g) were raised on six different treatment diets: three prebiotics (0.2% β-glucan, 1% galacto-oligosaccharides [GOS], 0.5% mannan-oligosaccharides [MOS]), two probiotics (1% live yeast [Saccharomyces cerevisiae] and 0.01% Lactobacillus acidophilus [LBA] powder) and a control (unsupplemented) diet; there were three replicates for each treatment. All diets contained 40% crude protein and 12% crude lipid. Fish were fed to satiation three times daily. No mortalities were recorded during Phase 1; however, 14% mortality was documented in the control and prebiotic-amended fish during Phase 2. At the end of Phase 1, growth performance and feed utilisation were significantly higher (p<0.05) in the LBA-treated fish, followed by live yeast treatment, compared with all other diets tested. The performance of fish on the three prebiotic diets were not significantly different from one another but was significantly higher than the control diet. During Phase 2 (the post-feeding phase), fish growth continued until the 6th week for the probiotic-based diets but levelled off after four weeks for the fish fed the prebiotic diets. The feed conversion ratio (FCR) was higher in all treatments during the post-feeding period. The hepatosomatic index (HSI) did not differ significantly among the tested diets. The visceral somatic index (VSI) and intraperitoneal fat (IPF) were highest in the LBA-based diet and the control diet, respectively. The body indices were significantly different (p<0.05) between Phases 1 and 2. This study demonstrates that probiotic-based diets have a more positive influence on the growth, feed utilisation, and