A pharmacy led program to review anti-psychotic prescribing for people with dementia

Background: Anti-psychotics, prescribed to people with dementia, are associated with approximately 1,800 excess annual deaths in the UK. A key public health objective is to limit such prescribing of anti-psychotics. Methods: This project was conducted within primary care in Medway Primary Care Trust (PCT) in the UK. There were 2 stages for the intervention. First, primary care information systems including the dementia register were searched by a pharmacy technician to identify people with dementia prescribed anti-psychotics. Second, a trained specialist pharmacist conducted targeted clinical medication reviews in people with dementia initiated on anti-psychotics by primary care, identified by the data search. Results: Data were collected from 59 practices. One hundred and sixty-one (15.3%) of 1051 people on the dementia register were receiving low-dose anti-psychotics. People with dementia living in residential homes were nearly 3.5 times more likely to receive an anti-psychotic [25.5% of care home residents (118/462) vs. 7.3% of people living at home (43/589)] than people living in their own homes (p?

Novel biomass conversion routes:ammonia from biomass, and marine macroalgae for energy

This thesis presents a techno-economic investigation of the generation of electricity from marine macroalgae (seaweed) in the UK (Part 1), and the production of anhydrous ammonia from synthesis gas (syngas) generated from biomass gasification (Part 2). In Part 1, the study covers the costs from macroalgae production to the generation of electricity via a CHP system. Seven scenarios, which varied the scale and production technique, were investigated to determine the most suitable scale of operation for the UK. Anaerobic digestion was established as the most suitable technology for macroalgae conversion to CHP, based on a number of criteria. All performance and cost data have been taken from published literature. None of the scenarios assessed would be economically viable under present conditions, although the use of large-scale electricity generation has more potential than small-scale localised production. Part 2 covers the costs from the delivery of the wood chip feedstock to the production of ammonia. Four cases, which varied the gasification process used and the scale of production, were investigated to determine the most suitable scale of operation for the UK. Two gasification processes were considered, these were O2-enriched air entrained flow gasification and Fast Internal Circulating Fluidised Bed. All performance and cost data have been taken from published literature, unless otherwise stated. Large-scale (1,200 tpd) ammonia production using O2-enriched air entrained flow gasification was determined as the most suitable system, producing the lowest ammonia-selling price, which was competitive to fossil fuels. Large-scale (1,200 tpd) combined natural gas/biomass syngas ammonia production also generated ammonia at a price competitive to fossil fuels.

Trigeneration using biomass energy for sustainable development

Purpose: The paper aims to design and prove the concept of micro-industry using trigeneration fuelled by biomass, for sustainable development in rural NW India. Design/methodology/approach: This is being tested at village Malunga, near Jodhpur in Rajasthan. The system components comprise burning of waste biomass for steam generation and its use for power generation, cooling system for fruit ripening and the use of steam for producing distilled water. Site was selected taking into account the local economic and social needs, biomass resources available from agricultural activities, and the presence of a NGO which is competent to facilitate running of the enterprise. The trigeneration system was designed to integrate off-the-shelf equipment for power generation using boilers of approximate total capacity 1 tonne of fuel per hour, and a back-pressure steam turbo-generator (200 kW). Cooling is provided by a vapour absorption machine (VAM). Findings: The financial analysis indicates a payback time of less than two years. Nevertheless, this is sensitive to market fluctuations and availabilities of raw materials. Originality/value: Although comparable trigeneration systems already exist in large food processing industries and in space heating and cooling applications, they have not previously been used for rural micro-industry. The small-scale (1-2 m3/h output) multiple effect distillation (3 effect plus condenser) unit has not previously been deployed at field level. © Emerald Group Publishing Limited.