Potentially inappropriate prescribing in older patients discharged from acute care hospitals to residential aged care facilities

Background The frequency of prescribing potentially inappropriate medications (PIMs) in older patients remains high despite evidence of adverse outcomes from their use. Little is known about whether admission to hospital has any effect on appropriateness of prescribing. Objectives This study aimed to identify the prevalence and nature of PIMs and explore the association of risk factors for receiving a PIM. Methods This was a prospective study of 206 patients discharged to residential aged care facilities (RACFs) from acute care. All patients were aged at least 70 years and were admitted between July 2005 and May 2010; their admission and discharge medications were evaluated. Results Mean patient age was 84.8 ± 6.7 years; the majority (57%) were older than 85 years and mean (SD) Frailty Index was 0.42 (0.15). At least one PIM was identified in 112 (54.4%) patients on admission and 102 (49.5%) patients on discharge. Of all medications prescribed at admission (1728), 10.8% were PIMs and at discharge of 1759 medications, 9.6% were PIMs. Of total 187 PIMs on admission, 56 (30%) were stopped and 131 were continued; 32 new PIMs were introduced. Of the potential risk factors considered, in-hospital cognitive decline and frailty status were the only significant predictors of PIMs. Conclusion Although, admission to hospital is an opportunity to review the indications for specific medications, a high prevalence of inappropriate drug use was observed. The only associations with PIM use were the frailty status and in-hospital cognitive decline. Additional studies are needed to further evaluate this association.

Battery energy storage systems to improve power system frequency response

Battery energy storage systems (BESS) are becoming feasible to provide system frequency support due to recent developments in technologies and plummeting cost. Adequate response of these devices becomes critical as the penetration of the renewable energy sources increases in the power system. This paper proposes effective use of BESS to improve system frequency performance. The optimal capacity and the operation scheme of BESS for frequency regulation are obtained using two staged optimization process. Furthermore, the effectiveness of BESS for improving the system frequency response is verified using dynamic simulations.

A framework for sustainable energy reduction in modern breweries

This thesis examines the existing frameworks for energy management in the brewing industry and details the design, development and implementation of a new framework at a modern brewery. The aim of the research was to develop an energy management framework to identify opportunities in a systematic manner using Systems Engineering concepts and principles. This work led to a Sustainable Energy Management Framework, SEMF. Using the SEMF approach, one of Australia's largest breweries has achieved number 1 ranking in the world for water use for the production of beer and has also improved KPI's and sustained the energy management improvements that have been implemented during the past 15 years. The framework can be adapted to other manufacturing industries in the Australian context and is considered to be a new concept and a potentially important tool for energy management.

Potentially inappropriate prescribing in older patients admitted to acute care hospitals and discharged to residential aged care facilities

Background The frequency of prescribing potentially inappropriate medications (PIMs) in older patients remains high regardless of the evidence of adverse outcomes from their use. This study aims to identify the prevalence and nature of PIMs at admission to acute care and at discharge to residential aged care facilities (RACFs) using the recently updated Beers’ Criteria. We also aim to identify if polypharmacy, age, gender and the frailty status of patients are independent risk factors for receiving a PIM. Methods This was a retrospective study of 206 patients discharged to RACFs from acute care. All patients were aged at least70 years and were admitted between July 2005 and May 2010; their admission and discharge medications were evaluated. Frailty status was measured as the Frailty Index (FI), adding each individual’s deficits and dividing by the total number of deficits considered, with FI 0.25 used as the cut-off between “fit” and “frail”. Results Mean patient age was 84.8 ± 6.7 years; the majority (57%) were older than 85 years and approximately 90% were frail. Patients were prescribed a mean of 7.2 regular medications at admission and 8.1 on discharge. At least one PIM was identified in 112 (54.4%) patients on admission and 102 (49.5%) patients on discharge. Of all medications prescribed at admission (1728), 10.8% were PIMs and at discharge of 1759 medications, 9.6% were PIMs. Of the total 187 PIMs on admission, 56 (30%) were stopped, and 131 were continued; 32 new PIMs were introduced. Commonly prescribed PIMs at both admission and discharge were central nervous system, cardiovascular and gastrointestinal drugs and analgesics. Of the potential risk factors, frailty status was the only significant predictor of PIMs at both admission and discharge (p = 0.016). Conclusion A high prevalence of unnecessary drug use was observed in frail older patients on admission to acute care hospitals and on discharge to RACFs. The only association with PIM use was the frailty status of patients. Further studies are needed to further evaluate this association.

An Investigation into the Options for Increasing the Extent of Energy Efficiency Knowledge and Skills in Engineering Education

Society is increasingly calling for professionals across government, industry, business and civil society to be able to problem-solve issues related to climate change and sustainable development as part of their work. In particular there is an emerging realisation of the fundamental need to swiftly reduce the growing demand for energy across society, and to then meet the demand with low emissions options. A key ingredient to addressing such issues is equipping professionals with emerging knowledge and skills to address energy challenges in all aspects of their work. The Council of Australian Governments has recognised this need, signing the National Partnership Agreement on Energy Efficiency in July 2009, which included a commitment to assist business and industry obtain the knowledge, skills and capacity to pursue cost-effective energy efficiency opportunities.2 Engineering will play a critical part among the professions, with Engineers Australia acknowledging that, ‘The need to make changes in the way energy is used and supplied throughout the world represents the greatest challenge to engineers in moving toward sustainability.’

Energy Efficiency Resources for Undergraduate Engineering Education: Final Report

This report presents the findings of an investigation of energy efficiency resources for undergraduate engineering education, undertaken by web-based research, conversations with educators, and a university survey. The investigation draws on the results of a number of previous investigations undertaken by the research team for NFEE related to energy efficiency education and presents the following findings and recommendations, as explained in greater detail in the body of the report. The findings suggest that even though certain EE concepts and principles have been identified by lecturers as being important there is little to no coverage of a number of these concepts in some programs/courses. Similarly, many topics relating to the most important EE workforce skills and significant shortages as identified in industry research, do not rate highly in terms of both perceived importance by lecturers, or coverage within existing courses. Overall, these findings suggest that despite growing awareness of the importance of EE in both industry and academia, the current depth and breadth of EE content in courses does not reflect this. It confirms that efforts in these areas can be better supported.

Energy Efficiency Graduate Attributes Project: Final Report

The Energy Efficiency (EE) Graduate Attributes Project focuses on engineering as a priority profession that has a significant role to play in addressing energy demand and supply issues in Australia. Specifically, this project aims to support embedding EE knowledge and skills throughout the engineering undergraduate curriculum, to help build capacity within the Australian workforce across major sectors of the economy, from mining, manufacturing and industrial applications to design, construction, maintenance and retrofitting built environments. The resultant report is intended to assist in future consultation with key groups such as Engineers Australia (EA), the Australian Council of Engineering Deans (ACED) and the eight EA colleges, to support systemic curriculum renewal and promote the design and development of high quality EE engineering education resources. The project is based on a whole-of-program outcomes-based approach to curriculum renewal, creating a transparent framework for integrating EE. This comprises collaborative consideration by academics and professional engineers who have experience in teaching and practising EE, to identify what students should learn to be equipped with relevant competencies by the time they graduate.

Deep geothermal: The ‘Moon Landing’ mission in the unconventional energy and minerals space

Deep geothermal from the hot crystalline basement has remained an unsolved frontier for the geothermal industry for the past 30 years. This poses the challenge for developing a new unconventional geomechanics approach to stimulate such reservoirs. While a number of new unconventional brittle techniques are still available to improve stimulation on short time scales, the astonishing richness of failure modes of longer time scales in hot rocks has so far been overlooked. These failure modes represent a series of microscopic processes: brittle microfracturing prevails at low temperatures and fairly high deviatoric stresses, while upon increasing temperature and decreasing applied stress or longer time scales, the failure modes switch to transgranular and intergranular creep fractures. Accordingly, fluids play an active role and create their own pathways through facilitating shear localization by a process of time-dependent dissolution and precipitation creep, rather than being a passive constituent by simply following brittle fractures that are generated inside a shear zone caused by other localization mechanisms. We lay out a new theoretical approach for the design of new strategies to utilize, enhance and maintain the natural permeability in the deeper and hotter domain of geothermal reservoirs. The advantage of the approach is that, rather than engineering an entirely new EGS reservoir, we acknowledge a suite of creep-assisted geological processes that are driven by the current tectonic stress field. Such processes are particularly supported by higher temperatures potentially allowing in the future to target commercially viable combinations of temperatures and flow rates.

Power quality improvements in low voltage distribution networks containing distributed energy resources

In this thesis various schemes using custom power devices for power quality improvement in low voltage distribution network are studied. Customer operated distributed generators makes a typical network non-radial and affect the power quality. A scheme considering different algorithm of DSTATCOM is proposed for power circulation and islanded operation of the system. To compensate reactive power overflow and facilitate unity power factor, a UPQC is introduced. Stochastic analysis is carried out for different scenarios to get a comprehensive idea about a real life distribution network. Combined operation of static compensator and voltage regulator is tested for the optimum quality and stability of the system.

Doubly Fed Induction Generators : Overview and Intelligent Control Strategies for Wind Energy Conversion Systems

Adjustable speed induction generators, especially the Doubly-Fed Induction Generators (DFIG) are becoming increasingly popular due to its various advantages over fixed speed generator systems. A DFIG in a wind turbine has ability to generate maximum power with varying rotational speed, ability to control active and reactive by integration of electronic power converters such as the back-to-back converter, low rotor power rating resulting in low cost converter components, etc, DFIG have become very popular in large wind power conversion systems. This chapter presents an extensive literature survey over the past 25 years on the different aspects of DFIG. Application of H8 Controller for enhanced DFIG-WT performance in terms of robust stability and reference tracking to reduce mechanical stress and vibrations is also demonstrated in the chapter.

Application of TS-Fuzzy Controller for Active Power and DC Capacitor Voltage Control in DFIG-Based Wind Energy Conversion Systems

This chapter focuses on the implementation of the TS (Tagaki-Sugino) fuzzy controller for the Doubly Fed Induction Generator (DFIG) based wind generator. The conventional PI control loops for mantaining desired active power and DC capacitor voltage is compared with the TS fuzzy controllers. DFIG system is represented by a third-order model where electromagnetic transients of the stator are neglected. The effectiveness of the TS-fuzzy controller on the rotor speed oscillations and the DC capacitor voltage variations of the DFIG damping controller on converter ratings is also investigated. The results from the time domain simulations are presented to elucidate the effectiveness of the TS-fuzzy controller over the conventional PI controller in the DFIG system. The proposed TS-fuzzy con-troller can improve the fault ride through capability of DFIG compared to the conventional PI controller.

Coordinated Operation of PV and Battery Energy Storage Systems

Despite tough economic times, the uptake of photovoltaic (PV) technology has seen tremendous growth over the past decade. More than 21 GW of rooftop PV systems were installed globally in the year 2012 alone. This is fueled by various incentives offered by policy makers around the world with a goal of enhancing renewable energy integration and reducing the dependence on fossil fuels. For instance, the goal of achieving 20% energy consumption from renewable resources by 2020 has been unanimously accepted by numerous countries in Europe, North America, and Australia. Uptake of PVs by residential and small businesses has been augmented by generous rebates offered by government on installations and on the amount of energy injected into the grid. Furthermore, the global market outlook report published by EPIA predicts that the rooftop PV installations will continue to grow for the foreseeable future.

Storing energy in plastics : a review on conducting polymers & their role in electrochemical energy storage

Conducting polymers have become the focus of research due to their interesting properties, such as a wide range of conductivity, facile production, mechanical stability, light weight and low cost and due to the ease with which conducting polymers can be nanostructured to meet the specific application. They have become valuable materials for many applications, such as energy storage and generation. Recently, conducting polymers have been studied to be used in supercapacitors, battery electrode and fuel cells. This article is to briefly discuss the background & theory behind their conductivity as well as to highlight the recent contributions of conducting polymers to the field of energy and their significance. Furthermore, the methods of production of the conducting polymers in addition to the different ways utilised to nano-engineer special morphologies are discussed.