Patterns of service utilisation within Australian hepatology clinics: High prevalence of advanced liver disease

Accepted Article Abstract Background: Liver diseases in Australia are estimated to affect 6 million people with a societal cost of $51 billion annually. Information about utilization of specialist hepatology care is critical in informing policy makers about the requirements for delivery of hepatology-related health care. Aims: This study examined etiology and severity of liver disease seen in a tertiary hospital hepatology clinic, as well as resource utilisation patterns. Methods: 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. Results: During the initial 3 month period 1471 appointments were scheduled with a hepatologist, 1136 of which were attended. 21% of patients were “new cases”. Hepatitis B (HBV) was the most common disease etiology for new cases (37%). Advanced disease at presentation varied between etiology, with HBV (5%), Hepatitis C (HCV) (31%), non-alcoholic fatty liver disease (NAFLD) (46%) and alcoholic liver disease (ALD) (72%). Most patients (83%) attended multiple hepatology appointments, and a range of referrals patterns for procedures, investigations and other specialty assessments were observed. Conclusions: There is a high prevalence of HBV in new case referrals. Patients with HCV, 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 patterns of health service utilisation among patients with liver disease provide useful information for planning sustainable health service provision for this clinical population

Prospects for wind energy utilisation in Karnataka State

An examination of the data available at 22 meteorological stations in Karnataka State shows that wind velocities in the State as a whole are neither spectacularly high nor negligibly low. The highest winds (annual mean of around 13 km/hr) are experienced in parts of the northern maidan region of the State (Gulbarga, Raichur and Bidar districts) and in Bangalore. The winds are strongly seasonal: typically, the five monsoon months May-September account for about 80% of the annual wind energy flux. Although the data available are inadequate to make precise estimates, they indicate that the total wind energy potential of the State is about an order of magnitude higher than the current electrical energy consumption. The possible exploitation of wind energy for applications in rural areas therefore requires serious consideration, but it is argued that to be successful it is essential to formulate an integrated and carefully planned programme. The output of current windpumps needs to be increased; a doubling should be feasible by the design of suitable load-matching devices. The first cost has to be reduced by careful design, by the use of local materials and skills and by employing a labour-intensive technology. A consideration of the agricultural factors in the northern maidan region of the State shows that there is likely to be a strong need for mechanical assistance in supplemental and life-saving irrigation for the dry crops characteristic of the area. A technological target for a windmill that could find applications in this area would be one with a rotor diameter of about 10 m that can lift about 10,000 litres of water per hour in winds of 10 km/hr (2.8 m/s) hourly average speed and costs less than about Rs 10,000. Although no such windmills exist as of today, the authors believe that achievement of this target is feasible. An examination of various possible scenarios for the use of windmills in this area suggests that with a windpump costing about Rs 12,000, a three hectare farm growing two dry crops a year can expect an annual return of about 150% from an initial investment of about Rs 15,000. It is concluded that it should be highly worthwhile to undertake a coordinated programme for wind energy development that will include more detailed wind surveys in the northern maidan area (as well as some others, such as the Western Ghats), the development of suitable windmill designs and a study of their applications to agriculture as well as to other fields.

Problems and prospects of red mud utilisation

A general survey is presented on the generation and characteristics of Red Muds. The interrelationship between Mud properties, their disposal and utilisation is emphasised. After an outline on the possible applications for Red Muds, the problems related to important (potential) uses have been pointed out. Suggestions have been incorporated on what needs to be done to promote the utilisation of Red Muds particularly in the Indian context.

Improved utilisation of an HF transformer in DC–AC application

Power conversion using high frequency (HF) link converters is popular because of compact size and light weight of highfrequency transformer. This study focuses on improved utilisation of HF transformer in DC–AC applications. In practical application, the operating condition of the power converter deviates significantly from the designed considerations. These deviating factors are commutation requirements (dead-time, overlap), mismatch in device drops and presence of the fundamental frequency in load current. As a result, the HF transformer handles some amount of low-frequency components (including DC) other than desired HF components. This causes the operating point in B-H curve to shift away from its normal or idealised position and hence results poor utilisation of the HF transformer and unwanted losses. This study investigates the nature of the problem with experimental determination of approximate lumped parameter modelling and saturation behaviour (B-H curve) of the HF transformer. A simple closed-loop control algorithm with online tuning of the controller parameters is proposed to improve the utilisation of the isolation transformer. The simulation and experimental results are presented.

Behaviour of Gaseous Chlorine and Alkali Metals During Biomass Thermal Utilisation

The behaviour of gaseous chlorine and alkali metals of three sorts of biomass (Danish straw, Swedish wood, and sewage sludge) in combustion or gasification is investigated by the chemical equilibrium calculating tool. The ranges of temperature, air-to-fuel ratio, and pressure are varied widely in the calculations (T=400-1800 K, gimel=0-1.8, and P=0.1-2.0 MPa). Results show that the air excess coefficient only has less significant influence on the release of gaseous chlorine and potassium or sodium during combustion. However, in biomass gasification, the influence of the air excess coefficient is very significant. Increasing air excess coefficient enhances the release of HCl(g), KOH(g), or NaOH(g) as well as it reduces the formation of KCl(g), NaCl(g), K(g), or Na(g). In biomass combustion or straw and sludge gasification, increasing pressure enhances the release of HCl(g) and reduces the amount of KCI(g), NaCl(g), KCI(g), or NaOH(g) at high temperatures. However, during wood gasification, the pressure enhances the formation of KOH(g) and KCI(g) and reduces the release of K(g) and HCl(g) at high temperatures. During wood and sewage sludge pyrolysis, nitrogen addition enhances the formation of KCN(g) and NaCN(g) and reduces the release of K(g) and Na(g). Kaolin addition in straw combustion may enhance the formation of potassium aluminosilicate in ash and significantly reduces the release of KCl(g) and KOH(g) and increases the formation of HCl(g).

Les attributs et contextes d'utilisation du travail collaboratif

Résumé: Le travail collaboratif s’invite à présent partout, et est identifié dans des domaines aussi multiples que variés. Dans le monde de l’entreprise, de la prise en charge médico-sociale, de l’éducation / formation, de la recherche, de l’économie, de la politique, de la gestion de carrière… etc. Ce travail vise dans un premier temps à décliner ce qu’est la collaboration, ses caractéristiques, ses contextes d’utilisation, et la façon dont elle se différencie des autres formes d’organisation (coopération et compétition notamment). Dans un deuxième temps, il réexamine la question de la nouveauté du travail collaboratif à la lumière des résultats obtenus. S’il est assez évident que les « ingrédients », les attributs du travail collaboratif ne sont pas nouveaux (le développement informatique mis à part), il semble en revanche que les combinaisons rencontrées et les domaines d’application génèrent de nouvelles questions. Pour finir, en s’inspirant des termes associés à collaboration, il considère quelques-uns des nouveaux enjeux dans la sphère professionnelle.

Genetic improvement and utilisation of indigenous tilapia in southern Africa: final technical report, December 1st 1998 to June 31st, 2002

Mozambique tilapia (Oreochromis mossambicus) is an indigenous tilapia species in southern Africa, until now the majority of genetic research has been carried out on Asian species of tilapia but this project aims to look at this African species. Those most suited to further development in aquaculture in southern Africa have now been identified. The genetic characterisation of strains has been completed. This information has aided the choice of strains for use in small scale aquaculture and for genetically male tilapia (GMT) production. They will form the basis of future strategies for further genetic improvement, and management of genetic diversity of Mozambique tilapia. The information will also contribute towards responsible management and development of genetic resources, particularly with regard to indigenous species of tilapia. Good progress has been made with the adaptation and implementation of producing the supermale fish required to produce all male offspring, resulting in faster growing populations of tilapia. The presence of the project and its associated activity has been a catalyst for a surge in interest in tilapia culture throughout southern Africa. [PDF contains 183 pages]

Traditions of fish utilisation for recipes in Nigeria

Some recipes for fish utilization in particular zones of Nigeria are assessed, giving details of their modes of preparation. The traditions of use of fish in the recipes shown appear to be based on the successful agricultural practices in particular zones and areas of Nigeria. This has helped to promote taste and values, since easily procured food items are cheaper for use in particular areas than others. The use of such fish items in the recipes are useful for promoting protein intake and stemming of malnutrition, especially in the rural areas, as well as helping to improve the incomes of women-in-agriculture

Digestibility and nutrient utilisation of soybean bran-based diets in Nile tilapia Oreochromis niloticus

The digestibility and utilisation of two soybean bran-based diets and two fishmeal-based diets serving as control, at optimal (30%) and suboptimal (20%) protein levels were evaluated in Oreochromis niloticus. These were Diet I (Control)-fishmeal based diet at 30% crude protein, Diet II (Control) - fishmeal based diet at 20% crude protein, Diet III - hydrolysed Soybean Bran based diet at 30% crude protein, Diet IV - hydrolysed Soybean Bran based diet at 20%. Dry matter digestibility differed insignificantly with variation in diets (P<0.05). There was significant variation in the protein (p 20.05), lipid and ash digestibility. Protein was more digestible at optimum level than sub-optimum level, while lipid and ash digestibility did not vary with their inclusion levels. Variation in the utilisation of the diets was significant (P<0.05) except for survival. It was observed that the best diet was Diet 1, closely followed by Diet II with highest values of mean final weight, specific growth rate, protein efficiency ratio and the apparent net protein utilisation. The high digestibility values of Diets III and IV suggests their inclusion in fish diet to spare protein for growth