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.

Gender differences in principal motivations

Women have traditionally not attained the position of secondary school principal as frequently as their male counterparts. Research in the field of motivation theory suggests the significance and impact of gender on career paths. Theorists and researchers believe that women face an orientation to life that is different than men. Some see the principalship as satisfying different values and working toward some psychological needs. ^ In this study, two hypotheses were used to explore whether substantive differences existed between men and women with regard to factors that motivate secondary school administrators to become principals in Miami-Dade County Public Schools. The administrators were surveyed during meetings held with them at Region meetings. Participants were asked to rate the motivation factors on a 7-point Likert Scale (1-strongly disagree to 7-strongly agree) and to rank the motivation factors (1-most important to 10-least important) that might discourage one from becoming a principal as well as those that might encourage one to retire from the principalship; and to identify motivation factors that most influenced their decision to become a school administrator. Two hundred twenty-six surveys were returned.^ Quantitative data were collected to measure differences between men and women with respect to their motivation to seek the principalship in terms of their ratings on the Motivation Factors Survey. Based upon a Factor Analysis, four factors (intrinsic satisfiers, extrinsic satisfiers, principalship challenges and job values) were identified. A MANOVA using the factors as dependent variables revealed that, as predicted by research and theory, women were significantly more likely than men to be motivated by intrinsic satisfiers and job values. In support of this finding, open-ended responses to the survey revealed that men found extrinsic satisfiers to be of greater importance than intrinsic satisfiers. ^

A tidal creek water budget: Estimation of groundwater discharge and overland flow using hydrologic modeling in the Southern Everglades

Taylor Slough is one of the natural freshwater contributors to Florida Bay through a network of microtidal creeks crossing the Everglades Mangrove Ecotone Region (EMER). The EMER ecological function is critical since it mediates freshwater and nutrient inputs and controls the water quality in Eastern Florida Bay. Furthermore, this region is vulnerable to changing hydrodynamics and nutrient loadings as a result of upstream freshwater management practices proposed by the Comprehensive Everglades Restoration Program (CERP), currently the largest wetland restoration project in the USA. Despite the hydrological importance of Taylor Slough in the water budget of Florida Bay, there are no fine scale (∼1 km2) hydrodynamic models of this system that can be utilized as a tool to evaluate potential changes in water flow, salinity, and water quality. Taylor River is one of the major creeks draining Taylor Slough freshwater into Florida Bay. We performed a water budget analysis for the Taylor River area, based on long-term hydrologic data (1999–2007) and supplemented by hydrodynamic modeling using a MIKE FLOOD (DHI,http://dhigroup.com/) model to evaluate groundwater and overland water discharges. The seasonal hydrologic characteristics are very distinctive (average Taylor River wet vs. dry season outflow was 6 to 1 during 1999–2006) with a pronounced interannual variability of flow. The water budget shows a net dominance of through flow in the tidal mixing zone, while local precipitation and evapotranspiration play only a secondary role, at least in the wet season. During the dry season, the tidal flood reaches the upstream boundary of the study area during approximately 80 days per year on average. The groundwater field measurements indicate a mostly upwards-oriented leakage, which possibly equals the evapotranspiration term. The model results suggest a high importance of groundwater contribution to the water salinity in the EMER. The model performance is satisfactory during the dry season where surface flow in the area is confined to the Taylor River channel. The model also provided guidance on the importance of capturing the overland flow component, which enters the area as sheet flow during the rainy season. Overall, the modeling approach is suitable to reach better understanding of the water budget in the mangrove region. However, more detailed field data is needed to ascertain model predictions by further calibrating overland flow parameters.

Mapping of the Eltanin impact area in the South-East Pacific

Two Polarstern expeditions were conducted in 1995 (ANT-XII/4) and 2001 (ANT-XVIII/5a) to the Bellingshausen Sea and Amundsen Sea and the suspected Eltanin meteorite impact in the SE-Pacific. A survey of the sediment distribution and its acoustic structure along the cruise track was performed. The seafloor topography was sampled using the multibeam sonar system Hydrosweep DS2 which operates on a frequency of 15.5 kHz. The resulting AWI Bathymetric Chart of the Eltanin Meteorite Impact Area is based on a Digital Terrain Model of this area. The mapping was performed using ArcGIS. The Eltanin impact area which covers the 4.100 m high Freden Seamount is visualized by one overview sheet of the scale 1:200,000 and four 1:100,000 subsheets.

Symptom Clusters and Survival in Portuguese Patients with Advanced Cancer

This study aimed to identify clusters of symptoms, to determine the patient characteristics associated with identified, and determine their strength of association with survival in patients with advanced cancer (ACPs). Consecutively eligible ACPs not receiving cancer-specific treatment, and referred to a Tertiary Palliative Care Clinic, were enrolled in a prospective cohort study. At first consultation, patients rated 9 symptoms through the Edmonton Symptom Assessment System (0-10 scale) and 10 others using a Likert scale (1-5). Principal component analysis was used in an exploratory factor analysis to identify. Of 318 ACPs, 301 met eligibility criteria with a median (range) age of 69 (37-94) years. Three SCs were identified: neuro-psycho-metabolic (NPM) (tiredness, lack of appetite, lack of well-being, dyspnea, depression, and anxiety); gastrointestinal (nausea, vomiting, constipation, hiccups, and dry mouth) and sleep impairment (insomnia and sleep disturbance). Exploratory factor analysis accounted for 40% of variance of observed variables in all SCs. Shorter survival was observed for patients with the NPM cluster (58 vs. 23, P < 0.001), as well as for patients with two or more SCs (45 vs. 21, P = 0.005). In a multivariable model for survival at 30-days, age (HR: 0.98; 95% CI: 0.97-0.99; P = 0.008), hospitalization at inclusion (HR: 2.27; 95% CI: 1.47-3.51; P < 0.001), poorer performance status (HR: 1.90, 95% CI: 1.24-2.89; P = 0.003), and NPM (HR: 1.64; 95% CI: 1.17-2.31; P = 0.005), were associated with worse survival. Three clinically meaningful SC in patients with advanced cancer were identifiable. The NPM cluster and the presence of two or more SCs, had prognostic value in relation to survival.

Rathbun Lake Special Project: BMPs for priority land in Targeted Sub-Watershed 2012 1221-010, Final Report 2013-2061,

The Rathbun Land and Water Alliance and partners have undertaken a highly effective approach to water quality protection through the Rathbun Lake Special Project. This approach is achieving a significant reduction in the sediment and phosphorus that impair water quality in Rathbun Lake and its tributaries as a result of the targeted application of best management practices (BMPs) for priority land in the watershed. This project application proposes to assist landowners to apply BMPs that will reduce sediment and phosphorus delivery from priority land in three targeted sub-watersheds as part of the Rathbun Lake Special Project. Features of this project are: (1) use of geographic information system (GIS) analysis to identify priority land that requires BMPs; (2) assistance for landowners to apply BMPs for 1,200 acres that will reduce the annual delivery of sediment by 1,800 tons and phosphorus by 6,000 pounds; (3) evaluation of the benefits from BMP application using GIS analysis and water quality monitoring; and (4) watershed outreach activities that encourage landowners to apply BMPs for priority land to protect water quality.

Rathbun Lake Special Project BMPs for Priority Land in Targeted Sub-Watersheds 2012: Final Report: 1221-010, 2013-2016, June 27, 2016

The Rathbun Land and Water Alliance and partners have undertaken a highly effective approach to water quality protection through the Rathbun Lake Special Project. This approach is achieving a significant reduction in the sediment and phosphorus that impair water quality in Rathbun Lake and its tributaries as a result of the targeted application of best management practices (BMPs) for priority land in the watershed. This project application proposes to assist landowners to apply BMPs that will reduce sediment and phosphorus delivery from priority land in three targeted sub-watersheds as part of the Rathbun Lake Special Project. Features of this project are:(1) use of geographic information system (GIS) analysis to identify priority land that requires BMPs;(2) assistance for landowners to apply BMPs for 1,200 acres that will reduce the annual delivery of sediment by 1,800 tons and phosphorus by 6,000 pounds;(3) evaluation of the benefits from BMP application using GIS analysis and water quality monitoring; and (4) watershed outreach activities that encourage landowners to apply BMPs for priority land to protect water quality.

& she was like "O_O" : Animation of reported speech on Twitter

This study relates discourse-pragmatic aspects of the use of the quotatives say, be like, be all, and go to the question of the supposed or actual spoken-likeness of written computer-mediated communication (CMC). 1,800 tokens of reported speech, collected from Twitter, were analyzed in a “constructed dialogue” framework (Tannen, 2007). The results show that users of Twitter employ various CMC devices to animate and modally enrich reported speech, especially in speech reports with be like, be all, and go. They perform a style of communication that is reminiscent of conversational speech, even while having qualities that seem to belong uniquely to CMC.

Vegetación arbórea del Cerro Verde: distribución altitudinal, dispersión y dominancia

Se hace un análisis del transecto discontinuo realizado en la ladera suroeste del Cerro Verde, localizado en el departamento de Santa Ana, determinando la dominancia de las especies, a diferentes alturas de transecto, el cual va desde 1,580 hasta 2,000 m.s.n.m. Se consideran todos los arboles con una circunferencia a la altura del pecho(C.A.P. de 30 cas. O más), se determina el índice de valor de importancia, para cada especie; las especies dominantes resultaron ser: Montanoa Guatemalensis a 1,580 m.s.n.m., Lonchocarpus minimiflorus a 1,600 m.s.n.m., Oreopanax xalapensis a 1,750 m.s.n.m., Styrax argentus a 1,750 m.s.n. m.a 1,800 m.s.n.m. Eugenia sp. a 2,000 m.s.n.m., Quercus sp. a 2,000 m.s.n.m. A cada especie se le aplica el modelo de Poisson para determinar el grado de dispersión de la vegetación; Roupala Borealis resulto distribuida al azar; las demás ya mencionadas aparecen como agregadas.

Cooperación internacional para la seguridad alimentaria Antioquia. 2015

El objetivo de la investigación fue analizar la cooperación internacional para la seguridad alimentaria en Suroeste y Oriente antioqueños, a través de la revisión del Convenio FAO-Gobernación de Antioquia, sus componentes y sus actividades, con el propósito de visualizar la cooperación internacional a nivel local. Estudio descriptivo cuali-cuantitativo con fuentes secundarias y primarias (entrevistas). La investigación fue autorizada por los gerentes de MANÁ y FAO, delegando en los coordinadores del convenio la entrega de la información. El investigador se desplazó a las oficinas de Medellín para su recolección. Una vez depurados los datos se procedió a elaborar las tablas para las dos subregiones estudiadas, analizar la información y presentarla en gráficos y tablas, complementando con las entrevistas semiestructuradas de los actores claves del convenio. Resultados: el convenio de cooperación internacional para la seguridad alimentaria se viene ejecutando de manera satisfactoria según los compromisos desarrollados en los componentes: emprendimiento de agricultura familiar se organizaron 16 asociaciones entre fincas; se establecieron 7.000 huertas de las oportunidades mediante procesos de capacitación y asesoría realizando para ello, 10.972 visitas y 1.483 talleres. Para el componente de plan de abastecimiento de alimentos lograron identificar los rubros pecuarios y de alimentos según la oferta y demanda local. Con el fortalecimiento institucional motivaron a las autoridades locales, familias y otras instituciones y utilizaron medios diferentes para informar los avances a 1.800 personas. Se concluye que la cooperación internacional ayuda a mejorar la seguridad alimentaria en Antioquia.

Interactions between Late Quaternary volcanic and sedimentary processes in the Naples Bay, Southern Tyrrhenian sea

The interactions between Late Quaternary volcanic and sedimentary processes in the Naples Bay, Southern Tyrrhenian sea, are here discussed through the results of the marine geological survey at the scale 1:25.000. The example of the geological map n. 465 “Isola di Procida”, herein presented, has put in evidence the stratigraphy of marine Quaternary deposits and related volcanic seismic units. The volcanic deposits cropping out in the Procida island have been explained as the result of eruptions of local eruptive centres. The geological survey carried out onshore indicates the occurrence of several pyroclastic units linked to the eruptive activity of the Ischian and Phlegrean volcanic complexes, interstratified with the products erupted by local volcanic centres. The occurrence in the pyroclastic sequences of Ischia and Procida islands of several marker horizons and their stratigraphic correlations have allowed to reconstruct the volcanological evolution of the two islands and the interactions with sedimentary processes at the scale of the whole Tyrrhenian margin. Four geological maps at the scale 1:25.000 covering the whole Naples Bay have been reconstructed based on the interpretation of marine geological and geophysical data. The stratigraphic relationships between the seismic units and the eruptive deposits have testified the activity of several monogenetic volcanic centers, whose products are interstratified with marine and continental deposits of the Late Quaternary depositional sequence.

A plan of the island of Cape Breton

Scale 1:253,440; 24 statute miles or 4 to 1 in.