Digital network of writers helps to foster spirit of collaboration.

Nurse Liz Charalambous has shown how a Facebook group can help boost writing (careers, June 3). We would like to take this idea one step further and argue that, contrary to a commonly held notion, 'too many cooks do not spoil the broth' when it comes to group writing. Instead, this approach fosters collaboration between writers, as Ms Charalambous suggests, and which has also been our experience

Emissions modeling of fluidised bed co-combustion of poultry litter and peat

Gaseous emissions from the fluidised bed co-combustion of 50% w/w chicken litter and peat were monitored and recorded. Emission data were used to create a dispersion model for a proposed site on a poultry farm in Ireland. Variables within the combustion unit influenced both combustion and emission levels of pollutants such as SO2 and NOx, CO. Concentrations of atmospheric pollutants decreased with use of the correct ratio between fluidising and secondary air. Dispersion modelling of combustion at a proposed poultry unit predicted that ground level concentrations for the set of emissions data would be below the limits and guidelines set by air quality standards

Behavior of heavy metals during fluidized bed combustion of poultry litter

In this study, we have examined the behavior of heavy metals during fluidized bed combustion of poultry litter. Heavy metals examined include As, Cd, Co, Cr, Cu, Hg, Mn, Mo, Ni, Pb, V, and Zn. Solid and gaseous streams were analyzed and compared with relevant guidelines to determine the potential environmental impact of combustion and subsequent land spreading or landfill of the resulting ash. The majority of heavy metals were associated with the solid ash fraction, with low gaseous emissions. Pb and As were concentrated in the fine baghouse ash (160 °C) due to their volatility. The remaining heavy metals, excluding Cd, were enriched in the heat exchangers and cyclone, where flue gas temperatures ranged from 580 to 220 °C. Under the waste acceptance criteria, all samples of process ash, excluding bed ash, exceeded the limits for nonhazardous landfill waste, as a result of high levels of water-soluble Cr. Water-soluble Cr indicated the presence of Cr(VI), and its presence was confirmed using X-ray absorption near-edge structure spectroscopy (18.4% to 38.3%). The source of Cr was identified as the bedding material (wood shavings), and its conversion to Cr(VI) was temperature-dependent and could be facilitated by the high alkali content found in poultry litter

Methodological challenges and issues of recruiting for mental health and substance use disorders trials in primary care.

Background: Poor recruitment to controlled trials is a frequently reported problem. Challenges related to study design, communication, participants, interventions, outcomes and clinician workload hinder recruitment, and the effectiveness of interventions used by trialists to increase recruitment rates is unknown. Objectives: To explore the methodological challenges and issues in recruiting for mental health and substance use disorders trials in primary care, and to consider how these methodological challenges can be addressed. Method: The presentation will recount the authors’ experience of recruiting for cluster randomised trials in primary care. Methodological challenges, such as clarity of instruction, patient characteristics, patient-doctor relationship, effects of intervention on patients and clinic, and personal benefits for clinicians will be described. The authors will consider how these might relate to and be used for peer-learning and peer-support in primary care research. Conclusion: The presentation will conclude with an overview of how lessons learned from past studies may be used to improve recruitment for trials of mental health and substance use disorders in primary care

Feasibility of alcohol screening among patients receiving opioid treatment in primary care

Background: Identifying and treating problem alcohol use among people who also use illicit drugs is a challenge. Primary care is well placed to address this challenge but there are several barriers which may prevent this occurring. The objective of this study was to determine if a complex intervention designed to support screening and brief intervention for problem alcohol use among people receiving opioid agonist treatment is feasible and acceptable to healthcare providers and their patients in a primary care setting. Methods: A randomised, controlled, pre-and-post design measured feasibility and acceptability of alcohol screening based on recruitment and retention rates among patients and practices. Efficacy was measured by screening and brief intervention rates and the proportion of patients with problem alcohol use. Results: Of 149 practices that were invited, 19 (12.8 %) agreed to participate. At follow up, 13 (81.3 %) practices with 81 (62.8 %) patients were retained. Alcohol screening rates in the intervention group were higher at follow up than in the control group (53 % versus 26 %) as were brief intervention rates (47 % versus 19 %). Four (18 %) people reduced their problem drinking (measured by AUDIT-C), compared to two (7 %) in the control group. Conclusions: Alcohol screening among people receiving opioid agonist treatment in primary care seems feasible. A definitive trial is needed. Such a trial would require over sampling and greater support for participating practices to allow for challenges in recruitment of patients and practices