An Economic Evaluation of Small-scale Distributed Electricity Generation Technologies

Numerous renewable and small-scale distributed generation (DG) technologies have now progressed to the stage where their technical feasibility has been proven and full-sclae projects have been successfully implemented worldwide. This paper surveys the available DG technologies and models their economic performance in rural areas of India with particular emphasis on comparing the costs of hybrid DG systems with conventional grid connectionsfor remote rural village-level applications. Modelling inputs are based on demand, fuel, availability, costs and local operating conditions found in the Kachchh District of Gujarat, India. Results demonstrate that hybrid power systems can economically provide electricity in rural areas if local energy resources are adequate. Additional environmental and economic benefits of hybrid DG are also quantified for the case study area and reveal a 40% reduction in diesel fuel use compared to diesel genset only systems.Distributed generation, hybrid power, renewables

A Deficit of Faint Red Galaxies in the Possible Large-Scale Structures around the RDCS J1252.9-2927 Cluster at z=1.24

(Abridged) We report a discovery of possible large-scale structures around the RDCS J1252.9-2927 cluster at z=1.24 based on photometric redshifts. We carried out multi-band wide-field imaging with Suprime-Cam on the Subaru Telescope and WFCAM on the United Kingdom Infra-Red Telescope (UKIRT). The distribution of photo-z selected galaxies reveals clumpy structures surrounding the central cluster. We compare the observed structure with an X-ray map and find that two of the four plausible clumps show significant X-ray emissions and one with a marginal detection, which strongly suggest that they are dynamically bound systems. Following the discovery of the possible large-scale structure, we carried out deeper SOFI K_s-band imaging with New Technology Telescope on the four plausible clumps. We construct the optical-to-near-infrared colour-magnitude diagrams of the galaxies in the clumps, and find that the colour-magnitude relation (CMR) of the red galaxies in the clumps is sharply truncated below K_s=22. Interestingly, the main cluster shows a clear relation down to K_s=23 (Lidman et al. 2004). We suggest that galaxies follow the 'environment-dependent down-sizing' evolution. Massive galaxies in high density environments first stop forming stars and become red. Less massive galaxies in less dense environments become red at later times. Based on a few assumptions, we predict that the brightest tip of the CMR appears at z~2.5.Comment: 10 pages, 8 figures, accepted for publication in MNRA

Impact Evaluation of a Central Australian Aboriginal Cultural Awareness Training Program for Health Professionals and Students

The aim of this study was to prospectively evaluate the impact of a Central Australian cultural awareness training program for health care staff. A mixed methods approach was used. Program participants completed a baseline and post-program questionnaire, which included an attitude scale assessing cultural safety, critical thinking and transformative unlearning, and open-ended questions. An online follow-up survey two months later repeated these questions. Mean scale scores were compared using paired and unpaired t-tests. Qualitative data were analysed thematically. Baseline scale mean was 45.7. At post-program it had statistically significantly increased to 47.3, using both the paired (p=\u3c 0.01) and unpaired t-test (p=\u3c 0.03). At the two-month follow-up it had decreased to 42.2. This was not statistically different from the baseline score with a paired (n=11) t-test (p=\u3c 0.37), however the difference was statistically significant with an unpaired t-test (p=\u3c 0.01) which included an additional eight respondents. Qualitative feedback was consistently positive. Many respondents learnt new information about the negative effects of colonisation on Aboriginal and/or Torres Strait Islander people, and how this continues to affect current health. Learning about Aboriginal and/or Torres Strait Islander cultures, kinship relationships and systems, and communication styles was identified as directly relevant to work practices. A cultural education program produced positive short-term changes in attitudes and was highly valued by participants. However, it is unclear if these changes are maintained in the medium term

A Millisecond Interferometric Search for Fast Radio Bursts with the Very Large Array

We report on the first millisecond timescale radio interferometric search for the new class of transient known as fast radio bursts (FRBs). We used the Very Large Array (VLA) for a 166-hour, millisecond imaging campaign to detect and precisely localize an FRB. We observed at 1.4 GHz and produced visibilities with 5 ms time resolution over 256 MHz of bandwidth. Dedispersed images were searched for transients with dispersion measures from 0 to 3000 pc/cm3. No transients were detected in observations of high Galactic latitude fields taken from September 2013 though October 2014. Observations of a known pulsar show that images typically had a thermal-noise limited sensitivity of 120 mJy/beam (8 sigma; Stokes I) in 5 ms and could detect and localize transients over a wide field of view. Our nondetection limits the FRB rate to less than 7e4/sky/day (95% confidence) above a fluence limit of 1.2 Jy-ms. Assuming a Euclidean flux distribution, the VLA rate limit is inconsistent with the published rate of Thornton et al. We recalculate previously published rates with a homogeneous consideration of the effects of primary beam attenuation, dispersion, pulse width, and sky brightness. This revises the FRB rate downward and shows that the VLA observations had a roughly 60% chance of detecting a typical FRB and that a 95% confidence constraint would require roughly 500 hours of similar VLA observing. Our survey also limits the repetition rate of an FRB to 2 times less than any known repeating millisecond radio transient.Comment: Submitted to ApJ. 13 pages, 9 figure

Depression and anxiety predict health-related quality of life in chronic obstructive pulmonary disease: systematic review and meta-analysis.

Published onlineJournal ArticleMeta-AnalysisResearch Support, Non-U.S. Gov'tReviewBACKGROUND: The causal association between depression, anxiety, and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD) is unclear. We therefore conducted a systematic review of prospective cohort studies that measured depression, anxiety, and HRQoL in COPD. METHODS: Electronic databases (Medline, Embase, Cumulative Index to Nursing and Allied Health Literature [CINAHL], British Nursing Index and Archive, PsycINFO and Cochrane database) were searched from inception to June 18, 2013. Studies were eligible for inclusion if they: used a nonexperimental prospective cohort design; included patients with a diagnosis of COPD confirmed by spirometry; and used validated measures of depression, anxiety, and HRQoL. Data were extracted and pooled using random effects models. RESULTS: Six studies were included in the systematic review; of these, three were included in the meta-analysis for depression and two were included for the meta-analysis for anxiety. Depression was significantly correlated with HRQoL at 1-year follow-up (pooled r=0.48, 95% confidence interval 0.37-0.57, P<0.001). Anxiety was also significantly correlated with HRQoL at 1-year follow-up (pooled r=0.36, 95% confidence interval 0.23-0.48, P<0.001). CONCLUSION: Anxiety and depression predict HRQoL in COPD. However, this longitudinal analysis does not show cause and effect relationships between depression and anxiety and future HRQoL. Future studies should identify psychological predictors of poor HRQoL in well designed prospective cohorts with a view to isolating the mediating role played by anxiety disorder and depression.NIHRUniversity of ManchesterCLAHR

The foundations framework for developing and reporting new models of care for multimorbidity

PURPOSE Multimorbidity challenges health systems globally. New models of care are urgently needed to better manage patients with multimorbidity; however, there is no agreed framework for designing and reporting models of care for multimorbidity and their evaluation. METHODS Based on findings from a literature search to identify models of care for multimorbidity, we developed a framework to describe these models. We illustrate the application of the framework by identifying the focus and gaps in current models of care, and by describing the evolution of models over time. RESULTS Our framework describes each model in terms of its theoretical basis and target population (the foundations of the model) and of the elements of care implemented to deliver the model. We categorized elements of care into 3 types: (1) clinical focus, (2) organization of care, (3) support for model delivery. Application of the framework identified a limited use of theory in model design and a strong focus on some patient groups (elderly, high users) more than others (younger patients, deprived populations). We found changes in elements with time, with a decrease in models implementing home care and an increase in models offering extended appointments. CONCLUSIONS By encouraging greater clarity about the underpinning theory and target population, and by categorizing the wide range of potentially important elements of an intervention to improve care for patients with multimorbidity, the framework may be useful in designing and reporting models of care and help advance the currently limited evidence base

Cost-effectiveness of a patient-centred approach to managing multimorbidity in primary care:a pragmatic cluster randomised controlled trial

Objective Patients with multiple chronic health conditions are often managed in a disjointed fashion in primary care, with annual review clinic appointments offered separately for each condition. This study aimed to determine the cost-effectiveness of the 3D intervention, which was developed to improve the system of care. Design Economic evaluation conducted alongside a pragmatic cluster-randomised trial. Setting General practices in three centres in England and Scotland. Participants 797 adults with three or more chronic conditions were randomised to the 3D intervention, while 749 participants were randomised to receive usual care. Intervention The 3D approach: comprehensive 6-monthly general practitioner consultations, supported by medication reviews and nurse appointments. Primary and secondary outcome measures The primary economic evaluation assessed the cost per quality-adjusted life year (QALY) gained from the perspective of the National Health Service (NHS) and personal social services (PSS). Costs were related to changes in a range of secondary outcomes (QALYs accrued by both participants and carers, and deaths) in a cost-consequences analysis from the perspectives of the NHS/PSS, patients/carers and productivity losses. Results Very small increases were found in both QALYs (adjusted mean difference 0.007 (-0.009 to 0.023)) and costs (adjusted mean difference 126 pound (-739 pound to 991)) pound in the intervention arm compared with usual care after 15 months. The incremental cost-effectiveness ratio was 18 pound 499, with a 50.8% chance of being cost-effective at a willingness-to-pay threshold of 20 pound 000 per QALY (55.8% at 30 pound 000 per QALY). Conclusions The small differences in costs and outcomes were consistent with chance, and the uncertainty was substantial; therefore, the evidence for the cost-effectiveness of the 3D approach from the NHS/PSS perspective should be considered equivocal

Radio and Millimeter Monitoring of Sgr A*: Spectrum, Variability, and Constraints on the G2 Encounter

We report new observations with the Very Large Array, Atacama Large Millimeter Array, and Submillimeter Array at frequencies from 1.0 to 355 GHz of the Galactic Center black hole, Sagittarius A*. These observations were conducted between October 2012 and November 2014. While we see variability over the whole spectrum with an amplitude as large as a factor of 2 at millimeter wavelengths, we find no evidence for a change in the mean flux density or spectrum of Sgr A* that can be attributed to interaction with the G2 source. The absence of a bow shock at low frequencies is consistent with a cross-sectional area for G2 that is less than $2 \times 10^{29}$ cm$^2$. This result fits with several model predictions including a magnetically arrested cloud, a pressure-confined stellar wind, and a stellar photosphere of a binary merger. There is no evidence for enhanced accretion onto the black hole driving greater jet and/or accretion flow emission. Finally, we measure the millimeter wavelength spectral index of Sgr A* to be flat; combined with previous measurements, this suggests that there is no spectral break between 230 and 690 GHz. The emission region is thus likely in a transition between optically thick and thin at these frequencies and requires a mix of lepton distributions with varying temperatures consistent with stratification.Comment: Accepted for publication in Ap

A primary care research agenda for multiple long-term conditions:A Delphi study

BackgroundMultiple long-term conditions (MLTC, multimorbidity) has been identified as a priority research topic, globally. Research priorities from the perspectives of patients and research funders have been described. Although most care for MLTC is delivered in primary care, the priorities of academic primary care have not been identified. AimTo identify and prioritise the academic primary care research agenda for MLTC.Design and SettingThree-phase study with primary care MLTC researchers from the UK and other high-income countries.Method(i) Open-ended survey question; (ii) face-to-face workshop to elaborate questions with researchers from the UK and Ireland; (iii) and a two-round Delphi consensus survey with international multimorbidity researchers.ResultsTwenty-five primary care researchers responded to the initial open-ended survey and generated 84 potential research questions. In the subsequent workshop discussion (18 participants), this list was reduced to 31 questions. The long list of 31 research questions was included in round one of the Delphi; 27 of the 50 (54%) round one and 24 of the 27 to round two (89%) invitees took part in the Delphi. Ten questions reached final consensus. These focused broadly on addressing complexity of the patient group with (a) development of new models of care for multimorbidity, (b) methods and data development.ConclusionThese high priority research questions offer funders and researchers a basis upon which to build future grant calls and research plans. Addressing complexity in our research is needed to inform improvements in our systems of care and for prevention.<br/

Plasma-induced alignment of carbon nanotubes

Uniform films of well-aligned carbon nanotubes have been grown using microwave plasma-enhanced chemical vapor deposition. It is shown that nanotubes can be grown on contoured surfaces and aligned in a direction always perpendicular to the local substrate surface. The alignment is primarily induced by the electrical self-bias field imposed on the substrate surface from the plasma environment. It is found that switching the plasma source off effectively turns the alignment mechanism off, leading to a smooth transition between the plasma-grown straight nanotubes and the thermally grown “curly” nanotubes. The nanotubes grow at a surprisingly high rate of ∼100 nm/s in our plasma process, which may be important for large-scale commercial production of nanotubes