Health Worker Compliance with a 'Test And Treat' Malaria Case Management Protocol in Papua New Guinea

The Papua New Guinea (PNG) Department of Health introduced a 'test and treat' malaria case management protocol in 2011. This study assesses health worker compliance with the test and treat protocol on a wide range of measures, examines self-reported barriers to health worker compliance as well as health worker attitudes towards the test and treat protocol. Data were collected by cross-sectional survey conducted in randomly selected primary health care facilities in 2012 and repeated in 2014. The combined survey data included passive observation of current or recently febrile patients (N = 771) and interviewer administered questionnaires completed with health workers (N = 265). Across the two surveys, 77.6% of patients were tested for malaria infection by rapid diagnostic test (RDT) or microscopy, 65.6% of confirmed malaria cases were prescribed the correct antimalarials and 15.3% of febrile patients who tested negative for malaria infection were incorrectly prescribed an antimalarial. Overall compliance with a strictly defined test and treat protocol was 62.8%. A reluctance to test current/recently febrile patients for malaria infection by RDT or microscopy in the absence of acute malaria symptoms, reserving recommended antimalarials for confirmed malaria cases only and choosing to clinically diagnose a malaria infection, despite a negative RDT result were the most frequently reported barriers to protocol compliance. Attitudinal support for the test and treat protocol, as assessed by a nine-item measure, improved across time. In conclusion, health worker compliance with the full test and treat malaria protocol requires improvement in PNG and additional health worker support will likely be required to achieve this. The broader evidence base would suggest any such support should be delivered over a longer period of time, be multi-dimensional and multi-modal

The X-ray photoelectron spectroscopy of surface films formed during the ASTM D-130/ISO 2160 copper corrosion test

This is an Author’s Accepted Manuscript of an article published in Petroleum Science & Technology [Volume 32, Issue 4, 2014 ], available online: http://www.tandfonline.com/10.1080/10916466.2011.588635The surfaces of ISO 2160 copper strips tested in iso-octane with elemental sulfur, aliphatic, cyclic and aromatic thiols, diphenyl sulfide, and diphenyl disulfide individually or in combination were studied using XPS. Aliphatic thiols bonded through the sulfur, whereas elemental sulfur formed a cuprous sulfide layer. Aromatics bonded partially through the sulfur with the rings oriented horizontally due to π orbital interactions, accounting in part for their inhibitory effects in the test. The test rating was not directly related to the sulfur concentration in solution or on the surface, and certain combinations of species resulted in higher levels of sulfur at the surface than found individually

Lateral scale calibration for focus variation microscopy

Areal surface texture measuring instruments can be calibrated by determining a set of metrological characteristics currently in the final stages of standardisation. In this paper, amplification, linearity and perpendicularity characteristics have been determined to calibrate the lateral performance of a focus variation microscope. The paper presents a novel and low-cost material measure and procedures that are used to determine the characteristics. The material measure is made of stainless steel with a cross-grating grid of hemispherical grooves. The design, manufacturing and calibration of the material measure are discussed. The (20 × 20) mm grid is measured with and without image stitching. The results show that the proposed material measure and procedures can be used to determine the error of the amplification, linearity and perpendicularity characteristics. In addition, the lateral stage error can be significantly reduced by measurement with image stitching

Residual stress measurement round robin on an electron beam welded joint between austenitic stainless steel 316L(N) and ferritic steel P91

This paper is a research output of DMW-Creep project which is part of a national UK programme through the RCUK Energy programme and India's Department of Atomic Energy. The research is focussed on understanding the characteristics of welded joints between austenitic stainless steel and ferritic steel that are widely used in many nuclear power generating plants and petrochemical industries as well as conventional coal and gas-fired power systems. The members of the DMW-Creep project have under- taken parallel round robin activities measuring the residual stresses generated by a dissimilar metal weld (DMW) between AISI 316L(N) austenitic stainless steel and P91 ferritic-martensitic steel. Electron beam (EB) welding was employed to produce a single bead weld on a plate specimen and an additional smoothing pass (known cosmetic pass) was then introduced using a defocused beam. The welding re- sidual stresses have been measured by five experimental methods including (I) neutron diffraction (ND), (II) X-Ray diffraction (XRD), (III) contour method (CM), (IV) incremental deep hole drilling (iDHD) and (V) incremental centre hole drilling (iCHD). The round robin measurements of weld residual stresses are compared in order to characterise surface and sub-surface residual stresses comprehensively

Impact of variation in structure of condensed tannins from sainfoin (Onobrychis viciifolia) on in vitro ruminal methan production and fermentation characteristics

Our study investigated the effects of condensed tannins (CT) on rumen in vitro methane (CH4) production and fermentation characteristics by incubating lucerne in buffered rumen fluid in combination with different CT extracts at 0 (control), 40, 80 and 120 g CT/kg of substrate DM. Condensed tannins were extracted from four sainfoin accessions: Rees ‘A’, CPI63763, Cotswold Common and CPI63767. Gas production (GP) was measured using a fully automated GP apparatus with CH4 measured at distinct time points. Condensed tannins differed substantially in terms of polymer size and varied from 13 (Rees ‘A’) to 73 (CPI63767) mean degree of polymerization, but had relatively similar characteristics in terms of CT content, procyanidin: prodelphinidin (PC: PD) and cis:trans ratios. Compared to control, addition of CT from CPI63767 and CPI63763 at 80 and 120 g CT/kg of substrate DM reduced CH4 by 43% and 65%, and by 23% and 57%, respectively, after 24-h incubation. Similarly, CT from Rees ‘A’ and Cotswold Common reduced CH4 by 26% and 46%, and by 28% and 46% respectively. Addition of increasing level of CT linearly reduced the maximum rates of GP and CH4 production, and the estimated in vitro organic matter digestibility. There was a negative linear and quadratic (p < 0.01) relation between CT concentration and total volatile fatty acid (VFA) production. Inclusion of 80 and 120 g CT/kg of substrate DM reduced (p < 0.001) branched-chain VFA production and acetate: propionate ratio and was lowest for CPI63767. A decrease in proteolytic activity as indirectly shown by a change in VFA composition favouring a shift towards propionate and reduction in branched-chain VFA production varied with type of CT and was highest for CPI63767. In conclusion, these results suggest that tannin polymer size is an important factor affecting in vitro CH4 production which may be linked to the CT interaction with dietary substrate or microbial cells

Life cycle energy and environmental analysis of a microgrid power pavilion

Microgrids—generating systems incorporating multiple distributed generator sets linked together to provide local electricity and heat—are one possible alterative to the existing centralized energy system. Potential advantages of microgrids include flexibility in fuel supply options, the ability to limit emissions of greenhouse gases, and energy efficiency improvements through combined heat and power (CHP) applications. As a case study in microgrid performance, this analysis uses a life cycle assessment approach to evaluate the energy and emissions performance of the NextEnergy microgrid Power Pavilion in Detroit, Michigan and a reference conventional system. The microgrid includes generator sets fueled by solar energy, hydrogen, and natural gas. Hydrogen fuel is sourced from both a natural gas steam reforming operation and as a by-product of a chlorine production operation. The chlorine plant receives electricity exclusively from a hydropower generating station. Results indicate that the use of this microgrid offers a total energy reduction potential of up to 38%, while reductions in non-renewable energy use could reach 51%. Similarly, emissions of CO 2 , a key global warming gas, can be reduced by as much as 60% relative to conventional heat and power systems. Hydrogen fuels are shown to provide a net energy and emissions benefit relative to natural gas only when sourced primarily from the chlorine plant. Copyright © 2006 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55887/1/1223_ftp.pd

Navigating environmental, economic, and technological trade-offs in the design and operation of submerged anaerobic membrane bioreactors (AnMBRs)

Anaerobic membrane bioreactors (AnMBRs) enable energy recovery from wastewater while simultaneously achieving high levels of treatment. The objective of this study was to elucidate how detailed design and operational decisions of submerged AnMBRs influence the technological, environmental, and economic sustainability of the system across its life cycle. Specific design and operational decisions evaluated included: solids retention time (SRT), mixed liquor suspended solids (MLSS) concentration, sludge recycling ratio (r), flux (J), and specific gas demand per membrane area (SGD). The possibility of methane recovery (both as biogas and as soluble methane in reactor effluent) and bioenergy production, nutrient recovery, and final destination of the sludge (land application, landfill, or incineration) were also evaluated. The implications of these design and operational decisions were characterized by leveraging a quantitative sustainable design (QSD) framework which integrated steady-state performance modeling across seasonal temperatures (using pilot-scale experimental data and the simulating software DESASS), life cycle cost (LCC) analysis, and life cycle assessment (LCA). Sensitivity and uncertainty analyses were used to characterize the relative importance of individual design decisions, and to navigate trade-offs across environmental, economic, and technological criteria. Based on this analysis, there are design and operational conditions under which submerged AnMBRs could be net energy positive and contribute to the pursuit of carbon negative wastewater treatment.This research work was possible thanks to project CTM2011-28595-C02-01/02 (funded by the Spanish Ministry of Economy and Competitiveness jointly with the European Regional Development Fund and Generalitat Valenciana GVA-ACOMP2013/203), and by the King Abdullah University of Science and Technology (KAUST) Academic Partnership Program (UIeRA 2012-06291), which are gratefully acknowledged. The authors would like also to acknowledge the Jack Kent Cooke Foundation for partial funding for B.D. Shoener.Pretel-Jolis, R.; Shoener, BD.; Ferrer, J.; Guest, J. (2015). Navigating environmental, economic, and technological trade-offs in the design and operation of submerged anaerobic membrane bioreactors (AnMBRs). Water Research. (87):531-541. https://doi.org/10.1016/j.watres.2015.07.002S5315418

Indentation Hardness Measurements at Macro-, Micro-, and Nanoscale: A Critical Overview

The Brinell, Vickers, Meyer, Rockwell, Shore, IHRD, Knoop, Buchholz, and nanoindentation methods used to measure the indentation hardness of materials at different scales are compared, and main issues and misconceptions in the understanding of these methods are comprehensively reviewed and discussed. Basic equations and parameters employed to calculate hardness are clearly explained, and the different international standards for each method are summarized. The limits for each scale are explored, and the different forms to calculate hardness in each method are compared and established. The influence of elasticity and plasticity of the material in each measurement method is reviewed, and the impact of the surface deformation around the indenter on hardness values is examined. The difficulties for practical conversions of hardness values measured by different methods are explained. Finally, main issues in the hardness interpretation at different scales are carefully discussed, like the influence of grain size in polycrystalline materials, indentation size effects at micro-and nanoscale, and the effect of the substrate when calculating thin films hardness. The paper improves the understanding of what hardness means and what hardness measurements imply at different scales.Funding Agencies|Swedish Government Strategic Research Area in Materials Science on Functional Materials at Linkoping University ((Faculty Grant SFO Mat LiU) [2009 00971]</p