A dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology, in the Department of Chiropractic at the Durban University of Technology, 2009. / Introduction: National Olympic Committees (NOCs) select medical personnel to support their athletes at the Olympic Games. To best support athletes the knowledge, perception and utilisation of all medical professions is assumed to be high, however literature seems to indicate that this is not so. Objective: To determine the knowledge, perception and utilisation of Chiropractic by NOCs in order to develop a better relationship so that more athletes can benefit from Chiropractic care. Methods: A questionnaire was emailed to the 205 NOCs worldwide. Respective executive committee and medical commission members were asked to complete the questionnaires. Results: 76 NOCs responded (37%), returning 27 questionnaires. 30% of the respondents were high ranking members. 93% were highly educated with a bachelor’s degree or higher and 33% had represented their country as an athlete. Both committees agreed on the importance of a post-graduate sports qualification and perceived the profession to be one of spinal care specialists. Overall knowledge of Chiropractic was poor. A trend was observed among the medical commissions in their choice of Medical Doctors or Physiotherapists over Chiropractors and other professionals. The executive committees in contrast seemed more open-minded in their choice of professionals. No association was found between the knowledge and perception of Chiropractic and use of Chiropractic Conclusion: There is confusion regarding the role and scope of practice of Chiropractic by NOCs. In order to achieve a greater level of acceptance and utilisation of Chiropractic in international sports medical teams the profession needs to clarify their role, better educate NOC members on the benefits of Chiropractic, and obtain sports specific post-graduate programmes that are recognised internationally.

The understanding that Attention Deficit/ Hyperactivity Disorder (ADHD) commonly persists into adulthood has not been widely accepted until recently. Accordingly, less is known about diagnostic and treatment prevalence or health and social outcomes of ADHD in adulthood. The objectives of this study were to: determine lifetime prevalence of ADHD diagnosis and treatment for Manitoba young adults, investigate whether a socioeconomic gradient exists within Manitoba young adults with a lifetime diagnosis of ADHD, and investigate the relationship between ADHD in Manitoba young adults and health service utilization. Using the Manitoba Population Health Research Data Repository, this cross-sectional analysis used 24 years of data (1984/85-2008/09) and included all Manitoba adults aged 18-29 during 2007/08-2008/09 with a lifetime diagnosis of ADHD. Crude prevalence was calculated for ADHD diagnosis and psychostimulant prescriptions, in addition to several demographic variables. The presence of a socioeconomic gradient in lifetime ADHD diagnosis was investigated using Poisson and negative binomial regression. Relationships between young adults with lifetime ADHD diagnosis and health service utilization for several health and social outcome variables were explored using a matched cohort design with two comparison groups and GEE regression models. In relation to previous Manitoba research on childhood ADHD, the socioeconomic gradient for ADHD diagnosis was found to dissipate into young adulthood. However, when region of residence was accounted for, a small inverse gradient in the urban population and a direct gradient in the rural population were evident. Individuals from the highest income quintile were significantly less likely to be diagnosed before age 18 than all other income quintiles. Depression, anxiety, personality disorders, conduct disorder, substance abuse, multiple types of injuries, receipt of income assistance, and reduced high school graduation were significantly correlated with lifetime ADHD diagnosis. Given the high lifetime prevalence of ADHD in Manitoba young adults, significant socioeconomic correlates for diagnosis, and multitude of adverse health and social outcomes in this population, further investigation into the trajectory of this relatively unexplored population is recommended. Furthermore, continued measurement of the provision and success of additional resources will ultimately be necessary for enhancing the health status of all Canadian adults living with ADHD.

A new peat replacement product is being manufactured in South Africa. This product which is marketed under the brand name Fibregro is made from spent wattle bark originating from the tanning extract manufacturing process. Fibregro is currently being used in South Africa to dilute and in some instances replace local peat in mushroom and horticultural applications. In addition to its role as a peat replacement, Fibregro is in a position where it could also qualify to cany a Forest Stewardship Council (FSC) label. Once in full production it is estimated that the company will be able to produce more products than can be sold locally. As a result export opportunities need to be pursued. The United Kingdom (UK) was identified as a potential export destination on account of developments in this country in respect of the certification of forest products (especially FSC certification) and moves to reduce peat mining. A mail survey was undertaken amongst growing media producers in the UK to address two key issues relating to Fibregro, namely: • Whether Fibregro's peat free status could be exploited in the UK growing media and mushroom casing markets. • Whether enough advantages existed in the UK market to justify the extra effort and cost associated with qualifying Fibrego to carry an FSC label. Key findings arising from this survey indicate that a niche is developing in the UK growing media market for a good peat substitute. The addition of an FSC label will render the product unique in the growing media market in this country. A number of recommendations arise from this work. These are: • In order to penetrate the UK growing media market Fibrgro must be positioned as an effective peat reducing agent which is capable of extending the peat reduction levels beyond that of composts. • Fibregro distributors should be identified from amongst the larger growing media producers in the UK. • Potential use of Fibregro as a mushroom casing in the UK appears to be limited. • A combination of peat free and FSC labelling while capable of rendering Fibregro unique in the UK growing media market needs to be carefully considered on account of chain-of-custody requirements along the supply chain. / Thesis (M.B.A.) University of KwaZulu-Natal, Pietermaritzburg 2004.

High fuel utilization SOFCs could eliminate emissions from systems that include afterburners and potentially be suitable for carbon sequestration, while producing electricity more efficiently. Current fuel utilization operating points are typically chosen at approximately 85% for Ni-cermet anodes because higher fuel utilization frequently results in the formation of nickel oxide and reduces drastically the performance of the SOFC. In this work the feasibility of an in-plane graded anode architecture with a transition from a material with high catalytic activity to materials more stable under high fuel utilization conditions was evaluated through a steady-state SOFC finite element model. Thereafter, plasma spraying of solution precursor feedstock (SPPS) and suspension feedstock (SPS) was used to fabricate ceramic coatings that could potentially be used as SOFC anodes for high fuel utilization conditions. Microstructural, electrical and electrochemical properties of LST, LSBT and LSFCr coatings with additions of carbon black pore former were investigated.

High fuel utilization SOFCs could eliminate emissions from systems that include afterburners and potentially be suitable for carbon sequestration, while producing electricity more efficiently. Current fuel utilization operating points are typically chosen at approximately 85% for Ni-cermet anodes because higher fuel utilization frequently results in the formation of nickel oxide and reduces drastically the performance of the SOFC. In this work the feasibility of an in-plane graded anode architecture with a transition from a material with high catalytic activity to materials more stable under high fuel utilization conditions was evaluated through a steady-state SOFC finite element model. Thereafter, plasma spraying of solution precursor feedstock (SPPS) and suspension feedstock (SPS) was used to fabricate ceramic coatings that could potentially be used as SOFC anodes for high fuel utilization conditions. Microstructural, electrical and electrochemical properties of LST, LSBT and LSFCr coatings with additions of carbon black pore former were investigated.

This dissertation has explored the problem of a yawning gap between policy and the implementation of lay participation in health development activities in Ghana, using data from 577 households in 22 rural communities. / A Health Systems model has been applied to data, to explain relationships and four sets of variables--household need for health services, predisposing attributes, participatory patterns, enabling factors--on household use of available health facilities and services. / Overall, results indicate a complex interdependence of factors which influence modern health services use. A multiple regression procedure identifies the presence of children under 5 years, the household's perception of its influence in the community, household participation in community health-related activities, household socio-economic and educational levels, to be significantly related to services use. Results suggest that Need for services is Not a sufficient condition for the Use of available health services.

In the first of three experiments, four Holstein multiparous dairy cows, equipped with ruminal and duodenal cannulas, were used to determine the impact of different methods of treating soybean meal (SBM) on ruminal degradability and intestinal digestibility of CP and amino acids (AA). Solvent extracted SBM (SE), expeller SBM (EP), lignosulfonate SBM (LS) and heat and soy hulls SBM (HS) were incubated in the rumen, in nylon bags, for various intervals up to 48h. Additional samples incubated for 16 h were pre-treated with pepsin HCI, and then used for determination of intestinal digestibility either in situ (mobile bag technique) or in vitro. Treatment of SBM (EP, LS, HS) increased rumen undegradable protein (RUP), and AA availability in 30%. Estimates of intestinal digestibility of AA and CP were lower when measured in vitro than in situ. Among the treated SBM products, four EAA (Ile, Leu, Phe and Val) showed differences in availability, with values consistently lower for HS than for LS. The second experiment involved a comparative assessment of the availability of lysine in SE and rumen protected SBM products (EP and LS). Lysine availability was assessed either by the increment in plasma flux of 15N lysine, the increment in intestinally digestible lysine (using chromic oxide as a digesta marker) or by the use of a "plasma lysine response curve" designed to predict intestinally available lysine. The plasma Lys flux was not different between the different SBM products. However, SE + 70 g.d-1 omasal infusion of Lys (SE70) increased Lys flux by exactly 70 g.d -1 above the SE treatment. No differences were observed on duodenal Lys flow, post-ruminal digestion and digestible Lys between the SBM diets (SE, EP, LS). Irrespective of the method of assessment, lysine availability was not altered by the method of treating SBM. The third study evaluated the relative impact of supplying rumen-undegraded protein (RUP) versus altering the carbohydrate source on milk yield and efficiency N usage for milk production. Protein supplementation (SE and EP) increased DMI, whereas the inclusion of beet pulp (BP) replacing 50% of high moisture shelled corn decreased DMI. The results of this research suggest that, under normal conditions of feeding, supplying rumen protected SBM to enhance the supply of intestinally available essential AA does not improve lactation performance; providing beet pulp as a source of readily fermentable fibre also failed to affect milk yield or efficiency of N usage for milk production by dairy cattle.

Exergy utilization calculations have been in the past repeatedly used to quantify the quality and quantity of energy used in thermal energy processes. This thesis is an attempt to derive a common language exergy utilization and compare for the first time two entirely different manufacturing processes, namely material processing by a mechanical method of straining of the material and simple heating of the same mass of the material using exergy utilization as a metric. The exergy utilization of material processing is determined by performed work and utilized heat transfer using 1) Ramberg-Osgood equation and 2) Lumped heat capacitance method. A comparison of these two methods is presented.

The impact of lactate producing direct-fed microbial (DFM) on growth performance and rumen fermentation in beef cattle was explored in four studies. Experiment 1 studied the interaction between DFM and degradable intake protein (DIP) supply in receiving cattle. No differences (P≥0.06) in intake, morbidity, or immune response were observed; however, during the first 28 d gain and efficiency responses to DFM were dependent on DIP (DIP×DFM P≤0.05). Experiment 2 showed that in vitro gas production and select endpoint metabolites differed (P≤0.04) with DFM application. Experiment 3 compared lactate producing DFM to a lactate producing/utilizing DFM in finishing cattle. No differences (P≥0.14) in intake, gain, efficiency, or carcass characteristics were observed between control and lactate DFM; however, gain and growth efficiency differed (P≤0.05) between the lactate producing and lactate producing/utilizing DFM during the later portions of feeding. Experiment 4 studied the impact of DFM on ruminal fermentation, lactate utilization, and total tract digestibility. Ruminal pH and molar proportions of acetate were increased (P≤0.05) with DFM; however, lactate utilization and total tract digestibility did not differ (P≥0.33). The studies suggest that DFM improve growth performance during receiving and responses are at least partly mediated through differences in ruminal fermentation.

Background: In 2007, Saskatchewan’s Ministry of Health launched the Seniors’ Drug Plan (SDP), whereby provincial beneficiaries at or above the age of 65 receive medications at a maximum self-payment of $15. The purpose of this study was to document the impact of the SDP using provincial health-administrative databases. Methods: Aggregate medication utilization and costs were described using the prescription drug database starting two years before the implementation of the SDP and continuing for two years after. Interrupted time series analysis using segmented regression models were developed to test the impact of the SDP. Also, the probability of achieving optimal medication adherence was examined among cohorts receiving medications after SDP implementation versus similar patients receiving medications before the SDP and also a group of patients <65 years who were not eligible for the SDP at all. The impact of the SDP on the outcome of optimal adherence was estimated using logistic regression models with generalized estimating equations (GEE). Results: Monthly government spending on medications increased by 47.5% following implementation of the SDP, while total medication dispensations only increased by 5.8%. The SDP was associated with more dispensations per month among prevalent users (+5.4%, 95% CI: 1.3% to 9.5%) but not incident users who did not receive the study medication in the previous 365 days (+1.3%, 95% CI: -8.0% to 10.7%). Similarly, the SDP did not appear to impact the use of blood-glucose-lowering agents, (-0.5%, 95% CI: -6.2% to 5.2%). A small but significant increase in the odds of optimal medication adherence was observed after the SDP compared with before (OR=1.08, 95% CI 1.04 to 1.11). However, the impact was only observed in prevalent users (OR=1.08, 95% CI 1.04 to 1.12), but not incident users (OR=1.05, 95% CI 0.98 to 1.13). Also, the impact of the SDP on medication adherence was not consistent for all medication classes examined. Discussion: In summary, the SDP resulted in substantially higher government investment into drug costs without a major effect on medication utilization and adherence. However, cost reduction for seniors must have provided substantial relief independent of the impact on adherence and utilization.