The HSE Quarterly 31

Health, Safety and Environment

ISSUE 31MA RCH 2016

31

HEAD OFFICELot. 5B Trincity Industrial Estate, Trincity, Trinidad W.ITel: 868-221-4100/ 223-1198 Fax: 868-222-2147Website: www.jaricesh.com Email: [email protected]

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BurglaryThis policy protects the insured’s property contained in a building as a result of theft by forcible entry or exit.

Employer’s LiabilityThis policy protects the employers’ This policy protects the employers’ liability to the employees during the course of their employment.

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E d i t o r ’ s N OT E

elcome once again!

As I researched the theme for this issue I came across an interesting article in one of our daily newspapers. In the article a question was asked; “Is it really possible that energy from renewable sources can be inserted into the Caricom energy mix in such a way as to make the slightest noticeable difference in the years ahead?”. This was a question asked by the former manager of Caricom’s Energy Programme, Mr. Joseph Williams. That question should be taken seriously given the fact that the energy requirements of the world including the Caribbean are increasing at alarming rates.

More and more, the subject of renewable energy receives public attention. The debate on renewable energy is fostered by the fact that fossil fuels are becoming scarce and that their combustion produces CO2 which contributes to climate change.

In this issue we look at the now critical matter of renewable energy in our region. There has been a lot of research and several countries have already made significant progress in exploring alternative sources of energy. One example is the Trafalgar Hydro Plant and the drilling works which started at three sites for the exploration of geothermal power in Dominica.

Our feature article written by Dr. Deryck Pattron, examines the downturn in global hydrocarbon prices and the necessary action on renewable energy sources, as alternatives to fossil fuels as sources of energy, in order to save our economy. Readers can also enjoy a piece by Dr. Abrahams Mwasha on Renewable Aggregates for use in the Construction Industry. Though our focus is on Renewable Resources readers can also find other interesting articles such as the very interesting research on Therapeutic Yoga as a Tool for Proactive Safety Culture.

We are pleased to make Mark Corbin our featured HSE professional in this issue. Mr. Corbin has a passion for Road Safety with an ambition to make roads safer in the Caribbean. He is the author of the 2013 report ‘Improving Caribbean Road Safety: Towards a Framework for the Caribbean’ which was published in issues 28 and 29 of the HSE Quarterly.

As we keep focus on road safety we again urge you to be responsible road users. In 2015 some countries in the region saw reductions in their road fatalities. However others had record high numbers. We all need to do our part to ensure that the senseless loss of life is curtailed.

I thank you all for supporting the publication over the past seven years. I ask for your continued support as we navigate these uncertain economic times which have had their effects on the publication. We however give our commitment to maintain the quality you have come to expect.

Thank you.

Janice SmithEditor-in-Chief

w

March 2016

Contents9. Global Drive for Renewable Energy in Light of Dwindling Hydrocarbon Reserves: Implications for Trinidad & Tobago & CARICOM

15. Renewable Aggregates for Ready Mix Concrete

20. Too Sweet for Life: Diabetes Mellitus

23. Occupational Psychology and Therapeutic Yoga -Tools for Proactive Safety Culture

P. 26

P.9

P. 27

29. Time to Think Business Continuity Plans: Lessons from Tropical Storm Erika

34. Leg Ulceration: A Vast Problem

43. Renewable Energy and Economic Development in the Caribbean

ISSUE 31

PUBLISHERJaric Environment, Safety and Health Services Limited.

EDITOR IN CHIEFJanice Smith

EDITORAppleloniah Kipps

EDITORIAL BOARDDr. Anthony J. Joseph Kandiss EdwardsEric KippsDevitra Maharaj-DashMagdalene Robin

WRITERSDr. Abrahams Mwasha Dr. Deryck D. PattronLeandra Belle-CharlesJayandran Mohan Allan Sandy Linda Sheridan Cherma St. Clair

CREATIVE DIRECTORKenneth Henry

GRAPHIC DESIGNERStefan Francis

PHOTOGRAPHYShutterstockGraphicstockFotolia

BUSINESS ADDRESSThe HSE QuarterlyLot 5B Trincity Industrial Estate,TrinicityEmail: [email protected]: www.jaricesh.com

The opinions expressed in the HSE Quarterly do not necessarily reflect those of the editor, publishers or their agents.

P. 20 Health Corner

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AbstractGlobal oil production and its hydrocarbon products are now experiencing a massive downturn in financial profits, worldwide. As the world moves towards the 21st century, countries worldwide are beginning to experience the effects of global warning with concomitant climatic changes and health problems. Trinidad and Tobago (T&T) is not well-advanced in the preparation process, in looking for and making use of alternative sources of renewable energy. This may be due to fact that T&T is a hydrocarbon-based economy. This approach, if not changed, would lead to serious economic hardships, ill-health and decreased environmental quality. It would therefore be prudent for us to critically reflect and to take the necessary action on renewable energy sources as alternatives to fossil fuels as sources of energy in order to save our economy, health and the environment, not only for our generation, but for all future generations.

Key words: renewable energy, fossil fuel, environmental health, pollution, greenhouse gases

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By Dr. Deryck D. Pattron, Ph.D.Public Health & Safety Consultant

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Introduction

The big question of when global oil production will reach its limit and how fast it will decline afterwards has marginalised energy experts for quite some time. The latest record-low oil prices have rekindled the debate (Energy Information Administration–EIA, 2003).For years, both sides have held their ground. Some believe that, given our reliance on petroleum, dwindling oil reserves would at the very least send shocking ripples through the global economy. Others believe it a bit further, predicting widespread economic collapse and even the onset of ‘a post-industrial stone age’. We are yet to fully experience the truth of this predicament (EIA, 2003).

In the reality of dwindling oil reserves, all-time low oil prices worldwide, threats of ozone depletion and climatic changes, countries worldwide (including countries in the Caribbean Region or Caribbean Community [CARICOM]) are forced to search for, develop and use alternative sources of energy, namely renewable energy. There is now a substantial body of evidence which suggests that with or without the peak oil there is need for change

in our present consumption of fossil fuels sooner rather than later (Sawin, 2003; EIA, 2008 and The Economist, 2008). It is estimated that the global energy consumption is to double by 2030. It would therefore be unwise to continue our energy consumption of fossil fuels as usual at the detriment of the environment, human health and safety (Wisner, Pickle and Eto, 1998).

The Problem

The awareness of the destructive effects of fossils fuels, and the economic hardships associated with its use, is now becoming more and more prevalent worldwide. The search for alternatives sources of energy have already been initiated in some developed and developing countries. Where do T&T and the CARICOM region fit into the scheme of things with regards to adopting and using more efficient and safer renewable sources of energy?

Renewable Energy Paradigm

Renewable energy is defined as energy that is replenished by nature at a rate faster than its rate of consumption by human

activities. Renewable energy plays an important role in the supply of energy for domestic and industrial purposes. When renewable energy sources are used, the demand for fossil fuels is reduced. Unlike fossil fuels, non-biomass renewable sources of energy such as hydropower, geothermal energy, wind energy and solar energy do not directly emit greenhouse gases–the major causes of ozone depletion (Swain, 2003 and Beattie, 2005).

A transition to cleaner, more secure energy is necessary, but it will not happen overnight. Currently, it is estimated by the International Energy Agency that 80% of the current global energy comes from finite fossil fuels (Deyette, Clemmer and Donovan,2003). Of this 80%, 35% comes from oil, 25% comes from coal and 20% comes from natural gas. It is only 11% that comes from renewable sources such as biomass waste, 6% from nuclear and 2% from hydropower. Solar, wind and geothermal power make up less than 1% of the global energy supply mix (EIA, 2003 and Sawin, 2003).

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Our main concern as scientists and environmentalists is that if we know that we have finite reserves of fossil fuels and they have had a bad effect on the environment and our health and quality of life, why do we continue to use it so aggressively? This may be due to fact that fossil fuels may be more available and more economical in the final analysis Wisner, Pickle and Eto, 1998).Renewable energy has generally been more expensive to use than fossil fuels. Renewable energy is often not available 24/7 in some instances and may be located in remote locations. The use of expensive infrastructure, equipment and human resources are required in order to make the use of renewable resources as a viable energy alternative to fossil fuels (Beattie, 2005).

United Kingdom Perspective on Renewable Energy

Much support is being given to the use of renewable energy resources by governments worldwide (The Economist, 2008). In the United Kingdom (UK) support for the use and development of renewable energy is provided in the 2003 Energy White Paper. It is prescribed in the 2003 Energy White Paper that 10% of electricity generation should come from renewable sources by 2010 and 20% by 2020. The UK government has set a goal that 5% of the total transport fuel must come from renewable sources by the year 2010. Additionally, renewable sources of energy have been exempted from Climate Change Levy (Wisner, Pickle and Eto, 1998).

Review of the data obtained from the UK renewable energy generation for 2004, revealed that the major renewable energy contributors in descending order are biomass (52%), hydropower (35%), landfill gas (28%), onshore wind (12%), municipal solid waste combustion (7%), cofiring of biomass with fossil fuel (7%), other biofuels (7%) sewage sludge digestion (3%), offshore wind (1%) and solar photovoltaics (0.03%) (Deyette, Clemmer and Donovan, 2003).

United States Perspective on Renewable EnergyIn the United States (US) renewable energy

accounts for approximately 2% of the total electricity produced. This is followed by 51% nuclear, 21%, natural gas, 17% hydropower, 6% and 3% other (EIA, 2003). There is now an increased number of State and Federal Energy Policy Acts (2002 and 2005) incentives that is expected to stimulate growth and use of renewable resources in the near future.

Arising out of these Policy Acts are three main categories of incentives to promote renewable energy technologies (EIA, 2008 and Database of State Incentives for Renewable Energy–DSIRE, 2003). There are financial incentives, volunteer and outreach programmes and rules and regulations (DSIRE, 2003). The financial incentives include tax exemptions rebate programmes, grant programmes, loan programmes and production incentives. Currently, there are 200 financial incentives that promote renewable energy in the US (DSIRE, 2003). Volunteer and outreach programmes include programmes that involve pricing, certification and outreach. Currently, there exists 201 volunteer and outreach programmes in the US (DSIRE, 2003). Rules, regulations and policies include a wide range of public benefits. There are 216 rules, regulations and policies in the US that deal with renewable portfolio standards, contractor licensing requirements, engineering standards, equipment certifications, solar access laws, metering rules and generation disclosure rules (DSIRE, 2003).

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CARICOM Perspective on Renewable Energy

The Caribbean Region is also following this trend of renewable energy initiative and development. CARICOM or the Caribbean Community in 1998 established the Caribbean Renewable Energy Development Programme (CREDP). The main objective of CREDP is to increase the use renewable energy in the Caribbean Region by removing barriers to its adoption. However, the removal of these barriers has not been easy. Since it requires political will, financing, policy reform, information and human capacity. The use of renewable energy in the Caribbean Region is therefore met with varying degrees of success (CARICOM, 2009).

In January 2008, the Government of Dominica signed a transnational partnership agreement with the Regional Council of Guadeloupe for the development of Dominica’s geothermal energy. This agreement falls under the Geothermal Energy in the Caribbean Island Project (CARICOM, 2009). Similarly, Costa Rica has achieved a high level of success in the use of renewable energy in the form of hydroelectricity or geothermal, wind and biomass energy (as alternative energy sources to fossil fuels). In 1994, two pieces of legislation were introduced that provided the impetus for the development of geothermal, wind and biomass electricity production and the promotion of efficient energy utilisation throughout the economy (CARICOM, 2009).

Brazil, like T&T, is a petroleum-based driven economy that has achieved success with the use of renewable energy. Brazil has developed its sugarcane, ethanol industry for production of vehicle fuel, which now replaces 40% of Brazil’s gasoline imports (CARICOM, 2009).

T&T Perspective on Renewable Energy

T&T’s vision of renewable energy resources is to supplement renewable sources of energy with existing petroleum-based sources of energy in the promotion of sustainable development. This objective is being achieved through partnerships with various stakeholders such as the Ministry of Energy and Energy Industries, the Tourism Development Company Ltd (TDC), British Petroleum Trinidad and Tobago (BPTT), and United Nations Development Programme (UNDP). The outcomes of this objective would serve to guide the development of a national, renewable, energy policy and programme.

Additionally, the UNDP and its partnership with the Tobago Bed and Breakfast Association and the Trinidad Host Home Association engaged in a Small Grants Programme Incentives to replace electric water heaters with solar water heater systems. This and other projects have already started since 2007 and are presently ongoing (UNDP, 2009). At present there exists no published energy policy regarding renewable energy in T&T. Yet,

it is hoped through the said initiatives that a national policy will soon be developed and be available. Incorporated in this policy would be the use of biofuels as alternative sources of energy from fossil fuels. Ethanol production has already started at Point Lisas, Trinidad and exported to the US for purification. The sustained futuristic development of biofuels may be challenging in T&T, since falling oil prices together with the global financial meltdown and the scarce availability of arable lands may place further hardships upon the population. New infrastructure in terms of factories and downstream industries would now have to be developed to sustain this new energy transition. Whether funding would be available in the near future would be somewhat doubtful and be highly competitive in light of other equally important issues such as health care, education and national security.

Conclusion

As a developing country, it is prudent that we utilise our resources in the wisest possible manner that would bring some measure of hope and security to the people, ensuring sustainable development, health and wellbeing. In keeping with the global drive for clean sustainably renewable energy, T&T is moving towards achieving this goal.

Reducing the dependency on the use of fossil fuels such as oil, coal and natural gas can prevent devastating effects on the environment. There in an urgent need not only for T&T to adopt this new culture of renewable energy, but for CARICOM and the rest the world as well, in order to protect ourselves and our future generations from the ill effects of global warming, climatic changes and threats to human, animal and plant life.

Trinidad and Tobago, like the rest of the Caribbean community should seriously consider looking

at all types of renewable energy such as wind energy, biological energy, fuel cell energy, hydro energy, solar energy, and ocean energy. The practicality of these various renewable energy sources should be thoroughly investigated and tested now to determine their suitability and applicability and to break the viscous cycle of dependence on dwindling hydrocarbon reserves (EIA, 2003). This would lead to a safer, healthier environment for all, including future generations.

References

Beattie, K. 2005. Engineering & Management. New York: Clarkson University.

Caribbean Community (CARICOM). 2009. Caribbean Renewable Energy Development Programme–CREDP. http://www.caricom.org. (accessed January 22, 2009).

Deyette, J., S. Clemmer, and D. Donovan. 2003. Plugging in Renewable Energy, Grading

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the States. Massachusetts: Union of Concerned Scientists.

Database of State Incentives for Renewable Energy (DSIRE). 2003. http://www.dsireusa.org. (accessed January 22, 2009).

Energy Information Administration (EIA), 2003. Annual Energy Review 2001: Energy Overview. http://www.eia.doe.gov/emeu/aer/overview.html. (accessed January 22, 2009).

Energy Information Administration (EIA). 2003. Electricity Restructuring Fact Sheets. http://www.eia.doe.gov. (accessed January 22, 2009).

Energy Information Administration (EIA). 2008. “How Much Renewable Energy Do We Use?” Energy in Brief–What everyone should know about energy.http://tonto.eia.doe.gov/energy_in_brief/renewable_energy.cfm.

Sawin, J. 2003. Charting a new energy future. In State of the World, ed. Lester R. Brown, 85–109. Boston: W.W. Norton & Company, Incorporated.

The Economist. 2008. The Future of Energy: The Power and the Glory. Special Report. Economist.Com. http://www.economist.com/opinion/displaystory.cfm?story_id=11565685.

United Nations Development Programme (UNDP). Energy and Environment. http://www.undp.org.tt. (accessed January 22, 2009).

Wisner, R., S. Pickle, and J. Eto. 1998. Details, Details… The Impact of Market Rules on Emerging “Green” Energy Markets. California: Lawrence Berkeley National Laboratory.

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AbstractFor any country in the world, a natural resource can be interpreted as a source of wealth. A natural resource qualifies as a renewable resource if it is replenished by natural processes at a rate comparable or faster than its rate of consumption by humans or other users. Renewable resources may also mean commodities used to create infrastructure such as rocks, timber, plastics and ceramics glasses used in construction industry. Some natural renewable resources such as rock (aggregates), water, timber and biomass must be carefully managed to avoid exceeding the environment’s capacity to replenish them.

The construction industry arguably has a number of negative impacts on the environment, with construction materials forming a significant part of those impacts. Most of the modern materials used in construction industry (e.g. building materials such as concrete, fossil fuels [as source of energy], etc) are manufactured using a finite resource. Finite resources include current resources such as natural aggregates. Despite the vast supply and recent drop in demand, the amount of new supplies being found is decreasing. Renewable construction materials such as recycled aggregates from construction wastes, i.e. concrete have extremely high embedded energy. In this paper, recycled aggregates, for ready mix concrete is analysed.

By Dr. Abrahams Mwasha Department of Civil and Environmental EngineeringUniversity of West Indies

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Introduction

The wealth of any country is measured by its gross national product and services (Arnold et al. 2008). The services, such as construction works, daily consume tonnes of natural resources on a daily basis for providing different types of engineering structures such as building, roads, bridges, etc. Concrete is a composite material made from the combination of three basic constituents viz. (1) cement (usually Portland cement), (2) coarse and fine aggregate (usually natural sand) and (3) water. Extraction of these materials requires high quality raw material, equipment and fossil fuel. Concrete is the most commonly used construction material. The several definitions of concrete today with regards to its specific application are:

• Reinforced Concrete• Prestressed Concrete• Fiber Reinforced Concrete• Shotcrete• High Strength Concrete• High Performance Concrete• Self Compacting Concrete, etc.

The cement industry may create employment and business opportunities for local people, particularly in the remote locations of developing countries where there are fewer opportunities for economic development. However, the process of manufacturing cement causes environmental impacts at all stages of processing. These environmental impacts include the emissions of airborne pollution in the form of dust, gases, noise and vibration when operating machinery and during blasting in quarries, as well as the damage to the countryside from quarrying. Cement manufacture contributes to greenhouse gases both directly through the production of carbon dioxide (CO2) when calcium carbonate is heated, producing lime

and CO2 (Energy Information and Administration–EIA, 2006) and also indirectly through the use of energy sourced from fossil fuels.

The cement industry produces 5% of global manmade CO2 emissions, of which 50% is from the chemical process and 40% from burning fuel. The amount of CO2 emitted by the cement industry is nearly 900 kg of CO2 for every 1000 kg of cement produced (Mahasenan et al. 2003). A cement plant consumes 3 to 6 GJ of fuel per tonne of clinker produced, depending on the raw materials and the process used.

Aggregates which occupy at least three quarters of the volume of concrete play a major role in reducing shrinkage, bleeding and, of course, enhancing the strength for medium and high strength concretes. Without proper alternative aggregates in the future, the concrete industry globally will consume 8-12 billion tonnes annually of natural aggregates after the year 2010. In this paper the properties of both fresh and hardened concretes using recycled quartzite aggregates from Trinidad and Tobago (T&T) has been investigated.

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Renewable Aggregates

Construction, demolition, reconstruction and restoration of buildings result in high quantities of demolition and construction waste; in the next years, the volume of these waste materials are expected to rise considerably. Relevant amounts of mineral rubble are used as engineering material for roads, earth constructions and dikes. Since construction materials are increasingly judged by their ecological characteristics, concrete recycling gains

importance because it protects natural resources and eliminates the need for disposal by using the readily available concrete as an aggregate source for new concrete. Recycled aggregate is the result of processing appropriate construction and demolition concrete wastes. The processing leads to crushed sand and gravel, derived from concrete rubble. According to Justman 1998 the market, researchers found over 1000 concrete recycling plants in operation in the United States producing more than 100 million

tons of concrete aggregates per year.

Concrete recycling is a relatively simple process. It involves breaking, removing, and crushing existing concrete into a material with a specified size and quality. ACI 555 (2001) has documented methods of processing old concrete into recycled concrete aggregates. The quality of the concrete with recycled concrete aggregates is very dependent on the quality of the recycled material used. Reinforcing steel and other

embedded items, if any, must be removed and care must be taken to prevent contamination by other materials such as asphalt, soil and clay balls, chlorides, glass, gypsum board, sealants, paper, plaster, wood and roofing materials, which can be troublesome.

Applications of Recycled Aggregates

Recycled aggregates can be used as both processed and unprocessed. According to Portland Cement Association

(PCA), the applications without any processing include

1. Many types of general bulk fills; 2. Bank protection;3. Base or fill for drainage structures;4. Road construction;5. Noise barriers and embankments. Most of the unprocessed, crushed concrete aggregate is sold as 37.5 mm (1½ inches) or 50 mm (2 inches) fraction for pavement sub-bases. After the removal of contaminants through selective demolition, screening, and/or

air separation and size reduction in a crusher to aggregate sizes, crushed concrete can be used’ (PCA). The PCA outlines that these contaminants can be used as:

1. new concrete for pavements, shoulders, median barriers, sidewalks, curbs and gutters, and bridge foundations;

2. structural grade concrete;

3. soil-cement pavement bases;

4. lean-concrete or econo-crete bases;

5. bituminous concrete.

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Testing of Recycled Aggregates in T&T

Two sets of testing were done using the recycled aggregate (RA) in concrete production; both examined different strength aspects associated with concrete production. The first series of tests examined the compressive strength of cubes using varying grades of RA. These grades include low strength (LS), medium strength (MS) and high strength (HS). It was found that when using recycled aggregate as coarse aggregate in the production of concrete, RA derived from medium or high strength concrete is a better choice than natural aggregate (NA) when comparing compressive strength.

Results and Discussions

The mode of failure for the concrete using the recycled aggregate was relatively difficult in ascertaining, as the general uniformity produced by using recycled aggregate complicated the specific mode of failure (Mark, 2007). The recycled aggregate itself is composed of coarse aggregate and mortar. When mixed with the other components to obtain the new concrete mix, the transition between old and new mortar may become less apparent. In this way, the meaning of aggregate failure (the failure of the coarse aggregate) or bond failure (failure due to the bonding between mortar and aggregate) changes slightly, as aggregate failure would encompass the failure of the coarse aggregate within the recycled aggregate, the failure of the bond between coarse aggregate and old mortar or the simultaneous failure of both coarse aggregate and mortar bond.

The maximum compressive strength achieved overall was the (Water (w)/Cement(c) (w/c) = 0.4) mix 28-day result of 58.9 MPa. Compressive strength results for RA mix (w/c = 0.5) after a period of 28 days showed a maximum of 53.2 MPa while NA (w/c = 0.5) strength results showed a maximum of 40.9 MPa. This is a 30% increase in compressive strength of the NA strength result. When the w/c was compared between samples, it was observed

that the (w/c = 0.4) RA mix had significantly higher values of compressive strength than the other RA mixes, this being expected, as it is well known that the higher the percentage of cement, the stronger the cement matrix, and the greater the strength of the concrete.

However, when comparing the (w/c = 0.5) RA mix and the (w/c = 0.55) RA mix, a discrepancy was observed. The general compressive strength of the (w/c = 0.5) RA mix was lower than those of the (w/c = 0.55) RA mix. It raises the question of invariability of compressive strength when using recycled aggregate. In addition, the 7-day compressive strength was greater than the 14-day compressive strength for both (w/c = 0.4 and w/c = 0.45) RA mixes. The addition of the admixture was done so that the workability of the concrete mix would increase, thus yield results without negatively affecting the true result. This apparent need for admixture is as a result of high water absorption rates possessed by the recycled aggregate.

Conclusions and Recommendations

• When using recycled aggregate as coarse aggregate in the production of concrete, it can be recommended that using RA derived from Medium or High strength concrete performed better than Natural aggregate when comparing compressive strength.

• RA derived from low strength concrete generally has a lower compressive strength than NA in concrete mix, but still can be used to some degree. It may not be economically feasible.

• The invariability of using a mixture of strengths of aggregate can lead to variance in compressive strength as shown in the concrete mix containing different strengths of concrete. This invariability may be accounted for with the analysis of the specimens shown under the electron microscope having lines of weaknesses.

• Concrete mixes containing RA with a w/c < 0.5 would require the addition of admixture, as the

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mix would become far unworkable for reliable results to be obtained. This inclusion of admixture, including analysis on cost to volume ratios involving admixture, should be done.

• What should be taken into consideration is the size of recycled aggregate used in the concrete mixes. Normally, particle sizes should not be greater than 25mm so as to ease the action of compacting, nor smaller than 10mm. A stricter size distribution regime can be assessed where the size of recycled aggregate components can be tested for their compressive strength in concrete mixes.

• It was observed in the electron beam microscope analysis that for a specific specimen, a fracture line was observed. A general aggregate test involving the influence of the somewhat randomness of structure of the recycled aggregate should be done.

References

American Concrete Institute (ACI) 555. 2001. ACI Committee 555 Report. Michigan: ACI.

Energy Information and Administration (EIA). 2006. Emissions of Greenhouse Gases in the United States (US). Washington, DC: EIA

Mahasenan, N., S. Smith, K. Humphreys, and Y. Kaya. 2003. The Cement Industry and Global Climate Change: Current and Potential Future Cement Industry CO2 Emissions. Greenhouse Gas Control Technologies–6th International Conference. Oxford: Pergamon.

Mark A. Justman. 1998. C&D Debris Recycling. William Turley. Private communication

Mark, J., A. Mwasha, and C. Paul. 2007. “Potential for the Use of Recycled Aggregates in Trinidad and Tobago.” http://www.irbdirekt.de/daten/iconda/CIB8518.pdf

Portland Cement Association (PCA) “Materials: Aggregates.” Concrete Technology. http://www.cement.org/tech/cct_aggregates_recycled.asp.

Tony Arnold J.R., N.C. Stephen., and M.C. Lloyd. 2008. Introduction to Material Management. USA: Pearson International Edition.

N Context

Diabetes Mellitus is a condition in which the amount of glucose (sugar) in the blood is too high because the body cannot break it down or use it properly. Insulin is a hormone produced by the pancreas that helps the glucose to enter the cells where it is used as fuel for the body; it is vital for life. The main symptoms of untreated diabetes are increased thirst; passing urine frequently especially at night; extreme tiredness; weight loss; genital itching or regular episodes of thrush; blurred vision; and excessive sweating. The main types of diabetes are Type 1, Type 2 and Gestational.

Type 1 Diabetes; also known as Insulin Dependent Diabetes, is an autoimmune disease which develops because the body is unable to produce insulin. It normally has an early onset appearing before the age 40 and is treated by insulin injections and diet. Regular

exercise is highly recommended.

Type 2 Diabetes; commonly known as Non-insulin Dependent Diabetes, develops when the body produces insufficient insulin and or uses the insulin produced ineffectively. It is a metabolic disorder, that usually appears in people over the age of 40, but can occur in the under 40 aged group. Treatment can include combinations of:

• Diet and exercise

• Diet, exercise and tablet (hypoglycaemic)

• Diet, exercise, tablet and insulin injection

• Diet, exercise and insulin injection

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By Cherma St. Clair MSc, PGCE, BA (Hons), DipMid, RNLead Nurse Practice Development, London, England

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Gestational Diabetes Mellitus (GDM) only occurs during pregnancy. Women who develop GDM have an increased risk of developing Type 2 Diabetes in later life. This type is treated with prescribed diet and insulin injection; however for some women, hypoglycaemic tablets are additionally needed and prescribed.

Diabetes is a costly disease for those affected, their families and health care systems. For Type I and Type 2 diabetes, the disease process can lead to pain, anxiety, inconvenience, and impaired quality of life. It is the leading cause of blindness in adults in developed countries and the most common cause of amputation (World Health Organization, 2003). Those with diabetes are two to four times more likely to develop cardiovascular disease and stroke due to the damage caused to the major arteries. Other complications include erectile dysfunction in men, increased incidences of still birth as pregnancy outcome for women, kidney disease and nerve damage – numbness in hands and

fingers and feet.

The main aim of treatment is to achieve blood glucose levels as near to normal as possible. There is conclusive evidence that good control of blood glucose levels can substantially reduce the risk of developing complications and slow their progression. This in addition to a healthy lifestyle will help improve wellbeing, protect against long term damage and contribute to a substantial improvement in quality of life.

In summary I will leave you with some tips to succeed in the fight against diabetes mellitus:

1) Get rid of the sedentary lifestyle. Remember Type 2 diabetes is a lifestyle disease.

2) Exercise – At a minimum a 30 minute walk of other type of physical activity is needed daily.

3) Reduce alcohol intake and stick within the recommended weekly unit limit.

4) Stop smoking

5) Take a careful look at what and how you eat. Switch from having high fat diet and sugary snacks to having three well balanced meals daily, inclusive of about five to seven portions of fruit and vegetables, and low to moderate protein as a high protein diet puts a strain on the kidneys.

6) Ensure that you have an adequate intake of fluid consisting of at least 1.5 litres of water per day.

7) Get adequate sleep of at least six hours in addition to periods of rest in twenty four hours.

References:

Diabetes UK. 2015. http://www.diabetes.co.uk/ (accessed July 31, 2015).

World Health Organization.2014. Diabetes. http://www.who.int/diabetes/en/ (accessed July 31, 2015).

The National Institute for Health and Care Excellence. 2013. Diabetes Guidelines. https://www.nice.org.uk/guidance/diabetes. (accessed July 31, 2015).

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Unit 3, Aunt Jobe Building,Arnos Vale, P.O Box 1427

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AbstractUnderstanding the emotional needs of employees, proactively sensing the psychological distress factors of the employees and tuning them through counseling therapy will be challenging work in any organization. The human body is composed of Physical and Mental layers, Counseling Therapy deals with mental comfort while Therapeutic Yoga deals with occupational diseases like Musculoskeletal Disorders, Hearing and Vision issues, Stress Management and Concentration loss. Detailed analysis has done about all the above human discomforts involved in high risk activities like Work at Heights and Confined Spaced entry. This article explains how Occupational Psychology and Therapeutic Yoga can be applied in Industry for high risk activities. Keywords: Occupational Psychology, Therapeutic Yoga, Confined Space, Work at Heights

Occupational Psychology and Therapeutic Yoga Tools for Proactive Safety CultureBy Jayandran Mohan Training Department, Green World Training Institute, Chennai, India

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Introduction Occupational Psychology is the science of measuring psychological variables, such as knowledge, self esteem, skills and abilities of an employee, and understanding human behavior in the workplace with respect to the organisation’s principles and policies. A field that is concerned with the safety, physical and mental well being of an employee is Therapeutic Yoga. Therapeutic Yoga is an initiative which can be implemented by the employer or appointed competent Occupational Yoga therapist and can be followed by the worker. It includes breath control, simple meditation, adoption of specific body postures practiced for health and relaxation so as to perform well in the assigned tasks especially in high risk activities.

Therapeutic Yoga can be applied to maintain worker fitness during high risk activities like Work at Heights and Confined Space Entry, and will help to remove their respective phobias i.e., Acrophobia and Claustrophobia. The employee well being is a very important factor to control accidents in the workplace. Individual behavior like Attitude, Competence, Perception, plays a vital role in Work Place Safety. Individual behavior and the mental well being can be improved if the employer applies the idea of Occupational Psychology and Therapeutic Yoga. The International Labour Office (ILO 161 and ILO 1959 R112) defines “Occupational

Health Services” as safe and healthy working environments which will facilitate optimal physical and mental health in relation to work and the adaptation of work to the capabilities of workers. Counseling Therapies Counseling aims to help employees to manage their accident prone psychological difficulties. The Safety Occupational Psychologist has to understand the types of psychological issues that exist in the workplace and has to decide on the counseling method as follows:

Psychoanalytic Therapy

Psychoanalytic therapy or talk therapy can be done by listening to Employees talk about their lives which will release their personal stress.

Behavioral Therapy

In Behavioral therapy employees are encouraged to gradually face their fears e.g. their fear of heights by explaining the safety precautions adapted in Work at Heights.

Group Therapy

Group therapy is a form of psychotherapy where two or more employees will interact with their superiors to pave the way healthy dignified relationship.

Art Therapy

Art therapy involves the use of artistic means to work through difficult emotions. It helps individuals who are having trouble discussing their problems verbally. High Risk Activities Health Assessment The International Labour Office, Occupational Health Service, 1985, R171, Section B11 (1a), states that the employer has to carry out a health assessment for the worker before deploying them

into high risk activities like Work at Heights and Confined Space entry. Areas considered in the fitness assessment for Work at Heights and Confined Space entry activities are Respiratory system, Cardiovascular system, Back/knee/foot/neck Joint or any Musculoskeletal Disorder, Hearing (with or without whispering sound),Nervous system, Obesity, Vision, Physical Stamina, Mental Stamina (Acrophobia - Fear of Height ,Claustrophobia -Fear of Enclosed Spaces, other depressions). Therapeutic Yoga Postures Therapeutic Yoga blends postures, breath work, hands-on healing and meditation techniques which will maintain the worker’s fitness level in par with High Risk activities and the below images will explain in detail.

Fig 1 – Therapeutic Yoga Postures

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Figure 2 – Workplace Incidents Caused by Human Error

The above statistics clearly indicate that Human Error is also one of the prime factors for work place accidents. By implementing Occupational Psychology and Therapeutic Yoga, workers physical and mental well being will be sound which will result in a reduction of accidents due to Human Error. References Cooper, Cary L and Robertson, Ivan T. 2004. International Review of Industrial and Organizational Psychology. Vol 19.

Cooper, Dominic C. 2002. Revitalizing Health and Safety – Achieving the Hard Target.

Iyer, Geeta. 2009. Illuminating Lives with Yoga. International Labor Office. 2007. The ILO at a Glance. Geneva.

National Examination Board in Occupational Safety and Health. n.d. Unit GC2 – Control of International Work Place Risks.

National Examination Board in Occupational Safety and Health. n.d. Unit GC1 – Management of International Health and Safety.

Total Access (UK) Ltd. 2015. Work at Height & Confined Space Medical Assessment.

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Mark Corbin is a transport planner and project manager currently working for one of the world’s leading road operators; Highways England. Mr. Corbin is originally from Barbados but has lived and worked in the UK for the past fifteen (15) years. He is a graduate of Oxford Brookes University where he pursued his Master’s Degree in Transport Planning. He also holds a Bachelor’s of Science Degree with Honours in Automotive Technology from the University of Huddersfield.

Prior to leaving Barbados he worked in the automotive industry and lectured at the Samuel Jackman Prescod Polytechnic on the City & Guilds Motor Vehicle Engineering certificate and diploma courses.

Throughout his career in England he has led the delivery of a number of highway, public transport and road safety improvements and numerous stakeholder management events. The development of long term transport strategies has also formed a key part of his work.

As a qualified project manager with Highways England, Mr. Corbin is currently leading two significant strategic studies in the North of England; the Trans-Pennine Tunnel and Manchester Northwest Quadrant study. The tunnel study aims to examine feasible options for connecting two of England’s major cities; Sheffield and Manchester by what could potentially be the world’s longest road tunnel. The Manchester Northwest Quadrant study seeks to address longstanding connectivity problems on one of England’s busiest motorways the M60.

Mark has a passion for Road Safety with an ambition to make roads safer in the Caribbean. He was the author of the 2013 report Improving Caribbean Road Safety: Towards a Framework for the Caribbean.

Professionally he is a registered member of the Institute of the Motor Industry and the Chartered Institute for Highways and Transportation.

Mark Corbin

Transport Planner and Project Manager Highways England, UK

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A very large expanse of sea, in particular, each of the main areas into which the sea is divided geographically A systematically organized body of knowledge on a particular subject. The presence in or introduction into the environment of a substance or thing that has harmful or poisonous e�ects. Relating to the production of electric current at the junction of two substances exposed to light Increase in the overall temperature of the earth's atmosphere generally A colorless, transparent, odorless, tasteless liquid that forms the seas, lakes, rivers, and rain A colorless, odorless gas produced by burning carbon and organic compounds and by respiration To make or become acid; convert into an acid The strength and vitality required for sustained physical or mental activity. The surroundings or conditions in which a person, animal, or plant lives or operates

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Convert (waste) into reusable material A synthetic material made from a wide range of organic polymers such as polyethylene, PVC, nylon, etc The ability to continue a de�ned behavior inde�nitely The wealth and resources of a country or region, especially in terms of the production and consumption of goods and services. A colorless, odorless �ammable gas that is the main constituent of natural gas. A thing used for transporting people or goods, especially on land, such as a car, truck, or cart The action of conserving something, in particular. Wild animals collectively; the native fauna (and sometimes �ora) of a region A viscous liquid derived from petroleum, especially for use as a fuel or lubricant The planet on which we live; the world The phenomena of the physical world collectively, including plants, animals, the landscape, and other features and products of the earth

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By Leandra Belle-CharlesProgramme Manager, The OSH Institute of Dominica

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Introduction

A natural disaster like tropical storm Erika, although infrequent, may require institutions to implement their disaster recovery plans and to improvise creative solutions to address unforeseen difficulties quickly. There may be a great need for businesses to reassess how well they are prepared for foreseeable natural disasters at all levels of the organization, not just from the perspective of recovering and restoring information technology but also managing staff who may suffer loss in one way or the other and even unforeseen absenteeism.

Employee Absence Due to Natural Disasters

When considering whether to grant employees annual leave it is good practice for employers to bear in mind the possibility of their absence due to the passage of a natural disaster . Employers should consider various alternatives to assist with productivity after a natural disaster. Could the stranded employee work from where they are, or from a nearby office? It may even be sensible to pay the employee for some or all of the missed time to maintain good relations and loyalty. It is very critical that employers demonstrate some level of sympathy/empathy in their approach to employees during these times. This brings across a critical aspect which every employer should consider, which is the idea of a Disaster Management Plan or Policy. Does your organization have one? If not, when negotiating collective bargaining

agreements, some reference should be made as to how the employer and employees treat in cases of natural disasters.

Operational Needs

Having a sense of direction in regards to operational needs is very essential for post natural disaster business continuity. Employers must know what critical functions need to be restored immediately in order to provide confidence to their employees when responding to a disaster. Identifying potential threats, assessing their potential impact, assigning priorities, and developing planned responses are the basic principles of sound business continuity planning. Employers must therefore implement reasonable safeguards to mitigate the range of risks that realistically may confront their institution. Developing, implementing, and regularly testing disaster recovery and business continuity plans to ensure their continued effectiveness for responding to changing business and operational needs takes time, resources, and money but is critical. Consideration must therefore be given to striking a balance between addressing the threats institutions face with cost-effective measures to mitigate those risks and recognizing areas where it may be either cost-prohibitive or impossible to alleviate the exposure.

Disaster drills should be relevant to specific locations and must consider worst-case scenarios. You may want to reconsider the frequency and scope of future testing strategies to incorporate

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more thorough functional and full-scale tests of all support operations and business lines. These periodic tests are most effective when they simulate realistic disasters and require the processing of a sufficient volume of all types of transactions to ensure adequate capacity and capability at all recovery sites.

Disaster recovery and business continuity plans should not assume that all key personnel will be available at designated sites to assist in recovery efforts. Evacuation orders, safety and health hazards, or damaged infrastructure (e.g., washed-out roads, collapsed bridges, and downed power lines) may prevent employees from timely reporting to assigned locations, despite their best efforts. Tropical storm Erika illustrated that a widespread disaster can leave employees stranded without access to working land-line or cellular telephone services. Employers may consider the development, testing and updating of a contact list for senior management, employees, customers, vendors, and key government agencies. Maintaining copies of this information at all sites, plus one or more off-site locations, can be very helpful in the event of a disaster. Similarly, employers may want to develop alternate ways for locating and communicating with employees and customers. Less-traditional communication methods might include two-way radios, cellular telephones with text messaging capability, satellite telephones, or personal data assistant (PDAs). Employees could use these less-traditional communication methods to report their location and obtain current information. In addition, you may want to establish a central point of contact outside the potential disaster area and make pre-established toll free telephone numbers available for employees and customers.

Facilities should be safe prior to allowing personnel to re-enter the premises. A professional inspection may be necessary or advisable as some types of structural problems are difficult to detect. An inspection of your sites/buildings may determine that the damage to these premises is so severe that it is not safe to resume business operations at those locations. Therefore, before reopening for business, a risk assessment and planning exercise should be undertaken to ensure that your facilities are safe.

Conclusion

The effects of tropical storm Erika have provided everyone with an opportunity to assess or reassess their preparedness for natural disasters. One’s reaction to the aftermath should provide a clear indication as to whether from a personal or business perspective there was some level of readiness and preparedness to deal with the worst case scenario of a disaster. The creation of a Business Continuity Plan, for each business location is the advisable counsel for sustained trading nowadays.

The OSH Institute and the Dominica Employers Federation takes this opportunity to express our deepest sympathies to all those who lost loved ones during the passing of Tropical storm Erika and to all who in one way or the other were affected. Keep the faith!

Reference

Federal Financial Institutions Examination Council, n.d. Lessons Learned from Hurricane Katrina. https://www.ffiec.gov/katrina_lessons.htm (accessed September 1st, 2015).

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“To truly transform our economy, protect our security, and save our planet from the ravages of climate change, we need to ultimately make clean, renewable energy the profitable kind of energy.” ~ Barack Obama

“Once the renewable infrastructure is built, the fuel is free forever. Unlike carbon-based fuels, the wind and the sun and the earth itself provide fuel that is free, in amounts that are effectively limitless.” ~ Al Gore

“It is time for a sustainable energy policy which puts consumers, the environment, human health, and peace first.” ~ Dennis Kucinich

“The sun provides more energy in one hour than all humanity uses, in all forms, in a single year. Sunlight can provide us with its own resolution to our energy problems. The only transformation required is for humanity to reduce, or end, consumption of stored solar (as fossil fuels) and, in its place, use freely available "fresh" solar.” ~ David S. Findley

“Studies show that investments to spur renewable energy and boost energy efficiency generate far more jobs than oil and coal.” ~ Jeff Goodell

“Clearly, we need more incentives to quickly increase the use of wind and solar power; they will cut costs, increase our energy independence and our national security and reduce the consequences of global warming.” ~ Hillary Rodham Clinton

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A Vast Problem

By Linda Sheridan. MSc, PG Cert, BSc, NDN, RN,T.V. Specialist NurseEngland UK

A Vast Problem

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Leg Ulcers are a vast problem for both patients and health services resources (Moffatt, Franks, Oldroyd et al. 1992). Leg Ulcers are not merely uncomfortable, they are sometimes painful dependent on the cause, and are always annoying. Often the affected individuals are prevented from leading their normal work and social lives. Furthermore millions of people every year are affected by this condition, including the family, friends and caregivers. This article focuses on the main categories of leg ulcers, whilst other leg ulcer aetiologies will be summarised in Table 1.

Table 1: Other Aetiologies of Leg Ulceration.

“A leg ulcer is a long-lasting chronic sore on your lower leg or foot, that takes more than four to six weeks to heal” (Davies et al. 1983).

About 1% of the middle-aged and elderly population are affected with chronic leg ulceration, which usually occurs secondary to a range of disease processes and or conditions. The most common of these are blood circulation disorders. Where the cause is due to ‘Circulatory Insufficiency’ leg ulceration aetiology can be sub-divided into Venous (45-80%) and Arterial (5-20%). Diabetic leg ulceration is another large supplementary group (15-25%).

Ulceration may be caused by minor injury resulting from a plaster cast or ill-fitting boots or may be triggered by bacterial infection, especially Impetigo, Erythema and Cellulitis and less often Tropical Ulcer, Tuberculosis or Leprosy. It is important to be able to differentiate between the main types of leg ulcers which are subdivided into venous and arterial insufficiency. Ascertaining the aetiology of the ulcer is paramount to ensure appropriate and safe management is provided.

Venous Insufficiency

This refers to improper functioning of the one-way valves in the veins. Veins transport venous blood from the capillaries towards the heart against gravity. Two mechanisms assist this uphill flow, the calf muscle pump which pushes blood towards the heart during exercise, and the one-way valves which prevent the flow of blood back downhill. There may be reflux through the valves, obstruction of the veins and/or impaired calf pumping action result in pooling of blood around the lower part of the leg to just below the ankle. The increased venous pressure causes fibrin deposits around the capillaries, which then act as a barrier to the flow of oxygen and nutrients to muscle and skin tissue. The persistent high pressure in the veins of the legs precipitates tissue and cell death that leads to the ulceration (Tortora and Grabowski, 2003).

Arterial Insufficiency

This refers to poor blood circulation to the lower leg and foot and is most often due to atherosclerosis. In atherosclerosis the arteries become narrowed from deposits of fatty substances in the arterial vessel walls, often due to high levels of circulating cholesterol and aggravated by smoking and high blood pressure (hypertension). In contrast to high pressure that causes venous ulcers, it is the lack of arterial blood supply in the delivery of oxygen and other nutrients to the leg and foot that result in tissue and cell death and subsequently ulceration. Diabetic leg ulcers are associated with poorly controlled diabetes mellitus and can be either venous or arterial. Diabetic patients have an increased risk for developing leg ulcers due to high blood sugars coupled with the interrelated nerve damage. Diabetic patients may not be fully aware of the risks associated with wearing tight clothing such as socks or tights, and the patient may not be aware of the need to check their skin for rubbing or areas of injury. In addition they may not be able to fully feel the effects of compression from bandages, plaster cast or any other restrictors that may have been applied for other underlying conditions, due to primary nerve damage.

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The predisposing causes of venous and arterial ulcers differ as detailed in Table 2 below. It is crucial to address the underlying cause, together with the management of the ulcer itself. This measure is to reduce the high risk of a venous leg ulcer recurring after treatment. Particularly important to note is that if you have previously had a leg ulcer there is a significant chance of recurrent leg ulceration developing in the future months or years.

Table 2: Pre-disposing Causes of Venous and Arterial Ulcers

Confirming the aetiology of the leg ulceration and formulating an appropriate treatment regime is critical, as the management of Venous ulcers differs from Arterial ulcers. The Royal College of Nursing (RCN) Guidelines for practice outline that nurses conducting the assessment (and who are responsible for the care and treatment of the patient) must be appropriately trained and experienced in leg ulcer management and care (RCN 2000). According to Ray et al. (1994) unless the practitioner has undergone formal training in the Doppler Ultrasound Technique and the Ankle Brachial Pressure Index (ABPI) measurement can be unreliable.

A full holistic patient assessment is pivotal to confirming the aetiology of the leg ulceration,

which will facilitate the appropriate management. This assessment should include, obtaining a comprehensive medical history, allergies, current medication and origin of the ulcer if known by the patient; followed by a physical review of the ulcer site and ulcer bed. Lastly an ABPI needs to be undertaken. This involves the use of a hand held Doppler and a Doppler probe to measure the pressure in the arm and the ankle. The calculation involves dividing the highest pedal pulses by the highest brachial pulse. The normal value is 0.90 to 1.3. If the ABPI is less than 0.9, there is likely to be arterial disease. Levels of less than 0.5 indicate severe arterial disease (RCN, 2006). This assessment is crucial for diagnosis (see Table 3 for interpretation of ABPI readings).

Table 3: Interpretation of ABPI

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The Characteristics of venous ulcers also differs from arterial ulcers. These are tabulated below (Table 4) and Figures 1 and 2 illustrate differences further.

Table 4: Characteristics of Venous Ulcers Compared to Arterial ulcers

Picture 1: Venous Leg Ulceration

Picture 2: Arterial Leg Ulceration

The management of diagnosed leg ulcers must be timely and involve the mulit-professional team approach. Patients may be referred to a Vascular Consultant to determine if vascular ultrasound is required and whether surgery intervention needs to be carried out. In addition patients should be advised to wear at least Category 2 support stockings (compression hosiery). This is particularly important for post-thrombotic syndrome, leg swelling or discomfort, and for long-distance flights.

Treatment for venous leg ulceration is best keeping the primary dressing simple, applying moist wound healing principles (Cutting and Tong, 2003) which usually involves cleaning with saline and appropriate dressing for the wound bed indicators (Dowsett and Ayello, 2004). Multilayer compression bandages or Short Stretch bandaging systems should be used to retain the primary dressing as it protects the bony prominences, absorbs exudate and assists with the improving the blood flow in the legs. Antibiotics may also be used if the ulcer becomes infected, but they do not help uninfected ulcers to heal.

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Arterial leg ulcers are notoriously hard to heal. The aim of treatment is keep the arterial ulcer dry and protected from pressure. Arterial surgery to improve blood supply may be necessary (Vuolo, 2009). The destruction of any emboli in the arteries or the opening of constricted arteries using balloon angioplasty or arterial stents or even bypass grafts should be considered which will increase the peripheral blood flow. Compression bandages should be used advisedly and under close supervision and not be considered as a first-line treatment choice.

Due to susceptibility of leg ulceration from primary conditions and precipitating factors some leg ulcers cannot be prevented. However measures can be taken to promote healing and minimise the risk of further recurrence. The simplest action is to be very careful not to injure your legs, particularly when pushing a supermarket trolley or push-chairs. Do consider the following tips:

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•Consider protective shin splints.

Walk and exercise for at least an hour a day to keep the calf muscle pump working properly.

Lose weight if you are overweight.

Stop smoking.

Check your feet and legs regularly. Look for cracks, sores or changes in colour. Moisturise after bathing.

Wear comfortable well-fitting shoes and socks. Avoid socks with a tight garter or cuff. Check the inside of shoes for small stones or rough patches before you put them on.

If you have to stand for more than a few minutes, try to vary your stance as much as possible.

When sitting, wriggle your toes, move your feet up and down and take frequent walks.

Avoid sitting with your legs crossed. Put your feet up on a padded stool to reduce swelling.

Avoid extremes of temperature such as hot baths or sitting close to a heater. Keep cold feet warm with socks and slippers.

Consult a Chiropodist or Podiatrist to remove callus or hard skin.

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Conclusion

Most Venous leg ulcers will heal within three to four months with timely diagnosis and intervention. However, some ulcers may take longer to heal, while a very small number may never heal. This said, if patients with leg ulcers are effectively investigated and promptly treated, the majority of venous ulcers should be permanently healed with on-going long term preventative measures.

On the other hand Arterial leg ulcers remain a challenge to even the most experienced practitioner, patients and relatives as the large number will never heal. Patients who have an underlying diagnosis of Diabetes will need to be stabilized and manage their blood sugars, in addition to the leg ulcer management.

Healthcare professionals should be competent to offer and deliver evidence based advice and practice for the desired outcome which is appropriate for every individual patient.

References

Cutting, K. and Tong, A. 2003. Wound Physiology and Moist Wound healing. Medical Communications Ltd, Holsworthy.

Dowsett, C. and Ayello E. 2004. Tiime Principles of Chronic Wound Bed Preparation and Treatment. Br J Nurs 13(Suppl 15). S16–S23.

Moffatt, C.J., Franks, P.J., Oldroyd, M.I., Bosanquet, N., Brown, P., Greenhalgh RM, and McCuollum, C.N. 1992. Community clinics for leg ulcers and impact on healing. BMJ 1992;305: 1389-92

Ray, S.A. Srodon, P.D. Taylor, R.S. & Dormandy, J.A. 1994. Reliability of Ankle: Brachial Pressure Index Measurement by Junior Doctors. British Journal of Surgery. 81, (2), p188-190.

Royal College of Nursing. 2006. The nursing management of patients with venous leg ulcers. Recommendations. London, U.K. R.C.N.

Royal College of Nursing. 2000. The management of patients with venous leg ulcers. Implementation guide. London, U.K. R.C.N.

Tortora, G.J. and Gabowski, S.R. 2003. Principles of anatomy and physiology. New York, U.S.A. John Wiley & Sons.

Vuolo, J. 2009. Wound care made incredibly easy. London, UK Lippincott Williams & Wilkins.

Wash clothes in cold water whenever possible. As much as 85 percent of the energy used to machine-wash clothes goes to heating the water.

Use a drying rack or clothesline to save the energy otherwise used during machine drying. If you must use a dryer, consider adding dryer balls to cut drying time.

Buy locally raised, humane, and organic meat, eggs, and dairy whenever you can. Purchasing from local farmers keeps money in the local economy.

Use a water filter to purify tap water instead of buying bottled water. Not only is bottled water expensive, but it generates large amounts of container waste.

Buy in bulk. Purchasing food from bulk bins can save money and packaging.

Unplug appliances when you're not using them. Or, use a "smart" power strip that senses when appliances are off and cuts "phantom" or "vampire" energy use.

The big secret: you can make very effective, non-toxic cleaning products whenever you need them. All you need are a few simple ingredients like baking soda, vinegar, lemon, and soap.

Donate or recycle your cell phones and computers responsibly when the time comes. E-waste contains mercury and other toxics and is a growing environ-mental problem.

Install compact fluorescent light bulbs (CFLs) when your older incandescent bulbs burn out.

Bring a reusable water bottle, preferably aluminum rather than plastic, with you when traveling or at work.

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Svitalsky Bros

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Images from forum8.com

Modelling and Simulation of pedestrians (and vehicles) during a variety of emergency scenarios. Traditionally, emergency response plans were tested by conducting live drills, to establish facility user response a nd c ompliance with e valuation time l imits and other standards.

Caribbean, using t he l atest technology t o simulate c rowd a nd vehicle movements.

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Contact us: 5B Trincity Industrial Estate,Trincity,Trinidad & Tobago

Phone: 868 -225 - 6926Website: [email protected]

Abstract

It is clear that as a result of the current bidding war for finite fossil fuels, those societies with limited resources could find themselves outbid for the vital energy supplies and, as a result,

precluded from increasing their energy use. In such an environment, cheaply produced renewable energy is an absolute necessity for economic development and sustainability.

We in the Caribbean, can derive these alternative energy sources from ocean and tidal currents since the region possesses a comparative advantage due to its

geography and location. The energy derived from these processes would be used to extract hydrogen and chlorine from the marine environment as

well as produce fresh water through desalination.

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By Allan Sandy Garifuna Energy Limited

Introduction

All economic systems depend critically on energy resources for sustainability, continuous evolution and growth. Furthermore, the direct relationship between energy use and economic development is noted. One observes, in most economies, the interrelationships and dependencies between the various sectors: Agricultural, Industrial, Transportation, Finance, Distribution and Advertising. These sectors are all very energy intensive as they depend on water, energy, transportation and telecommunication infrastructure.

As concerns the Caribbean islands, the level of infrastructural development varies in quality from poor to satisfactory. The main influence is the lack of capital for infrastructural development that is due in part to the high energy costs for fossil fuels. These high costs in turn lead to repeated balance payments problems. This chronic indebtedness leaves very little funding available for capital-intensive infrastructure projects financed from domestic sources. The infrastructural deficiencies are pervasive, long-term and have a severely negative impact on economic growth and development. This lack of economic growth subsequently inhibits any future domestic capital accumulation, thus leading to a vicious circle of low growth and underdevelopment. In our development of alternative energy, there are four basic considerations on which the developmental strategies rest:

(1) Any development is sustainable over the long-term.

(2) Environmental protection and climate change mitigation is an intrinsic part of the process.

(3) Local resources (technical, administrative, land, sea, air and mineral commodities) are fully utilized.

(4) Labour-force participation and income from employment must increase from current levels at a sustained rate.

The Impact of High Cost Energy on Caribbean Economies

As an economy grows, it increases its utilisation of energy, which when combined with land, labour, capital and technology creates wealth. The role of technology is critical in the wealth production process. Energy provides the capacity for doing work. Work, when applied to one’s technological capital stock, serves to amplify human labour to produce goods and services. It is not possible to achieve such growth without technology and technological systems do not work without energy inputs. This amplification in labour productivity is critical to economic development. One now witnesses the world’s major economies evolving into very complex systems as typified by phenomena such as globalisation and the establishment of multinational federations and consolidated trading blocks; these are all linked together through complex telecommunication networks. As a result of this increase in complexity and economic activity by the major world economies, one notices a constant increase in the demand for energy.

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There has been a progression of energy sources used in the amplification of human labour, for example the advances from strictly human power, to domesticated animals and later wood, charcoal and coal (in that order). Strides made with respect to coal were followed by advances in the current regimen of oil and gas, and the future promise of hydrogen-fueled electricity. These developments were all made to facilitate this economic work of wealth creation.

The Caribbean economies because of their low levels of technological development and limited capital resources have had to resort to the production of goods and services with very little value added. Lacking the capital base and the technology to increase the value added to their products, these economies continue to produce low-margin agricultural products, minerals and metals, which are sold mainly in the world’s commodity markets where the trade terms over time move against commodity suppliers to result in decreasing revenues.

The high energy costs combined with a reduction in revenues have served to seriously inhibit and constrain economic activity in the Caribbean to such an extent that some of the islands have experienced negative economic growth, with no prospect of an improvement in the situation as long as the cost of energy remains high. The president of the Inter-American Development Bank (IDB) in 2007, Luis Alberto Moreno, describes the economic situation that the nations of the Caribbean face: ‘They have had a long history of cultivating sugar cane, the world’s most cost-effective feedstock for ethanol; that, with the exception of Trinidad and Tobago, they are almost totally dependent on imported fossil fuels; and that the reduction of preferential prices for Caribbean sugar by European buyers is forcing sugar producing countries to find new sources of revenue.’

The present economic situation of the Caribbean nations is characterised by stifled economic growth, poor basic infrastructure (for providing water and energy) and an economic system mired in the production of low value-added commodities and low-

margin services such as tourism. The World Bank (WB), in a report prepared for the Development committee of the Board of Governors 2006 meeting, stated that ‘Developing countries must accelerate access to affordable and reliable modern energy services to decrease poverty, increase productivity, enhance competitiveness, and thus improve their economic growth prospects. Without access to modern, clean, and sustainable energy services, the poor are exposed to unhealthy air pollution and deprived of modern energy services, which provide lighting, cooking, heating, refrigeration, transportation, motive power and electronic communication that are indispensable to increasing productivity, creating enterprises, employment and incomes.’

This, in summary, is the economic problem faced by the majority of Caribbean countries. It is a problem characterised by poor terms of integration into the world’s economic system, inefficient use of productive resources and a technological capital stock that is not directly derived from and adapted to the domestic resource base.

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Low Cost Renewable Energy as a Solution to facilitate Economic Growth

As aforementioned, we see emerging a three prong strategy for achieving the objectives of economic growth and development in the Caribbean. This strategic initiative depends on the following:

• An external source of capital for investment in infrastructural development with respect to areas of energy, transportation, water and telecommunications;• A cheap and reliable source of energy;• A transfer of technology modified for the environment and resources of the region.

Capital

Funding sources of capital may be provided by internally-generated, private sector investments, public sector government-led investments and externally-based, multilateral, lending agencies. These areas together form the major source of funds. Two divisions of the WB–the International Finance Corporation (IFC) and the Overseas Private Investment Corporation (OPIC), the United Nations (UN), the Organisation of American States (OAS) and the IDB are some of the major multilateral funding sources for infrastructural development projects in the Caribbean.

Energy

The Caribbean region has a strong comparative advantage in ocean/tidal current-driven energy production. This is because the region has one of the world’s major ocean currents–the North Equatorial Current, which is driven by the Trade Winds, and the forces generated by the earth’s rotation joining with the Guiana current, to move huge masses of water from the Atlantic through the passages between the islands into the Caribbean Sea. Among the findings, the team at Garifuna Energy Limited determined that the strongest marine currents are generally found in narrow straits, around headlands, between islands and at the entrances of bays. In these locations, the areas that have the greatest tidal variation

and shallow water will have the strongest marine currents. Locations where island chains interact with major ocean currents are prime areas for exploiting these energy resources. The Caribbean islands, with an abundance of marine features such as shallow waters with high tidal variation, interaction with major ocean currents and many narrow straits, keys and inlets among the islands are ideally situated for cheap energy production from tidal and ocean current sources.

Johns et al. (2002) has indicated that of the total Caribbean inflow of about 28 Sverdrup (Sv), the division of volumes is almost equal among the Windward Islands, Leeward Islands and Greater Antilles passages. The most consistent and strongest surface current inflow velocities occur in the Grenada and St. Vincent passages with typical speeds that range from 40–60 cms−1, with observed highs of 90 cms−1 (Wilson and Johns 1997). Average volume transports for the Grenada and St. Vincent passages were 4.7 and 3.4 Sv (Wilson and Johns 1997). Later research (Johns et al. 2002) has shown a mean of 5.7 Sv and 3.2 Sv respectively. The Greater Antilles have two major passages, the Shallow Mona Passage which accounts for 3 Sv and the Windward Passage which accounts for 7 Sv of the total inflow of 10 Sv (Johns et al. 2002). The Lesser Antilles shows a total of 18 Sv flow compared to about 10 Sv for the Greater Antilles. This establishes the Grenada and St. Vincent passages in the Lesser Antilles and the Windward and Mona Passage in the Greater Antilles as the most significant sources of motive power from ocean current flow.

Figure 1: Caribbean Topography/Bathymetry. (Source: The Cooperative Institute for Marineand Atmospheric Studies)

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In particular, the consistently high ocean current velocities and high surface inflow volumes of the various island passages, present an ideal location for deploying technology solutions for generating energy from ocean and tidal currents. These small islands, many of them uninhabited, volcanic in nature and separated by narrow channels can be used to anchor large arrays of turbines stretching across the channels directly in the stream, at a depth between 40–60 feet below sea level.

Technological Basis

The main technological objective is to efficiently extract energy from moving water and then use that energy in downstream industrial activity. The extractor device should be mass produced with a decentralised installation base. A five-bladed turbine, designed as a variant on the common pelton turbine, installed in the shallow areas around headlands and inlets between islands where the water, moving with a velocity of approximately 1.5 m/sec or greater, turns the turbine blades, is used. The rotating turbine drives an electrical generator, directly attached to the main shaft, producing electricity. This device is designed with a hollow, inner cylinder that allows it to float on the surface. The waves and water currents both act on the blades causing a rotation around the shaft. The system is anchored to the seafloor in at least 20 feet of water.

The motive power from the marine current flow is represented by the equation P=1/2ρV3A where P=power output, ρ=water density V= ocean current velocity and A=turbine rotor area. From this equation one can observe that power is directly proportional to area and proportional to the cube of velocity.

Figure 2: The Full-scale Model of the Turbine

Figure 3: The Structure of the Generator Model

The full-scale model of the turbine, as shown above in Figure 2, is a system designed for high torque, low rotation speed energy generation. This turbine operates in a range of 50–70 RPM. Figure 3 shows a diagrammatic representation of the generator’s model designed for use with the turbine. This generator uses a torus-type, double-sided, axial-flux, disc-type permanent magnet and brushless machine. It has a simple toroidal, strip-wound stator core with a slotless, three phase winding. These machines are relatively simple to construct, have a low cost of manufacture and operate at high efficiency.

Developmental strategy

The main goal here is to use the resources available to the island economies to facilitate economic development. As island states, the aim is to use the energy of moving water (hydropower) to provide energy for industry and society. Furthermore, the mineral resources of the sea can be used to provide raw materials for industrial production.

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Physical plant capacity can be increased by scaling up production in modular blocks to accommodate increase in demand if required. The combination of the energy of ocean-driven hydropower systems with seawater-derived mineral resources will produce high value-added, energy intensive, downstream industrial goods, with minimal impact on the environment.

Desalinated Water Production

Figure 4: Seawater Reverse Osmosis Desalination Plant (4-8 kw/m3 of water)

The desalination plant uses Sea Water Reverse Osmosis Membrane Technology that allows only fresh water to pass through its membrane, thus leaving the salt behind. This is accomplished by separating salt at a higher pressure than the osmotic pressure of seawater using a high-pressure pump together with an energy recovery unit. Plants manufactured can that range from a capacity of approximately 20 tons of fresh water per day for a compact model to 100,000 tons per day for a large model. The energy utilisation for this class of plant lies within the 4-8 kw/h per M3 range.

The by-product of Reverse Osmosis Desalination is a concentration of dissolved salts, commonly known as brine. Instead of discarding brine as a waste product of desalination, brine can be utilized as an input into the chloro-alkali industry plant. This type of industrial plant utilises ocean energy to produce three basic chemicals derived from the electrolysis of brine. These are the primary products of electrolysis–chlorine gas or oxygen (depending on the electrodes), hydrogen gas and sodium hydroxide solution (‘caustic soda’). Sodium chlorate or sodium hypochlorite (also

known as bleach) could be further produced from the processing of caustic soda and chlorine. The commercial by-products of this activity:

• Generate a continuous supply of clean renewable energy• Produce fresh water from desalination of seawater• Generate sea salt• Generate oxygen from electrolysis of steam• Generate hydrogen from the electrolysis of steam• Generate chlorine from the electrolysis of brine• Generate hydrogen from the electrolysis of brine

Francis Acquah (1998) notes ‘The other product of electrolysis of brine is hydrogen. It is used in the synthesis of ammonia, hydrogenation of oils production of margarine, production of hydrochloric acid and in the petroleum industry. The use of hydrogen depends on the capacity of the chloro-alkali plant. For example, a 40,000 ton/year ammonium factory could be integrated with a 300,000 ton chlorine per year plant’. Similar units are available for the production of chlorine, oxygen and fresh water. These containers are built 20 to 40 feet long based on output capacity. The modular design allows for increasing or decreasing production based on market demand.

Figure 5: A Self-Contained Modular Unit for the Production of Hydrogen. (Hydrogenics Corporation)

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Hydrogenics Corporation states that the ISO container is ideal for outdoor installations or industrial applications, offers heated interior access to equipment for maintenance and operation, and is a transportable container. For the ISO Option 1 20 ft Container the Hydrogen Production Range is up to 60 (2280) Nm3 /h (scfh) and the ISO Option 2 420 ft Container the Hydrogen Production Range is up to 120 (4560) Nm3 /h (scfh).

Chlorine / Caustic Soda Production

A hydrogen chlorine, caustic soda-based chemical industry using minerals extracted from the sea, powered by energy derived from the sea promises to revitalise the economies of small island states in the Caribbean. Of this energy generating process, Francis Acquah (1998) expresses ‘A large potential exists for the utilisation of chlorine in the manufacture of ethylene dichloride, vinyl chloride, polyvinylchloride (PVC), hexachlorobenzene, dichlorobenzene, phenol, etc. … of resins for the manufacture of various thermoplastic products (plastic water tanks, plastic crates, PVC pipes, polyethylene bags, etc.) …. The plastic industry has grown significantly in the past decade with increased demand for plastic packaging materials particularly for the food and beverage industries. Production of thermoplastics promises to be the main consumer of chlorine from the chloro-alkali plant.’ He continues ‘In general the chemical industry is characterised by the use of complex process technologies, sophisticated marketing strategies and inter-industry competition. For the sector to remain competitive, it requires linkages with local production of basic chemicals. The chloro-alkali industry provides the necessary linkage. The major requirement of the existing chemical and allied industries is the intermediate product–caustic soda. The largest consumers of caustic soda are soaps and detergents factories, plastics, paints and pharmaceutical industries. Large quantities of caustic soda are used in the textiles, paper and metallurgical industries and in the production of synthetic fibres.’

Figure 6: The Various Industrial Uses of Chlorine

Summary

A positive economic and social benefit to the Caribbean islands can be expected by significantly reducing the high-energy dependence on fossil fuels, which has such a ruinous effect on the local economies as a result of high-energy costs. As a renewable energy source, it is also expected that our energy production will ultimately reduce greenhouse gas production, thus having a very beneficial impact on the environment. Moreover, it is hoped that export of the downstream products of Hydrogen, Oxygen Caustic Soda and Chlorine, will subsequently earn hard currency for the islands, and produce fresh water and electricity for domestic consumption.

References

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Bioletti, Rob and Ian Potter.nd. “Offshore Alternative Energy Generation. Inter-American Association of Sanitary and Environmental Engineering.” h t t p : / / w w w. a i d i s . o r g . b r / s p a n / f t p / O F F S H O R E % 20ALTERNATIVE%20ENERGY%20GENERATION.pdf. Blue Energy Canada. 2004.http://www.bluenergy.com (accessed December 12, 2003)

Commission of the European Communities (CEC) DGXII. 1996. “Wave Energy Project Results: The Exploitation of Tidal Marine Currents”, Report EUR16683EN.

Fauvarque, Jacqueline. 1996. The chlorine industry, Ecole Superieure de Chimie Organique et Minerale (ESCOM). Pure and Applied

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Ghoroghchian, J., and Bockris, J O’M. 1985. Use of a Homopolar Generator in Hydrogen Production from Water. International Journal of Hydrogen Energy 10 (1): 101-112

Gorban, A.N., Gorlov, A.M. and Silantyev, V.M. 2001. Limits of the Turbine Efficiency for Free Fluid Flow. Journal of Energy Resources Technology 123: 311-317.

Gorlov, A.M. 2004. Harnessing Power from Ocean Currents and Tides. Sea Technology 45 (7) (July): 40. ProQuest Science Journals.

Hayashi, D., T. Senjyu, R. Sakamoto, N. Urasaki, T. Funabashi, and H. Sekine. 2005. Generating power leveling of renewable energy for small power system in isolated island. 2005 Proceedings of the 13th International Conference on Intelligent Systems Application to Power System, 6-10.

Hydrogenics Corporation. “HySTAT-A, Hydrogen Generation Plant.” Product Literature. http://www.hydrogenics.com/onsite/pdf/Hydrogen_Plants_web.pdf

Isaacs, J.D., and R.J. Seymour. 1973. The Ocean as a Power Source, International Journal of Environmental Studies. 4 (3): 201-205.

Johns, W.E., T.L. Townsend, D.M. Fratantoni, Wilson W.D. 2002: On the Atlantic inflow to the Caribbean Sea. Deep-Sea Research Part I 49: 211-243.

Kirke, Brian. 2003. Developments in Ducted Water Current Turbines. Queensland: School of Engineering, Griffith University.

Lazar, R., 2002. Using the fuel cell technology to produce electricity from hydrogen electrolyzing seawater and as a by-product desalinized water. 2002 The 22nd Convention of Electrical and Electronics Engineers in Israel, 44-46.

Muljadi, E., C.P. Butterfield, Wan.Yih-Huei. 1998. Axial Flux, Modular, Permanent-Magnet Generator with a Toroidal Winding for Wind Turbine Applications. 1998 Thirty-Third IAS Annual Meeting, 174-178. The Institute of Electrical and Electronics Engineers (IEEE) Industry Applications Conference. Missouri: IEEE

Paine, J.S., and L.E. Felton. 1984. Bulb Turbine/Generators for the Idaho Falls Hudroelectric Project. The Institute of Electrical and Electronics Engineers (IEEE) Transactions on Power Apparatus and Systems (PAS) 103 (9) (September): 2405-2409.

Powell, C.A. 2002. “Preventing Biofouling with Copper-nickel.” Copper Development Association. http://www.cda.org.uk/megab2/corr_rs/pub-157-preventing-biofouling-with-copper-nickel.pdf

Profumo, F., A. Tenconi, M. Cerchio, J.F. Eastham, and P.C. Coles. 2004. Axial flux plastic multi-disc brushless PM motors: performance assessment. 2004 Applied Power Electronics Conference and Exposition, 1117-1123. Nineteenth Annual IEEE (The Institute of

Electrical and Electronics Engineers )

Rong-Jie, W., M.J. Kamper, K. Van der Westhuizen, J.F. Gieras. 2005. Optimal design of a coreless stator axial flux permanent-magnet generator. Magnetics, The Institute of Electrical and Electronics Engineers (IEEE) Transactions on 41 (1) (January): 55-64.

Ronghai Qu, M. Aydin, and T.A. Lipo. 2003. Performance comparison of dual-rotor radial-flux and axial-flux permanent-magnet BLDC machines. 2003 Electric Machines and Drives Conference, 1948-1954. New York: The Institute of Electrical and Electronics Engineers (IEEE) International

Rosenberg, L.T., 1982. Abnormal Vibration Problems in Large Turbine-Driven Generators and Their Solutions. The Institute of Electrical and Electronics Engineers (IEEE) Transactions on Power Apparatus and Systems. PAS-101 (10) (October): 4131-4135.

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Sharma, C. 1998. Modeling of an Island Grid. Power Systems, IEEE Transactions on. 13 (3) (August): 971-978.

First High Level Seminar on Expanding Bioenergy Opportunities in the Caribbean .2007. Expanding Bioenergy Opportunities in the Caribbean, 6–7: Georgetown: Guyana International Conference Centre.

Soderlund, L., J.-T. Eriksson, J. Salonen, H. Vihriala, and R. Perala. 1996. A Permanent-Magnet Generator for Wind Power Applications. Magnetics, IEEE Transactions on., 32 (4) (July): 2389-2392.

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