scholarly journals A hydrological assessment of the November 2009 floods in Cumbria, UK

2012 ◽  
Vol 44 (1) ◽  
pp. 180-197 ◽  
Author(s):  
J. D. Miller ◽  
T. R. Kjeldsen ◽  
J. Hannaford ◽  
D. G. Morris
Keyword(s):  
River Flow ◽  
Frequency Estimation ◽  
Flood Frequency ◽  
Estimation Methods ◽  
Lake Levels ◽  
North West ◽  
The North ◽  
Flood Estimation ◽  
The Uk ◽  
Maximum Flows

In November 2009, record-breaking rainfall resulted in severe, damaging flooding in Cumbria, in the north-west of England. This paper presents an analysis of the river flows and lake levels experienced during the event. Comparison with previous maxima shows the exceptional nature of this event, with new maximum flows being established at 17 river flow gauging stations, particularly on catchments influenced by lakes. The return periods of the flood peaks are estimated using the latest Flood Estimation Handbook statistical procedures. Results demonstrate that the event has had a considerable impact on estimates of flood frequency and associated uncertainty. Analysis of lake levels suggests that their record high levels reduced their attenuating effect, significantly affecting the timing and magnitude of downstream peaks. The peak flow estimate of 700 m3s–1 at Workington, the lowest station on the Derwent, was examined in the context of upstream inputs and was found to be plausible. The results of this study have important implications for the future development of flood frequency estimation methods for the UK. It is recommended that further research is undertaken on the role of abnormally elevated lake levels and that flood frequency estimation procedures in lake-influenced catchments are reviewed.

scholarly journals FRI0649-HPR HYDROXYCHLOROQUINE PRESCRIBING AND OPHTHALMOLOGY SCREENING WITHIN RHEUMATOLOGY DEPARTMENTS IN THE NORTH-WEST OF THE UNITED KINGDOM: A PROSPECTIVE REGIONAL AUDIT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 928.2-929
Author(s):  
S. Juman ◽  
T. David ◽  
L. Gray ◽  
R. Hamad ◽  
S. Horton ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Service Level ◽  
High Risk Group ◽  
North West ◽  
The North ◽  
The United Kingdom ◽  
The Uk ◽  
Treatment Dosage ◽  
Sd Oct

Background:Hydroxychloroquine (HCQ) is widely used in the management of rheumatoid arthritis and connective tissue disease. The prevalence of retinopathy in patients taking long-term HCQ is approximately 7.5%, increasing to 20-50% after 20 years of therapy. Hydroxychloroquine prescribed at ≤5 mg/kg poses a toxicity risk of <1% up to five years and <2% up to ten years, but increases sharply to almost 20% after 20 years. Risk factors for retinopathy include doses >5mg/kg/day, concomitant tamoxifen or chloroquine use and renal impairment. The UK Royal College of Ophthalmologists (RCOphth) 2018 guidelines for HCQ screening recommend optimal treatment dosage and timing for both baseline and follow-up ophthalmology review for patients on HCQ, with the aim of preventing iatrogenic visual loss. This is similar to recommendations made by the American Academy of Ophthalmology (2016).Objectives:To determine adherence to the RCOphth guidelines for HCQ screening within the Rheumatology departments in the North-West of the UK.Methods:Data for patients established on HCQ and those initiated on HCQ therapy were collected over a 7 week period from 9 Rheumatology departments.Results:473 patients were included of which 56 (12%) were new starters and 417 (88%) were already established on HCQ. 79% of the patients were female, with median ages of 60.5 and 57 years for new and established patients respectively. The median (IQR) weight for new starters was 71 (27.9) kg and for established patients, 74 (24.7) kg.20% of new starters exceeded 5mg/kg daily HCQ dose. 16% were identified as high risk (9% had previously taken chloroquine, 5% had an eGFR <60ml/min/m2and 2% had retinal co-pathology). Of the high-risk group, 44% were taking <5mg/kg. In total, 36% of new starters were referred for a formal baseline Ophthalmology review.In the established patients, 74% were taking ≤5mg/kg/day HCQ dose and 16% were categorized as high risk (10% had an eGFR less than 60ml/min/m2, 3% had previous chloroquine or tamoxifen use and 2% had retinal co-pathology). In the high-risk group, 75% were not referred for spectral domain optical coherence tomography (SD-OCT). 41% of patients established on HCQ for <5 years, and 33% of patients on HCQ for >5 years were not referred for SD-OCT. Reasons for not referring included; awaiting 5 year review, previous screening already performed and optician review advised.Since the introduction of the RCOphth guidelines, 29% patients already established on HCQ had an alteration in the dosage of HCQ in accordance with the guidelines. In the high-risk group, 16% were not on the recommended HCQ dose.Conclusion:This audit demonstrates inconsistencies in adherence to the RCOphth guidelines for HCQ prescribing and ophthalmology screening within Rheumatology departments in the North-West of the UK for both new starters and established patients. Plans to improve this include wider dissemination of the guidelines to Rheumatology departments and strict service level agreements with ophthalmology teams to help optimize HCQ prescribing and screening for retinopathy.Acknowledgments:Drs. S Jones, E MacPhie, A Madan, L Coates & Prof L Teh. Co-1st author, T David.Disclosure of Interests:None declared

scholarly journals Morphology of <i>Emiliania huxleyi</i> coccoliths on the North West European shelf – is there an influence of carbonate chemistry?

2014 ◽  
Vol 11 (3) ◽  
pp. 4531-4561 ◽  
Author(s):  
J. R. Young ◽  
A. J. Poulton ◽  
T. Tyrrell
Keyword(s):  
Environmental Samples ◽  
Significant Variation ◽  
Emiliania Huxleyi ◽  
Morphometric Study ◽  
Saturation State ◽  
North West ◽  
The North ◽  
Microscope Images ◽  
Calcite Saturation ◽  
The Uk

Abstract. Within the context of the UK Ocean Acidification project, Emiliania huxleyi (type A) coccolith morphology was examined from samples collected during cruise D366. In particular, a morphometric study of coccolith size and degree of calcification was made on scanning electron microscope images of samples from shipboard CO2 perturbation experiments and from a set of environmental samples with significant variation in calcite saturation state (Ωcalcite). One bioassay in particular (E4 from the southern North Sea) yielded unambiguous results – in this bioassay exponential growth from a low level occurred with no artificial stimulation and coccosphere numbers increased ten-fold during the experiment. The samples with elevated CO2 saw significantly reduced coccolithophore growth. However, coccolithophore morphology was not significantly affected by the changing CO2 conditions even under the highest levels of perturbation (1000 μatm). Environmental samples similarly showed no correlation of coccolithophore morphology with calcite saturation state. Some variation in coccolith size and degree of calcification does occur but this seems to be predominantly due to genotypic differentiation between populations on the shelf and in the open ocean.

scholarly journals 'Greenfields' and 'Brownfields': automotive industrial development in the UK and in Portugal

Finisterra ◽  
2012 ◽  
Vol 31 (62) ◽  
Author(s):  
Andrew Pike ◽  
Mário Vale
Keyword(s):  
Industrial Policy ◽  
Automobile Industry ◽  
Industrial Development ◽  
Development Strategies ◽  
North West ◽  
Demonstration Effect ◽  
North East ◽  
The North ◽  
The Uk ◽  
The Impact

The industrial policy in the UK and in Portugal, as in most EU countries, seeks to attract new investment capacity, to create jobs and to promote the impact of the so-called "demonstration efect" of "greenfield" development strategies pursued in the new plants of inward investors on existing or "brownfield" plants. This industrial policy focus is particularly evident in the automobile industry.This paper compares the industrial policy oriented towards the automobile industry in the UK and in Portugal. Two recent "greenfield" investments are analised: Nissan in the North-East region (UK) and Ford/VW in the Setúbal Peninsula (Portugal), as well as three "brownfield" plants: Ford Halewood and GM Vauxhall Ellesmere Port in the North-West region (UK) and Renault in Setúbal (Portugal). The first part starts with a discussion of industrial policy in the automobile sector, the role of "greenfield" development strategies and the "demonstration effect" on "brownfield" plants. Then, the limits of new inward investment are pointed out, basically their problems and restrictions. Afterwards, the structural barriers to the "demonstration effect" within "brownfield" plants are outlined and some possabilities for alternative "brownfield" development strategies are presented.

Equine uveitis in the UK: a retrospective study (2008–2018)

2019 ◽  
Vol 186 (3) ◽  
pp. 92-92
Author(s):  
Fernando Malalana ◽  
Jo L Ireland ◽  
Gina Pinchbeck ◽  
Cathy M McGowan
Keyword(s):  
Retrospective Study ◽  
General Hospital ◽  
Medical Records ◽  
Referral Hospital ◽  
North West ◽  
The North ◽  
The World ◽  
Recurrent Case ◽  
Hospital Population ◽  
The Uk

BackgroundUveitis appears to be less prevalent in the UK compared with other parts of the world and studies characterising the disease in the UK are lacking. The objectives of this retrospective study were to describe acute and recurrent cases presenting for management of uveitis in a referral hospital on the North West of England and compare the signalment of horses presenting with uveitis with the equine hospital population during the same period.MethodsMedical records of horses presented to the referral Equine Hospital, University of Liverpool with signs of uveitis between 2008 and 2018 were reviewed and clinical details extracted.ResultsSeventy horses presented with uveitis; 33 were classified as acute and 37 as recurrent cases. Sixteen of the horses were affected bilaterally. More bilateral cases were classified as recurrent than acute (P=0.04). No differences in age or sex were noted between acute and recurrent cases, or between cases and the general hospital population. Warmbloods and Appaloosas were over-represented when compared with the general hospital population (P<0.001). Twenty-one horses (30 per cent, 95 per cent CI 20.5 to 41.4) underwent surgery for the control of the uveitis. Fourteen of the 70 horses (20.0 per cent, 95 per cent CI 12.3 to 30.8) underwent enucleation.ConclusionWhile relatively uncommon in the UK, uveitis can affect horses from a relatively young age. The disease appears to have a relatively higher frequency than expected in Warmbloods and Appaloosas. It is more likely that a recurrent case will have both eyes affected.

scholarly journals Building partnerships

2017 ◽  
Vol 1 (1) ◽  
pp. 1-8
Author(s):  
Richard Byrne
Keyword(s):  
Water Quality ◽  
Landscape Conservation ◽  
Sustainable Change ◽  
North West ◽  
The North ◽  
Quality Issue ◽  
The United Kingdom ◽  
Peat Deposits ◽  
The Uk ◽  
Water Quality Issue

Water is generally plentiful in the United Kingdom; however, there is an emerging water quality issue driven by agricultural intensification. Poor land management over generations has contributed to the degradation of upland peat deposits leading to discolouration of potable water and the loss of valuable habitats. Employing agri-environmental schemes operated by the UK Government and private Capital One water company in the North West of England is achieving water quality gains as well as landscape, conservation and habitat benefit at the same time as supporting tenant farm incomes. We describe the pressures on the uplands and how innovative partnerships are achieving sustainable change.

scholarly journals Words Don't Come Easy: How Male Prisoners' Difficulties Identifying and Discussing Feelings Relate to Suicide and Violence

2020 ◽  
Vol 11 ◽  
Author(s):  
Laura Hemming ◽  
Peer Bhatti ◽  
Jennifer Shaw ◽  
Gillian Haddock ◽  
Daniel Pratt
Keyword(s):  
Lived Experience ◽  
Harm Minimization ◽  
Open Communication ◽  
Cultural Shift ◽  
North West ◽  
The Past ◽  
The North ◽  
External Pressures ◽  
The Uk ◽  
Male Prisoners

Suicide and violence are prevalent within male prisons in the UK. It has been suggested that alexithymia may be associated with both suicide and violence. Alexithymia can be defined as an inability to identify or discuss emotions. The present study aimed to qualitatively explore male prisoners' experiences of alexithymia and how these experiences may relate to suicide and violence. Fifteen male prisoners were recruited from two prisons in the North West of England. All participants had experienced suicidal and/or violent thoughts and/or behaviors in the past 3 months, and all screened positive on an established measure of alexithymia. Participants took part in a qualitative interview during which they were also given the opportunity to provide drawings of their emotions. Data were transcribed and analyzed using thematic analysis, with a collaborative approach taken between researchers and an individual with lived experience of residing in prison. The results indicated that male prisoners tended not to talk about their emotions with others, due to external pressures of residing in prison in addition to internal difficulties with recognizing and articulating emotions. Not discussing emotions with others was associated with a build-up of emotions which could result in either an emotional overload or an absence of emotions. Both experiences were perceived to be associated with hurting self or others, however, participants also identified a “safety valve” where it was acknowledged that using more adaptive approaches to releasing emotions could prevent harm to self and others. These findings suggest three main clinical implications; (1) a cultural shift in male prisons is needed which encourages open communication of emotions (2) individualized support is needed for those identified as experiencing a difficulty in recognizing and articulating emotions and (3) prison staff should encourage alternative ways of releasing emotions such as by using harm minimization or distraction techniques.

Mechanisms for nitrogen supply to the Australian North West Shelf

1985 ◽  
Vol 36 (6) ◽  
pp. 753 ◽  
Author(s):  
PE Holloway ◽  
SE Humphries ◽  
M Atkinson ◽  
J Imberger
Keyword(s):  
River Flow ◽  
Tidal Flow ◽  
Vertical Mixing ◽  
Low Frequency ◽  
Transport Processes ◽  
Physical Processes ◽  
Mixing Processes ◽  
North West ◽  
Tidal Motion ◽  
The North

An upper bound for the rate of supply of new nitrate required to maintain the observed primary production on the North West Shelf is estimated to be 0.1 g N m-2 day -1. Nitrate concentrations over the shelf and slope regions are high ( > 100 mg N m-3, in water deeper than - 100 m and usually low (~10 mg N m-3), on the shelf. River flow is weak and carries little nutrient into the shelf waters and so it remains for ocean physical processes to advect and mix the nutrient-rich deep waters onto the shallower shelf regions to meet the nutrient demand. Several mechanisms are reviewed to determine their potential in carrying out the required transport processes. Estimates of the advection of nitrate onto the shelf show that both semi-diurnal tidal flow and low-frequency (periods > 35 h) upwelling events can each contribute approximately half the required demand, providing there is rapid use of nutrients. The upwelling events occur in summer and are associated with reversals of the south-west-flowing Leeuwin Current. Tropical cyclones are also shown to be capable of meeting a small, but significant, portion of the demand through enrichment of the surface layers in the offshelf waters by upwelling and vertical mixing. The enriched water can then be advected onto the shelf. Both tidal and internal tidal motion have the potential to transport nitrate onto the shelf from deeper water through vertical and horizontal mixing processes. However, these processes are difficult to quantify accurately. It is concluded that nitrogen is supplied to this shelf ecosystem by physical processes that are regular throughout the year, as opposed to large sporadic events that occur only once or twice a year.

scholarly journals What do consultants think about the development of specialist mental health teams?

2004 ◽  
Vol 28 (3) ◽  
pp. 83-86 ◽  
Author(s):  
Judy Harrison ◽  
Barry Traill
Keyword(s):  
Early Onset ◽  
Hospital Admissions ◽  
Postal Survey ◽  
Crisis Resolution ◽  
Assertive Outreach ◽  
North West ◽  
The North ◽  
Early Onset Psychosis ◽  
The Uk ◽  
Early Intervention In Psychosis

Aims and MethodThe UK Government is promoting three types of specialist team in psychiatry: assertive outreach, crisis resolution and early intervention in psychosis. Policy guidance suggests that psychiatrists be recruited to work exclusively within these teams, but little is known about the views of psychiatrists regarding their development. A postal survey was undertaken to seek the views of consultant psychiatrists in the North West.ResultsSeventy per cent of psychiatrists responded to the questionnaire. Equal numbers agreed and disagreed with the development of specialist roles. Few services had been able to recruit to extra consultant sessions within the new teams and only a third of consultants believed the resources so far available to be reasonable. Overall views of the new teams were positive (mean scores 6.36, 6.51 and 6.03 on a 1–10 visual analogue scale for assertive outreach, crisis resolution and early onset psychosis teams). Consultants are particularly likely to believe that the new teams will increase patient satisfaction and provide a welcome change in role for some psychiatrists. A total of 64% of consultants believe that crisis resolution services could reduce hospital admissions, compared with 41% for assertive outreach and 31% for early onset psychosis teams. The concern most often voiced was that new services are being developed at the expense of existing teams.Clinical ImplicationsConsultants perceive benefits associated with the new teams but are concerned about their impact on the rest of the organisation. If resource and recruitment issues can be addressed, consultants could prove to be supportive of these new models of service.

scholarly journals “How can you be allergic to peas?” – A qualitative study to explore food handler’s knowledge, attitudes and understanding of food allergens

2019 ◽  
Vol 13 (1) ◽  
pp. 12-24
Author(s):  
David Allen ◽  
Graeme Mitchell ◽  
Michael Pascucilla
Keyword(s):  
Learning Styles ◽  
Significant Risk ◽  
Food Allergies ◽  
Food Allergens ◽  
The European Union ◽  
Structured Interviews ◽  
North West ◽  
The North ◽  
Training Programmes ◽  
The Uk

AbstractIt is clear that there is an increasing proportion of the United Kingdom (UK) population who are suffering with food allergies and this combined with an increase in the frequency of eating away from home (where there is less control over the content of food) poses a significant risk. In December 2014, the European Union (EU) introduced legislation which aimed to ensure that customers with food allergens could make informed choices and safely consume food, without the risk of a potentially life-threatening reaction. The research used semi-structured interviews with staff from a BCB, located in the North West of the UK, as the aim of the research was to explore food handlers’ knowledge, attitudes and understanding of food allergens. The findings of the semi-structured interviews identified five themes: E-learning training programmes: the staff felt that these were ineffective and did not take into account individual learning styles. Responsibility: there is a lack of clarity as to who is responsible, with staff believing the key responsibility lies with the customer. Communication: similarly, communication, both within the kitchen and within the company was not clear and likely to give rise to confusion. Need to make a profit: the staff felt that the drive for profit meant that customer safety was being compromised, especially when staff numbers were reduced. Staff awareness: the staff felt confident in their own ability to prepare a safe meal but indicated that staff may be dismissive towards claims of allergen sufferers. In conclusion, these themes illustrate that a significant risk exists for allergen suffers, who rely upon the knowledge, attitudes and understanding of BCB staff to ensure their meals are safely prepared.

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