A review of the factors involved in older people's decision making with regard to influenza vaccination: a literature review

Aims and objectives. The aim of this paper was to develop an understanding of the factors involved in older people's decision making with regard to influenza vaccination to inform strategies to improve vaccine uptake and reduce morbidity and mortality. Background. Influenza is a major cause of morbidity and mortality world-wide. In the UK, it accounts for 3000–6000 deaths annually; 85% of these deaths are people aged 65 and over. Despite this, and the widespread and costly annual government campaigns, some older people at risk of influenza and the associated complications remain reluctant to take advantage of the offer of vaccination. Methods. A review of the English language literature referring to older people published between 1996 and 2005 was the method used. Inclusion and exclusion criteria were identified and applied. Results. The majority of the literature was quantitative in nature, investigating personal characteristics thought to be predictors of uptake, such as age, sex, co-morbidity, educational level, income and area of residence. However, there was little discussion of the possible reasons for the significance of these factors and conflict between findings was often evident, particularly between studies employing different methodologies. Other factors identified were prior experience, concerns about the vaccine, perceived risk and advice and information. Relevance to clinical practice. The wealth of demographic information available will be useful at a strategic level in targeting groups identified as being unlikely to accept vaccination. However, the promotion of person-centred ways of working that value the health beliefs, attitudes, perceptions and subjective experiences of older people is likely to be more successful during individual encounters designed to promote acceptance. Without more research in investigating these concepts, our understanding is inevitably limited

Proglacial Lakes Control Glacier Geometry and Behavior During Recession

Ice‐contact proglacial lakes are generally absent from numerical model simulations of glacier evolution, and their effects on ice dynamics and on rates of deglaciation remain poorly quantified. Using the BISICLES ice flow model, we analyzed the effects of an ice‐contact lake on the Pukaki Glacier, New Zealand, during recession from the Last Glacial Maximum. The ice‐contact lake produced a maximum effect on grounding line recession >4 times further and on ice velocities up to 8 times faster, compared to simulations of a land‐terminating glacier forced by the same climate. The lake contributed up to 82% of cumulative grounding line recession and 87% of ice velocity during the first 300 years of the simulations, but those values decreased to just 6% and 37%, respectively, after 5,000 years. Numerical models that ignore lake interactions will, therefore, misrepresent the rate of recession especially during the transition of a land‐terminating to a lake‐terminating environment

Uneven onset and pace of ice-dynamical imbalance in the Amundsen Sea Embayment, West Antarctica

We combine measurements acquired by five satellite altimeter missions to obtain an uninterrupted record of ice-sheet elevation change over the Amundsen Sea Embayment, West Antarctica, since 1992. Using these data, we examine the onset of surface lowering arising through ice-dynamical imbalance, and the pace at which it has propagated inland, by tracking elevation changes along glacier flowlines. Surface lowering has spread slowest (<6 km/yr) along the Pope, Smith, and Kohler (PSK) Glaciers, due to their small extent. Pine Island Glacier (PIG) is characterized by a continuous inland spreading of surface lowering, notably fast at rates of 13 to 15 km/yr along tributaries draining the southeastern lobe, possibly due to basal conditions or tributary geometry. Surface lowering on Thwaites Glacier (THG) has been episodic, and has spread inland fastest (10 to 12 km/yr) along its central flowlines. The current episodes of surface lowering started approximately 10 yr before the first measurements on PSK, around 1990 on PIG, and around 2000 on THG. Ice-dynamical imbalance across the sector has therefore been uneven during the satellite record

The effect of landfast sea ice buttressing on ice dynamic speedup in the Larsen B embayment, Antarctica

We observe the evacuation of 11-year-old landfast sea ice in the Larsen B embayment on the East Antarctic Peninsula in January 2022, which was in part triggered by warm atmospheric conditions and strong offshore winds. This evacuation of sea ice was closely followed by major changes in the calving behaviour and dynamics of a subset of the ocean-terminating glaciers in the region. We show using satellite measurements that, following a decade of gradual slow-down, Hektoria, Green, and Crane glaciers sped up by approximately 20%-50% between February and the end of 2022, each increasing in speed by more than 100ma-1. Circumstantially, this is attributable to their transition into tidewater glaciers following the loss of their ice shelves after the landfast sea ice evacuation. However, a question remains as to whether the landfast sea ice could have influenced the dynamics of these glaciers, or the stability of their ice shelves, through a buttressing effect akin to that of confined ice shelves on grounded ice streams. We show, with a series of diagnostic modelling experiments, that direct landfast sea ice buttressing had a negligible impact on the dynamics of the grounded ice streams. Furthermore, we suggest that the loss of landfast sea ice buttressing could have impacted the dynamics of the rheologically weak ice shelves, in turn diminishing their stability over time; however, the accompanying shifts in the distributions of resistive stress within the ice shelves would have been minor. This indicates that this loss of buttressing by landfast sea ice is likely to have been a secondary process in the ice shelf disaggregation compared to, for example, increased ocean swell or the drivers of the initial landfast sea ice disintegration

Generating synthetic fjord bathymetry for coastal Greenland

Bed topography is a critical boundary for the numerical modelling of ice sheets and ice-ocean interactions. A persistent issue with existing topography products for the bed of the Greenland Ice Sheet and surrounding sea floor is the poor representation of coastal bathymetry, especially in regions of floating ice and near the grounding line. Sparse data coverage, and the resultant coarse resolution at the ice-ocean boundary, poses issues in our ability to model ice flow advance and retreat from the present position. In addition, as fjord bathymetry is known to exert strong control on ocean circulation and ice-ocean forcing, the lack of bed data leads to an inability to model these processes adequately. Since the release of the last complete Greenland bed topography-bathymetry product, new observational bathymetry data have become available. These data can be used to constrain bathymetry, but many fjords remain completely unsampled and therefore poorly resolved. Here, as part of the development of the next generation of Greenland bed topography products, we present a new method for constraining the bathymetry of fjord systems in regions where data coverage is sparse. For these cases, we generate synthetic fjord geometries using a method conditioned by surveys of terrestrial glacial valleys as well as existing sinuous feature interpolation schemes. Our approach enables the capture of the general bathymetry profile of a fjord in north-west Greenland close to Cape York, when compared to observational data. We validate our synthetic approach by demonstrating reduced overestimation of depths compared to past attempts to constrain fjord bathymetry. We also present an analysis of the spectral characteristics of fjord centrelines using recently acquired bathymetric observations, demonstrating how a stochastic model of fjord bathymetry could be parameterised and used to create different realisations.This study was supported by UK NERC grant NE/M000869/1

IPCC reasons for concern regarding climate change risks

The reasons for concern framework communicates scientific understanding about risks in relation to varying levels of climate change. The framework, now a cornerstone of the IPCC assessments, aggregates global risks into five categories as a function of global mean temperature change. We review the framework's conceptual basis and the risk judgments made in the most recent IPCC report, confirming those judgments in most cases in the light of more recent literature and identifying their limitations. We point to extensions of the framework that offer complementary climate change metrics to global mean temperature change and better account for possible changes in social and ecological system vulnerability. Further research should systematically evaluate risks under alternative scenarios of future climatic and societal conditions

Mapping alterations to the endogenous elemental distribution within the lateral ventricles and choroid plexus in brain disorders using X-ray fluorescence imaging

The choroid plexus and cerebral ventricles are critical structures for the production of cerebral spinal fluid (CSF) and play an important role in regulating ion and metal transport in the brain, however many aspects of its roles in normal physiology and disease states, such as psychiatric illness, remain unknown. The choroid plexus is difficult to examine in vivo, and in situ ex vivo, and as such has typically been examined indirectly with radiolabeled tracers or ex vivo stains, making measurements of the endogenous K+, Cl-, and Ca+ distributions unreliable. In the present study, we directly examined the distribution of endogenous ions and biologically relevant transition metals in the choroid plexus and regions surrounding the ventricles (ventricle wall, cortex, corpus callosum, striatum) using X-ray fluorescence imaging (XFI). We find that the choroid plexus was rich in Cl- and Fe while K+ levels increase further from the ventricle as Cl- levels decrease, consistent with the known role of ion transporters in the choroid plexus CSF production. A polyI:C offspring displayed enlarged ventricles, elevated Cl- surrounding the ventricles, and intraventricular calcifications. These observations fit with clinical findings in patients with schizophrenia and suggest maternal treatment with polyI:C may lead to dysfunctional ion regulation in offspring. This study demonstrates the power of XFI for examining the endogenous elemental distributions of the ventricular system in healthy brain tissue as well as disease models

Recent progress in understanding and projecting regional and global mean sea-level change

Considerable progress has been made in understanding the present and future regional and global sea level in the 2 years since the publication of the Fifth Assessment Report (AR5) of the Intergovernmental Panel on Climate Change. Here, we evaluate how the new results affect the AR5’s assessment of (i) historical sea level rise, including attribution of that rise and implications for the sea level budget, (ii) projections of the components and of total global mean sea level (GMSL), and (iii) projections of regional variability and emergence of the anthropogenic signal. In each of these cases, new work largely provides additional evidence in support of the AR5 assessment, providing greater confidence in those findings. Recent analyses confirm the twentieth century sea level rise, with some analyses showing a slightly smaller rate before 1990 and some a slightly larger value than reported in the AR5. There is now more evidence of an acceleration in the rate of rise. Ongoing ocean heat uptake and associated thermal expansion have continued since 2000, and are consistent with ocean thermal expansion reported in the AR5. A significant amount of heat is being stored deeper in the water column, with a larger rate of heat uptake since 2000 compared to the previous decades and with the largest storage in the Southern Ocean. The first formal detection studies for ocean thermal expansion and glacier mass loss since the AR5 have confirmed the AR5 finding of a significant anthropogenic contribution to sea level rise over the last 50 years. New projections of glacier loss from two regions suggest smaller contributions to GMSL rise from these regions than in studies assessed by the AR5; additional regional studies are required to further assess whether there are broader implications of these results. Mass loss from the Greenland Ice Sheet, primarily as a result of increased surface melting, and from the Antarctic Ice Sheet, primarily as a result of increased ice discharge, has accelerated. The largest estimates of acceleration in mass loss from the two ice sheets for 2003–2013 equal or exceed the acceleration of GMSL rise calculated from the satellite altimeter sea level record over the longer period of 1993–2014. However, when increased mass gain in land water storage and parts of East Antarctica, and decreased mass loss from glaciers in Alaska and some other regions are taken into account, the net acceleration in the ocean mass gain is consistent with the satellite altimeter record. New studies suggest that a marine ice sheet instability (MISI) may have been initiated in parts of the West Antarctic Ice Sheet (WAIS), but that it will affect only a limited number of ice streams in the twenty-first century. New projections of mass loss from the Greenland and Antarctic Ice Sheets by 2100, including a contribution from parts of WAIS undergoing unstable retreat, suggest a contribution that falls largely within the likely range (i.e., two thirds probability) of the AR5. These new results increase confidence in the AR5 likely range, indicating that there is a greater probability that sea level rise by 2100 will lie in this range with a corresponding decrease in the likelihood of an additional contribution of several tens of centimeters above the likely range. In view of the comparatively limited state of knowledge and understanding of rapid ice sheet dynamics, we continue to think that it is not yet possible to make reliable quantitative estimates of future GMSL rise outside the likely range. Projections of twenty-first century GMSL rise published since the AR5 depend on results from expert elicitation, but we have low confidence in conclusions based on these approaches. New work on regional projections and emergence of the anthropogenic signal suggests that the two commonly predicted features of future regional sea level change (the increasing tilt across the Antarctic Circumpolar Current and the dipole in the North Atlantic) are related to regional changes in wind stress and surface heat flux. Moreover, it is expected that sea level change in response to anthropogenic forcing, particularly in regions of relatively low unforced variability such as the low-latitude Atlantic, will be detectable over most of the ocean by 2040. The east-west contrast of sea level trends in the Pacific observed since the early 1990s cannot be satisfactorily accounted for by climate models, nor yet definitively attributed either to unforced variability or forced climate change

Anxiety and Depression in Adults with Autism Spectrum Disorder: A Systematic Review and Meta-analysis

Adults with autism spectrum disorder (ASD) are thought to be at disproportionate risk of developing mental health comorbidities, with anxiety and depression being considered most prominent amongst these. Yet, no systematic review has been carried out to date to examine rates of both anxiety and depression focusing specifically on adults with ASD. This systematic review and meta-analysis examined the rates of anxiety and depression in adults with ASD and the impact of factors such as assessment methods and presence of comorbid intellectual disability (ID) diagnosis on estimated prevalence rates. Electronic database searches for studies published between January 2000 and September 2017 identified a total of 35 studies, including 30 studies measuring anxiety (n = 26 070; mean age = 30.9, s.d. = 6.2 years) and 29 studies measuring depression (n = 26 117; mean age = 31.1, s.d. = 6.8 years). The pooled estimation of current and lifetime prevalence for adults with ASD were 27% and 42% for any anxiety disorder, and 23% and 37% for depressive disorder. Further analyses revealed that the use of questionnaire measures and the presence of ID may significantly influence estimates of prevalence. The current literature suffers from a high degree of heterogeneity in study method and an overreliance on clinical samples. These results highlight the importance of community-based studies and the identification and inclusion of well-characterized samples to reduce heterogeneity and bias in estimates of prevalence for comorbidity in adults with ASD and other populations with complex psychiatric presentations