The effects of sediment loading on morphology and flood risk in a lowland river system

Diffuse sources of sediment may have important implications for flood risk management (FRM), especially as catchment sediment yields are predicted to increase in future. UK legislation requires FRM to work with natural processes wherever possible, including accounting for sediments. However, the importance of wash-material load to FRM has been under researched and both a robust evidence-base and practical sediment models are needed to identify, prioritise and justify sediment-related catchment management. Research addressing these issues was centred on the River Tone, a sub-catchment of the Parrett, in which features excessive inputs of sediment in its upper catchment combined with high potential for deposition in its lower reaches. Links between sediment sources, water and sediment runoff, and downstream sediment sinks were established and the research examined the role played by sediment, especially wash-material load, within the fluvial system. The greatest sediment-related threats to the functioning of this lowland river stem from either: a protracted, major reduction in wash-material load; or a significant increase in bed-material load. Imbalance in the Tone fluvial-sediment system may not significantly affect flood risk directly, but has implications for FRM operations, maintenance and monitoring. Impacts on land quality result from soil loss. For example, ~2.5 million tonnes of soil has been eroded from the Parrett catchment since WWII. Water quality issues include delivery of phosphate and other pollutants into the river, and potentially more frequent dredging that remobilises contaminants. The thesis defines the key sediment-related components of sustainable, integrated catchment management and provides an improved evidence-base upon which to engage stakeholders. It tests and benchmarks sediment assessment tools including the Sediment Impact Assessment Model (SIAM). An approach to catchment-scale sediment assessment for lowland rivers is recommended, which involves a nested-approach using routinely collected and project-specific field data, stream power screening and SIAM

The effects of sediment loading on morphology and flood risk in a lowland river system

Diffuse sources of sediment may have important implications for flood risk management (FRM), especially as catchment sediment yields are predicted to increase in future. UK legislation requires FRM to work with natural processes wherever possible, including accounting for sediments. However, the importance of wash-material load to FRM has been under researched and both a robust evidence-base and practical sediment models are needed to identify, prioritise and justify sediment-related catchment management. Research addressing these issues was centred on the River Tone, a sub-catchment of the Parrett, in which features excessive inputs of sediment in its upper catchment combined with high potential for deposition in its lower reaches. Links between sediment sources, water and sediment runoff, and downstream sediment sinks were established and the research examined the role played by sediment, especially wash-material load, within the fluvial system. The greatest sediment-related threats to the functioning of this lowland river stem from either: a protracted, major reduction in wash-material load; or a significant increase in bed-material load. Imbalance in the Tone fluvial-sediment system may not significantly affect flood risk directly, but has implications for FRM operations, maintenance and monitoring. Impacts on land quality result from soil loss. For example, ~2.5 million tonnes of soil has been eroded from the Parrett catchment since WWII. Water quality issues include delivery of phosphate and other pollutants into the river, and potentially more frequent dredging that remobilises contaminants. The thesis defines the key sediment-related components of sustainable, integrated catchment management and provides an improved evidence-base upon which to engage stakeholders. It tests and benchmarks sediment assessment tools including the Sediment Impact Assessment Model (SIAM). An approach to catchment-scale sediment assessment for lowland rivers is recommended, which involves a nested-approach using routinely collected and project-specific field data, stream power screening and SIAM

Filling in the gaps: estimating numbers of chlamydia tests and diagnoses by age group and sex before and during the implementation of the English National Screening Programme, 2000 to 2012.

To inform mathematical modelling of the impact of chlamydia screening in England since 2000, a complete picture of chlamydia testing is needed. Monitoring and surveillance systems evolved between 2000 and 2012. Since 2012, data on publicly funded chlamydia tests and diagnoses have been collected nationally. However, gaps exist for earlier years. We collated available data on chlamydia testing and diagnosis rates among 15-44-year-olds by sex and age group for 2000-2012. Where data were unavailable, we applied data- and evidence-based assumptions to construct plausible minimum and maximum estimates and set bounds on uncertainty. There was a large range between estimates in years when datasets were less comprehensive (2000-2008); smaller ranges were seen hereafter. In 15-19-year-old women in 2000, the estimated diagnosis rate ranged between 891 and 2,489 diagnoses per 100,000 persons. Testing and diagnosis rates increased between 2000 and 2012 in women and men across all age groups using minimum or maximum estimates, with greatest increases seen among 15-24-year-olds. Our dataset can be used to parameterise and validate mathematical models and serve as a reference dataset to which trends in chlamydia-related complications can be compared. Our analysis highlights the complexities of combining monitoring and surveillance datasets

The effects of sediment loading on morphology and flood risk in a lowland river system

Diffuse sources of sediment may have important implications for flood risk management (FRM), especially as catchment sediment yields are predicted to increase in future. UK legislation requires FRM to work with natural processes wherever possible, including accounting for sediments. However, the importance of wash-material load to FRM has been under researched and both a robust evidence-base and practical sediment models are needed to identify, prioritise and justify sediment-related catchment management. Research addressing these issues was centred on the River Tone, a sub-catchment of the Parrett, in which features excessive inputs of sediment in its upper catchment combined with high potential for deposition in its lower reaches. Links between sediment sources, water and sediment runoff, and downstream sediment sinks were established and the research examined the role played by sediment, especially wash-material load, within the fluvial system. The greatest sediment-related threats to the functioning of this lowland river stem from either: a protracted, major reduction in wash-material load; or a significant increase in bed-material load. Imbalance in the Tone fluvial-sediment system may not significantly affect flood risk directly, but has implications for FRM operations, maintenance and monitoring. Impacts on land quality result from soil loss. For example, ~2.5 million tonnes of soil has been eroded from the Parrett catchment since WWII. Water quality issues include delivery of phosphate and other pollutants into the river, and potentially more frequent dredging that remobilises contaminants. The thesis defines the key sediment-related components of sustainable, integrated catchment management and provides an improved evidence-base upon which to engage stakeholders. It tests and benchmarks sediment assessment tools including the Sediment Impact Assessment Model (SIAM). An approach to catchment-scale sediment assessment for lowland rivers is recommended, which involves a nested-approach using routinely collected and project-specific field data, stream power screening and SIAM.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Ketamine in the Prehospital Environment: A National Survey of Paramedics in the United States.

AbstractBackgroundUse of ketamine in the prehospital setting may be advantageous due to its potent analgesic and sedative properties and favorable risk profile. Use in the military setting has demonstrated both efficacy and safety for pain relief. The purpose of this study was to assess ketamine training, use, and perceptions in the civilian setting among nationally certified paramedics (NRPs) in the United States.MethodsA cross-sectional survey of NRPs was performed. The electronic questionnaire assessed paramedic training, authorization, use, and perceptions of ketamine. Included in the analysis were completed surveys of paramedics who held one or more state paramedic credentials, indicated “patient care provider” as their primary role, and worked in non-military settings. Descriptive statistics were calculated.ResultsA total of 14,739 responses were obtained (response rate=23%), of which 10,737 (73%) met inclusion criteria and constituted the study cohort. Over one-half (53%) of paramedics reported learning about ketamine during their initial paramedic training. Meanwhile, 42% reported seeking ketamine-related education on their own. Of all respondents, only 33% (3,421/10,737) were authorized by protocol to use ketamine. Most commonly authorized uses included pain management (55%), rapid sequence intubation (RSI; 72%), and chemical restraint/sedation (72%). One-third of authorized providers (1,107/3,350) had never administered ketamine, with another 32% (1,070/3,350) having administered ketamine less than five times in their career. Ketamine was perceived to be safe and effective as the vast majority reported that they were comfortable with the use of ketamine (94%) and would, in similar situations (95%), use it again.ConclusionThis was the first large, national survey to assess ketamine training, use, and perceptions among paramedics in the civilian prehospital setting. While training related to ketamine use was commonly reported among paramedics, few were authorized to administer the drug by their agency’s protocols. Of those authorized to use ketamine, most paramedics had limited experience administering the drug. Future research is needed to determine why the prevalence of ketamine use is low and to assess the safety and efficacy of ketamine use in the prehospital setting.BucklandDM, CroweRP, CashRE, GondekS, MalusoP, SirajuddinS, SmithER, DangerfieldP, ShapiroG, WankaC, PanchalAR, SaraniB. Ketamine in the prehospital environment: a national survey of paramedics in the United States. Prehosp Disaster Med. 2018;33(1):23–28.</jats:sec