Climate change and farmers' mental health: Risks and responses

Climate change is exacerbating climate variability, evident in more frequent and severe weather-related disasters, such as droughts, fires, and floods. Most of what is known about the possible effects of climate change on rural mental health relates to prolonged drought. But though drought is known to be a disproportionate and general stressor, evidence is mixed and inconclusive. Over time, like drought other weather-related disasters may erode the social and economic bases on which farming communities depend. Rural vulnerability to mental health problems is greatly increased by socioeconomic disadvantage. Related factors may compound this, such as reduced access to health services as communities decline and a “stoical” culture that inhibits help-seeking. Australia has the world’s most variable climate and is a major global agricultural producer. Yet despite Australia’s (and, especially, rural communities’) dependence on farmers’ well-being and success, there is very little—and inconclusive—quantitative evidence about farmers’ mental health. The aim of this review is to consider, with a view to informing other countries, how climate change and related factors may affect farmers’ mental health in Australia. That information is a prerequisite to identifying, selecting, and evaluating adaptive strategies, to lessen the risks of adverse mental health outcomes. The authors identify the need for a systematic epidemiology of the mental health of farmers facing increasing climate change— related weather adversity. </jats:p

Experiments on steady state particle control in Tore Supra and DIII-D

Particle control is playing an increasingly important role in tokamak plasma performance. The present paper discusses particle control of hydrogen/deuterium by wall pumping on graphite or carbonized surfaces, as well as by external exhaust with pumped limiters and pumped divertors. Wall pumping is ultimately a transient effect and by itself not suitable for steady state particle exhaust. Therefore, external exhaust techniques with pumped divertors and limiters are being developed. How wall pumping phenomena interact and correlate with these inherently steady state, external exhaust techniques, is not well known to date. In the present paper, the processes involved in wall pumping and in external pumping are investigated in an attempt to evaluate the effect of external exhaust on wall pumping. Some of the key elements of this analysis are: (1) charge-exchange fluxes to the wall play a crucial role in the core-wall particle dynamics, (2) the recycling fluxes of thermal molecules have a high probability of ionization in the scrape-off layer, (3) thermal particles originating from the wall, which are ionized within the scrape-off layer, can be directly exhausted, thus providing a direct path between wall and exhaust which can be used to control the wall inventory. This way, the wall can be kept in a continuous pumping state in the sense that it continuously absorbs energetic particles and releases thermal molecules which are then removed by the external exhaust mechanism. While most of the ingredients of this analysis have been observed individually before, the present evaluation is an attempt to correlate effects of wall recycling and external exhaust

Designing an e-learning tool to support health practitioners caring for patients taking multiple medications

Background: Population ageing and improvements in healthcare mean the number of people living with two or more chronic conditions, or ‘multimorbidity’, is rapidly increasing. This presents a challenge to current disease-specific care delivery models. Adherence to prescribed medications appears particularly challenging for individuals living with multimorbidity, given the often-complex drug regimens required to treat multiple conditions. Poor adherence is associated with increased mortality, as well as wasted healthcare resources. Supporting medication adherence is a key priority for general practitioners (GPs) and practice nurses as they are responsible for much of the disease counselling and medication prescribing associated with chronic illnesses. Despite this, practical resources and training for health practitioners on how to promote adherence in practice is currently lacking. Informed by the principles of patient and public involvement (PPI), the aim of this research was to develop a patient informed e-learning resource to help GPs and nurses support medication adherence. Method: Utilising collective intelligence (CI) and scenario-based design (SBD) methodology, input was gathered from key stakeholders in medication adherence to gain insights into barriers to supporting people with multimorbidity who are receiving polypharmacy, strategies for overcoming these barriers, and user needs and requirements to inform the design of the e-learning tool. Results: In total, 67 barriers to supporting people who are taking multiple medications were identified across 8 barrier categories. 162 options for overcoming the identified barriers were then generated. This data was used in the design of a flexible e-learning tool for continuous professional development, that has been integrated into general practice and clinical education programmes as a supportive tool. Conclusions: Using CI and SBD methodology was an effective way of facilitating collaboration, idea-generation, and the co-creation of design solutions amongst a diverse group of stakeholders. This approach could be usefully applied to address other complex healthcare-related challenges

ROSAT PSPC observations of 36 high-luminosity clusters of galaxies: constraints on the gas fraction

We present a detailed and homogeneous analysis of the ROSAT PSPC surface brightness profiles of 36 clusters of galaxies with high X-ray luminosity (L_X > 10^{45} erg s^{-1}) and redshifts between 0.05 and 0.44. Using recent ASCA estimates of the temperature of the gas for most of the clusters in the sample, we apply both the deprojection technique and model fitting to the surface brightness profiles to constrain the gas and dark matter distributions under the assumption that the gas is both isothermal and hydrostatic. Applying robust estimators, we find that the gas fraction within r_{500} of the clusters in our sample has a distribution centred on f_gas(r_{500}) = 0.168 h_{50}^{-1.5}. The gas fraction ranges from 0.101 to 0.245 at the 95 per cent confidence level. The values of f_gas show highly significant variations between individual clusters, which may be explained if the dark matter has a significant baryonic component. Within a cluster, the average radial dependence of the gas mass fraction increases outward as r^s, with s~0.20. Combining these results with those of primordial nucleosynthesis calculations and the current estimate of H_0, the above central location implies \Omega_{0, m} < 0.56 at the 95 per cent confidence level. This upper limit decreases to 0.34 if we take the highest significant estimates for f_gas. A significant decrease in cluster gas fraction with redshift from the local value, f_{gas, 0}, of 0.21, found assuming \Omega_{0, m} =1, is also reduced if \Omega_{0, m} is low.Comment: 17 pages, 15 figures, MNRAS in press. Also available at http://xalph3.ast.cam.ac.uk/~settori/paper.htm

Occupational Silica Exposure and Chronic Kidney Disease

Occupational exposure to silica may be associated with chronic kidney disease (CKD). Most studies have been conducted in occupational cohorts with high levels of exposure but small numbers of cases. We analyzed data from a population-based case-control study of occupational silica exposure and CKD