Merredin townsite groundwater pumping and desalination pilot project

Townsite salinity affects more than 40 towns in the WA wheatbelt. Waterlogging and salinity are responsible for damamge to townsite infrastructure. Through groundwater pumping and desalination, the State Salinity Council (now the Natural Resource Management Council) granted Merredin the the chance to prevent further damage to the townsite by funding this project

Managing to learn - learning to change : reflection and refraction in action.

This qualitative practitioner research is set in a mixed, rural 11-16 Church of England Comprehensive School. It embraces reflective action enquiry into leadership and management of innovation in a turbulent period of national educational change. It is founded on the belief that if change processes are to be understood widely, practitioners must share experience emanating from reflective and analytical practice. This study is about "managing to learn" It embraces concepts of managing personal learning; managing colleagues' and students' learning; and managing processes leading to the emergence of the school as a "learning organisation" It is also about "learning to change" and espouses learning to promote personal change; learning to facilitate change in others; and learning to establish institutional change as a natural on-going characteristic of organisational life. This study is founded on a process of "reflection", as characterised by Schön (1983). Consequently, it employs a process of personal reflection on leadership roles in managing change and learning processes. It employs processes of reflection on cultural and political aspects of organisational life and resultant manifestations and implications of introducing, implementing, and institutionalising organisational and cultural change. This research utilises "refraction"- that is, convergence and divergence. Firstly, it promotes divergent and creative ways of organising which encourage and facilitate innovative processes. Secondly, it employs processes of converging, focusing, and concentrating on taken-for-granted "critical incidents" in the life of a developing school, to elicit meanings of events as understood by participants. Thirdly, it applies cultural and political prisms to school organisation, together with autocratic, bureaucratic, adhocratic, and reticular-democratic lenses in order to elucidate important cultural, political and organisational data. Finally this research is about "action" It is about doing, intervening, intending, committing, motivating, accomplishing, fulfilling and achieving. The essential concept and understanding of ""action" is that it should be informed action

Evidence and Ideology in Macroeconomics: The Case of Investment Cycles

The paper reports the principal findings of a long term research project on the description and explanation of business cycles. The research strongly confirmed the older view that business cycles have large systematic components that take the form of investment cycles. These quasi-periodic movements can be represented as low order, stochastic, dynamic processes with complex eigenvalues. Specifically, there is a fixed investment cycle of about 8 years and an inventory cycle of about 4 years. Maximum entropy spectral analysis was employed for the description of the cycles and continuous time econometrics for the explanatory models. The central explanatory mechanism is the second order accelerator, which incorporates adjustment costs both in relation to the capital stock and the rate of investment. By means of parametric resonance it was possible to show, both theoretically and empirically how cycles aggregate from the micro to the macro level. The same mathematical tool was also used to explain the international convergence of cycles. I argue that the theory of investment cycles was abandoned for ideological, not for evidential reasons. Methodological issues are also discussed

Response of a peat bog vegetation community to long-term experimental addition of nitrogen

1. We report results from a long‐term experiment in which additional nitrogen has been deposited on a peat bog in central Scotland for over 14 years, in three different forms: as ammonia (NH3) gas, as ammonium (NH4+) solution, or as nitrate (NO3-) solution. The automated experiment was designed to apply nitrogen in such a way that mimics real‐world nitrogen deposition. Background nitrogen deposition at the site was 0.8 g N m−2 year−1). 2. Observations of cover for 46 species were made. We analysed the change in six common species in relation to nitrogen dose and form. The responses differed among species and nitrogen forms, but five out of the six species declined, and NH3 produced the biggest change in cover per unit of nitrogen addition. The exception was the graminoid sedge Eriophorum vaginatum, which increased dramatically in the NH3 treatment. Multivariate analyses identified responses to nitrogen dose across treatments which were consistent with the univariate results. 3. We surmised that the larger experimental response to nitrogen observed in the NH3 treatment (cf. the NH4+ and NO3- treatments) was because of the higher nitrogen concentrations at the vegetation surface produced by dry deposition. NH4+ and NO3- were sprayed in solution, but much of this will enter the peat porewater, and be further diluted. Because NH3 deposits directly to the leaf, it stays contained within the small volume of water on and in the leaf, producing a high internal concentration of nitrogen ions. 4. Synthesis: Consistent trends with nitrogen were discernible across species. All species showed a decline with NH3 treatment, except for Eriophorum vaginatum which increased. In the absence of phosphorous and potassium (PK), all species declined with NH4+ and NO3-, except for Calluna vulgaris and Hypnum jutlandicum. The effect of PK was not consistent across species. Per unit of nitrogen deposited, NH3 generally had a larger impact on vegetation composition than NH4+ or NO3-. However, the actual deposition rate of NH3 on UK peat bogs is lower than the other forms. In the case of the most common species of the peat‐forming genus Sphagnum, we estimate that NH4+ deposition has the largest impact, followed by NO3- and NH3

Lamotrigine for people with borderline personality disorder: a RCT

Background: No drug treatments are currently licensed for the treatment of borderline personality disorder (BPD). Despite this, people with this condition are frequently prescribed psychotropic medications and often with considerable polypharmacy. Preliminary studies have indicated that mood stabilisers may be of benefit to people with BPD. Objective: To examine the clinical effectiveness and cost-effectiveness of lamotrigine for people with BPD. Design: A two-arm, double-blind, placebo-controlled individually randomised trial of lamotrigine versus placebo. Participants were randomised via an independent and remote web-based service using permuted blocks and stratified by study centre, the severity of personality disorder and the extent of hypomanic symptoms. Setting: Secondary care NHS mental health services in six centres in England. Participants: Potential participants had to be aged ≥ 18 years, meet diagnostic criteria for BPD and provide written informed consent. We excluded people with coexisting psychosis or bipolar affective disorder, those already taking a mood stabiliser, those who spoke insufficient English to complete the baseline assessment and women who were pregnant or contemplating becoming pregnant. Interventions: Up to 200 mg of lamotrigine per day or an inert placebo. Women taking combined oral contraceptives were prescribed up to 400 mg of trial medication per day. Main outcome measures: Outcomes were assessed at 12, 24 and 52 weeks after randomisation. The primary outcome was the total score on the Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD) at 52 weeks. The secondary outcomes were depressive symptoms, deliberate self-harm, social functioning, health-related quality of life, resource use and costs, side effects of treatment and adverse events. Higher scores on all measures indicate poorer outcomes. Results: Between July 2013 and October 2015 we randomised 276 participants, of whom 195 (70.6%) were followed up 52 weeks later. At 52 weeks, 49 (36%) of those participants prescribed lamotrigine and 58 (42%) of those prescribed placebo were taking it. At 52 weeks, the mean total ZAN-BPD score was 11.3 [standard deviation (SD) 6.6] among those participants randomised to lamotrigine and 11.5 (SD 7.7) among those participants randomised to placebo (adjusted mean difference 0.1, 95% CI –1.8 to 2.0; p = 0.91). No statistically significant differences in secondary outcomes were seen at any time. Adjusted costs of direct care for those prescribed lamotrigine were similar to those prescribed placebo. Limitations: Levels of adherence in this pragmatic trial were low, but greater adherence was not associated with better mental health. Conclusions: The addition of lamotrigine to the usual care of people with BPD was not found to be clinically effective or provide a cost-effective use of resources. Future work: Future research into the treatment of BPD should focus on improving the evidence base for the clinical effectiveness and cost-effectiveness of non-pharmacological treatments to help policy-makers make better decisions about investing in specialist treatment services

UK-SCAPE flux tower network: monitoring terrestrial greenhouse gas, water and energy balance

To predict, assess and mitigate the impacts of anthropogenic climate change, it is essential to (i) understand the drivers and dynamics of terrestrial carbon sequestration, greenhouse gas (GHG) emission and energy balance at site scale; and (ii) to deploy standardised observation networks to quantify flux variability in space and time. Under UK-SCAPE, CEH continuously monitors long-term GHG, water and energy balance across a network of eddy covariance (EC) sites using harmonised protocols, data processing and quality assurance

Increased variability in Greenland Ice Sheet runoff from satellite observations

Runoff from the Greenland Ice Sheet has increased over recent decades affecting global sea level, regional ocean circulation, and coastal marine ecosystems, and it now accounts for most of the contemporary mass imbalance. Estimates of runoff are typically derived from regional climate models because satellite records have been limited to assessments of melting extent. Here, we use CryoSat-2 satellite altimetry to produce direct measurements of Greenland’s runoff variability, based on seasonal changes in the ice sheet’s surface elevation. Between 2011 and 2020, Greenland’s ablation zone thinned on average by 1.4 ± 0.4 m each summer and thickened by 0.9 ± 0.4 m each winter. By adjusting for the steady-state divergence of ice, we estimate that runoff was 357 ± 58 Gt/yr on average – in close agreement with regional climate model simulations (root mean square difference of 47 to 60 Gt/yr). As well as being 21 % higher between 2011 and 2020 than over the preceding three decades, runoff is now also 60 % more variable from year-to-year as a consequence of large-scale fluctuations in atmospheric circulation. Because this variability is not captured in global climate model simulations, our satellite record of runoff should help to refine them and improve confidence in their projections

A high resolution record of Greenland mass balance

We map recent Greenland Ice Sheet elevation change at high spatial (5-km) and temporal (monthly) resolution using CryoSat-2 altimetry. After correcting for the impact of changing snowpack properties associated with unprecedented surface melting in 2012, we find good agreement (3 cm/yr bias) with airborne measurements. With the aid of regional climate and firn modelling, we compute high spatial and temporal resolution records of Greenland mass evolution, which correlate (R=0.96) with monthly satellite gravimetry, and reveal glacier dynamic imbalance. During 2011-2014, Greenland mass loss averaged 269±51 Gt/yr. Atmospherically-driven losses were widespread, with surface melt variability driving large fluctuations in the annual mass deficit. Terminus regions of five dynamically-thinning glaciers, which constitute less than 1% of Greenland's area, contributed more than 12% of the net ice loss. This high-resolution record demonstrates that mass deficits extending over small spatial and temporal scales have made a relatively large contribution to recent ice sheet imbalance

The clinical effectiveness and cost effectiveness of lamotrigine for people with borderline personality disorder: a randomized, placebo-controlled trial

Objectives: To examine whether lamotrigine is a clinically effective and cost-effective treatment for people with borderline personality disorder. Method: Multicentre, double-blind, placebo-controlled randomized trial. Between July 2013 to November 2016, we recruited 276 people aged 18 or over, who met diagnostic criteria for borderline personality disorder. We excluded those with co-existing bipolar affective disorder or psychosis, those already taking a mood stabiliser, and women at risk of pregnancy. We randomly allocated participants on a 1:1 ratio to up to 400mg of lamotrigine per day or an inert placebo using a remote web-based randomization service. The primary outcome was total score on the Zanarini Rating scale for Borderline Personality Disorder (ZAN-BPD) at 52 weeks. Secondary outcomes included depressive symptoms, deliberate self-harm, social functioning, health-related quality of life, resource use and costs, side effects of treatment and adverse events. Results: 195 (70.6%) participants were followed up at 52 weeks, at which point 49 (36%) of those prescribed lamotrigine and 58 (42%) of those prescribed placebo were taking it. Mean total ZAN-BPD score was 11.3 (SD = 6.6) among those randomized to lamotrigine and 11.5 (SD = 7.7) among those randomized to placebo (adjusted difference in means = 0.1, 95% C.I = -1.8 to 2.0, p=0.91). There was no evidence of any differences in secondary outcomes. Costs of direct care for those prescribed lamotrigine were similar to those prescribed placebo. Conclusions: Treating people with borderline personality disorder with lamotrigine is not a clinically effective or cost-effective use of resources

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely