Reaction products of aquatic humic substances with chlorine.

A major concern of the chlorination of aquatic humic materials is the ubiquitous production of trihalomethanes. A large number of other chlorinated organic compounds, however, have been shown to be formed by chlorine's reaction with humic substances. In this study, humic material was concentrated from a coastal North Carolina lake and chlorinated at a chlorine to carbon mole ratio of 1.5 at pH 12. A high pH was necessary for complete dissolution of the humic material and for production of adequate quantities of oxidation and chlorination products for extraction, separation and mass spectrometric identification. After concentration in ether, samples were methylated, separated with a 50-m OV-17 glass capillary column or a 25 m SP-2100 fused-silica column and identified. A Hewlett-Packard 5710A gas chromatograph interfaced to a VG Micromass 7070F double-focusing mass spectrometer was used. Low resolution, accurate mass measurements were made with a combined EI-Cl source. The ability to do low resolution, accurate mass measurements made possible a rapid scan function necessary for capillary column gas chromatography. Accurate mass measurements allowed increased confidence in the identification of compounds, most of which are not available as standards. The products identified in these studies were chlorinated aliphatic straight-chain acids dominated by di- and trichloroacetic acid and the chlorinated dicarboxylic acids: succinic, fumaric and maleic acids. Chlorinated and unchlorinated aliphatic mono- and dicarboxylic acids and unchlorinated polycarboxylic aromatic acids comprise the remaining bulk of the compounds identified

Local winter deer density: Effects of forest structure and snow in a managed forest landscape

*Background/Questions/Methods*
White-tailed deer (_Odocoileus virginianus_) are a ‘keystone herbivore’ with the potential to cause tree regeneration failure and greatly affect vegetation dynamics, stand structure and ecological function of forests across eastern North America. In northern mixed conifer-hardwood forests, local winter-time deer populations are dependent on habitat characterized by patterns of forest cover that provide shelter from snow and cold temperatures (lowland conifer stands) in close proximity to winter food (deciduous hardwood stands). Stand structure may also influence winter spatial deer distribution. Consequently, modification of forest cover patterns and stand structure by timber harvesting will affect local spatial deer distributions, with potential ecological and economic consequences. Here, we ask if forest cover pattern and stand structure, and their interactions with snow depth, can explain winter deer density in the managed forests of the central Upper Peninsula of Michigan, USA. For each local winter deer density estimate (from fecal pellet counts) we calculate stand-level characteristics for surrounding ‘landscapes of influence’ of radius 200 m. For these data, and modeled snow depth estimates, we use multivariate techniques to produce predictive models and to identify the most important factors driving local deer densities across our 400,000 ha study area. 

*Results/Conclusions*
Distance to the nearest conifer stand consistently explains the most variance in univariate regression models. Deer densities are highest near lowland conifer stands in areas where mean hardwood tree diameter-at-breast-height is low. Multiple regression models including these factors explain 22% of variance in deer density and have up to a 65% chance of correctly ranking a site’s deer density (relative to other sites within our study area). We use model ensembles to produce maps of estimated deer density (and associated uncertainty) for a subset of our study area and show how managers might use these maps to aid co-management of deer and forest regeneration. Our results highlight the importance of local and regional factors (forest cover-type pattern, stand structure, climate) on winter white-tailed deer density in managed hardwood-conifer forests. Use of these results, and the simulation model being developed, will help identify management practices that can decrease deer impacts and ensure the ecological and economic sustainability of forests in which deer browse is proving problematic for tree regeneration.
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Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): Results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer.

Objectives: Transitioning into palliative care is psychologically demanding for people with advanced cancer, and there is a need for acceptable and effective interventions to support this. We aimed to develop and pilot test a brief Acceptance and Commitment Therapy (ACT) based intervention to improve quality of life and distress. Methods: Our mixed-method design included: (i) quantitative effectiveness testing using Single Case Experimental Design (SCED), (ii) qualitative interviews with participants, and (iii) focus groups with hospice staff. The five-session, in-person intervention was delivered to 10 participants; five completed at least 80%. Results: At baseline, participants reported poor quality of life but low distress. Most experienced substantial physical health deterioration during the study. SCED analysis methods did not show conclusively significant effects, but there was some indication that outcome improvement followed changes in expected intervention processes variables. Quantitative and qualitative data together demonstrates acceptability, perceived effectiveness and safety of the intervention. Qualitative interviews and focus groups were also used to gain feedback on intervention content and to make design recommendations to maximise success of later feasibility trials. Conclusions: This study adds to the growing evidence base for ACT in people with advanced cancer. A number of potential intervention mechanisms, for example a distress-buffering hypothesis, are raised by our data and these should be addressed in future research using randomised controlled trial designs. Our methodological recommendations—including recruiting non-cancer diagnoses, and earlier in the treatment trajectory—likely apply more broadly to the delivery of psychological intervention in the palliative care setting

A 6 year study of mammographic compression force : practitioner variability within and between screening sites

Background The application of compression force in mammography is more heavily influenced by the practitioner rather than the client. This can affect client experience, radiation dose and image quality. This research investigates practitioner compression force variation over a 6 year screening cycle in three different screening units. Methods: Recorded data included: practitioner code, applied compression force(N), breast thickness(mm), BI-RADS® density category. Exclusion criteria included: previous breast surgery, previous/ongoing assessment, breast implants. 975 clients (2925) client visits, 11,700 mammogram images) met inclusion criteria across three sites. Data analysis assessed practitioner variation of compression force and breast thickness. Results: Practitioners across three breast screening sites behave differently in the application of compression force. Two of the three sites demonstrate variability within themselves, though they demonstrated no significant difference in mean, first and third quartile compression force and breast thickness values CC(p>0.5), MLO(p>0.1) between themselves. However, the third site (where mandate dictates a minimum compression force is applied) greater consistency was demonstrated; a significant difference in mean, first and third quartile compression force and breast thickness values(p<0.001) was demonstrated between this site and the other two sites. Conclusion: Stabilisation of variations in compression force may have a positive impact on image quality, radiation dose reduction, re-attendance levels and potentially cancer detection. The large variation in compression forces could negatively impact on client experience between the units and within a unit. Further research is required to establish best practice guidelines for compression force within mammography. Keywords: Compression force, Breast compression, Compression variabilit

Extra patient movement during mammographic imaging : an experimental study

Objectives: To determine if movement external to the patient occurring during mammography may be a source of image blur. Methods: Four mammography machines with seven flexible and nine fixed paddles were evaluated. In the first stage, movement at the paddle was measured mechanically using two calibrated linear potentiometers. A deformable breast phantom was used to mimic a female breast. For each paddle, the movement in millimeters and change in compression force in Newton was recorded at 0.5 and 1 second intervals respectively for 40 seconds with the phantom in an initially compressed state under a load of 80N. In the second stage, clinical audit on 28 females was conducted on one mammography machine with the 18x24cm and 24x29cm flexible paddles. Results: Movement at the paddle followed an exponential decay with a settling period of approximately 40 seconds. The compression force readings for both fixed and flexible paddles decreased exponentially with time while fixed paddles have a larger drop in compression force than flexible paddles. There is a linear relationship between movement at the paddle and change in compression force. Conclusions: Movement measured at the paddle during an exposure can be represented by a second order system. The amount of extra-patient movement during the actual exposure can be estimated using the linear relationship between movement at the paddle and the change in compression force. Advances in knowledge: This research provides a possible explanation to mammography image blurring caused by extra patient movement and proposes a theoretical model to analyze the movement

How primary care can contribute to good mental health in adults.

The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers

The perception and management of risk in UK office property development

Risk is an ever-present aspect of business, and risk taking is necessary for profit and economic progress. Speculative property development is popularly perceived as a 'risky business' yet, like other entrepreneurs, developers have opportunities to manage the risks they face; techniques include phasing and joint ventures. The associated areas of investment portfolio risk, development risk analysis and construction risk management have all been addressed by research. This article presents new knowledge about how developers perceive risks and the means they subsequently adopt to manage them. The developers of office projects across the UK were sent questionnaires by post. Respondents were asked about their perceptions of risks at the first appraisal stage and currently and about the risk management techniques that they had adopted. In-depth interviews with a selection of respondents were then used to discuss and augment the findings. Developers were most concerned about market-based risks at both stages. Concern about production-orientated risks was lower and fell significantly between the two stages. A fixed price contract was the most common risk management technique. Risk management techniques were used more often outside London and the South East. Developer type affects both the perception and management of risk. While developers do manage risk, decisions are made on the basis of professional and business experience. These findings should help development companies manage risk in a more objective and analytical way

A History of Blackpool Illuminations

Cities of Light is the first global overview of modern urban illumination, a development that allows human wakefulness to colonize the night, doubling the hours available for purposeful and industrious activities. Urban lighting is undergoing a revolution due to recent developments in lighting technology, and increased focus on sustainability and human-scaled environments. Cities of Light is expansive in coverage, spanning two centuries and touching on developments on six continents, without diluting its central focus on architectural and urban lighting. Covering history, geography, theory, and speculation in urban lighting, readers will have numerous points of entry into the book, finding it easy to navigate for a quick reference and or a coherent narrative if read straight through. With chapters written by respected scholars and highly-regarded contemporary practitioners, this book will delight students and practitioners of architectural and urban history, area and cultural studies, and lighting design professionals and the institutional and municipal authorities they serve

Evaluating case studies of community-oriented integrated care.

This paper summarises a ten-year conversation within London Journal of Primary Care about the nature of community-oriented integrated care (COIC) and how to develop and evaluate it. COIC means integration of efforts for combined disease-treatment and health-enhancement at local, community level. COIC is similar to the World Health Organisation concept of a Community-Based Coordinating Hub - both require a local geographic area where different organisations align their activities for whole system integration and develop local communities for health. COIC is a necessary part of an integrated system for health and care because it enables multiple insights into 'wicked problems', and multiple services to integrate their activities for people with complex conditions, at the same time helping everyone to collaborate for the health of the local population. The conversation concludes seven aspects of COIC that warrant further attention