A revised parameterization for gaseous dry deposition in air-quality models

International audienceA parameterization scheme for calculating gaseous dry deposition velocities in air-quality models is revised based on recent study results on non-stomatal uptake of O3 and SO2 over 5 different vegetation types. Non-stomatal resistance, which includes in-canopy aerodynamic resistance, soil resistance and cuticle resistance, for SO2 and O3 is parameterized as a function of friction velocity, relative humidity, leaf area index, and canopy wetness. Non-stomatal resistance for all other species is scaled to those of SO2 and O3 based on their chemical and physical characteristics. Stomatal resistance is calculated using a leaf-stomatal-resistance model for all gaseous species of interest. The improvements in the present model compared to its earlier version include a newly developed non-stomatal resistance formulation, a realistic treatment of cuticle and ground resistance in winter and the handling of seasonally-dependent input parameters. Model evaluation shows that the revised parameterization can provide more realistic deposition velocities for both O3 and SO2, especially for wet canopies. Example model output shows that the parameterization provides reasonable estimates of dry deposition velocities for different gaseous species, land types and diurnal and seasonal variations. Maximum deposition velocities from model output are close to reported measurement values for different land types. The current parameterization can be easily adopted into different air-quality models that require inclusion of dry deposition processes

Estimating the number needed to treat from continuous outcomes in randomised controlled trials: methodological challenges and worked example using data from the UK Back Pain Exercise and Manipulation (BEAM) trial

Background Reporting numbers needed to treat (NNT) improves interpretability of trial results. It is unusual that continuous outcomes are converted to numbers of individual responders to treatment (i.e., those who reach a particular threshold of change); and deteriorations prevented are only rarely considered. We consider how numbers needed to treat can be derived from continuous outcomes; illustrated with a worked example showing the methods and challenges. Methods We used data from the UK BEAM trial (n = 1, 334) of physical treatments for back pain; originally reported as showing, at best, small to moderate benefits. Participants were randomised to receive 'best care' in general practice, the comparator treatment, or one of three manual and/or exercise treatments: 'best care' plus manipulation, exercise, or manipulation followed by exercise. We used established consensus thresholds for improvement in Roland-Morris disability questionnaire scores at three and twelve months to derive NNTs for improvements and for benefits (improvements gained+deteriorations prevented). Results At three months, NNT estimates ranged from 5.1 (95% CI 3.4 to 10.7) to 9.0 (5.0 to 45.5) for exercise, 5.0 (3.4 to 9.8) to 5.4 (3.8 to 9.9) for manipulation, and 3.3 (2.5 to 4.9) to 4.8 (3.5 to 7.8) for manipulation followed by exercise. Corresponding between-group mean differences in the Roland-Morris disability questionnaire were 1.6 (0.8 to 2.3), 1.4 (0.6 to 2.1), and 1.9 (1.2 to 2.6) points. Conclusion In contrast to small mean differences originally reported, NNTs were small and could be attractive to clinicians, patients, and purchasers. NNTs can aid the interpretation of results of trials using continuous outcomes. Where possible, these should be reported alongside mean differences. Challenges remain in calculating NNTs for some continuous outcomes

Streamwise turbulence modulation in non-uniform open-channel clay suspension flows

Cohesive sediment particles are ubiquitous in environmental flows. The cohesive properties of clay promote the formation of clay flocs and gels and relatively small suspended clay concentrations can enhance or suppress turbulence in a flow. Furthermore, flows are naturally non-uniform, varying in space and time, yet the dynamics of non-uniform open-channel clay suspension flows is poorly understood. For the first time, the adaptation time and length scales of non-uniform clay suspension flows were quantified using novel experiments with spatially varying but temporally uniform flow. Different levels of turbulence enhancement and attenuation were identified as the flow decelerates or accelerates. Results highlight that decelerating clay suspension flows crucially have a longer adaptation time than accelerating clay suspension flows. This is explained by the longer timescale required for the formation of bonds between cohesive particles in turbulence attenuated flows after deceleration than the rapid breakdown of bonds in turbulent flows after acceleration of clay suspension flows. This hysteresis is more pronounced for higher concentration decelerating flows that pass through a larger variety of clay flow types of turbulence enhancement and attenuation. These different adaptation time scales and associated clay flow type transitions are likely to affect clay flow dynamics in a variety of fluvial and submarine settings

Vechten tegen verleiding

Onze omgeving maakt dik. Porties worden groter, eten is overal en beweging wordt ontmoedigd. Emely de Vet, universitair hoofddocent bij Strategische communicatie, zoekt daarom naar strategieën om de lokroep van brownies en zakken chips te weerstaan

Characterization of the size-segregated water-soluble inorganic ions at eight Canadian rural sites

Size-segregated water-soluble inorganic ions, including particulate sulphate (SO<sub>4</sub><sup>2-</sup>), nitrate (NO<sub>3</sub><sup>-</sup>), ammonium (NH<sub>4</sub><sup>+</sup>), chloride (Cl<sup>-</sup>), and base cations (K<sup>+</sup>, Na<sup>+</sup>, Mg<sup>2+</sup>, Ca<sup>2+</sup>), were measured using a Micro-Orifice Uniform Deposit Impactor (MOUDI) during fourteen short-term field campaigns at eight locations in both polluted and remote regions of eastern and central Canada. The size distributions of SO<sub>4</sub><sup>2-</sup> and NH<sub>4</sub><sup>+</sup> were unimodal, peaking at 0.3–0.6 µm in diameter, during most of the campaigns, although a bimodal distribution was found during one campaign and a trimodal distribution was found during another campaign made at a coastal site. SO<sub>4</sub><sup>2-</sup> peaked at slightly larger sizes in the cold seasons (0.5–0.6 µm) compared to the hot seasons (0.3–0.4 µm) due to the higher relative humidity in the cold seasons. The size distributions of NO<sub>3</sub><sup>-</sup> were unimodal, peaking at 4.0–7.0 µm during the warm-season campaigns, and bimodal, with one peak at 0.3–0.6 µm and another at 4–7 µm during the cold-season campaigns. A unimodal size distribution, peaking at 4–6 µm, was found for Cl<sup>-</sup>, Na<sup>+</sup>, Mg<sup>2+</sup>, and Ca<sup>2+</sup> during approximately half of the campaigns and a bimodal distribution, with one peak at 2 µm and the other at 6 µm, was found during the rest of the campaigns. For K<sup>+</sup>, a bimodal distribution, with one peak at 0.3 µm and the other at 4 µm, was observed during most of the campaigns. Seasonal contrasts in the size-distribution profiles suggest that emission sources and air mass origins were the major factors controlling the size distributions of the primary aerosols while meteorological conditions were more important for the secondary aerosols. <br><br> The dependence of the particle acidity on the particle size from the nucleation mode to the accumulation mode was not consistent from site to site or from season to season. Particles in the accumulation mode were more acidic than those in the nucleation mode when submicron particles were in the state of strong acidity; however, when submicron particles were neutral or weakly acidic, particles in the nucleation mode could sometimes be more acidic. The inconsistency of the dependence of the particle acidity on the particle size should have been caused by the different emission sources of all the related species and the different meteorological conditions during the different campaigns. The results presented here at least partially explain the controversial phenomenon found in previous studies on this topic

Initial psychological responses to influenza A, H1N1 ("Swine flu")

Background The outbreak of the pandemic flu, Influenza A H1N1 (Swine Flu) in early 2009, provided a major challenge to health services around the world. Previous pandemics have led to stockpiling of goods, the victimisation of particular population groups, and the cancellation of travel and the boycotting of particular foods (e.g. pork). We examined initial behavioural and attitudinal responses towards Influenza A, H1N1 ("Swine flu") in the six days following the WHO pandemic alert level 5, and regional differences in these responses. Methods 328 respondents completed a cross-sectional Internet or paper-based questionnaire study in Malaysia (N = 180) or Europe (N = 148). Measures assessed changes in transport usage, purchase of preparatory goods for a pandemic, perceived risk groups, indicators of anxiety, assessed estimated mortality rates for seasonal flu, effectiveness of seasonal flu vaccination, and changes in pork consumption Results 26% of the respondents were 'very concerned' about being a flu victim (42% Malaysians, 5% Europeans, p < .001). 36% reported reduced public transport use (48% Malaysia, 22% Europe, p < .001), 39% flight cancellations (56% Malaysia, 17% Europe, p < .001). 8% had purchased preparatory materials (e.g. face masks: 8% Malaysia, 7% Europe), 41% Malaysia (15% Europe) intended to do so (p < .001). 63% of Europeans, 19% of Malaysians had discussed the pandemic with friends (p < .001). Groups seen as at 'high risk' of infection included the immune compromised (mentioned by 87% respondents), pig farmers (70%), elderly (57%), prostitutes/highly sexually active (53%), and the homeless (53%). In data collected only in Europe, 64% greatly underestimated the mortality rates of seasonal flu, 26% believed seasonal flu vaccination gave protection against swine flu. 7% had reduced/stopped eating pork. 3% had purchased anti-viral drugs for use at home, while 32% intended to do so if the pandemic worsened. Conclusion Initial responses to Influenza A show large regional differences in anxiety, with Malaysians more anxious and more likely to reduce travel and to buy masks and food. Discussions with family and friends may reinforce existing anxiety levels. Particular groups (homosexuals, prostitutes, the homeless) are perceived as at greater risk, potentially leading to increased prejudice during a pandemic. Europeans underestimated mortality of seasonal flu, and require more information about the protection given by seasonal flu inoculation

Cost-effectiveness of a workplace intervention for sick-listed employees with common mental disorders: design of a randomized controlled trial

Background. Considering the high costs of sick leave and the consequences of sick leave for employees, an early return-to-work of employees with mental disorders is very important. Therefore, a workplace intervention is developed based on a successful return-to-work intervention for employees with low back pain. The objective of this paper is to present the design of a randomized controlled trial evaluating the cost-effectiveness of the workplace intervention compared with usual care for sick-listed employees with common mental disorders. Methods. The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are on sick leave for 2 to 8 weeks with common mental disorders. The workplace intervention will be compared with usual care. The workplace intervention is a stepwise approach that aims to reach consensus about a return-to-work plan by active participation and strong commitment of both the sick-listed employee and the supervisor. Outcomes will be assessed at baseline, 3, 6, 9 and 12 months. The primary outcome of this study is lasting return-to-work, which will be acquired from continuous registration systems of the companies after the follow-up. Secondary outcomes are total number of days of sick leave during the follow-up, severity of common mental disorders, coping style, job content, and attitude, social influence, and self-efficacy determinants. Cost-effectiveness will be evaluated from the societal perspective. A process evaluation will also be conducted. Discussion. Return-to-work is difficult to discuss in the workplace for sick-listed employees with mental disorders and their supervisors. Therefore, this intervention offers a unique opportunity for the sick-listed employee and the supervisor to discuss barriers for return-to-work. Results of this study will possibly contribute to improvement of disability management for sick-listed employees with common mental disorders. Results will become available in 2009. Trial registration. ISRCTN92307123. © 2008 van Oostrom et al; licensee BioMed Central Ltd

Feasibility of sedation and analgesia interruption following cannulation in neonates on extracorporeal membrane oxygenation

Purpose: In most extracorporeal membrane oxygenation (ECMO) centers patients are heavily sedated to prevent accidental decannulation and bleeding complications. In ventilated adults not on ECMO, daily sedation interruption protocols improve short- and long-term outcome. This study aims to evaluate safety and feasibility of sedation interruption following cannulation in neonates on ECMO. Methods: Prospective observational study in 20 neonates (0.17-5.8 days of age) admitted for ECMO treatment. Midazolam (n = 20) and morphine (n = 18) infusions were discontinued within 30 min after cannulation. Pain and sedation were regularly assessed using COMFORT-B and visual analog scale (VAS) scores. Midazolam and/or morphine were restarted and titrated according to protocolized treatment algorithms. Results: Median (interquartile range, IQR) time without any sedatives was 10.3 h (5.0-24.1 h). Median interruption duration for midazolam was 16.5 h (6.6-29.6 h), and for morphine was 11.2 h (6.7-39.4 h). During this period no accidental extubations, decannulations or bleeding complications occurred. Conclusions: This is the first study to show that interruption of sedatives and analgesics following cannulation in neonates on ECMO is safe and feasible. Interruption times are 2-3 times longer than reported for adult ICU patients not on ECMO. Further trials are needed to substantiate these findings and evaluate short- and long-term outcomes