Explicitly modelling microtopography in permafrost landscapes in a land surface model (JULES vn5.4_microtopography)

Microtopography can be a key driver of heterogeneity in the ground thermal and hydrological regime of permafrost landscapes. In turn, this heterogeneity can influence plant communities, methane fluxes, and the initiation of abrupt thaw processes. Here we have implemented a two-tile representation of microtopography in JULES (the Joint UK Land Environment Simulator), where tiles are representative of repeating patterns of elevation difference. Tiles are coupled by lateral flows of water, heat, and redistribution of snow, and a surface water store is added to represent ponding. Simulations are performed of two Siberian polygon sites, (Samoylov and Kytalyk) and two Scandinavian palsa sites (Stordalen and Iškoras). The model represents the observed differences between greater snow depth in hollows vs. raised areas well. The model also improves soil moisture for hollows vs. the non-tiled configuration (“standard JULES”) though the raised tile remains drier than observed. The modelled differences in snow depths and soil moisture between tiles result in the lower tile soil temperatures being warmer for palsa sites, as in reality. However, when comparing the soil temperatures for July at 20 cm depth, the difference in temperature between tiles, or “temperature splitting”, is smaller than observed (3.2 vs. 5.5 ∘C). Polygons display small (0.2 ∘C) to zero temperature splitting, in agreement with observations. Consequently, methane fluxes are near identical (+0 % to 9 %) to those for standard JULES for polygons, although they can be greater than standard JULES for palsa sites (+10 % to 49 %). Through a sensitivity analysis we quantify the relative importance of model processes with respect to soil moisture and temperatures, identifying which parameters result in the greatest uncertainty in modelled temperature. Varying the palsa elevation between 0.5 and 3 m has little effect on modelled soil temperatures, showing that using only two tiles can still be a valid representation of sites with a range of palsa elevations. Mire saturation is heavily dependent on landscape-scale drainage. Lateral conductive fluxes, while small, reduce the temperature splitting by ∼ 1 ∘C and correspond to the order of observed lateral degradation rates in peat plateau regions, indicating possible application in an area-based thaw model

Predictors of quality of care in mental health supported accommodation services in England: a multiple regression modelling study.

BACKGROUND: Specialist mental health supported accommodation services are a key component to a graduated level of care from hospital to independently living in the community for people with complex, longer term mental health problems. However, they come at a high cost and there has been a lack of research on the quality of these services. The QuEST (Quality and Effectiveness of Supported tenancies) study, a five-year programme of research funded by the National Institute for Health Research, aimed to address this. It included the development of the first standardised quality assessment tool for supported accommodation services, the QuIRC-SA (Quality Indicator for Rehabilitative Care - Supported Accommodation). Using data collected from the QuIRC-SA, we aimed to identify potential service characteristics that were associated with quality of care. METHODS: Data collected from QuIRC-SAs with 150 individual services in England (28 residential care, 87 supported housing and 35 floating outreach) from four different sources were analysed using multiple regression modelling to investigate associations between service characteristics (local authority area index score, total beds/spaces, staffing intensity, percentage of male service users and service user ability) and areas of quality of care (Living Environment, Therapeutic Environment, Treatments and Interventions, Self-Management and Autonomy, Social Interface, Human Rights and Recovery Based Practice). RESULTS: The local authority area in which the service is located, the service size (number of beds/places) and the usual expected length of stay were each negatively associated with up to six of the seven QuIRC-SA domains. Staffing intensity was positively associated with two domains (Therapeutic Environment and Treatments and Interventions) and negatively associated with one (Human Rights). The percentage of male service users was positively associated with one domain (Treatments and Interventions) and service user ability was not associated with any of the domains. CONCLUSIONS: This study identified service characteristics associated with quality of care in specialist mental health supported accommodation services that can be used in the design and specification of services

Quality of care and its determinants in longer term mental health facilities across Europe; a cross-sectional analysis.

BACKGROUND: The Quality Indicator for Rehabilitative Care (QuIRC) is an international, standardised quality tool for the evaluation of mental health facilities that provide longer term care. Completed by the service manager, it comprises 145 items that assess seven domains of care: living environment; treatments and interventions; therapeutic environment; self-management and autonomy; social interface; human rights; and recovery based practice. We used the QuIRC to investigate associations between characteristics of longer term mental health facilities across Europe and the quality of care they delivered to service patients. METHODS: QuIRC assessments were completed for 213 longer term mental health units in ten countries that were at various stages of deinstitutionalisation of their mental health services. Associations between QuIRC domain scores and unit descriptive variables were explored using simple and multiple linear regression that took into account clustering at the unit and country level. RESULTS: We found wide variation in QuIRC domain scores between individual units, but across countries, fewer than a quarter scored below 50 % on any domains. The quality of care was higher in units that were smaller, of mixed sex, that had a defined expected maximum length of stay and in which not all patients were severely disabled. CONCLUSIONS: This is the first time longer term mental health units across a number of European countries have been compared using a standardised measure. Further use of the QuIRC will allow greater understanding of the quality of care in these units across Europe and provide an opportunity to monitor pan-European quality standards of care for this vulnerable patient group

Quality of Longer Term Mental Health Facilities in Europe: Validation of the Quality Indicator for Rehabilitative Care against Service Users’ Views

BACKGROUND: The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. METHOD: At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. RESULTS: 1750/2495 (70%) users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning). A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. CONCLUSIONS: Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care. Interventions that improve quality of care in these settings may promote service users' autonomy

The Joint IOC (of UNESCO) and WMO collaborative effort for met-ocean services

The Joint Committee for Oceanography and Marine Meteorology (JCOMM), a joint technical commission of IOC of UNESCO and WMO, has devised a coordination mechanism for the fit-for-purpose delivery of an end-to-end system, from ocean observations to met-ocean operational services. This paper offers a complete overview of the activities carried out by JCOMM and the status of the achievements up to 2017. The JCOMM stakeholders are the WMO Members and the IOC Member States, their research and operational Institutions, which mandated JCOMM to devise an international strategy to advance toward the achievement of the United Nations Sustainable Development Goals. The three activity areas, namely the Observation Program Area-OPA, the Data Management Program Area-DMPA and the Services and Forecasting Services Program Area-SFSPA have established several expert teams to contribute to the international coordination. OPA is organized in observing networks connected with different observing technologies, DMPA organizes the overall near-real time and delayed mode data assembly and delivery methodology and architecture and the SFSPA coordinates the met-ocean services stemming out of observations and data management. The future developments should strengthen the coordination in the three program areas considering the inclusion of new and emergent observing technologies, the interoperability of met-ocean data assembly centers and the establishment of efficient research to operations protocols, as well as better fit-for-purpose customized services for the public and private sectors

Argo data 1999-2019: two million temperature-salinity profiles and subsurface velocity observations from a global array of profiling floats.

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Wong, A. P. S., Wijffels, S. E., Riser, S. C., Pouliquen, S., Hosoda, S., Roemmich, D., Gilson, J., Johnson, G. C., Martini, K., Murphy, D. J., Scanderbeg, M., Bhaskar, T. V. S. U., Buck, J. J. H., Merceur, F., Carval, T., Maze, G., Cabanes, C., Andre, X., Poffa, N., Yashayaev, I., Barker, P. M., Guinehut, S., Belbeoch, M., Ignaszewski, M., Baringer, M. O., Schmid, C., Lyman, J. M., McTaggart, K. E., Purkey, S. G., Zilberman, N., Alkire, M. B., Swift, D., Owens, W. B., Jayne, S. R., Hersh, C., Robbins, P., West-Mack, D., Bahr, F., Yoshida, S., Sutton, P. J. H., Cancouet, R., Coatanoan, C., Dobbler, D., Juan, A. G., Gourrion, J., Kolodziejczyk, N., Bernard, V., Bourles, B., Claustre, H., D'Ortenzio, F., Le Reste, S., Le Traon, P., Rannou, J., Saout-Grit, C., Speich, S., Thierry, V., Verbrugge, N., Angel-Benavides, I. M., Klein, B., Notarstefano, G., Poulain, P., Velez-Belchi, P., Suga, T., Ando, K., Iwasaska, N., Kobayashi, T., Masuda, S., Oka, E., Sato, K., Nakamura, T., Sato, K., Takatsuki, Y., Yoshida, T., Cowley, R., Lovell, J. L., Oke, P. R., van Wijk, E. M., Carse, F., Donnelly, M., Gould, W. J., Gowers, K., King, B. A., Loch, S. G., Mowat, M., Turton, J., Rama Rao, E. P., Ravichandran, M., Freeland, H. J., Gaboury, I., Gilbert, D., Greenan, B. J. W., Ouellet, M., Ross, T., Tran, A., Dong, M., Liu, Z., Xu, J., Kang, K., Jo, H., Kim, S., & Park, H. Argo data 1999-2019: two million temperature-salinity profiles and subsurface velocity observations from a global array of profiling floats. Frontiers in Marine Science, 7, (2020): 700, doi:10.3389/fmars.2020.00700.In the past two decades, the Argo Program has collected, processed, and distributed over two million vertical profiles of temperature and salinity from the upper two kilometers of the global ocean. A similar number of subsurface velocity observations near 1,000 dbar have also been collected. This paper recounts the history of the global Argo Program, from its aspiration arising out of the World Ocean Circulation Experiment, to the development and implementation of its instrumentation and telecommunication systems, and the various technical problems encountered. We describe the Argo data system and its quality control procedures, and the gradual changes in the vertical resolution and spatial coverage of Argo data from 1999 to 2019. The accuracies of the float data have been assessed by comparison with high-quality shipboard measurements, and are concluded to be 0.002°C for temperature, 2.4 dbar for pressure, and 0.01 PSS-78 for salinity, after delayed-mode adjustments. Finally, the challenges faced by the vision of an expanding Argo Program beyond 2020 are discussed.AW, SR, and other scientists at the University of Washington (UW) were supported by the US Argo Program through the NOAA Grant NA15OAR4320063 to the Joint Institute for the Study of the Atmosphere and Ocean (JISAO) at the UW. SW and other scientists at the Woods Hole Oceanographic Institution (WHOI) were supported by the US Argo Program through the NOAA Grant NA19OAR4320074 (CINAR/WHOI Argo). The Scripps Institution of Oceanography's role in Argo was supported by the US Argo Program through the NOAA Grant NA15OAR4320071 (CIMEC). Euro-Argo scientists were supported by the Monitoring the Oceans and Climate Change with Argo (MOCCA) project, under the Grant Agreement EASME/EMFF/2015/1.2.1.1/SI2.709624 for the European Commission

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

The Joint IOC (of UNESCO) and WMO collaborative effort for Met-Ocean services

The WMO-IOC Joint Technical Commission for Oceanography and Marine Meteorology (JCOMM) has devised a coordination mechanism for the fit-for-purpose delivery of an end-to-end system, from ocean observations to met-ocean operational services. This paper offers a complete overview of the activities carried out by JCOMM and the status of the achievements up to 2018. The JCOMM stakeholders consist of the research and operational institutions of WMO members and the IOC member states, which mandated JCOMM to devise an international strategy to move toward the achievement of the United Nations Sustainable Development Goals. The three areas of activity are the Observation Program Area (OPA), the Data Management Program Area (DMPA) and the Services and Forecasting Services Program Area (SFSPA), and several expert teams have been established to contribute to the international coordination efforts. OPA is organized into observing networks connected by different observing technologies, DMPA organizes the overall near-real time and delayed mode data assembly, and the delivery methodology and architecture, and the SFSPA coordinates the met-ocean services resulting from the observations and data management. Future developments should enhance coordination in these three program areas by considering the inclusion of new and emergent observing technologies, the interoperability of met-ocean data assembly centers and the establishment of efficient research to operations protocols, in addition to better fit-for-purpose customized services in both the public and private sectors