Using early extremes to place the 2022 UK heat waves into historical context

As global surface temperatures continue to rise, both the duration and the intensity of heat waves across most land areas are expected to increase. The 2022 European summer broke a number of temperature records where a new record daily maximum temperature of 40.3°C was reached on 19th July making it the hottest July heat wave event in the UK. This paper aims to detect and analyse historical heat wave events, particularly prior to 1927 and compare these with recent events, particularly, 2022, which featured four summer heat wave events in the UK. This allows us to understand how noteworthy historical extremes are in comparison to those in recent decades, to place modern events into historical context, and to extend the sample of extreme events. Summer heat wave events have been detected between 1878 and 2022 from long station data in the UK. Heat wave extent, duration, and intensity have been analysed to compare past heat waves to the recent 2022 heat waves. For each of the summer months at least one of the top 10 most intense events between 1878 and 2022 occurred in the earliest third of the dataset (before 1927) emphasising the value of analysing early heat events. In all detected events, the anomalous UK heat was part of large-scale European extreme heat when examining 20th-century reanalysis data, associated with a high-pressure system. The 2022 July event resembles in pattern of warming and circulation some earlier events, for example, in 1925. While there is a clear trend in the monthly data and the overall frequency of anomalously hot days, heat wave activity on daily scales even in the period 1878 and 1926 is considerable and in some cases comparable to modern heat wave events in the UK. The most intense events detected led to societal impacts based on UK newspaper articles from the period including impacts on the agricultural sector, health impacts, and travel disruptions, broadly comparable to impacts from recent events

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Climate and weather extremes in the UK: learning from the past and preparing for the future

As global surface temperatures continue to rise, both the duration and intensity of heat- waves in Europe and the UK are expected to increase. The 2022 European summer heat- wave broke a number of temperature records and was associated with a range of societal impacts that were felt unequally across society. Heatwaves cause health impacts and fatalities with the 2003 European heatwave resulting in the loss of life of up to 70,000 people. However, compared to hazards with more visible consequences such as flooding events, the impacts of heatwaves can be overlooked leading them to be termed “silent killer” events. It is therefore important to improve our understanding of heatwaves and their impacts and how these may change in a warming world. The first part of this thesis explores what we can learn from past examples of heatwave events. Past events can provide points of reference to help with future decision making, allowing us to learn from the past. As extreme events are relatively rare by definition, by focusing on detecting early heatwaves, the sample of extreme events available for further analysis is extended. We detected and analysed historical heatwave events prior to 1927 in the UK and compared these to more recent events, including the 2022 heatwave event, allowing us to place modern events into historical context. We found that while there is a clear warming trend in the monthly data, the heatwave activity at the daily scale between 1878 and 1926 was considerable and in some cases comparable to modern heatwave events therefore, early events could be used as case studies to help us learn more about potential future heatwave events. We find that some impacts of early events are similar to those impacts today, such as the disparity in impacts of high and low-income regions. The second part of this thesis uses these examples of early heatwaves as case studies to analyse how the intensity of such events could change in the future. While many studies focus on the changing return periods of events in a warmer climate, fewer studies focus on a past event, from the early 20th century for example, and how it may look in a warmer climate based on a range of potential warming scenarios. We used a flow analogue methodology to explore what the early extreme events may look like in the future. We find that heat events such as the UK heatwave in 1923 increase in intensity at a similar rate to climatology as the global temperature increases, according to the models used. We find that at 4oC of global warming, the mean summer days during the 1923 heatwave in England is between 4.9 and 6.4 degrees warmer than pre-industrial levels across the three models used. Mean temperatures during analogous events, events of similar circulation patterns as 1923, over England range from 6.9 to 10.7oC higher than pre-industrial levels, for three different climate models used at 4oC. In addition, we comment on the limitations of this approach as well as the potential benefits, particularly as a communication tool to improve decision making around extreme heat. The interface between the scientific study of extreme event risk and how this is communicated and used by decision makers is currently a knowledge gap. The third part of this thesis investigates what tools, data and knowledge may aid adaptation decision makers while identifying what barriers exist in creating policies to increase resilience to extreme events. This research uses the Scottish public sector as a case study and we find that the majority of organisations are still at the planning phase of adaptation. We highlight key challenges including capacity and lack of organisational awareness of the need for adaptation and potential solutions to increase adaptation action in Scotland, including adaptation literacy training, tighter legislation and the use of boundary organisations or knowledge brokers. This research can help bridge the gap between climate science and decision makers by highlighting some key data requirements to help accelerate adaptation action and how it is monitored and evaluated. The novelty of this thesis is in the interdisciplinary approach taken, with contributions made throughout the impact chain, from hazard to risk and impacts. Overall, this inter- disciplinary research provides a method for learning from the past, while also exploring what is required to prepare for the future

Using early extremes to place the 2022 UK heat waves into historical context

As global surface temperatures continue to rise, both the duration and the intensity of heat waves across most land areas are expected to increase. The 2022 European summer broke a number of temperature records where a new record daily maximum temperature of 40.3°C was reached on 19th July making it the hottest July heat wave event in the UK. This paper aims to detect and analyse historical heat wave events, particularly prior to 1927 and compare these with recent events, particularly, 2022, which featured four summer heat wave events in the UK. This allows us to understand how noteworthy historical extremes are in comparison to those in recent decades, to place modern events into historical context, and to extend the sample of extreme events. Summer heat wave events have been detected between 1878 and 2022 from long station data in the UK. Heat wave extent, duration, and intensity have been analysed to compare past heat waves to the recent 2022 heat waves. For each of the summer months at least one of the top 10 most intense events between 1878 and 2022 occurred in the earliest third of the dataset (before 1927) emphasising the value of analysing early heat events. In all detected events, the anomalous UK heat was part of large-scale European extreme heat when examining 20th-century reanalysis data, associated with a high-pressure system. The 2022 July event resembles in pattern of warming and circulation some earlier events, for example, in 1925. While there is a clear trend in the monthly data and the overall frequency of anomalously hot days, heat wave activity on daily scales even in the period 1878 and 1926 is considerable and in some cases comparable to modern heat wave events in the UK. The most intense events detected led to societal impacts based on UK newspaper articles from the period including impacts on the agricultural sector, health impacts, and travel disruptions, broadly comparable to impacts from recent events

Using analogues to predict changes in future UK heatwaves

The intensity and frequency of extreme heat events is increasing due to climate change, resulting in a range of societal impacts. In this paper, we use temporal analogues to analyse how past UK heatwave events, such as during the summer of 1923, may change if they were to occur under different global warming scenarios. We find that the six most intense early heat events are caused by circulation patterns similar to that of 1923, which can cause intense heat over the UK and parts of NW Europe. Circulation analogues for the 1923 heatwave are also linked to intense heat events in the future, although not all analogues are anomalously hot. At 4 °C of global warming, mean summer temperatures in England over the duration of the 1923 heatwave are between 4.9 and 6.4 degrees warmer than pre-industrial levels across the three models used. At that global mean warming level, future heat events with similar circulation as 1923 over England are estimated to be on average 6.9 °C–10.7 °C hotter than those at pre-industrial levels. Exploring how the intensity of events similar to past events may change in the future could be an effective risk communication tool for adaptation decision making, particularly if past events are stored in society’s memory, for example, due to high impacts

Chronic respiratory diseases strongly influence major life-changing decisions

Introduction Major life-changing decisions (MLCD) are influenced by chronic skin conditions,1 but the effect of other chronic conditions such as respiratory disease has been less explored. We studied the influence of cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) on MLCD. Methods Survey packs were posted or given at outpatient appointments to adult patients who had CF (n=100) or COPD (n=100) for more than 1 year. Patients were asked to write down any ways in which their long-term disease had influenced their MLCD. Qualitative software Nvivo 8 was used for detailed data analysis. Different life-changing decisions were grouped into core decisions. Results Of the 200, 110 (55%) survey forms were returned (CF=61, COPD=49). Of these, 91 patients (58% male, mean age: CF=27 years (range 18–53), COPD=65 years (range 53–84)) reported the impact of their chronic condition on MLCD. 81 patients (CF=50, COPD=31) reported there was an influence on at least 1 MLCD (range 1–9), 10 patients (CF=3, COPD=7) reported no influence, 17 patients (CF=8, COPD=9) declined to take part and 2 patients had died (COPD). MLCD affected by CF and COPD were job (n=39), having children (n=36), career (n=31), early retirement (n=32), education (n=24), relationships (n=19), moving abroad (n=15), change of profession (n=10), separation (n=9), moving to another house (n=9), marriage (n=6), buying a house (n=4) and moving to another city (n=4). Decisions related to holidays (n=21) and life style change (n=4) were also regarded by patients as life changing. The most prevalent influential factors of the condition for both CF and COPD are shown in table 1. Conclusions This study demonstrates that respiratory conditions such as CF and COPD influence MLCD which impact on patients’ lives significantly over time. Appropriate and timely advice and support may help patients to cope better with long-term illnesses. In parallel, greater understanding by clinicians might enhance health outcomes. Targeted help at an early stage may improve patients’ future health and lives

The scientific paper, how to prepare it, how to write it ...

Earlier editions, by S. F. Trelease and E. S. Yule, pub. under title: Preparation of scientific and technical papers.Bibliography: p. 142-144.Mode of access: Internet

Using analogues to predict changes in future UK heatwaves

The intensity and frequency of extreme heat events is increasing due to climate change, resulting in a range of societal impacts. In this paper, we use temporal analogues to analyse how past UK heatwave events, such as during the summer of 1923, may change if they were to occur under different global warming scenarios. We find that the six most intense early heat events are caused by circulation patterns similar to that of 1923, which can cause intense heat over the UK and parts of NW Europe. Circulation analogues for the 1923 heatwave are also linked to intense heat events in the future, although not all analogues are anomalously hot. At 4 degrees of global warming, mean summer temperatures in England over the duration of the 1923 heatwave are between 4.9 and 6.4 degrees warmer than pre-industrial levels across the three models used. At that global mean warming level, future heat events with similar circulation as 1923 over England are estimated to be on average 6.9 to 10.7 degrees hotter than those at pre-industrial levels, with the most intense up 19.6 degrees higher. Exploring how the intensity of events similar to past events may change in the future could be an effective risk communication tool for adaptation decision making, particularly if past events are stored in society's memory, for example, due to high impacts