Groundwater in Cretaceous carbonates: KG@B field trip 21st June 2015

The Upper Cretaceous Chalk of southern England is the UK’s most important aquifer, providing more than 75% of the public supply for southeast England, including London. The aquifer also sustains rivers and wetlands, and their associated groundwater dependent ecosystems. However, the aquifer is facing a multitude of threats including over-abstraction, nitrate pollution, and climate change. The Chalk is a complex aquifer in which groundwater flow is through the matrix, fractures and karstic dissolutional voids. The Chalk matrix has a porosity of around 35% (Bloomfield et al., 1995). The matrix is thought to provide an important contribution to storage, although the size of the pore throats is very small, and therefore the permeability is very low (Price et al., 1993). The average permeability of 977 core samples was only 6.3 x 10-4 m/day (Allen et al., 1997). The matrix is particularly important in solute transport, because solutes move between the matrix and the more permeable parts of the aquifer via diffusion (Foster 1975). The unmodified fracture network provides an important contribution to storage and flow, and has a hydraulic conductivity of about 0.1 m/d, and a transmissivity of about 20 m2/day (Price, 1987). However, it is the dissolutionally enlarged fissures and conduits that make the Chalk such a good aquifer. The median transmissivity from 2100 pumping tests is 540 m2/day, and the 25th and 75th percentiles are 190 and 1500 m2/day respectively (MacDonald and Allen, 2001). Borehole packer testing, logging and imaging have shown that most of this transmissivity comes from a small number of dissolutional voids (e.g. Tate et al., 1970; Schurch and Buckley, 2002). Laterally extensive lithostratigraphical horizons including marl seams, bedding planes, sheet and tabular flint bands, and hard-grounds have an important influence on these groundwater flows. They are all horizons where downward percolation of water may be impeded. Dissolution often occurs where flow is concentrated along these horizons, creating conduits or fissures, especially where they are intersected by joint sets

Healthcare professionals' and parents' experiences of the confirmatory testing period:A qualitative study of the UK expanded newborn screening pilot

Background: With further expansion of the number of conditions for which newborn screening can be undertaken, it is timely to consider the impact of positive screening results and the confirmatory testing period on the families involved. This study was undertaken as part of a larger programme of work to evaluate the Expanded Newborn Screening (ENBS) programme in the United Kingdom (UK). It was aimed to determine the views and experiences of healthcare professionals (HCPs) and parents on communication and interaction during the period of confirmatory testing following a positive screening result. Methods: Semi-structured interviews were undertaken with parents of children who had received a positive ENBS result and HCPs who had been involved with the diagnosis and support of parents. Ten parents and 11 healthcare professionals took part in the in-depth interviews. Questions considered the journey from the positive screening result through confirmatory testing to a confirmed diagnosis and the communication and interaction between the parents and HCPs that they had been experienced. Key themes were identified through thematic analysis. Results: The results point to a number of elements within the path through confirmatory testing that are difficult for parents and could be further developed to improve the experience. These include the way in which the results are communicated to parents, rapid turnaround of results, offering a consistent approach, exploring interventions to support family relationships and reviewing the workload and scheduling implications for healthcare professionals. Conclusions: As technology enables newborn screening of a larger number of conditions, there is an increasing need to consider and mediate the potentially negative effects on families. The findings from this study point to a number of elements within the path through confirmatory testing that are difficult for parents and could be further developed to benefit the family experience

The systematic development of guidance for parents on talking to children of primary school age about weight

Background: The prevalence of overweight and obesity in children is increasing, alongside increases in rates of children’s anxiety and worry about their weight. In many countries children’s weight is measured, and parents are made aware if a child has been classified as having overweight or obesity. However, many parents are concerned that raising their child’s awareness of their weight, and talking to children about their weight could harm their wellbeing. The aim of this project was to develop guidance for parents on constructive ways to talk to children of primary school age about weight when they need to. // Methods: The project followed a mixed-methods design: Phase 1 involved the collation of evidence including (a) two previously published systematic literature reviews to identify the associations between parent–child weight talk, and broader health discussions, and children’s wellbeing, (b) interviews with children, and (c) development and refinement of narrative messaging (previously published). In Phase 2 we developed a conceptual model and mapped primary findings to techniques and content within a draft guidance document for parents on talking to children about weight. Phase 3 involved a modified Delphi process with 29 stakeholders to refine and agree a final version. // Results: An acceptable draft guidance was agreed following two stages of feedback from Delphi participants. Key areas for debate and adaptation included: encouraging discussion about health and growth with lesser focus on weight; finding ways to reduce stigma and perceptions of blame; emphasising a whole-family approach; inclusive representation of diversity among children and families. // Conclusions: Consensus on the content of guidance for parents on talking to children about weight was achieved through a process of evidence review and stakeholder and expert engagement. The next steps are to measure the impact of the resource on improving the experience of parents and children in communicating about weight

Objectively assessed physical activity and sedentary behaviour during pregnancy in portuguese women:Differences between trimesters and weekdays and weekends

Background: Engaging in physical activity (PA) and reducing sedentary behaviour (SB) are important for health during pregnancy, yet relatively few studies have examined these variables using objective measures and across trimesters during pregnancy. Objective: To determine the amount of objectively assessed PA and SB engaged in whether there was any weekday to weekend day variation in PA and SB during the first and second trimester of pregnancy. Method: PA and SB were determined using accelerometry worn over 7 consecutive days during each trimester in 137 Portuguese females (mean age ± SD = 29.6 ± 5.7). Results: In regard to the proportion of participants meeting the ACSM guidelines for PA, 37.5% of the participants in the first trimester and 29.6% of participants in the second trimester met the cut off of 30min or more of any type of moderate intensity activity on most (5) days of the week. Moderate intensity PA was significantly lower in trimester 2 compared to trimester 1 (P = 0.003). Moderate intensity PA was also significantly lower during weekends compared to weekdays irrespective of trimester (P = 0.003). SB, light and vigorous intensity PA were relatively stable from trimester 1 to trimester 2 and between weekdays and weekends (P < 0.05). Conclusion: The present study suggests that the majority of women do not meet PA guidelines for health during pregnancy and that moderate intensity PA declines form trimester 1 to 2 and is lower at weekends

Have the public's expectations for antibiotics for acute uncomplicated respiratory tract infections changed since the H1N1 influenza pandemic? A qualitative interview and quantitative questionnaire study

Objective: To investigate the effect of the H1N1 influenza pandemic on the public's expectations for a general practice consultation and antibiotic for acute respiratory illness. Design: Mixed methods. Participants: Qualitative interviews: 17 participants with acute respiratory tract infection (RTI) visiting English pharmacies. Face-to-face survey: about 1700 adults aged 15 years and older were recruited from households in England in January 2008, 2009 and 2011. Results: The qualitative data indicated that the general public had either forgotten about the 'swine flu' (H1N1 influenza) pandemic or it did not concern them as it had not affected them directly or affected their management of their current RTI illness. Between 2009 and 2011, we found that there was little or no change in people's expectations for antibiotics for runny nose, colds, sore throat or cough, but people's expectations for antibiotics for flu increased (26%e32%, p=0.004). Of the 1000 respondents in 2011 with an RTI in the previous 6 months, 13% reported that they took care of themselves without contacting their general practitioners and would not have done so before the pandemic, 9% reported that they had contacted their doctor's surgery and would not have done so before the pandemic and 0.6% stated that they had asked for antibiotics and would not have done so before the pandemic. In 2011, of 123 respondents with a young child (0-4 years) having an RTI in the previous 6 months, 7.4% requested antibiotics and would not have done so before the pandemic. Unprompted, 20% of respondents thought Tamifl

Promoting healthy eating in pregnancy: What kind of support services do women say they want?

Aim: To identify characteristics of the services and support women want to enable them to eat healthily during pregnancy to make a potential future service acceptable to this population. Background: An unhealthy diet during pregnancy may have a significant influence on pregnancy outcome, either directly through nutrient deficiencies or indirectly through maternal weight gain. Many pregnant women in the United Kingdom gain too much weight in pregnancy, and this weight gain may lead to an increased risk of preeclampsia, gestational diabetes and having an obese child. Thus, there is a need for interventions aimed at improving healthy eating in pregnancy. It is crucial in developing successful interventions to understand how participation can be maximised by optimising intervention acceptability. Methods: Four focus groups were conducted; two with prenatal women (n = 9) and two with postnatal women (n = 14). Discussion focused on identifying relevant characteristics of a service targeting prenatal and postnatal women's eating to ensure that a future service was acceptable to the women. Findings: The participants’ responses were clustered into three broad themes: (1) early information leading to routine formation of healthier eating habits, (2) the delivery of practical sessions to increase information and (3) health professionals providing support and signposting to services. The participants reported wanting a practical service held in a convenient location, preferably led by women who have been pregnant themselves. The participants also reported wanting to be offered this service in pregnancy to help them get into a routine before they gave birth. Several suggestions for how this service should be marketed were mentioned, including through midwives and the internet. This research provides practical information for how to design support for prenatal women to increase their knowledge and practical skills regarding eating healthily during their pregnancy

From nothing to something: discrete integrable systems

Chinese ancient sage Laozi said that everything comes from `nothing'. Einstein believes the principle of nature is simple. Quantum physics proves that the world is discrete. And computer science takes continuous systems as discrete ones. This report is devoted to deriving a number of discrete models, including well-known integrable systems such as the KdV, KP, Toda, BKP, CKP, and special Viallet equations, from `nothing' via simple principles. It is conjectured that the discrete models generated from nothing may be integrable because they are identities of simple algebra, model-independent nonlinear superpositions of a trivial integrable system (Riccati equation), index homogeneous decompositions of the simplest geometric theorem (the angle bisector theorem), as well as the M\"obious transformation invariants.Comment: 11 pages, side 10 repor

Midwives' experiences of referring obese women to either a community or home-based antenatal weight management service:Implications for service providers and midwifery practice

Objective a variety of services to support women to undertake weight management behaviours during pregnancy have recently been implemented as a means to reduce the risks to mother and infant. In the UK, midwives lead the care of the majority of pregnant women and are seen as the ideal source of referral into antenatal services. However, midwives have reported concerns regarding raising the topic of weight with obese women and negative referral experiences have been cited as a reason not to engage with a service. This study explored midwives’ experiences of referring women to one of two antenatal weight management services. Design qualitative, cross-sectional interview and focus group study, with data analysed thematically. Setting midwifery teams in the West Midlands, England. Participants midwives responsible for referring to either a home-based, one to one service (N=12), or a community-based, group service (N=11). Findings four themes emerged from the data. Participants generally had a positive View of the service, but their Information needs were not fully met, as they wanted more detail about the service and feedback regarding the women they had referred. Approaches to referral differed, with some participants referring all women who met the eligibility criteria, and some offering women a choice to be referred or not. Occasionally the topic was not raised at all when a negative reception was anticipated. Reasons for poor uptake of the services included pragmatic barriers, and their perception of women's lack of interest in weight management. Key conclusions midwives’ differing views on choice and gaining agreement to refer means referral practices vary, which could increase the risk that obese women have inequitable access to weight management services. However, midwives’ confidence in the services on offer may be increased with more detailed information about the service and feedback on referrals, which would additionally act as prompts to refer. Implications for practice weight management services need to improve communication with their referral agents and try to overcome practical and psychosocial barriers to uptake. It would be beneficial to develop a shared understanding of the concept of ‘informed choice’ specifically regarding referral to health promotion services among midwives. Training which demonstrates effective methods of sensitively introducing a weight management service to obese women may increase midwives’ confidence to consistently include this in their practice. These measures may improve women's engagement with services which have the potential to reduce the risks associated with maternal obesity