Enthusiasm for ID card is waning outside Parliament

Brief commentary by Gareth Crossman (Policy Director, Liberty) on issues related to possible government introduction of compulsory registration cards. Published in Amicus Curiae – Journal of the Society for Advanced Legal Studies at the Institute of Advanced Legal Studies. The Journal is produced by SALS at the IALS (Institute of Advanced Legal Studies, School of Advanced Study, University of London)

Identifying priorities for nutrient mitigation using river concentration-flow relationships: the Thames basin, UK

The introduction of tertiary treatment to many of the sewage treatment works (STW) across the Thames basin in southern England has resulted in major reductions in river phosphorus (P) concentrations. Despite this, excessive phytoplankton growth is still a problem in the River Thames and many of its tributaries. There is an urgent need to determine if future resources should focus on P removal from the remaining STW, or on reducing agricultural inputs, to improve ecological status. Nutrient concentration-flow relationships for monitoring sites along the River Thames and 15 of its major tributaries were used to estimate the relative inputs of phosphorus and nitrogen from continuous (sewage point sources) and rain-related (diffuse and within-channel) sources, using the Load Apportionment Model (LAM). The model showed that diffuse sources and remobilisation of within-channel phosphorus contributed the majority of the annual P load at all monitoring sites. However, the majority of rivers in the Thames basin are still dominated by STW P inputs during the ecologically-sensitive spring-autumn growing season. Therefore, further STW improvements would be the most effective way of improving water quality and ecological status along the length of the River Thames, and 12 of the 15 tributaries. The LAM outputs were in agreement with other indicators of sewage input, such as sewered population density, phosphorus speciation and boron concentration. The majority of N inputs were from diffuse sources, and LAM suggests that introducing mitigation measures to reduce inputs from agriculture and groundwater would be most appropriate for all but one monitoring site in this study. The utilisation of nutrient concentration-flow data and LAM provide a simple, rapid and effective screening tool for determining nutrient sources and most effective mitigation options

A systematic scoping review on the evidence behind debriefing practices for the well-being/emotional outcomes of healthcare workers

Debriefings give healthcare workers voice through the opportunity to discuss unanticipated or difficult events and recommend changes. The typical goal of routine debriefings has been to improve clinical outcomes by learning through discussion and reflection of events and then transferring that learning into clinical practice. However, little research has investigated the effects of debriefings on the emotional experiences and well-being of healthcare workers. There is some evidence that debriefings are a multi-faceted and cost-effective intervention for minimising negative health outcomes, but their use is inconsistent and they are infrequently adopted with the specific intention of giving healthcare workers a voice. The purpose of this systematic scoping review is therefore to assess the scope of existing evidence on debriefing practices for the well-being and emotional outcomes of healthcare workers. Following screening, 184 papers were synthesised through keyword mapping and exploratory trend identification. The body of evidence reviewed were clustered geographically, but diverse on many other criteria of interest including the types of evidence produced, debriefing models and practices, and outcomes captured. The current review provides a clear map of our existing understanding and highlights the need for more systematic, collaborative and rigorous bodies of evidence to determine the potential of debriefing to support the emotional outcomes of those working within healthcare

The importance of the microbial N cycle in soil for crop plant nutrition

Nitrogen is crucial for living cells, and prior to the introduction of mineral N fertilizer, fixation of atmospheric N2 by diverse prokaryotes was the primary source of N in all ecosystems. Microorganisms drive the N cycle starting with N2 fixation to ammonia, through nitrification in which ammonia is oxidized to nitrate and denitrification where nitrate is reduced to N2 to complete the cycle, or partially reduced to generate the greenhouse gas nitrous oxide. Traditionally, agriculture has relied on rotations that exploited N fixed by symbiotic rhizobia in leguminous plants, and recycled wastes and manures that microbial activity mineralized to release ammonia or nitrate. Mineral N fertilizer provided by the Haber–Bosch process has become essential for modern agriculture to increase crop yields and replace N removed from the system at harvest. However, with the increasing global population and problems caused by unintended N wastage and pollution, more sustainable ways of managing the N cycle in soil and utilizing biological N2 fixation have become imperative. This review describes the biological N cycle and details the steps and organisms involved. The effects of various agricultural practices that exploit fixation, retard nitrification, and reduce denitrification are presented, together with strategies that minimize inorganic fertilizer applications and curtail losses. The development and implementation of new technologies together with rediscovering traditional practices are discussed to speculate how the grand challenge of feeding the world sustainably can be met

Cardiometabolic effects of genetic upregulation of the interleukin 1 receptor antagonist : A Mendelian randomisation analysis

To investigate potential cardiovascular and other effects of long-term pharmacological interleukin 1 (IL-1) inhibition, we studied genetic variants that produce inhibition of IL-1, a master regulator of inflammation. Methods: We created a genetic score combining the effects of alleles of two common variants (rs6743376 and rs1542176) that are located upstream of IL1RN, the gene encoding the IL-1 receptor antagonist (IL-1Ra; an endogenous inhibitor of both IL-1α and IL-1β); both alleles increase soluble IL-1Ra protein concentration. We compared effects on inflammation biomarkers of this genetic score with those of anakinra, the recombinant form of IL-1Ra, which has previously been studied in randomised trials of rheumatoid arthritis and other inflammatory disorders. In primary analyses, we investigated the score in relation to rheumatoid arthritis and four cardiometabolic diseases (type 2 diabetes, coronary heart disease, ischaemic stroke, and abdominal aortic aneurysm; 453 411 total participants). In exploratory analyses, we studied the relation of the score to many disease traits and to 24 other disorders of proposed relevance to IL-1 signalling (746 171 total participants). Findings: For each IL1RN minor allele inherited, serum concentrations of IL-1Ra increased by 0·22 SD (95% CI 0·18-0·25; 12·5%; p=9·3 × 10-33), concentrations of interleukin 6 decreased by 0·02 SD (-0·04 to -0·01; -1·7%; p=3·5 × 10-3), and concentrations of C-reactive protein decreased by 0·03 SD (-0·04 to -0·02; -3·4%; p=7·7 × 10-14). We noted the effects of the genetic score on these inflammation biomarkers to be directionally concordant with those of anakinra. The allele count of the genetic score had roughly log-linear, dose-dependent associations with both IL-1Ra concentration and risk of coronary heart disease. For people who carried four IL-1Ra-raising alleles, the odds ratio for coronary heart disease was 1·15 (1·08-1·22; p=1·8 × 10-6) compared with people who carried no IL-1Ra-raising alleles; the per-allele odds ratio for coronary heart disease was 1·03 (1·02-1·04; p=3·9 × 10-10). Per-allele odds ratios were 0·97 (0·95-0·99; p=9·9 × 10-4) for rheumatoid arthritis, 0·99 (0·97-1·01; p=0·47) for type 2 diabetes, 1·00 (0·98-1·02; p=0·92) for ischaemic stroke, and 1·08 (1·04-1·12; p=1·8 × 10-5) for abdominal aortic aneurysm. In exploratory analyses, we observed per-allele increases in concentrations of proatherogenic lipids, including LDL-cholesterol, but no clear evidence of association for blood pressure, glycaemic traits, or any of the 24 other disorders studied. Modelling suggested that the observed increase in LDL-cholesterol could account for about a third of the association observed between the genetic score and increased coronary risk. Interpretation: Human genetic data suggest that long-term dual IL-1α/β inhibition could increase cardiovascular risk and, conversely, reduce the risk of development of rheumatoid arthritis. The cardiovascular risk might, in part, be mediated through an increase in proatherogenic lipid concentrations. Funding: UK Medical Research Council, British Heart Foundation, UK National Institute for Health Research, National Institute for Health Research Cambridge Biomedical Research Centre, European Research Council, and European Commission Framework Programme 7