A study of general practitioners' perspectives on electronic medical records systems in NHS Scotland

<b>Background</b> Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. <p></p><b> Methods</b> We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs' perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees' responses, using Normalisation Process Theory as the underpinning conceptual framework. <p></p> <b>Results</b> The majority of GPs' interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities - for example: in relation to usability, system navigation and information visualisation. <b>Conclusion </b>Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs' interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors

Water resource management & supply in Central India: report of Grassroots Field Exposure session February 2019

The India-UK Water Centre (IUKWC) promotes cooperation and collaboration between the complementary priorities of NERC-MoES water security research. This report presents an overview of the joint India-UK scientific Grassroots Field Exposure Initiative held in Bhopal from 25th-27th February, 2019. The event was convened by the IndiaUK Water Centre co-coordinators Dr A.K. Sahai (Indian Institute of Tropical Meteorology, Pune, India) and Dr Harry Dixon (Centre for Ecology & Hydrology, Wallingford, UK). The initiative was organised by IUKWC Secretariat in collaboration Dr Pankaj Kumar (Indian Institute of Science Education and Research (IISER) Bhopal, India), Dr Alexandre Gagnon (Liverpool John Moores University, UK) and Dr Sumit Sinha (University of Leeds, UK). The event aimed to gain a closer perspective of the management of water at ground level, its associated issues and the use – and need for - scientific outputs by end users in central India. To tackle the multi-faceted and intertwined nature of the various water related issues in the region the focus of the event was sub-divided into three major sectors for easy and efficient analysis of regional water balance: Agriculture & water resource; Domestic energy & water resource; Energy and industrial water resource. The event was multi-sectoral with focus on water supply and resource management for Agriculture, domestic and energy sectors. This was the field based interactive approach to discuss and understand the grass-root level status quo by scientists from both India & UK. Scientist interacted with the end users and tried to understand their techniques and traditional knowledge and discussed about various socio-economic aspects of the local water user scenario. Indian Institutions including the National Institute of Hydrology- Roorkee, Jamia Millia Islamia University- Delhi, Indian Institute of Science Education and Research Bhopal, Amity UniversityJaipur, TERI School of Advanced Studies- New Delhi, Symbiosis International (Deemed University)- Pune, Indian Institute of Soil Sciences- Bhopal, Central Institute of Agriculture EngineeringBhopal and Banaras Hindu University- Varanasi participated in the event. UK participants included experts from the Loughborough University, Centre for Ecology and Hydrology, University of the West of England, Liverpool John Moores University, Cranfield University, University of Plymouth, University of Dundee and University of Leeds

The hydrology of sand rivers in Zimbabwe and the use of remote sensing to assess their level of saturation

Sand rivers are ephemeral watercourses containing sand that are occasionally flooded with rainwater runoff during the rainy season. Although the riverbed appears dry for most of the year, there is perennial groundwater flow within the sand. This water flowing beneath the surface is a valuable resource for local communities; nonetheless our understanding of such river systems is limited. Hence, this paper aims to improve our understanding of the hydrology of sand rivers and to examine the potential use of remote sensing to detect the presence of water in the sand. The relationship between rainfall events and changes in the water level of two sand rivers in the Matabeleland South Province of Zimbabwe was investigated. A lagged relationship was observed for the Manzamnyama River but for the Shashani River the relationship was seen only when considering cumulative rainfall events. The comparison of the modelled flow as simulated by a water balance model with observations revealed the important influence of the effective sediment depth on the recharge and recession of the alluvial channels in addition to the length of the channel. The possibility of detecting water in the alluvial sands was investigated using remote sensing. During the wet season, optical images showed that the presence of water on the riverbed was associated with a smooth signal, as it tends to reflect the incident radiation. A chronological analysis of radar images for different months of the year demonstrates that it is possible to detect the presence of water in the sand rivers. These results are a first step towards the development of a methodology that would aim to use remote sensing to help reducing survey costs by guiding exploratory activities to areas showing signs of water abstraction potential

Influences of salinity on the physiology and distribution of the Arctic coralline algae, Lithothamnion glaciale (Corallinales, Rhodophyta)

In Greenland, free-living red coralline algae contribute to and dominate marine habitats along the coastline. Lithothamnion glaciale dominates coralline algae beds in many regions of the Arctic, but never in Godthåbsfjord, Greenland, where Clathromorphum sp. is dominant. To investigate environmental impacts on coralline algae distribution, calcification and primary productivity were measured in situ during summers of 2015 and 2016, and annual patterns of productivity in L. glaciale were monitored in laboratory-based mesocosm experiments where temperature and salinity were manipulated to mimic high glacial melt. The results of field and cold-room measurements indicate that both L. glaciale and Clathromorphum sp. had low calcification and photosynthetic rates during the Greenland summer (2015 and 2016), with maximum of 1.225 ± 0.17 or 0.002 ± 0.023 μmol CaCO3 · g-1 · h-1 and -0.007 ±0.003 or -0.004 ± 0.001 mg O2 · L-1 · h-1 in each species respectively. Mesocosm experiments indicate L. glaciale is a seasonal responder; photosynthetic and calcification rates increase with annual light cycles. Furthermore, metabolic processes in L. glaciale were negatively influenced by low salinity; positive growth rates only occurred in marine treatments where individuals accumulated an average of 1.85 ± 1.73 mg · d-1 of biomass through summer. These results indicate high freshwater input to the Godthåbsfjord region may drive the low abundance of L. glaciale, and could decrease species distribution as climate change increases freshwater input to the Arctic marine system via enhanced ice sheet runoff and glacier calving.Peer reviewedFinal Accepted Versio

Freshwater Availability for Agriculture in Sundarbans. Variability due to changes in the summer monsoon under current and climate change conditions

The India–UK Water Centre (IUKWC) funded a Pump Priming Project (PPP) titled: “The influence of the monsoon on freshwater availability for agriculture in the Sundarbans region of West Bengal, India, under current and climate change conditions” between June and September 2019. This Knowledge Exchange brief was developed from the outputs of the activities conducted during this study: i) investigating the variability of the Indian Summer Monsoon (ISM) and the ensuing freshwater availability for agriculture in the Sundarbans region through the collection and analysis of climatic data and outputs from Global Climate Models (GCMs); and ii) understanding how changes in water resource availability are affecting livelihoods and discussing issues related to adaptation to those changes through meetings with farmers, NGOs and local government officials engaged in water resource management. The research results were communicated through a workshop with agricultural, water and climate scientists, NGOs and government stakeholders working in the Sundarbans region, where the team gained feedback, and shared knowledge and ideas for future research. This Brief was prepared by Professor Lalu Das, Principal Investigator (PI) and India Project Lead, and Professor Gautam Saha, both from Bidhan Chandra Krishi Viswavidyalaya (BCKV) in India, and Dr Alexandre Gagnon, UK Project Lead, and Dr Indrani Roy from Liverpool John Moores University (LJMU) in the UK

25-Hydroxyvitamin D levels and chronic kidney disease in the AusDiab (Australian Diabetes, Obesity and Lifestyle) study

<p>Abstract</p> <p>Background</p> <p>Low 25-hydroxy vitamin D (25(OH)D) levels have been associated with an increased risk of albuminuria, however an association with glomerular filtration rate (GFR) is not clear. We explored the relationship between 25(OH)D levels and prevalent chronic kidney disease (CKD), albuminuria and impaired GFR, in a national, population-based cohort of Australian adults (AusDiab Study).</p> <p>Methods</p> <p>10,732 adults ≥25 years of age participating in the baseline survey of the AusDiab study (1999–2000) were included. The GFR was estimated using an enzymatic creatinine assay and the CKD-EPI equation, with CKD defined as eGFR <60 ml/min/1.73 m². Albuminuria was defined as a spot urine albumin to creatinine ratio (ACR) of ≥2.5 mg/mmol for men and ≥3.5 for women. Serum 25(OH)D levels of <50 nmol/L were considered vitamin D deficient. The associations between 25(OH)D level, albuminuria and impaired eGFR were estimated using multivariate regression models.</p> <p>Results</p> <p>30.7% of the study population had a 25(OH)D level <50 nmol/L (95% CI 25.6-35.8). 25(OH)D deficiency was significantly associated with an impaired eGFR in the univariate model (OR 1.52, 95% CI 1.07-2.17), but not in the multivariate model (OR 0.95, 95% CI 0.67-1.35). 25(OH)D deficiency was significantly associated with albuminuria in the univariate (OR 2.05, 95% CI 1.58-2.67) and multivariate models (OR 1.54, 95% CI 1.14-2.07).</p> <p>Conclusions</p> <p>Vitamin D deficiency is common in this population, and 25(OH)D levels of <50 nmol/L were independently associated with albuminuria, but not with impaired eGFR. These associations warrant further exploration in prospective and interventional studies.</p

A Measurement of Rb using a Double Tagging Method

The fraction of Z to bbbar events in hadronic Z decays has been measured by the OPAL experiment using the data collected at LEP between 1992 and 1995. The Z to bbbar decays were tagged using displaced secondary vertices, and high momentum electrons and muons. Systematic uncertainties were reduced by measuring the b-tagging efficiency using a double tagging technique. Efficiency correlations between opposite hemispheres of an event are small, and are well understood through comparisons between real and simulated data samples. A value of Rb = 0.2178 +- 0.0011 +- 0.0013 was obtained, where the first error is statistical and the second systematic. The uncertainty on Rc, the fraction of Z to ccbar events in hadronic Z decays, is not included in the errors. The dependence on Rc is Delta(Rb)/Rb = -0.056*Delta(Rc)/Rc where Delta(Rc) is the deviation of Rc from the value 0.172 predicted by the Standard Model. The result for Rb agrees with the value of 0.2155 +- 0.0003 predicted by the Standard Model.Comment: 42 pages, LaTeX, 14 eps figures included, submitted to European Physical Journal

Complex temporal climate signals drive the emergence of human water-borne disease

Predominantly occurring in developing parts of the world, Buruli ulcer is a severely disabling mycobacterium infection which often leads to extensive necrosis of the skin. While the exact route of transmission remains uncertain, like many tropical diseases, associations with climate have been previously observed and could help identify the causative agent's ecological niche. In this paper, links between changes in rainfall and outbreaks of Buruli ulcer in French Guiana, an ultraperipheral European territory in the northeast of South America, were identified using a combination of statistical tests based on singular spectrum analysis, empirical mode decomposition and cross-wavelet coherence analysis. From this, it was possible to postulate for the first time that outbreaks of Buruli ulcer can be triggered by combinations of rainfall patterns occurring on a long (i.e., several years) and short (i.e., seasonal) temporal scale, in addition to stochastic events driven by the El Nino-Southern Oscillation that may disrupt or interact with these patterns. Long-term forecasting of rainfall trends further suggests the possibility of an upcoming outbreak of Buruli ulcer in French Guiana

Measurement of the B+ and B-0 lifetimes and search for CP(T) violation using reconstructed secondary vertices

The lifetimes of the B+ and B-0 mesons, and their ratio, have been measured in the OPAL experiment using 2.4 million hadronic Z(0) decays recorded at LEP. Z(0) --> b (b) over bar decays were tagged using displaced secondary vertices and high momentum electrons and muons. The lifetimes were then measured using well-reconstructed charged and neutral secondary vertices selected in this tagged data sample. The results aretau(B+) = 1.643 +/- 0.037 +/- 0.025 pstau(Bo) = 1.523 +/- 0.057 +/- 0.053 pstau(B+)/tau(Bo) = 1.079 +/- 0.064 +/- 0.041,where in each case the first error is statistical and the second systematic.A larger data sample of 3.1 million hadronic Z(o) decays has been used to search for CP and CPT violating effects by comparison of inclusive b and (b) over bar hadron decays, No evidence fur such effects is seen. The CP violation parameter Re(epsilon(B)) is measured to be Re(epsilon(B)) = 0.001 +/- 0.014 +/- 0.003and the fractional difference between b and (b) over bar hadron lifetimes is measured to(Delta tau/tau)(b) = tau(b hadron) - tau((b) over bar hadron)/tau(average) = -0.001 +/- 0.012 +/- 0.008

Observation of associated near-side and away-side long-range correlations in √sNN=5.02 TeV proton-lead collisions with the ATLAS detector

Two-particle correlations in relative azimuthal angle (Δϕ) and pseudorapidity (Δη) are measured in √sNN=5.02  TeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1  μb-1 of data as a function of transverse momentum (pT) and the transverse energy (ΣETPb) summed over 3.1<η<4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2<|Δη|<5) “near-side” (Δϕ∼0) correlation that grows rapidly with increasing ΣETPb. A long-range “away-side” (Δϕ∼π) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ΣETPb, is found to match the near-side correlation in magnitude, shape (in Δη and Δϕ) and ΣETPb dependence. The resultant Δϕ correlation is approximately symmetric about π/2, and is consistent with a dominant cos⁡2Δϕ modulation for all ΣETPb ranges and particle pT