Black Carbon Contribution to Organic Carbon Stocks in Urban Soil.

Soil holds 75% of the total organic carbon (TOC) stock in terrestrial ecosystems. This comprises ecosystem-derived organic carbon (OC) and black carbon (BC), a recalcitrant product of the incomplete combustion of fossil fuels and biomass. Urban topsoils are often enriched in BC from historical emissions of soot and have high TOC concentrations, but the contribution of BC to TOC throughout the urban soil profile, at a regional scale is unknown. We sampled 55 urban soil profiles across the North East of England, a region with a history of coal burning and heavy industry. Through combined elemental and thermogravimetic analyses, we found very large total soil OC stocks (31-65 kg m(-2) to 1 m), exceeding typical values reported for UK woodland soils. BC contributed 28-39% of the TOC stocks, up to 23 kg C m(-2) to 1 m, and was affected by soil texture. The proportional contribution of the BC-rich fraction to TOC increased with soil depth, and was enriched in topsoil under trees when compared to grassland. Our findings establish the importance of urban ecosystems in storing large amounts of OC in soils and that these soils also capture a large proportion of BC particulates emitted within urban areas.

"Are you otherwise fit and well?": Past medical history questions in UK paediatric consultations.

Accurate diagnosis and treatment depend upon detailed knowledge of both the child's presenting symptoms and their past medical history. However, the process of soliciting past medical history has never been subject to systematic scrutiny in actual clinical practice. OBJECTIVE: To examine the function of the question "are you otherwise fit and well?" to elicit a child's general medical history in UK paediatric allergy outpatient consultations. METHODS: Examination of 30 video-recorded UK paediatric outpatient consultations involving children (2-10 years), caregivers, and one doctor. We identified, transcribed, and interrogated 13 examples, deploying the systematic and rigorous method of conversation analysis to elucidate the question's micro-design elements and their consequences for the consultation's trajectory. RESULTS: Asking "Are you otherwise fit and well?" is built to efficiently solicit a problem-free report of good health. Nonetheless patients can and do raise other relevant matters. In practice, the question initiates several interactional matters simultaneously: establishing/resolving (mis)understandings of "fitness" and "wellness"; negotiating opportunities for children's participation; and importantly, a shift towards discussing more general wellbeing. CONCLUSION: Past medical history questions unavoidably generate broader interactional matters which are skilfully resolved in real-time between clinicians, caregivers, and children. PRACTICE IMPLICATIONS: Clinical training could be greatly enhanced by integrating insights into the interactional consequences of asking questions, particularly in the complex multiparty environment of paediatrics. While the question 'Are you otherwise fit and well' clearly serves an important function, clinicians should be alert to the possible problems it might raise, especially when directed towards younger children.

High-utility conserved avian microsatellite markers enable parentage and population studies across a wide range of species.

BACKGROUND: Microsatellites are widely used for many genetic studies. In contrast to single nucleotide polymorphism (SNP) and genotyping-by-sequencing methods, they are readily typed in samples of low DNA quality/concentration (e.g. museum/non-invasive samples), and enable the quick, cheap identification of species, hybrids, clones and ploidy. Microsatellites also have the highest cross-species utility of all types of markers used for genotyping, but, despite this, when isolated from a single species, only a relatively small proportion will be of utility. Marker development of any type requires skill and time. The availability of sufficient "off-the-shelf" markers that are suitable for genotyping a wide range of species would not only save resources but also uniquely enable new comparisons of diversity among taxa at the same set of loci. No other marker types are capable of enabling this. We therefore developed a set of avian microsatellite markers with enhanced cross-species utility. RESULTS: We selected highly-conserved sequences with a high number of repeat units in both of two genetically distant species. Twenty-four primer sets were designed from homologous sequences that possessed at least eight repeat units in both the zebra finch (Taeniopygia guttata) and chicken (Gallus gallus). Each primer sequence was a complete match to zebra finch and, after accounting for degenerate bases, at least 86% similar to chicken. We assessed primer-set utility by genotyping individuals belonging to eight passerine and four non-passerine species. The majority of the new Conserved Avian Microsatellite (CAM) markers amplified in all 12 species tested (on average, 94% in passerines and 95% in non-passerines). This new marker set is of especially high utility in passerines, with a mean 68% of loci polymorphic per species, compared with 42% in non-passerine species. CONCLUSIONS: When combined with previously described conserved loci, this new set of conserved markers will not only reduce the necessity and expense of microsatellite isolation for a wide range of genetic studies, including avian parentage and population analyses, but will also now enable comparisons of genetic diversity among different species (and populations) at the same set of loci, with no or reduced bias. Finally, the approach used here can be applied to other taxa in which appropriate genome sequences are available.

Understanding mixed emotions in organized helping through emotionography.

Introduction: Emotionography studies emotion: (a) as it occurs naturally in display, reception, attribution, and avowal; (b) within and across diverse stretches of interaction and varied institutional contexts; (c) grounded purposefully in the perspectives of the interactants as those perspectives are displayed in real-time through unfolding talk; (d) using materials that are recorded and transcribed in sufficient precision to capture the granularity consequential for the interactants. We overview contemporary research on "mixed emotion" highlighting theoretical and methodological issues and explore the potential of emotionography as a generative alternative. Methods: The analysis will use contemporary conversation analysis and discursive psychology to illuminate the workings of organized helping using a collection of recordings from a child protection helpline all of which include laughter alongside crying. Results: Analysis shows, on the one hand, how crying and upset display the caller's stance on the trouble being reported, and mark its action-relevant severity; on the other, how laughter manages ongoing parallel issues such as advice resistance. We show that the "mixture" is public and pragmatic, displaying different concerns and stances, and dealing with different issues; all is in the service of action. Discussion: When analyzing the specifics of interaction, the concept of "mixed emotion" loses clarity, and it is more accurate to observe competing pragmatic endeavors being pursued in an intricately coordinated fashion. These practices would not be captured by conventional emotion measurement tools such as scales, vignettes, or retrospective interviews. Broader implications for theories of emotion and methods of emotion research are discussed.

Managing patients with COPD exacerbation: does age matter?

INTRODUCTION: there is little information about the relationship between age and management of COPD exacerbation (AECOPD), although older persons are known to be at a greater risk of hospital admission. METHODS: we have investigated responses from the clinical and patient questionnaire elements of the 2008 UK COPD audit, splitting the data into age decile. RESULTS: age ranged from 27 to 102. Patient-reported data suggested older patients had inferior knowledge of COPD, undertook less self-care and were less likely to recognise symptoms of exacerbation prior to hospitalisation. Clinician-reported data showed that although older patients had severe disease and symptoms, greater co-morbidity at presentation and higher mortality, fewer were seen in hospital or followed up subsequently by respiratory specialists. Older patients were more likely to have a DNR order signed within 24 h of admission, irrespective of co-morbidities or performance status. The observations were particularly applicable to those aged 80 or above. CONCLUSIONS: clinicians should consider increasing age as a specific risk factor in the management of COPD. Acute units and community teams should review carefully their protocols and pathways for how they assess, manage, discharge and follow-up older patients with COPD exacerbation.

Commissioning health care in England: an evolving story.

The general election in the United Kingdom in May 2010 resulted in the election of a new government, a coalition between Conservative and Liberal Democrat parties. Six weeks after the election, a white paper, "Equity and Excellence: Liberating the NHS," that proposed profound changes to the structure and organization of the health service was published. The change that generated the most discussion was the proposal that general practitioners be placed at the center of the system and given control of about 80% of the National Health Service's £100 billion budget. The proposals were greeted with considerable concern by many health care professionals, patient representatives, and the media. In response, the government organized an independent review, and proposals have been altered in response. This article outlines the current organization of the National Health Service, the rationale for change, and government proposals.

The National Falls and Bone Health Audit: implications for UK emergency care.

INTRODUCTION: The National Clinical Audit of Falls and Bone Health, coordinated by the Royal College of Physicians, assesses progress in implementing integrated falls services across the UK against national standards and enables benchmarking between service providers. Nationally, falls are a leading contributor towards mortality and morbidity in older people and account for 700,000 visits to emergency departments and 4 million annual bed days in England alone. METHODS: Two rounds of national organisational audit in 2005 and 2008 and one national clinical audit in 2006 were carried out based on indicators developed by a multidisciplinary group. RESULTS: These showed that management of falls and bone health in older people remains suboptimal in emergency departments and minor injury units and opportunities are being missed in carrying out evidence-based risk assessment and management. CONCLUSIONS: Older people attending emergency departments in the UK following a fall are receiving a poor deal. There is an urgent need to ensure more effective assessment and management to prevent further falls and fractures.

Fast X-ray powder diffraction on I11 at Diamond.

The commissioning and performance characterization of a position-sensitive detector designed for fast X-ray powder diffraction experiments on beamline I11 at Diamond Light Source are described. The detecting elements comprise 18 detector-readout modules of MYTHEN-II silicon strip technology tiled to provide 90° coverage in 2θ. The modules are located in a rigid housing custom designed at Diamond with control of the device fully integrated into the beamline data acquisition environment. The detector is mounted on the I11 three-circle powder diffractometer to provide an intrinsic resolution of Δ2θ approximately equal to 0.004°. The results of commissioning and performance measurements using reference samples (Si and AgI) are presented, along with new results from scientific experiments selected to demonstrate the suitability of this facility for powder diffraction experiments where conventional angle scanning is too slow to capture rapid structural changes. The real-time dehydrogenation of MgH(2), a potential hydrogen storage compound, is investigated along with ultrafast high-throughput measurements to determine the crystallite quality of different samples of the metastable carbonate phase vaterite (CaCO(3)) precipitated and stabilized in the presence of amino acid molecules in a biomimetic synthesis process.

Threats: power, family mealtimes, and social influence.

One of the most basic topics in social psychology is the way one agent influences the behaviour of another. This paper will focus on threats, which are an intensified form of attempted behavioural influence. Despite the centrality to the project of social psychology, little attention has been paid to threats. This paper will start to rectify this oversight. It reviews early examples of the way social psychology handles threats and highlights key limitations and presuppositions about the nature and role of threats. By contrast, we subject them to a programme of empirical research. Data comprise video records of a collection of family mealtimes that include preschool children. Threats are recurrent in this material. A preliminary conceptualization of features of candidate threats from this corpus will be used as an analytic start point. A series of examples are used to explicate basic features and dimensions that build the action of threatening. The basic structure of the threats uses a conditional logic: if the recipient continues problem action/does not initiate required action then negative consequences will be produced by the speaker. Further analysis clarifies how threats differ from warnings and admonishments. Sequential analysis suggests threats set up basic response options of compliance or defiance. However, recipients of threats can evade these options by, for example, reworking the unpleasant upshot specified in the threat, or producing barely minimal compliance. The implications for broader social psychological concerns are explored in a discussion of power, resistance, and asymmetry; the paper ends by reconsidering the way social influence can be studied in social psychology.

A review of grading systems for evidence-based guidelines produced by medical specialties.

The development of evidence-based guidelines requires scrupulous attention to the method of critical appraisal. Many critical appraisal systems give 'gold standard' status to randomised controlled trials (RCTs) due to their ability to limit bias. While guidelines with a prominent research base consisting of RCTs have been well served by such systems, specialist societies with research bases consisting of a wide range of study designs have been at a disadvantage, potentially leading to inappropriately low grades being given for recommendations. A review of the Scottish Intercollegiate Guidelines Network, the Grading of Recommendations Assessment, Development and Evaluation, the Graphic Appraisal Tool for Epidemiology and the National Service Framework for Long Term Conditions grading systems was therefore undertaken. A matrix was developed suggesting the optimum grading system for the type of guideline being developed or question being addressed by a specialist society.

Mapping the literature of occupational therapy: an update.

OBJECTIVES: This study updated Reed's 1999 "Mapping the Literature of Occupational Therapy." An analysis of citation patterns and indexing coverage was undertaken to identify the core literature of occupational therapy and to determine access to that literature. METHODS: Citations from three source journals for the years 2006 through 2008 were studied following the common methodology of the "Mapping the Literature of Allied Health Project." Bradford's Law of Scattering was applied to analyze the productivity of cited journals. A comparative analysis of indexing was conducted across three bibliographic databases. RESULTS: A total of 364 articles cited 10,425 references. Journals were the most frequently cited format, accounting for 65.3% of the references, an increase of 4.1% over the 1999 study. Approximately one-third of the journal references cited a cluster of 9 journals, with the American Journal of Occupational Therapy dominating the field. An additional 120 journals were identified as moderately important based on times cited. CINAHL provided the most comprehensive indexing of core journals, while MEDLINE provided the best overall coverage. CONCLUSIONS: Occupational therapy is a multidisciplinary field with a strong core identity and an increasingly diverse literature. Indexing has improved overall since 1999, but gaps in the coverage are still evident.

Contemporary discursive psychology: issues, prospects, and Corcoran's awkward ontology.

This paper is both an overview of the status of contemporary discursive psychology and a response to Corcoran's critical article. The first part of the paper reports on the main traditions that make up contemporary discursive psychology and how they relate to one another. Then it responds to Corcoran's claims that much of contemporary discursive psychology: (a) is over concerned with epistemic issues at the expense of ontological issues; (b) is too concerned with data purity while failing reflexively to address its own practices; (c) fails to address ethical, applied, and political issues in the way that a reformed 'ontological' discursive psychology would be able to; (d) fails to provide an adequate and rich account of relationality (of the kind offered by thinkers such as Bakhtin, Shotter, and Chouliaraki). The limitations of each point are addressed in turn, highlighting errors and confusions. The broadly epistemic focus is appropriate for the subject matter of discursive psychology; discursive psychology is less concerned with data purity than with pursuing the radical and empirically progressive possibilities in studying records of people living their lives in everyday and institutional settings (a surprising oversight in a discipline focused on the actions of human beings) and it has a reflexive tradition going back two decades; it has a strong and distinctive focus on ethical, applied, and political issues; it has an account of relationality that is grounded in conversational materials. A single example from interaction on a child protection helpline is analysed to illustrate the way relationality, knowledge, and intersubjectivity have been made analytically tractable in contemporary discursive research.

Shaming interrogatives: Admonishments, the social psychology of emotion, and discursive practices of behaviour modification in family mealtimes.

This paper contributes to the study of admonishments, the operation of shaming in family interaction, and more broadly presses the virtue of a discursive psychological reconsideration of the social psychology of emotion. It examines the methodological basis of contemporary research on shame in experimental and qualitative social psychology, illustrated through the Test of Self-Conscious Affect (TOSCA) and qualitative work using shame narratives. Doubts are raised about how these methods can throw light on shaming practices in natural situations. The study uses a collection of video recordings of family mealtimes, focusing on admonishment sequences in which parents address the interrogatives 'what are you doing' or 'what did I say' to a 'misbehaving' child. Despite the interrogative syntax, rather than soliciting information we show that these interrogative forms pursue behaviour change by publicly highlighting both the problem behaviour and the child's active and intentional production of that behaviour. This is the sense in which the practice can be understood as shaming. Although this practice prosecutes shaming, ways in which the children can ignore, push back, or rework parents' actions are highlighted. This study contributes to a broader consideration of how enduring behavioural change can be approached as a parents' project.

Long-Term Stability of MFM-300(Al) toward Toxic Air Pollutants.

Temperature- or pressure-swing sorption in porous metal-organic framework (MOF) materials has been proposed for new gas separation technologies. The high tunability of MOFs toward particular adsorbates and the relatively low energy penalty for system regeneration indicate that reversible physisorption in MOFs has the potential to create economic and environmental benefits compared with state-of-the-art chemisorption systems. However, for MOF-based sorbents to be commercialized, they have to show long-term stability under the conditions imposed by the application. Here, we demonstrate the structural stability of MFM-300(Al) in the presence of a series of industrially relevant toxic and corrosive gases, including SO2, NO2, and NH3, over 4 years using long-duration synchrotron X-ray powder diffraction. Full structural analysis of gas-loaded MFM-300(Al) confirms the retention of these toxic gas molecules within the porous framework for up to 200 weeks, and cycling adsorption experiments verified the reusability of MFM-300(Al) for the capture of these toxic air pollutants.

Do self-reported 'integrated' continence services provide high-quality continence care?

INTRODUCTION: systematic collection of clinical outcome data remains the most difficult task in the measurement of clinical effectiveness. However, the examination of the relationship between organisational and clinical process of care may provide a surrogate measure of quality in care. METHODS: data from the 2006 National Audit of Continence Care for Older People were used to examine whether there was an association between organisational structure and standard of continence care for older people. 'Quality' scores were produced and the relationship between scores was examined. RESULTS: there were statistically significant correlations between organisational and process scores for continence care. Primary care scored higher than hospitals or care homes in regard to service organisation [median (IQR): 57 (45-68) vs 48 (36-65) vs 50 (38-55), P = 0.001]. Differences were less with clinical process scores for urinary incontinence (UI) [median (IQR): 42 (32-52) vs 40 (29-49) vs 43 (34-52), P = 0.06] and for faecal incontinence (FI) [median: 42 (34-53) vs 45 (36-55) vs 47 (41-53), P = 0.12]. CONCLUSION: those with an integrated service provide higher quality care to older people. The provision of high-quality care for continence appears to be dependent upon well-organised services with personnel who have the appropriate training and skills to deliver the care.

Introducing the national COPD resources and outcomes project.

BACKGROUND: We report baseline data on the organisation of COPD care in UK NHS hospitals participating in the National COPD Resources and Outcomes Project (NCROP). METHODS: We undertook an initial survey of participating hospitals in 2007, looking at organisation and performance indicators in relation to general aspects of care, provision of non-invasive ventilation (NIV), pulmonary rehabilitation, early discharge schemes, and oxygen. We compare, where possible, against the national 2003 audit. RESULTS: 100 hospitals participated. These were typically larger sized Units. Many aspects of COPD care had improved since 2003. Areas for further improvement include organisation of acute care, staff training, end-of-life care, organisation of oxygen services and continuation of pulmonary rehabilitation. KEY POINTS: positive change occurs over time and repeated audit seems to deliver some improvement in services. It is necessary to assess interventions such as the Peer Review used in the NCROP to achieve more comprehensive and rapid change.

Acute medical care. The right person, in the right setting--first time: how does practice match the report recommendations?

An acute medicine Royal College of Physicians report makes key recommendations. This study reviews organisational issues and consultant working patterns against these recommendations. Thirty-nine trusts in England and Wales were asked to participate in an online survey, which 27 completed. Twenty-six sites had an acute medical unit (AMU) and all had a lead consultant. Two trusts had no written operational policy. Of the 26 AMUs, 22 had at least level 1 facilities and 21 used an early warning score at point of entry to care. Ten reported a minimum of twice daily ward rounds seven days a week. Consultant of the day was the most common pattern of work. Ten trusts cancelled other clinical duties for consultants responsible for acute take. The pilot shows evidence of good practice in leadership and operational policies. Further work to standardise and improve acute care is needed including a more consistent twice daily consultant review.

Caring: building a 'psychological disposition' in pre-closing sequences in phone calls with a young adult with a learning disability.

This article has a joint focus on the way both psychological dispositions and matters of potential disability figure in interaction. The study works with a collection of more than fifty telephone calls between a young adult with a learning disability staying in a residential placement and three other members of her family. It focuses on the closing sections of the telephone calls and in particular how pre-closing turns may be designed to display caring. This paper analyses three formats through which pre-closings are delivered; through the use of announcements, interrogatives and imperatives. In each case the pre-closing commonly includes an account which provides a warrant for the impending termination. Detailed comparative study of the closing sequences in a corpus of mundane phone calls which do not include a disabled member finds very few such accounts. It is suggested that participants draw on accounts in a way that manages the potentially interactionally troubling matter of closing the call and, more specifically, to build the speakers' affiliative, 'caring', stance to one another. The analysis is used to consider broader issues about psychology and interaction, family relations and disability.

National audit of continence care for older people: management of urinary incontinence.

INTRODUCTION: the Department of Health report 'Good practice in continence services' highlights the need for proper assessment and management of urinary incontinence. The National Service Framework for Older People required service providers to establish integrated continence services by April 2004. A national audit was conducted to assess the quality of continence care for older people and whether these requirements have been met. METHOD: the audit studied incontinent individuals of 65 years and over. Each site returned data on organisational structure and the process of 20 patients' care. Data were submitted via the internet, and all were anonymous. RESULTS: the national audit was conducted across England, Wales and Northern Ireland. Data on the care of patients/residents with bladder problems were returned by 141/326 (43%) of primary care trusts (PCT), by 159/196 (81%) of secondary care trusts (involving 198 hospitals) and by 29/309 (9%) of invited care homes. In all 58% of PCT, 48% of hospitals and 74% of care homes reported that integrated continence services existed in their area. Whilst basic provision of care appeared to be in place, the audit identified deficiencies in the organisation of services, and in the assessment and management of urinary incontinence in the elderly. CONCLUSION: the results of this audit indicate that the requirement for integrated continence services has not yet been met. Assessment and care by professionals directly looking after the older person were often lacking. There is an urgent need to re-establish the fundamentals of continence care into the practice of medical and nursing staff and action needs to be taken with regard to the establishment of truly integrated, quality services in this neglected area of practice.

Guidance for the assessment of pain in older adults: a literature review.

This paper presents guidance for the assessment of pain in older adults, which was developed as a collaborative project by the British Pain Society and the British Geriatric Society. The guidance was published in November 2007 and was designed to provide health professionals with practical skills to assess pain as the first step towards its effective management. The guidance did not seek to differentiate between acute and persistent pain as the literature relating to pain in older people renders such distinction impractical. The next stage will involve the development of guidance for the management of pain in older adults, which will commence this year.