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Objective: This article reports on a pilot study designed to collect dose data representative of current CT chest abdomen pelvis (CAP) practice in Scotland, make any immediately obvious interventions and to identify if the current UK diagnostic reference level (DRL) of 940 mGy cm is still appropriate. The aims are to identify if a Scotland-wide picture archiving and communication system (PACS)-based dose audit of a number of CT examinations is likely to have value in terms of optimization of patient doses and to comment on the significance of the results in terms of future optimization strategies. Methods: Dose audit of CT CAP examinations at 32 different scanner sites across Scotland using accepted data collection and analysis methods. The minimum sample size was 30. Results: Results indicate that CT CAP doses are lower than those previously reported (median, 800 mGy cm, 75th percentile 840 mGy cm) but follow a distribution that is not in keeping with the concept of DRLs as presently understood or implemented. Conclusion: There is value in a PACS-based dose audit project to provide serial snapshots of patient doses as optimization efforts take place and to revise current knowledge about CT doses. In our opinion, the results call into question whether DRLs or the concept of "achievable dose" are suitable for devising optimization strategies once a certain degree of optimization has taken place. Advances in knowledge: The results reported here suggest that it may be time to take a different approach to optimization, concentrating on tools that are more refined than the DRL, which may have become more of a compliance tool than an aid to optimization. [ABSTRACT FROM AUTHOR]

Recent dry years (combined dry winter and summer months) within the UK (2005 and 2006) have enhanced concerns relating to long term water resources and future water provision in large conurbations. This paper examines the mechanisms responsible for precipitation variability for five different areas in Edinburgh (precipitation regions) using composite historic precipitation records for the period 1861–2005. Trend analysis and principal component analysis (PCA) were undertaken to examine precipitation variability over time and space. Annual correlation co-efficients were derived for relationships between precipitation areas, atmospheric–oceanographic variations and geographic parameters. Stepwise regression models were constructed to specify annual precipitation, through atmospheric variations, for each of the precipitation areas. Significant downward trends in precipitation ( p < 0.05) were noted in two out of the five precipitation areas, with one principal component representing precipitation variability over Edinburgh and the Pentland Hills. Precipitation variability is best explained by fluctuations in pressure, altitude and proximity to coast. Precipitation trends cannot be explained by changes in atmospheric circulation patterns. [ABSTRACT FROM AUTHOR]

The management of urban storm water and flooding is challenging, particularly within older, post-industrial urban environments where infrastructure, housing and businesses already operate. The urban environment constrains opportunities for the development and integration of new approaches to drainage management, particularly the use of sustainable drainage systems (SuDS). These issues are investigated through a case study of Glasgow. The northeast of the city suffered significant urban flooding in July 2002 following an intense convective summer storm. This event overloaded the urban drainage system, which was heavily integrated and led to the back flow of foul water into streets and homes. This study examines the response to this event and the construction of an integrated drainage management plan for the city, the Glasgow Strategic Drainage Plan (GSDP), which includes greater use of SuDS in tackling the city's capacity problems. Reflecting on the interdisciplinary nature of urban drainage management, this study adopts a social science method, undertaking semi-structured interviews with key actors involved in producing the GSDP. [ABSTRACT FROM AUTHOR]

This paper constructs annual homogenised precipitation series for 13 locations in Scotland (1861–1991) from non-standard sources. Whilst the British Rainfall series represents the backbone of most UK rainfall records before the middle of the twentieth century, this paper returns to the original records to examine spatial and temporal variations in Scottish precipitation. The records were subjected to trend analysis and principal components analysis (PCA), and then related to atmospheric circulation parameters to understand the synoptic- scale mechanisms involved. Upward (downward) trends in precipitation were noted in western (eastern) Scotland over the period 1870–1991. Precipitation variability in western (eastern) Scotland is best explained by fluctuations in the westerly circulation (pressure), with the west- east precipitation gradient closing in those years with below average pressure, and a greater frequency of northerly and/or easterly winds. Precipitation trends cannot be explained by changes in atmospheric circulation patterns, suggesting that other factors must be involved. [ABSTRACT FROM AUTHOR]

Improved estimates of UK flood risk during a period of increased climatic variability place challenges on existing methods that rely on short instrumental records. This paper examines the value of using historical data (both documentary and epigraphic) to augment existing gauged records for the River Tay at Perth as part of a multi-method approach to assessing flood risk. Single station and pooled methods are compared with flood risk estimates based on an augmented historical series (1815–2000) using the Generalized Logistic and Generalized Pareto distributions. The value of using an even longer, but less reliable, extended historical series (1210–2000) is also examined. It is recommended that modelling flood risk for return periods >100 years should incorporate historical data, where available, and that a multi-method approach using a high threshold Generalized Pareto distribution can also add confidence in flood risk estimates for return periods <100 years based on standard methods. [ABSTRACT FROM AUTHOR]

Abstract: Proxy flood records from sediment stacks in floodplain palaeochannels provide an opportunity to extend short instrumental records and thus improve current estimates of flood risk. The ‘Bloody Inches’ (a meander cutoff on the lower River Tay, Scotland) has been infilling with flood deposits since c. 1761. Agricultural flood embankments locally breach with flows >850 m3 s−1 (introducing silts into the palaeochannel) and extensively fail with flows >1200 m3 s−1 (which deposit sand). Repeated cores at the site (up to 1.4 m in depth) consistently reveal sand-rich flood units. In the upper section of the core, 137Cs dating enables these units to be correlated with clusters of floods in the post-1950 discharge record. Sand units in the lower part of the profile are correlated with major floods from 1814 onwards using a 210Pb-based chronology. These dates are independently corroborated by flood marks inscribed on Smeaton''s Bridge in Perth, 15 km downstream. Estimates of historic high flows back to 1814 can also be recovered from these flood stage levels at Smeaton''s Bridge. When combined with the 48-year-long flow record, these historic floods yield an augmented POT series extending back to 1847. Using a relatively high threshold of 1361 m3 s−1 and the Generalised Pareto Distribution to model this POT series, estimates of the 50-, 100- and 200-year floods are 1875, 2250 and 2050 m3 s−1, respectively. These results provide independent and robust confirmation of the flood risk at Perth using the standard statistical procedures advocated in the Flood Estimation Handbook. If successfully replicated at other sites, radiometric dating of sediment stacks in palaeochannels provides a new technique to further advance palaeohydrology and the recovery of historic floods. [Copyright &y& Elsevier]

Objective: To determine the prevalence of hypernatraemic dehydration and to assess the hydration and nutritional state of patients in a large hospital for the mentally and physically handicapped; also to assess the efficacy of an intervention programme to reduce the prevalence of hypernatraemic dehydration in the hospital., Design: Prospective study of patients admitted with hypernatraemic dehydration from a large hospital for mentally and physically handicapped patients (hospital A) to a district general hospital between 1986 and 1988. In 1986 the hydration and nutritional state of a random sample of patients from hospital A was compared with a random sample of patients from a small hospital for the physically and mentally handicapped (hospital B) and with control groups from the community. The hydration of the patients from hospital A examined in 1986 was reassessed in 1988., Patients: 12 Patients were admitted from hospital A to the district general hospital during 1986-8 (seven women, five men; age range 29-82). In 1986, 72 patients were randomly selected for the assessment of hydration and nutritional state from hospital A, 33 who required help with feeding and 39 who could feed independently. Fifty patients were similarly selected from hospital B, half of them requiring help with feeding. In 1988 the hydration state of 60 of the 72 patients from hospital was reassessed. Control values were taken from two published studies., Interventions: In 1987 nursing staff in hospital A were asked to provide between 2.5 and 3.0 litres of fluid daily for all patients. The use of hypertonic enemas was discontinued, and the ratio of staff to patients was increased., Main Outcome Measures: Serum concentrations of urea and electrolytes (hydration) and body mass index (nutritional state)., Results: Of the 10 patients admitted with hypernatraemic dehydration from hospital A to the district general hospital in 1986, four died of intercurrent infection. No patients were admitted from hospital B with hypernatraemic dehydration during the same time. In 1986 the hydration and nutritional state of patients in hospital A were inferior to those in patients from hospital B and control subjects from the community (serum urea concentrations were 6.1 (SD 1.8) mmol/l v 5.5 (1.9) and 5.6 (0.4) mmol/l, respectively) 50% (36/72) of patients in hospital A had a body mass index less than or equal to 20 compared with 34% (17/50) of patients from hospital B and 12% (1141/9434) of control subjects). After the initiation of the preventive programme only one patient was admitted with hypernatraemic dehydration in each of the years 1987 and 1988. The mean serum urea concentration of the 60 patients who were reassessed in 1988 fell significantly between 1986 and 1988 from 6.1 (SD 1.8) mmol/l to 5.7 (2.1) mmol/l, the value in a control group matched for age and sex., Conclusions: Hypernatraemic dehydration, subclinical underhydration, and undernutrition were common in a large hospital for the mentally and physically handicapped. The problem of hypernatraemic dehydration was successfully dealt with by the hospital management team. Similar problems may be encountered in hospitals for patients who are mentally and physically handicapped and mentally ill, including psychogeriatric units.