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Turbidity is commonly monitored as an important water quality index. Human activities, such as dredging and dumping operations, can disrupt turbidity levels and should be monitored and analysed for possible effects. In this paper, we model the variations of turbidity in Dublin Bay over space and time to investigate the effects of dumping and dredging while controlling for the effect of wind speed as a common atmospheric effect. We develop a Vector Auto-Regressive Integrated Conditional Heteroskedasticity (VARICH) approach to modelling the dynamical behaviour of turbidity over different locations and at different water depths. We use daily values of turbidity during the years 2017–2018 to fit the model. We show that the results of our fitted model are in line with the observed data and that the uncertainties, measured through Bayesian credible intervals, are well calibrated. Furthermore, we show that the daily effects of dredging and dumping on turbidity are negligible in comparison to that of wind speed. [ABSTRACT FROM AUTHOR]

Understanding regional sea level variations is crucial for assessing coastal vulnerability, with accurate sea level data playing a pivotal role. Utilizing historical sea level marigrams can enhance datasets, but current digitization techniques face challenges such as bends and skews in paper charts, impacting sea level values. This study explores often‐overlooked issues during marigram digitization, focusing on the case study of Dún Laoghaire in Ireland (1925–1931). The methodology involves digitizing the original marigram trace and underlying grid to assess offsets at the nearest ft (foot) interval on the paper chart, corresponding to changes in the water level trace for each hour interval. Subtracting the digitized value from the known value (the actual measurement) allows for the determination of differences, which are then subtracted from each hourly trace value. After adjusting for offsets ranging from −3.962 to 13.716 mm (millimetres), the study improves the final accuracy of sea level data to approximately the 10 mm level. Notably, data from 1926 and 1931 exhibit modest offsets (<7 mm), while other years show more substantial offsets (>9–14 mm), emphasizing the importance of adjustments for accuracy. Such 10 mm accuracy is compatible with requirements of the Global Sea Level Observing System. Comparing the adjusted digitized data with other survey data shows similar amplitudes and phases for Dún Laoghaire in both the historical and modern datasets, and there is an overall mean sea level rise of 1.5 mm/year when combined with the available data from the Dublin region. [ABSTRACT FROM AUTHOR]

Background: Over 65s are frequent attenders to the Emergency Department (ED) and more than half are admitted for overnight stays. Early assessment and intervention by a dedicated ED-based Health and Social Care Professionals (HSCP) team reduces ED length of stay and the risk of hospital admissions among older adults while improving patient health-related quality-of-life and satisfaction with care. This study aims to evaluate whether augmenting the treatment as usual for older adults admitted to ED is cost-effective. Methods and findings: Cost-effectiveness analysis (CEA), conducted alongside the OPTI-MEND randomised controlled trial of 353 patients aged ≥65 with lower urgency complaints compared the effectiveness of early assessment and intervention by a dedicated HSCP team in the ED to treatment as usual (TAU). An economic analysis estimated the average cost per older adults randomised to the HSCP team, and compared to TAU, how contact with HSCP team changed health care use, and associated total costs, and estimated the effect of HSCP on Quality-Adjusted Life Years (QALYs). Within the OPTI-MEND trial, the average cost of a contact with the HSCP team during ED attendance is estimated to be €801 per patient. Compared to TAU, the incremental QALY of intervention is 0.053 (95% CI: 0.023 to 0.0826, p<0.0001). Accounting for cost savings because of contact with HSCP team, the average incremental saving in the total cost, compared to TAU, is -€6,128 (95% CI: -€9,217 to -€3,038, p<0.0001). Given the incremental health gains and significant cost savings, bootstrapped cost CEA suggests that dedicated HSCP care dominates over TAU for low urgency older adults attending the ED. Conclusions: A dedicated HSCP team in the ED significantly improves overall health for lower acuity older adults and, by reducing inpatient length of stay, results in staggering cost savings. This economic evaluation conducted on the OPTI-MEND trial provides convincing evidence that HSCP should be adopted as part of treatment as usual in Irish EDs. Trial registration: ClinicalTrials.gov, NCT03739515; registered on 12th November 2018. https://classic.clinicaltrials.gov/ct2/show/NCT03739515. [ABSTRACT FROM AUTHOR]

The social and economic impacts of COVID-19 have been devastating for many, and collectively young people generally fared worse than older adults, with the impact amongst young people also being highly uneven. Most studies on this topic focus on Global North contexts, with experiences in the Global South being less well understood. Focusing on young people in Nepal and Indonesia who were especially exposed to the fallout from the pandemic (in part due to their occupations), this paper analyzes over 1400 weekly diary entries from 100 respondents written across four months in the first half of 2021. Participants recall increasingly precarious individual and family situations due to pandemic-related livelihood upheavals and insufficient access to social protection. Amongst diverse ‘coping strategies’, many turned to debt to smooth fluctuating incomes – leading to both financial and social obligations and forcing sometimes life-altering decisions such as leaving education and moving into risky work. Spiralling indebtedness may have consequences for livelihoods across young people’s life-courses; with futures mortgaged to survive precarity at the peak of the Delta wave of COVID-19. Looking ahead, policy makers should reconfigure disaster responses and social protection with a youth-lens to ensure a robust, fair and sustainable recovery from future crises, mitigating inter-generational scarring effects. [ABSTRACT FROM AUTHOR]

The Atlantic Meridional Overturning Circulation (AMOC), a crucial element of the Earth's climate system, is projected to weaken over the course of the twenty-first century which could have far reaching consequences for the occurrence of extreme weather events, regional sea level rise, monsoon regions and the marine ecosystem. The latest IPCC report puts the likelihood of such a weakening as 'very likely'. As our confidence in future climate projections depends largely on the ability to model the past climate, we take an in-depth look at the difference in the twentieth century evolution of the AMOC based on observational data (including direct observations and various proxy data) and model data from climate model ensembles. We show that both the magnitude of the trend in the AMOC over different time periods and often even the sign of the trend differs between observations and climate model ensemble mean, with the magnitude of the trend difference becoming even greater when looking at the CMIP6 ensemble compared to CMIP5. We discuss possible reasons for this observation-model discrepancy and question what it means to have higher confidence in future projections than historical reproductions. This article is part of a discussion meeting issue 'Atlantic overturning: new observations and challenges'. [ABSTRACT FROM AUTHOR]

Background Older adults frequently attend the emergency department (ED) and experience high rates of adverse events following ED presentation. This randomised controlled trial evaluated the impact of early assessment and intervention by a dedicated team of health and social care professionals (HSCPs) in the ED on the quality, safety, and clinical effectiveness of care of older adults in the ED. Methods and findings This single-site randomised controlled trial included a sample of 353 patients aged [greater than or equal to]65 years (mean age = 79.6, SD = 7.01; 59.2% female) who presented with lower urgency complaints to the ED a university hospital in the Mid-West region of Ireland, during HSCP operational hours. The intervention consisted of early assessment and intervention carried out by a HSCP team comprising a senior medical social worker, senior occupational therapist, and senior physiotherapist. The primary outcome was ED length of stay. Secondary outcomes included rates of hospital admissions from the ED; hospital length of stay for admitted patients; patient satisfaction with index visit; ED revisits, mortality, nursing home admission, and unscheduled hospital admission at 30-day and 6-month follow-up; and patient functional status and quality of life (at index visit and follow-up). Demographic information included the patient's gender, age, marital status, residential status, mode of arrival to the ED, source of referral, index complaint, triage category, falls, and hospitalisation history. Participants in the intervention group (n = 176) experienced a significantly shorter ED stay than the control group (n = 177) (6.4 versus 12.1 median hours, p < 0.001). Other significant differences (intervention versus control) included lower rates of hospital admissions from the ED (19.3% versus 55.9%, p < 0.001), higher levels of satisfaction with the ED visit (p = 0.008), better function at 30-day (p = 0.01) and 6-month follow-up (p = 0.03), better mobility (p = 0.02 at 30 days), and better self-care (p = 0.03 at 30 days; p = 0.009 at 6 months). No differences at follow-up were observed in terms of ED re-presentation or hospital admission. Study limitations include the inability to blind patients or ED staff to allocation due to the nature of the intervention, and a focus on early assessment and intervention in the ED rather than care integration following discharge. Conclusions Early assessment and intervention by a dedicated ED-based HSCP team reduced ED length of stay and the risk of hospital admissions among older adults, as well as improving patient satisfaction. Our findings support the effectiveness of an interdisciplinary model of care for key ED outcomes. Trial registration ClinicalTrials.gov NCT03739515; registered on 12 November 2018., Author(s): Marica Cassarino 1,2, Katie Robinson 1, Dominic Trépel 3,Íde O'Shaughnessy 4, Eimear Smalle 4, Stephen White 4, Collette Devlin 1, Rosie Quinn 5, Fiona Boland 6, Marie E. Ward [...]