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Aim: To review the existing evidence regarding the use of language in clinical encounters. Background: Awareness of the importance of language in clinical encounters is mostly lacking or located within broader discussions on communication. Methods: A scoping study was conducted to review existing research that could increase our understanding of the role language plays as well as identify gaps in knowledge and inform the development of a position statement on language in diabetes care. Results: Evidence shows that, although carefully chosen language can have a positive effect, there is a potential negative impact of language on people's experiences of diabetes care. The use of stigmatizing and discriminatory words during communication between healthcare practitioners and people with diabetes can lead to disengagement with health services as well as sub‐optimal diabetes self‐management. Clinical encounters can be compromised where language barriers exist or where there is limited understanding of cultural differences that may have an impact on diabetes self‐management. What little empirical evidence there is shows that training can improve language and communication skills. Conclusion: This review raises a number of questions that are being addressed by the NHS England Language Matters Group, which has developed a set of recommendations to support the use of appropriate language in clinical encounters. What's new?: This paper reviews existing evidence regarding the use of language in clinical encounters.Poor language practices can lead to stigma, lack of engagement with self‐management, low satisfaction with care and poor clinical outcomes.Research has demonstrated the importance of good communication skills and that appropriate use of language can benefit psychosocial well‐being and support optimal diabetes self‐management.Our review has directly informed the publication of a UK Position Statement on Language Matters. [ABSTRACT FROM AUTHOR]

The measurement of discharge is fundamental in nutrient load estimation. Because of our ability to monitor discharge routinely, it is generally assumed that the associated uncertainty is low. This paper challenges this preconception, arguing that discharge uncertainty should be explicitly taken into account to produce robust statistical analyses. In many studies, paired discharge and chemical datasets are used to calculate 'true' loads and used as the benchmark to compare with other load estimates. This paper uses two years of high frequency (daily and sub-hourly) discharge and nutrient concentration data (nitrate-N and total phosphorus (TP)) collected at four field sites as part of the Hampshire Avon Demonstration Test Catchment (DTC) programme. A framework for estimating observational nutrient load uncertainty was used which combined a flexible non-parametric approach to characterising discharge uncertainty, with error modelling that allowed the incorporation of errors which were heteroscedastic and temporally correlated. The results showed that the stage-discharge relationships were non-stationary, and observational uncertainties from ±2 to 25% were recorded when the velocity-area method was used. The variability in nutrient load estimates ranged from 1.1 to 9.9% for nitrate-N and from 3.3 to 10% for TP when daily laboratory data were used, rising to a maximum of 9% for nitrate-N and 83% for TP when the sensor data were used. However, the sensor data provided a better representation of the 'true' load as storm events are better represented temporally, posing the question: is it more beneficial to have high frequency, lower precision data or lower frequency but higher precision data streams to estimate nutrient flux responses in headwater catchments? [ABSTRACT FROM AUTHOR]

The addition of cattle slurry to agricultural land is a widespread practise, but if not correctly managed it can pose a contamination risk to aquatic ecosystems. The transport of inorganic and organic components of cattle slurry to watercourses is a major concern, yet little is known about the physical transport mechanisms and associated fluxes and timings of contamination threats. Therefore, the aim of the study was to ascertain the importance of flow pathway partitioning in the transport (fluxes and timing) of dissolved and particulate slurry-derived compounds with implications for off-site contamination. A series of rainfall-runoff and erosion experiments were carried out using the TRACE (Test Rig for Advancing Connectivity Experiments) experimental hillslope facility. The experiments allowed the quantification of the impact of changing slope gradient and rainfall intensity on nutrient transport from cattle slurry applied to the hillslope, via surface, subsurface and vertical percolated flow pathways, as well as particulate transport from erosion. The dissolved components were traced using a combination of ammonium (NH4+) and fluorescence analysis, while the particulate fraction was traced using organic biomarkers, 5β-stanols. Results showed that rainfall events which produced flashy hydrological responses, resulting in large quantities of surface runoff, were likely to move sediment and also flush dissolved components of slurry-derived material from the slope, increasing the contamination risk. Rainfall events which produced slower hydrological responses were dominated by vertical percolated flows removing less sediment-associated material, but produced leachate which could contaminate deeper soil layers, and potentially groundwater, over a more prolonged period. Overall, this research provides new insights into the partitioning of slurry-derived material when applied to an unvegetated slope and the transport mechanisms by which contamination risks are created. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the influence of occupational prestige and work strain on mood, the occurrence of interpersonal conflict, and ambulatory blood pressure and heart rate.Methods: Participants were 50 men and 50 women matched for occupational prestige who were healthy and middle-aged and who completed measures of mood and conflict simultaneously with measures of ambulatory blood pressure and heart rate recorded every 30 minutes during waking hours of two workdays and one nonworkday; at the end of each day, overall ratings were made. Work strain was assessed by the Work Section of the Self-Evaluation and Social Support Interview Schedule. Multiple level random regression coefficients analyses were conducted.Results: Men and women with low-prestige occupations experienced more interpersonal conflict, b = -0.03, p = .04, and higher ambulatory heart rate, b = -4.83, p = .004, throughout the three days of the study. Relative to those with low work strain, those reporting high work strain experienced negative emotion, b = -0.41, p < .0001, and boredom, b = -0.17, p < .0004. End of the day ratings of negative mood were more influenced by work strain among men than among women. No effects of occupational prestige or work strain were obtained for ambulatory blood pressure readings after adjustment for physical activity, posture, and location.Conclusions: Individuals in low-prestige occupations experience greater exposure to interpersonal conflict and arousal as indexed by heart rate, which might increase risk for stress-related illnesses often associated with social class. Individuals who report work strain experience negative mood and boredom, both at work and at home. The absence of work effects on ambulatory blood pressure may be due to the participants being healthy. [ABSTRACT FROM AUTHOR]