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The relationship between annual rainfall totals and gauge elevation over Great Britain is re-examined using the recently developed technique of geographically weighted regression (GWR). This enables the spatial drift of regression parameters to be identified, estimated and mapped. It is shown that the rate of increase of precipitation with height, or height coefficient, varies from around 4.5 mm/m in the northwest to almost zero in the southeast. There is a particularly rapid change in this value across the English Midlands. The predicted sea level precipitation varies from 1250 mm to less than 600 mm in much the same way.

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The increasing availability of very high spatial resolution data using the unit post code as its geo-reference is making possible new kinds of urban analysis and modelling. However, at this resolution the granularity of the data used to represent urban functions makes it difficult to apply traditional analytical and modelling methods. An alternative suggested here is to use kernel density estimation to transform these data from point or area 'objects' into continuous surfaces of spatial densities. The use of this transformation is illustrated by a study in which we attempt to develop a robust, generally applicable methodology for identifying the central areas of UK towns for the purpose of statistical reporting and comparison. Continuous density transformations from unit post code data relating to a series of indicators of town centredness created using ArcView are normalised and then summed to give a composite 'Index of Town Centredness'. Selection of key contours on these index surfaces enables town centres to be delineated. The work results from a study on behalf of DETR.

AISSTKACT. If glacial till contains more than a certain minimum boulder content, it is dilatant and requires a much larger stress to initiate shear deformation than to sustain il. If the stress level at the glacierlerrain interface drops below a certain critical level, or the till reaches its critical boulder-content density, then the till beneath the glacier packs into stable obstructions. These are shaped into streamlined forms by the giacier and are found distributed at random i" drumlin fields. Due to drumliii coalescence there is a normal distribution of drumlin axes about the direction of ice movement. RESUME. La formation rt mor/jlurlogir de drumlins et four repartition cl orientation en champs de drumlins. Si mi argile a blocaux contient plus d'une certaine quantite minimum de blocaux. il est dilatable et exige une plus grande tension pour debuter line deformation par cissaillement que pour 1c soutenir. Si le niveau de tension entre le glacier et le terrain descend au-dessous d'un certain niveau critique, ou si l'argile a blocaux atteint sa densite critique de blocaux, alors l'argile a blocaux au-dessous du glacier s'agglomere et forme des obstacles stables de formes carenees et distributes au hasard en champs de dnmihns. A cause de leur coalescences, les axes des drumlins s'alignem avec la direction ciu mouvement glaeiaire en une repartition normale.

BackgroundIn a single general practice (GP) surgery in England, there was an eightfold increase in the prevalence of type 2 diabetes (T2D) in three decades with 57 cases and 472 cases recorded in 1987 and 2018, respectively. This mirrors the growing burden of T2D on the health of populations round the world along with healthcare funding and provision more broadly. Emerging evidence suggests beneficial effects of carbohydrate-restricted diets on glycaemic control in T2D, but its impact in a ‘real-world’ primary care setting has not been fully evaluated.MethodsAdvice on a lower carbohydrate diet was offered routinely to patients with newly diagnosed and pre-existing T2D or prediabetes between 2013 and 2019, in the Norwood GP practice with 9800 patients. Conventional ‘one-to-one’ GP consultations were used, supplemented by group consultations, to help patients better understand the glycaemic consequences of their dietary choices with a particular focus on sugar, carbohydrates and foods with a higher Glycaemic Index. Those interested were computer coded for ongoing audit to compare ‘baseline’ with ‘latest follow-up’ for relevant parameters.ResultsBy 2019, 128 (27%) of the practice population with T2D and 71 people with prediabetes had opted to follow a lower carbohydrate diet for a mean duration of 23 months. For patients with T2D, the median (IQR) weight dropped from of 99.7 (86.2, 109.3) kg to 91.4 (79, 101.1) kg, p<0.001, while the median (IQR) HbA1c dropped from 65.5 (55, 82) mmol/mol to 48 (43, 55) mmol/mol, p<0.001. For patients with prediabetes, the median (IQR) HbA1c dropped from 44 (43, 45) mmol/mol to 39 (38, 41) mmol/mol, p<0.001. Drug-free T2D remission occurred in 46% of participants. In patients with prediabetes, 93% attained a normal HbA1c. Since 2015, there has been a relative reduction in practice prescribing of drugs for diabetes leading to a T2D prescribing budget £50 885 per year less than average for the area.ConclusionsThis approach to lower carbohydrate dietary advice for patients with T2D and prediabetes was incorporated successfully into routine primary care over 6 years. There were statistically significant improvements in both groups for weight, HbA1c, lipid profiles and blood pressure as well as significant drug budget savings. These results suggest a need for more empirical research on the effects of lower carbohydrate diet and long-term glycaemic control while recording collateral impacts to other metabolic health outcomes.

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AISSTKACT. If glacial till contains more than a certain minimum boulder content, it is dilatant and requires a much larger stress to initiate shear deformation than to sustain il. If the stress level at the glacierlerrain interface drops below a certain critical level, or the till reaches its critical boulder-content density, then the till beneath the glacier packs into stable obstructions. These are shaped into streamlined forms by the giacier and are found distributed at random i" drumlin fields. Due to drumliii coalescence there is a normal distribution of drumlin axes about the direction of ice movement. RESUME. La formation rt mor/jlurlogir de drumlins et four repartition cl orientation en champs de drumlins. Si mi argile a blocaux contient plus d'une certaine quantite minimum de blocaux. il est dilatable et exige une plus grande tension pour debuter line deformation par cissaillement que pour 1c soutenir. Si le niveau de tension entre le glacier et le terrain descend au-dessous d'un certain niveau critique, ou si l'argile a blocaux atteint sa densite critique de blocaux, alors l'argile a blocaux au-dessous du glacier s'agglomere et forme des obstacles stables de formes carenees et distributes au hasard en champs de dnmihns. A cause de leur coalescences, les axes des drumlins s'alignem avec la direction ciu mouvement glaeiaire en une repartition normale.