Background: The literature suggests that many health professionals hold stigmatising attitudes towards those with mental illness and that this impacts on patient care. Little attention has been given to how these attitudes affect colleagues with a mental illness. Current research demonstrates that stigma and discrimination are common in the UK workplace and impact on one's decision to disclose mental illness. Aims: This study aims to explore health professionals' experiences of and attitudes towards mental illness and disclosure in the workplace. Methods: This qualitative study involved semi-structured interviews with 24 health professionals employed by an NHS (National Health Service) trust. 13 of these worked in mental health, and 11 in other health fields. Interviews were transcribed and thematic analysis was used to identify themes. Results: Five key themes were identified from the data: personal experiences and their effect in changing attitudes; perceived stigmatising views of mental illness in other staff members; hypothetical disclosure: factors affecting one's decision; attitudes towards disclosure; support in the workplace after disclosure; and, applying only to those working outside of the mental health field, mental illness is not talked about. The results indicated that participants had a great deal of experience with colleagues with a mental illness and that support in the workplace for such illnesses is variable. Attitudes of participating health professionals towards colleagues with a mental illness appeared to be positive, however, they did report that other colleagues held negative attitudes. Deciding to disclose a mental illness was a carefully thought out decision with a number of advantages and disadvantages noted. In particular, it was found that health professionals' fear stigma and discrimination from colleagues and that this would dissuade participants from disclosing a mental illness. Conclusion: In many respects, this research supports the findings in other workplaces. Such findings need to be investigated further to identify the degree to which these experiences and attitudes can be applied to other health professionals in other healthcare settings to determine what intervention is necessary. Importantly, this study has also indicated that the level of support available to NHS health professionals with a mental illness is variable, suggesting the need to identify and replicate positive practice.

[1] Optimization of water use in agriculture and quantification of percolation from landfills and watersheds require reliable estimates of vadose zone water fluxes. Current technology is limited primarily to lysimeters, which directly measure water flux but are expensive and may in some way disrupt flow, causing errors in the measured drainage. We report on design considerations and field tests of an alternative approach, passive wick fluxmeters, which use a control tube to minimize convergent or divergent flow. Design calculations with a quasi-three-dimensional model illustrate how convergence and divergence can be minimized for a range of soil and climatic conditions under steady state and transient fluxes using control tubes of varying heights. There exists a critical recharge rate for a given wick length, where the fluxmeter collection efficiency is 100% regardless of the height of the control tube. Otherwise, convergent or divergent flow will occur, especially when the control tube height is small. While divergence is eliminated in coarse soils using control tubes, it is reduced but not eliminated in finer soils, particularly for fluxes <100 mm/a. Passive wick fluxmeters were tested in soils ranging from nonvegetated semiarid settings in the United States to grasslands in Germany and rain-fed crops in New Zealand and the South Pacific. Where side-by-side comparisons of drainage were made between passive wick fluxmeters and conventional lysimeters in the United States and Germany, agreement was very good. In semiarid settings, drainage was found to depend upon precipitation distribution, surface soil, topographic relief, and the type and amount of vegetation. In Washington State, United States, soil texture dominated all factors controlling drainage from test landfill covers. As expected, drainage was greatest (>60% annual precipitation) from gravel surfaces and least (no drainage) from silt loam soils. In Oregon and New Mexico, United States, and in New Zealand, drainage showed substantial spatial variability. The New Mexico tests were located in semiarid canyon bottom terraces, with flash flood prone locations having extremely high drainage/precipitation ratios. In the wettest environments, drainage was found to be closely linked to the rate and duration of precipitation events.

BackgroundStigma and discrimination are a significant public health concern and cause great distress to people with mental illness. Healthcare professionals have been identified as one source of this discrimination. In this article we describe the protocol of an international, multisite controlled study, evaluating the effectiveness of READ, an anti-stigma training for medical students towards patients with mental illness. READ aims to improve students’ ability to minimise perceived discriminatory behaviours and increase opportunities for patients, therefore developing the ability of future doctors to address and challenge mental illness related discrimination. READ includes components that medical education research has shown to be effective at improving attitudes, beliefs and understanding.Methods/designREAD training was developed using evidence based components associated with changes in stigma related outcomes. The study will take place in multiple international medical schools across high, middle and low income countries forming part of the INDIGO group network, with 25 sites in total. Students will be invited to participate via email from the lead researcher at each site during their psychiatry placement, and will be allocated to an intervention or a control arm according to their local teaching group at each site. READ training will be delivered solely to the intervention arm. Standardised measures will be used to assess students’ knowledge, attitudes and skills regarding discrimination in both the intervention and control groups, at baseline and at follow up immediately after the intervention. Statistical analyses of individual-level data will be conducted using random effects models accounting for clustering within sites to investigate changes in mean or percentages of each outcome, at baseline and immediately after the intervention.DiscussionThis is the first international study across high, middle and low income countries, which will evaluate the effectiveness of training for medical students to respond effectively to patients’ experiences and anticipation of discrimination. The results will promote implementation of manualised training that will help future doctors to reduce the impact of mental illness related discrimination on their patients. Limitations of the study are also discussed.

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Soil erosion could reduce the water storage capacity of barriers that have been propo,,;ed for the disposal al t)['rtear-surface waste al the U,S. Department ofEnergy's llanford Site. Gravel mixed into the top soil surface may create a self-healing veneer lhal greally retards soil loss. ilowever, grat_,l admixtures may also enhance infiltration of rainwater, suppress plant grOwlh and water extraction, and h, ad lo lhe le)wh ing of underlying waste,. This report describes plans fi)r two experiments lhal were designed to lesl hypolheses concerning the interactive effects ofsurface gravel admixtures, revegetation, and enhanced precipitation on soil water balance and plant abundance, 7'he, first experime, nt is a factorial riehl plot se,t up on lhc site selected as a st)il borrow area fi)r the eventual construction of barriers. The treatments, arranged irt a split,split-plot design structure, include lwo densilies oi'gravel admix, a mixlure oi'native and inlrOduced grasses, and irrigation to simulate a wetter climate. Changes in soil water storage und plant cover are montlored with neutron moisture probes and point intercept sampling, respectively. 7'he second experiment con.sists of an array of 80 lysimeh,.rs ctmtaining several diffitrent barrier prototypes. Surface treatments are similar to the/'leld-plot experiment, l)rainage is collected from a valve at the base of each lysimeter tube. and evapotranspiration is estimated by subtraction. The lysimeh,rs are also designed lo be coupled to a whole-plant gas exchange system that will be used lo conduct controlled experi meats on evapotranspiralion fi)r modeling purposes. This test plan was writte, n in 1986 as an engineering support thJcument. Publication has become necessary because of lhe need to reference the lest plan in status reports tlnd olher documenls scheduled " for publication by the Prolectiw', Barrier l)evehJpment Program. Anv changes in the tJriginul experi. mental design, lest procedure, or cost estimates will he documented in ihe latter reports.

We attempted to restore native plants on disturbed sites at a former uranium mill on the Colorado Plateau near Tuba City, AZ. Four-wing saltbush [Atriplex canescens (Pursh) Nutt.] was successfully established in compacted caliche soil and in unconsolidated dune soil when transplants were irrigated through the first summer with 20 L/plant/wk. The caliche soil was ripped before planting to improve water-holding capacity. The diploid saltbush variety, angustifolia, had higher survival and growth than the common tetraploid variety, occidentalis, especially on dune soil. The angustifolia variety grew to 0.3 to 0.4 m3 per plant over 3 yr even though irrigation was provided only during the establishment year. By contrast, direct seeding of a variety of native forbs, grasses, and shrubs yielded poor results, despite supplemental irrigation throughout the first summer. In this arid environment (precipitation = 100 to 200 mm/yr), the most effective revegetation strategy is to establish keystone native shrubs, such as four-wing saltbush, using transplants and irrigation during the establishment year, rather than attempting to establish a diverse plant community all at once.

Purpose Studies of mental illness stigma reduction interventions have been criticised for failing to evaluate behavioural outcomes and mechanisms of action. This project evaluates training for medical students entitled ‘Responding to Experienced and Anticipated Discrimination’ (READ), developed to focus on skills in addition to attitudes and knowledge. We aimed to (i) evaluate the effectiveness of READ with respect to knowledge, attitudes, and clinical communication skills in responding to mental illness-related discrimination, and (ii) investigate whether its potential effectiveness was mediated via empathy or/and intergroup anxiety. Methods This is an international multisite non-randomised pre- vs post-controlled study. Eligible medical students were currently undertaking their rotational training in psychiatry. Thirteen sites across ten countries (n = 570) were included in the final analysis. Results READ was associated with positive changes in knowledge (mean difference 1.35; 95% CI 0.87 to 1.82), attitudes (mean difference − 2.50; 95% CI − 3.54 to − 1.46), skills (odds ratio 2.98; 95% CI 1.90 to 4.67), and simulated patient perceived empathy (mean difference 3.05; 95% CI 1.90 to 4.21). The associations of READ with knowledge, attitudes, and communication skills but not with simulated patient perceived empathy were partly mediated through student reported empathy and intergroup anxiety. Conclusion This is the first study to identify mediating effects of reduced intergroup anxiety and increased empathy in an evaluation of anti-stigma training that includes behavioural measures in the form of communication skills and perceived empathy. It shows the importance of both mediators for all of knowledge, skills, and attitudes, and hence of targeting both in future interventions.