The concept of adaptation is becoming part of mainstream public discourse on climate change. Yet the diversity, complexity, and novelty of the adaptation concept itself leads to interpretive flexibility, differing public understanding of (and engagement with) adaptation strategies, and hence differentiated policy responses. The boundary work of communicative practices and public understanding of the adaptation concept therefore requires empirical analysis in different cases and contexts. This study employs Q-methodology (a combined quantitative–qualitative social research method) to reveal the typologies of perspectives that emerge around the adaptation concept among a diverse group of citizen-stakeholders in the United Kingdom. Four such typologies are identified under the labels 1) top-down climate action, 2) collective action on climate change, 3) optimistic, values-focused adaptation, and 4) adaptation skepticism. The division between these perspectives reveals a perceived “responsibility gap” between the governmental–institutional and/or individual–community levels. Across the emergent discourses we find a consensual call for a multisector, multiscalar, and multistakeholder-led approach that posits adaptation as a contemporary, intragenerational problem, with a strong emphasis upon managing extreme weather events, and not as an abstract future problem. By attending to these public discourses in climate policy, this presents a potential means to lessen such a responsibility gap.

Our objective was to explore and compare, in the context of other exposures, lay and professional perceptions of the links between urban air pollution and children's asthma. We used a triangulated survey approach, using quantitative questionnaire surveys enriched by qualitative interviews. Derivation of indicators of actual local air quality used modelled air pollution and a geographical information system. Our setting involved families and community health professionals in the London borough of Ealing, and pediatric respiratory specialists across the United Kingdom. Participants included 863 parents of children aged 3-11 years, 151 reporting currently asthmatic children, of whom 20 were extensively interviewed; 98 local general practitioners and 50 practice nurses; and 75 paediatric respiratory consultants and 55 specialist nurses. Main outcome measures involved views about the links between urban air pollution and children's asthma, relative to other triggers. Comparison of assessments of local air quality, with actual pollution levels, was made by parents with and without asthmatic children. Many parents were unsure as to what factors initiate asthma, but the most frequently cited was traffic pollution; it was also considered important in the exacerbation of asthma. Health professionals' assessments were inconsistent: specialists conformed to the dominant literature dismissing strong links between air pollution and asthma, while local clinicians reflected the views of parents in their community. Surrounding parents' views were difficulties defining exposures to urban air pollution, underlying concerns about risks to general health, perceived lack of control, unclear expert opinion, and widely accepted informal "messages" which assumed strong links. Parents with experience of asthma were found to have significantly less accurate (negatively biased) perceptions of local air quality. In conclusion, reactions to uncertainty surrounding associations between asthma and urban air pollution varied: parents' concerns were heightened (and propagated by other influences), specialist clinicians were dismissive, and community clinicians fell between these extremes.

Objectives: This study sought to document the trends in drug use among intravenous drug users (IDUs) in northern British Columbia, and to discuss the public health implications. Method: We conducted a 7-year medical-chart review of all IDU-related admissions (n=2072) to an inpatient alcohol and drug detoxification centre in Prince George, British Columbia. Primary detoxification diagnosis was modeled onto year of admission using generalized estimating equations (GEE). Results: Our study demonstrated an increasing prevalence of cocaine as the primary detoxification diagnosis in IDU-related admissions in northern BC, from 32% of all IDU admissions in 1999 to 64% in 2001, and then a relatively steady elevated rate of approximately 60% between 2001-2005. Conclusions: Given that needle exchange programs and other harm reduction services for IDUs in British Columbia are not readily available in many northern and rural areas, the risks associated with intravenous cocaine use among northern IDUs represent a serious public health challenge. Tailored harm reduction strategies should take into account the prominence of intravenous cocaine use as an HIV risk factor. In areas without wellestablished intravenous drug use monitoring programs, such as rural and remote areas, detoxification treatment records may serve as important sentinels for changing drug use patterns among IDUs.

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Dr. Polk of New York reports four cases of procidentia treated by abdominal hysterectomy all successful. In these cases Dr. Polk removed the entire uterus.