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Assessing the significance of current glacier loss on Kilimanjaro, Tanzania, demands a well-constrained temporal perspective. That context is provided by direct measurements, ancillary observations of the ice fields and the analyses of the ice cores collected from them. Ice retreat mechanisms observed there today are consistent with the preservation of the oldest ice, ~11.7 ka, in the central deepest part of the Northern Ice Field (NIF). This ice-core derived paleoclimate history published by Thompson and others (2002) is further confirmed by more recent paleoclimate records from tropical East Africa. Mounting evidence suggests that the (anticipated) loss of the entire NIF will be unprecedented within the past 10 000 years. New evidence bears directly on the mechanisms driving the current ice loss. Measurements made in 2000 on the NIF document that air temperature at 0.5 and 1.5 m above the surface remained below 5°C, while a surface temperature of 0.0°C was sustained for up to 8 hours d-1 under clear conditions, consistent with observations of melting on all Kilimanjaro summit ice fields. The linear relationship between oxygen and hydrogen isotopic ratios for all six ice cores drilled in 2000 lies very close to the global meteoric waterline and does not support sublimation (evaporation) as a major driver of ice loss today or in the past on Kilimanjaro.
The recent drive within the UK National Health Service to improve psychosocial care for people with mental illness is both understandable and welcome: evidence-based psychological and social interventions are extremely important in managing psychiatric illness. Nevertheless, the accompanying downgrading of medical aspects of care has resulted in services that often are better suited to offering non-specific psychosocial support, rather than thorough, broad-based diagnostic assessment leading to specific treatments to optimise well-being and functioning. In part, these changes have been politically driven, but they could not have occurred without the collusion, or at least the acquiescence, of psychiatrists. This creeping devaluation of medicine disadvantages patients and is very damaging to both the standing and the understanding of psychiatry in the minds of the public, fellow professionals and the medical students who will be responsible for the specialty's future. On the 200th birthday of psychiatry, it is fitting to reconsider the specialty's core values and renew efforts to use psychiatric skills for the maximum benefit of patients
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