Adaptation of WASH Services Delivery to Climate Change and Other Sources of Risk and Uncertainty

This report urges WASH sector practitioners to take more seriously the threat of climate change and the consequences it could have on their work. By considering climate change within a risk and uncertainty framework, the field can use the multitude of approaches laid out here to adequately protect itself against a range of direct and indirect impacts. Eleven methods and tools for this specific type of risk management are described, including practical advice on how to implement them successfully

Monitoring bioaerosol and odour emissions from composting facilities - WR1121

Government policy requires that valuable resources should be recovered and recycled from biodegradable waste. A successful and growing organics recycling industry delivers this policy with composting being one of the principal technologies deployed to process suitable feedstock such as garden and food waste. Composting inevitably generates bioaerosols – particulate matter comprising cells or cellular components that are released into the air as a result of disturbance of composting feedstock or the processing of final product. Exposure to bioaerosols has the potential to be harmful to human and animal health. The Environment Agency adopts a precautionary and risk-based approach to the regulation of composting facilities which was developed on the basis of research by Wheeler et al. (2001) and which has been updated as new evidence has become available. The Environment Agency also requires site operators to monitor bioaerosols around their facilities using methods specified in a standard protocol which relies upon classical microbiology methods which are tried and tested but which are labour-intensive, slow and offer only a snapshot view of a highly dynamic system. A recent IOM review commissioned by Defra (Searl, 2009) on exposure-response relationships for bioaerosol emissions from waste treatment processes identified significant gaps in knowledge of exposure to bioaerosols and recommended that more research was needed into alternatives to viable microbial monitoring such as priority biomarkers (notably endotoxin) and potential surrogates such as particulate matter. The IOM review also concluded that there is a lack of information to support the development of appropriate stand-off distances. The overall aim of this project was to provide evidence on bioaerosol production, dispersion and potential exposures from composting facilities in support of future developments in policy and regulation of biowaste facilities. The objectives were: (i) to undertake a comprehensive set of standard and novel bioaerosol measurements at representative composting sites to assess comparability between different methods and also to measure spatial and temporal variations; and (ii) to determine the odour emissions and then compare these with bioaerosol emissions to see if odour is a marker of significant bioaerosol exposure. Standard (AfOR, 2009) and novel (CEN filter method, endotoxin, glucan, qPCR, real-time particulates) bioaerosols measurements were taken on a minimum of three to a maximum of six occasions over a twelve month period at four different composting facilities in England. The composting facilities were selected to represent sites of varying sizes (tonnages) and to allow a comparison of bioaerosol concentrations at standard open windrow sites versus a fully-contained site. Additional supporting information was collected including meteorological data at the time of sampling, observation of site operations and measurements of odour at one of the sites. Supporting bioaerosol and odour dispersion modelling was conducted at the site where the odour measurements were made. The spatial trend of bioaerosol concentrations described by Wheeler et al., (1991) and upon which EA regulatory policy is based was broadly corroborated by this dataset. Excursions above the EA acceptable levels at or beyond 250m from source were rare. Bioaerosol concentrations at the enclosed site were generally lower than at the open windrow sites. There was no evidence of a seasonal pattern in bioaerosol concentrations at any of the sites whereas between-sampling day variations were apparent. The cause(s) of these variations were not identified. No consistent relationship was observed between the concentration of bioaerosols measured by the two AfOR standard methods. The two methods displayed certain strengths and weakness in different situations. The IOM sampling device proved to be better suited to situations where high bioaerosol concentrations were encountered (close to source); the Andersen proving to be more effective in the lower concentration range typically found upwind of a site or at distance downwind from source. The higher volume filtration device tested in this project (referred to as the CEN method) produced data that did not consistently match either of the AfOR standard methods. This device demonstrated greater sensitivity than the IOM filter method but suffered drawbacks associated with its weight and a lack of ease of use in the field. Endotoxin concentrations were normally below the level recommended by the Dutch Expert Committee on Occupational Safety but occasional exceedances of this standard were detected at the larger open windrow sites. The majority of glucan measurements were below a widely referred to 10ng/m3 threshold. Significantly elevated concentrations were detected at one of the larger open windrow sites. The dynamic range of the qPCR method is wider (4-5-log) than either of the AfOR and the CEN methods. It is also quicker to carry out and has the potential for automation. The results from the qPCR method are mainly higher than standard AfOR methods, as the method does not distinguish viable and non-viable spores. The spatial distribution of Aspergillus fumigatus spores (by qPCR) along sampling transects, gives similar results compared to AfOR (and CEN) methods. Real time particle detection showed that both TSP and PM10 are correlated to Aspergillus fumigatus spore concentration. No consistent relationship was observed between odour and bioaerosol concentrations (although this was a limited dataset). The envelope of modelled (back-extrapolated) bioaerosol emission rates straddles several orders of magnitude. Distinguishing the influences of meteorological conditions on this variability was not possible. It was not possible to predict bioaerosol or odour emission rates with confidence. This continues to hamper confidence in modelling of odours and bioaerosols from open windrow facilities. The findings of this research have implications for the current standard monitoring protocol which should be reviewed accordingly. The findings of this multi-site survey accord with existing regulatory policy and are supportive of the general trend towards enclosed facilities. Notwithstanding this, continuing research is needed to enhance the database on emission from bioaerosol and odour abatement technologies (e.g. biofilters); to determine the cause(s) of occasional bioaerosol peaks from open facilities; to improve exposure assessments through better modelling protocols; and to link enhanced exposure information to future health impact studies

Evaluating the cost-effectiveness of existing needle and syringe programmes in preventing hepatitis C transmission in people who inject drugs

AIM: To evaluate the cost-effectiveness of needle and syringe programmes (NSPs) compared with no NSPs on hepatitis C virus (HCV) transmission in the United Kingdom. DESIGN: Cost-effectiveness analysis from a National Health Service (NHS)/health-provider perspective, utilizing a dynamic transmission model of HCV infection and disease progression, calibrated using city-specific surveillance and survey data, and primary data collection on NSP costs. The effectiveness of NSPs preventing HCV acquisition was based on empirical evidence. SETTING AND PARTICIPANTS: UK settings with different chronic HCV prevalence among people who inject drugs (PWID): Dundee (26%), Walsall (18%) and Bristol (45%) INTERVENTIONS: Current NSP provision is compared with a counterfactual scenario where NSPs are removed for 10 years and then returned to existing levels with effects collected for 40 years. MEASUREMENTS: HCV infections and cost per quality-adjusted life year (QALY) gained through NSPs over 50 years. FINDINGS: Compared with a willingness-to-pay threshold of £20 000 per QALY gained, NSPs were highly cost-effective over a time-horizon of 50 years and decreased the number of HCV incident infections. The mean incremental cost-effectiveness ratio was cost-saving in Dundee and Bristol, and £596 per QALY gained in Walsall, with 78, 46 and 40% of simulations being cost-saving in each city, respectively, with differences driven by coverage of NSP and HCV prevalence (lowest in Walsall). More than 90% of simulations were cost-effective at the willingness-to-pay threshold. Results were robust to sensitivity analyses, including varying the time-horizon, HCV treatment cost and numbers of HCV treatments per year. CONCLUSIONS: Needle and syringe programmes are a highly effective low-cost intervention to reduce hepatitis C virus transmission, and in some settings they are cost-saving. Needle and syringe programmes are likely to remain cost-effective irrespective of changes in hepatitis C virus treatment cost and scale-up

Managing Water under Uncertainty and Risk: The United Nations World Water Development Report 4

This report introduces new aspects of water issues: 1) it reintroduces the 12 challenge area reports that provided the foundation for the first two World Water Development Reports (WWDR); 2) 4 new reports on water quality, groundwater, gender, and desertification, land degradation and drought; 3) in recognition that the global challenges of water can vary considerably across countries and regions, a series of 5 regional reports have been included; 4) a deeper analysis of the main external forces of freshwater resources and possibilities for their future evolution; 5) managing water under uncertainty and risk

Data-driven modelling of biological multi-scale processes

Biological processes involve a variety of spatial and temporal scales. A holistic understanding of many biological processes therefore requires multi-scale models which capture the relevant properties on all these scales. In this manuscript we review mathematical modelling approaches used to describe the individual spatial scales and how they are integrated into holistic models. We discuss the relation between spatial and temporal scales and the implication of that on multi-scale modelling. Based upon this overview over state-of-the-art modelling approaches, we formulate key challenges in mathematical and computational modelling of biological multi-scale and multi-physics processes. In particular, we considered the availability of analysis tools for multi-scale models and model-based multi-scale data integration. We provide a compact review of methods for model-based data integration and model-based hypothesis testing. Furthermore, novel approaches and recent trends are discussed, including computation time reduction using reduced order and surrogate models, which contribute to the solution of inference problems. We conclude the manuscript by providing a few ideas for the development of tailored multi-scale inference methods.Comment: This manuscript will appear in the Journal of Coupled Systems and Multiscale Dynamics (American Scientific Publishers

Effective skill refinement: Focusing on process to ensure outcome

In contrast to the abundance of motor skill acquisition and performance research, there is a paucity of work which addresses how athletes with an already learnt and well-established skill may go about making a subtle change, or refinement, to that skill. Accordingly, the purpose of this review paper is to provide a comprehensive overview of current understanding pertaining to such practice. Specifically, this review addresses deliberately initiated refinements to closed and self-paced skills (e.g., javelin throwing, golf swing and horizontal jumps). In doing so, focus is directed to three fundamental considerations within applied coaching practice and future research endeavours; the intended outcomes, process and evaluative measures of skill refinement. Conclusions suggest that skill refinement is not the same as skill acquisition or performing already learnt skills with high-levels of automaticity. Due to the complexity of challenge faced, refinements are best addressed as an interdisciplinary solution, with objective measures informing coach decision making

Managing Process Variants in the Process Life Cycle

When designing process-aware information systems, often variants of the same process have to be specified. Each variant then constitutes an adjustment of a particular process to specific requirements building the process context. Current Business Process Management (BPM) tools do not adequately support the management of process variants. Usually, the variants have to be kept in separate process models. This leads to huge modeling and maintenance efforts. In particular, more fundamental process changes (e.g., changes of legal regulations) often require the adjustment of all process variants derived from the same process; i.e., the variants have to be adapted separately to meet the new requirements. This redundancy in modeling and adapting process variants is both time consuming and error-prone. This paper presents the Provop approach, which provides a more flexible solution for managing process variants in the process life cycle. In particular, process variants can be configured out of a basic process following an operational approach; i.e., a specific variant is derived from the basic process by applying a set of well-defined change operations to it. Provop provides full process life cycle support and allows for flexible process configuration resulting in a maintainable collection of process variants

Network destabilization and transition in depression : new methods for studying the dynamics of therapeutic change

The science of dynamic systems is the study of pattern formation and system change. Dynamic systems theory can provide a useful framework for understanding the chronicity of depression and its treatment. We propose a working model of therapeutic change with potential to organize findings from psychopathology and treatment research, suggest new ways to study change, facilitate comparisons across studies, and stimulate treatment innovation. We describe a treatment for depression that we developed to apply principles from dynamic systems theory and then present a program of research to examine the utility of this application. Recent methodological and technological developments are also discussed to further advance the search for mechanisms of therapeutic change