Climate Ready Estuaries - COAST in Action: 2012 Projects from Maine and New Hampshire

In summer 2011 the US EPA’s Climate Ready Estuaries program awarded funds to the Casco Bay Estuary Partnership (CBEP) in Portland, Maine, and the Piscataqua Region Estuaries Partnership (PREP) in coastal New Hampshire, to further develop and use COAST (COastal Adaptation to Sea level rise Tool) in their sea level rise adaptation planning processes. The New England Environmental Finance Center worked with municipal staff, elected officials, and other stakeholders to select specific locations, vulnerable assets, and adaptation actions to model using COAST. The EFC then collected the appropriate base data layers, ran the COAST simulations, and provided visual, numeric, and presentation-based products in support of the planning processes underway in both locations. These products helped galvanize support for the adaptation planning efforts. Through facilitated meetings they also led to stakeholders identifying specific action steps and begin to determine how to implement them

Negative emotional reactivity as a marker of vulnerability in the development of borderline personality disorder symptoms

Negative emotionality is a distinguishing feature of borderline personality disorder (BPD). However, this person-level characteristic has not been examined as a marker of vulnerability in the development of this disorder. The current study utilized a multi-method approach to examine the interplay between negative emotional reactivity and cumulative exposure to family adversity on the development of BPD symptoms across three years (ages 16–18) in a diverse, at-risk sample of adolescent girls (N=113). A latent variable of negative emotional reactivity was created from multiple assessments at age 16: (1) self-report, (2) emotion ratings to stressors from ecological assessments across one week, and (3) observer-rated negative affectivity during a mother-daughter conflict discussion task. Exposure to family adversity was measured cumulatively between ages 5 and 16 from annual assessments of family poverty, single parent household, and difficult life circumstances. Results from latent growth curve models demonstrated a significant interaction between negative emotional reactivity and family adversity, such that exposure to adversity strengthened the association between negative emotional reactivity and BPD symptoms. Additionally, family adversity predicted increasing BPD symptoms during late adolescence. These findings highlight negative emotional reactivity as a marker of vulnerability that ultimately increases risk for the development of BPD symptoms

Managing climate risk in water supply systems : materials and tools designed to empower technical professionals to better understand key issues

This manual has been developed as a learning tool to be used with a companion series of practical exercises. They have been developed to provide a hands-on approach to learning key concepts in hydrology and climate science as they relate to climate risk management in water supply systems, as introduced in the text

Precision targeting of preventative therapy for tuberculosis

Background: Scale-up of preventative treatment for tuberculosis (TB) represents a cornerstone of global control efforts. I examined a range of approaches to enable more precise targeting of preventative treatment to people at highest risk. Methods: I evaluated whether prognostic tests for TB (tuberculin skin test (TST), QuantiFERON Gold-in-tube (QFT-GIT) and T-SPOT.TB) may be optimised by implementing higher thresholds, or by a newer generation assay (QuantiFERON-TB Gold Plus; QFT-Plus). Next, I conducted a systematic review and individual participant data meta-analysis (IPD-MA) to examine TB risk among people tested for latent infection (LTBI) in settings with low TB transmission and to develop a multivariable prognostic model for incident TB. Finally, I performed a systematic review and IPD-MA of whole-blood RNA sequencing data to evaluate blood transcriptomic signatures as next-generation biomarkers. Results: In a UK cohort of 9,610 adults, higher TST, QFT-GIT and T-SPOT.TB results were associated with increased incident TB risk. Implementing higher cut-offs led to a marginal improvement in positive predictive value, but at the cost of a marked loss in sensitivity. The newer generation QFT-Plus had similar predictive ability. In a pooled dataset of >80,000 participants from 18 cohort studies, TB risk was heterogeneous among people with LTBI, even after stratification by indication for testing. I developed and validated a multivariable prognostic model, which incorporates quantitative LTBI test results and clinical covariates, and demonstrated strong potential for clinical utility to inform provision of preventative treatment. Among 1,126 whole-blood RNA sequencing samples, eight transcriptomic signatures (comprising 1-25 transcripts) performed similarly for predicting incident TB, but only met global accuracy benchmarks over a 3-6 month time-horizon. Conclusions: Personalised risk estimates integrating quantitative LTBI test results and clinical covariates may facilitate more precise targeting of preventative treatment. Blood transcriptomic biomarkers show promise, but only represent short-term TB risk. Future research priorities are highlighted