The epidemiology of the first wave of H1N1 influenza pandemic in Australia : a population-based study

Objectives: Following the recent H1N1 influenza pandemic we were able to describe seropositivity in a repre-sentative sample of adults prior to the availability of a specific vaccine.Methods: This cross-sectional serological study is set in the Barwon Statistical Division, Australia. Blood samples were collected from September 2009 through to May 2010, from 1184 individuals (569 men, 615 women; median age 61.7 years), randomly selected from electoral rolls. Serum was analysed for specific H1N1 immunity using a haemagglutina-tion inhibition test. A self-report provided information about symptoms, demographics and healthcare. Associations be-tween H1N1 infection, gender, households and occupation were determined using logistic regression, adjusting for age.Results: Of 1184 individuals, 129 (58 men, 71 women) were seropositive. Gender-adjusted age-specific prevalence was: 8.3% 20-29 years, 13.5% 30-39, 10.4% 40-49, 6.5% 50-59, 9.7% 60-69, 10.3% 70-79, 18.8% 80+. Standardised preva-lence was 10.3% (95%CI 9.6-11.0). No associations were detected between seropositivity and gender (OR=0.82, 95%CI 0.57-1.19) or being a healthcare worker (OR=1.43, 95%CI 0.62-3.29). Smokers (OR=1.86, 95%CI 1.09-3.15) and those socioeconomically disadvantaged (OR=2.52, 95%CI 1.24-5.13) were at increased risk. Among 129 seropositive individu-als, 31 reported symptoms that were either mild (n = 13) or moderate (time off work, doctor visit, n = 18). For age &lt;60, 39.6% of seropositive individuals reported symptoms, whereas the proportion was 13.2% for age 60+.Conclusions: Following the pandemic, the proportion of seropositive adults was low, but significant subclinical infection was found. Social disadvantage increased the likelihood of infection. The low symptom rate for older ages may relate to pre-existing immunity.<br /

Environmental hydro-refugia demonstrated by vegetation vigour in the Okavango Delta, Botswana

Climate shifts at decadal scales can have environmental consequences, and therefore, identifying areas that act as environmental refugia is valuable in understanding future climate variability. Here we illustrate how, given appropriate geohydrology, a rift basin and its catchment can buffer vegetation response to climate signals on decadal time-scales, therefore exerting strong local environmental control. We use time-series data derived from Normalised Difference Vegetation Index (NDVI) residuals that record vegetation vigour, extracted from a decadal span of MODIS images, to demonstrate hydrogeological buffering. While this has been described previously it has never been demonstrated via remote sensing and results in relative stability in vegetation vigour inside the delta, compared to that outside. As such the Delta acts as a regional hydro-refugium. This provides insight, not only to the potential impact of future climate in the region, but also demonstrates why similar basins are attractive to fauna, including our ancestors, in regions like eastern Africa. Although vertebrate evolution operates on time scales longer than decades, the sensitivity of rift wetlands to climate change has been stressed by some authors, and this work demonstrates another example of the unique properties that such basins can afford, given the right hydrological conditions

NASA ExoPAG Study Analysis Group 11: Preparing for the WFIRST Microlensing Survey

NASA's proposed WFIRST-AFTA mission will discover thousands of exoplanets with separations from the habitable zone out to unbound planets, using the technique of gravitational microlensing. The Study Analysis Group 11 of the NASA Exoplanet Program Analysis Group was convened to explore scientific programs that can be undertaken now, and in the years leading up to WFIRST's launch, in order to maximize the mission's scientific return and to reduce technical and scientific risk. This report presents those findings, which include suggested precursor Hubble Space Telescope observations, a ground-based, NIR microlensing survey, and other programs to develop and deepen community scientific expertise prior to the mission.Comment: 35 pages, 5 Figures. A brief overview of the findings is presented in the Executive Summary (2 pages

How well do ecosystem-based planning units represent different componenets of biodiversity?

There are many proposals for managing biodiversity by using surrogates, such as umbrella, indicator, focal, and flagship species. We use the term biodiversity management unit for any ecosystem-based classificatory scheme for managing biodiversity. The sufficiency of biodiversity management unit classification schemes depends upon (1) whether different biotic elements (e.g., trees, birds, reptiles) distinguish between biodiversity management units within a classification (i.e., coherence within classes}; and (2) whether different biotic elements agree upon similarities and dissimilarities among biodiversity management unit classes (i.e., conformance among classes). Recent evaluations suggest that biodiversity surrogates based on few or single taxa are not useful. Ecological vegetation classes are an ecosystem-based classification scheme used as one component for biodiversity management in Victoria, Australia. Here we evaluated the potential for ecological vegetation classes to be used as biodiversity management units in the box-ironbark ecosystem of central Victoria, Australia. Eighty sites distributed among 14 ecological vegetation classes were surveyed in the same ways for tree species, birds, mammals, reptiles, terrestrial invertebrates, and nocturnal flying insects. Habitat structure and geographic separations also were measured, which, with the biotic elements, are collectively referred to as variables. Less than half of the biotic element-ecological vegetation class pairings were coherent. Generalized Mantel tests were used to examine conformance among variables with respect to ecological vegetation classes. While most tests were not significant, birds, mammals, tree species, and habitat structure together showed significant agreement on the rating of similarities among ecological vegetation classes. In this system, use of ecological vegetation classes as biodiversity management units may account reasonably well for birds, mammals, and trees; but reptiles and invertebrates would not be accommodated. We conclude that surrogates will usually have to be augmented or developed as hierarchies to provide general representativeness

Scaling community-based services in Gauteng, South Africa : a comparison of three workforce-planning scenarios

BACKGROUND : The introduction of community-based services through community health workers is an opportunity to redefine the approach and practice of primary health care. Based on bestpractice community oriented primary care (COPC), a COPC planning toolkit has been developed to model the creation of a community-based tier in an integrated district health system. AIM : The article describes the methodologies and assumptions used to determine workforce numbers and service costs for three scenarios and applies them to the poorest 60% of the population in Gauteng, South Africa. SETTING : The study derives from a Gauteng Department of Health, Family Medicine (University of Pretoria) partnership to support information and communication technology (ICT)-enabled COPC through community-based health teams (termed as ward-based outreach teams). METHODS : The modelling uses national census age, gender and income data at small area level, provincial facility and national burden of disease data. Service calculations take into account multidimensional poverty, demand-adjusted burden of disease and available work time adjusted for conditions of employment and geography. RESULTS : Assuming the use of ICT for each, a health workforce of 14 819, 17 925 and 7303 is required per scenario (current practice, national norms and full-time employed COPC), respectively. Total service costs for the respective scenarios range from R1.1 billion, through R947 million to R783 million. CONCLUSION : Modelling shows that delivering ICT-enabled COPC with full-time employees is the optimal scenario. It requires the smallest workforce, is the most economical, even when individual community health worker costs of employment are twice those of current practice, and is systemically the most effective.Rod Bennett and Geoff Abbott received payments for their work from the World Health Organization and the University of Pretoria (UP).http://www.phcfm.orgam2019Family Medicin

Modelling cost benefit of community-oriented primary care in rural South Africa

BACKGROUND: Globally, rural populations have poorer health and considerably lower levels of access to healthcare compared with urban populations. Although the drive to ensure universal coverage through community healthcare worker programmes has shown significant results elsewhere, their value has yet to be realised in South Africa. AIM: The aim of this study was to determine the potential impact, cost-effectiveness and benefit-to-cost ratio (BCR) of information and communications technology (ICT)-enabled community-oriented primary care (COPC) for rural and remote populations. SETTING: The Waterberg district of Limpopo province in South Africa is a rural mining area. The majority of 745 000 population are poor and in poor health. METHODS: The modelling considers condition-specific effectiveness, population age and characteristics, health-determined service demand, and costs of delivery and resources. RESULTS: Modelling showed 122 teams can deliver a full ICT-enabled COPC service package to 630 565 eligible people. Annually, at scale, it could yield 35 877 unadjusted life years saved and 994 deaths avoided at an average per capita service cost of R170.37, and R2668 per life year saved. There could be net annual savings of R120 million (R63.4m for Waterberg district) from reduced clinic (110.7m) and hospital outpatient (23 646) attendance and admissions. The service would inject R51.6m into community health worker (CHW) households and approximately R492m into district poverty reduction and economic growth. CONCLUSION: With a BCR of 3.4, ICT-enabled COPC is an affordable systemic investment in universal, pro-poor, integrated healthcare and makes community-based healthcare delivery particularly compelling in rural and remote areas.Anglo-American PLChttp://www.phcfm.orgpm2020Family Medicin

Scaling community-based services in Gauteng, South Africa: A comparison of three workforce-planning scenarios

Background: The introduction of community-based services through community health workers is an opportunity to redefine the approach and practice of primary health care. Based on bestpractice community oriented primary care (COPC), a COPC planning toolkit has been developed to model the creation of a community-based tier in an integrated district health system. Aim: The article describes the methodologies and assumptions used to determine workforce numbers and service costs for three scenarios and applies them to the poorest 60% of the population in Gauteng, South Africa. Setting: The study derives from a Gauteng Department of Health, Family Medicine (University of Pretoria) partnership to support information and communication technology (ICT)-enabled COPC through community-based health teams (termed as ward-based outreach teams). Methods: The modelling uses national census age, gender and income data at small area level, provincial facility and national burden of disease data. Service calculations take into account multidimensional poverty, demand-adjusted burden of disease and available work time adjusted for conditions of employment and geography. Results: Assuming the use of ICT for each, a health workforce of 14 819, 17 925 and 7303 is required per scenario (current practice, national norms and full-time employed COPC), respectively. Total service costs for the respective scenarios range from R1.1 billion, through R947 million to R783 million. Conclusion: Modelling shows that delivering ICT-enabled COPC with full-time employees is the optimal scenario. It requires the smallest workforce, is the most economical, even when individual community health worker costs of employment are twice those of current practice, and is systemically the most effective

The effect of modulating the quantity of enzymes in a model ethanol pathway on metabolic flux in <i>Synechocystis</i> sp. PCC 6803

Synthetic metabolism allows new metabolic capabilities to be introduced into strains for biotechnology applications. Such engineered metabolic pathways are unlikely to function optimally as initially designed and native metabolism may not efficiently support the introduced pathway without further intervention. To develop our understanding of optimal metabolic engineering strategies, a two-enzyme ethanol pathway consisting of pyruvate decarboxylase and acetaldehyde reductase was introduced into Synechocystis sp. PCC 6803. We characteriseda new set of ribosome binding site sequences in Synechocystis sp. PCC 6803 providing a range of translation strengths for different genes under test. The effect of ribosome-bindingsite sequence, operon design and modifications to native metabolism on pathway flux was analysed by HPLC. The accumulation of all introduced proteins was also quantified using selected reaction monitoring mass spectrometry. Pathway productivity was more strongly dependent on the accumulation of pyruvate decarboxylase than acetaldehyde reductase. In fact, abolishment of reductase over-expression resulted in the greatest ethanol productivity, most likely because strains harbouringsingle-gene constructs accumulated more pyruvate decarboxylase than strains carrying any of the multi-gene constructs. Overall, several lessons were learned. Firstly, the expression level of the first gene in anyoperon influenced the expression level of subsequent genes, demonstrating that translational coupling can also occur in cyanobacteria. Longer operons resulted in lower protein abundance for proximally-encoded cistrons. And, implementation of metabolic engineering strategies that have previously been shown to enhance the growth or yield of pyruvate dependent products, through co-expression with pyruvate kinase and/or fructose-1,6-bisphosphatase/sedoheptulose-1,7-bisphosphatase, indicated that other factors had greater control over growth and metabolic flux under the tested conditions

Investigation of Heavy Metals in a Large Mortality Event in Caribou of Northern Alaska

We measured element concentrations (As, Cd, Cu, Pb, Zn, Fe) and body condition (gross and histologic endpoints) of animals from a caribou (Rangifer tarandus) mortality event that occurred in Alaska, in the area of Point Hope and Cape Thompson (including the Chariot site), in 1995. These were compared to results from hunter-killed caribou from reference sites (Barrow and Teshekpuk Lake, Alaska) and from the area of a mine (Red Dog Mine) to determine whether heavy metals had played a role in the mortality event or whether any elements were at concentrations of concern for human consumers. Starvation and malnutrition were major factors leading to death or severe weakness, as very little or no fat (very low body condition scores) and serous atrophy of fat (observed as watery contents of the marrow cavity, with no apparent fat, and histologically) were more prevalent in caribou associated with the mortality event than in hunter-killed animals from reference sites. Accumulation of hepatic (liver) hemosiderin in Kupffer cells (macrophages) was noted as an indicator of cachexia. Concentrations of lead in feces and liver, copper in the rumen contents, and arsenic in muscle were higher in caribou harvested near Red Dog Mine, as might be expected in that mineral-rich area, but were not at levels of concern for toxicoses. Kidney concentrations of cadmium, which increased significantly with increasing age, present a potential concern for human consumers, and this is an expected finding. We concluded that caribou had starved and that heavy metals had played no role in the mortality event. Further investigation of regional mineral differences is required to understand the sources and transport mechanisms that explain these findings and to properly address mining activity. Mortality events on the north slope of Alaska are common and likely involve starvation as described here, but in most cases they are not investigated, even though recent industrial activities have heightened concern among some local residents and wildlife managers.On a mesuré la concentration en éléments (As, Cd, Cu, Pb, Zn, Fe) et l'état corporel (points limites bruts et histologiques) de caribous (Rangifer tarandus) prélevés lors d'un épisode de mortalité qui s'est produit en 1995 en Alaska, dans la région de Point Hope et de Cape Thompson (y compris le site Chariot). On a comparé ces résultats à ceux de caribous tués par des chasseurs à des emplacements témoins (Barrow et Teshekpuk Lake, en Alaska) et à proximité d'une mine (Red Dog Mine) pour trouver si les métaux lourds avaient joué un rôle dans l'épisode de mortalité ou si la concentration d'un ou plusieurs éléments pouvait constituer un risque pour la consommation humaine. La famine et la malnutrition étaient des facteurs majeurs ayant causé la mort ou une extrême faiblesse, vu que la présence minime ou l'absence de graisse (très basses notes d'état corporel) et une atrophie séreuse de la graisse (observée sous forme de contenu aqueux de la cavité médullaire, sans graisse visible, et à la suite de l'examen histologique) étaient plus courantes chez le caribou associé à l'épisode de mortalité que chez les animaux des emplacements témoins tués par les chasseurs. On a noté dans le foie une accumulation d'hémosidérine hépatique des cellules de Kupffer (cellules macrophages) témoignant d'une cachexie. La concentration de plomb dans les matières fécales et le foie, de cuivre dans le rumen et d'arsenic dans le tissu musculaire était plus élevée chez le caribou provenant de Red Dog Mine, comme on pouvait s'y attendre dans cette zone riche en minéraux, mais cette concentration n'atteignait pas un niveau pouvant provoquer des toxicoses. La concentration de cadmium dans le rein, qui augmentait de façon significative avec l'âge, pourrait constituer un risque pour la consommation humaine, ce qui n'est pas surprenant. On a conclu que les caribous étaient morts de faim et que les métaux lourds n'avaient joué aucun rôle dans l'épisode de mortalité. Il faudrait effectuer des recherches plus poussées sur les différences régionales en minéraux afin de comprendre les mécanismes d'origine et de transport qui expliquent ces résultats et d'aborder comme il le faut les activités minières. Les épisodes de mortalité sont courants sur le versant Nord de l'Alaska et sont probablement liés à la famine, comme le décrit cet article, mais dans la plupart des cas ils ne font pas l'objet d'une enquête, même si l'activité industrielle récente est un sujet qui préoccupe de plus en plus certains résidents et gestionnaires locaux de la faune

Localism and energy: Negotiating approaches to embedding resilience in energy systems

Tensions are evident in energy policy objectives between centralised top-down interconnected energy systems and localised distributed approaches. Examination of these tensions indicates that a localised approach can address a systemic problem of interconnected systems; namely vulnerability. The challenge for energy policy is to realise the interrelated goals of energy security, climate and environmental targets and social and economic issues such as fuel poverty, whilst mitigating vulnerability. The effectiveness of conventional approaches is debateable. A transition to a low carbon pathway should focus on resilience, counter to vulnerability. This article draws from on-going work which evaluates the energy aspects of a Private Finance Initiative (PFI) project to refurbish and re-build a local authority’s entire stock of sheltered accommodation to high environmental standards. Initial findings suggest that whereas more conventional procurement processes tend to increase systemic vulnerability, a user focussed process driven through PFI competitive dialogue is beginning to motivate some developers to adopt innovative approaches to energy system development. Conceptually these findings strongly suggest that embedding ‘Open Source’ principles in energy system development acts to work against systemic vulnerabilities by embedding resilience