Parameterization of pharmaceutical emissions and removal rates for use in UK predictive exposure models: steroid estrogens as a case study.

Newly available prescription data has been used along with census data to develop a localised method for predicting pharmaceutical concentrations in sewage influent and effluent for England, and applied to a case study: the steroid estrogens estrone, 17β-estradiol, and 17α-ethinylestradiol in a selected catchment. The prescription data allows calculation of the mass consumed of synthetic estrogens, while use of highly localised census data improves predictions of naturally excreted estrogens by accounting for regional variations in population demographics. This serves two key purposes; to increase the accuracy of predictions in general, and to call attention to the need for more accurate predictions at a localised and/or catchment level, especially in light of newly proposed regulatory measures which may in the future require removal of steroid estrogens by sewage treatment facilities. In addition, the general lack of measured sewage works data necessitated the development of a novel approach which allowed comparison of localised predictions to average national measurements of influent and effluent. Overall in the case study catchment, estrogen predictions obtained using the model described herein were within 95% confidence intervals of measured values drawn from across the UK, with large improvements to predictions of EE2 being made compared with previous predictive methods

Potential changes in disease patterns and pharmaceutical use in response to climate change

This is the final version of the article. Available from Taylor & Francis via the DOI in this record.As climate change alters environmental conditions, the incidence and global patterns of human diseases are changing. These modifications to disease profiles and the effects upon human pharmaceutical usage are discussed. Climate-related environmental changes are associated with a rise in the incidence of chronic diseases already prevalent in the Northern Hemisphere, for example, cardiovascular disease and mental illness, leading to greater use of associated heavily used Western medications. Sufferers of respiratory diseases may exhibit exacerbated symptoms due to altered environmental conditions (e.g., pollen). Respiratory, water-borne, and food-borne toxicants and infections, including those that are vector borne, may become more common in Western countries, central and eastern Asia, and across North America. As new disease threats emerge, substantially higher pharmaceutical use appears inevitable, especially of pharmaceuticals not commonly employed at present (e.g., antiprotozoals). The use of medications for the treatment of general symptoms (e.g., analgesics) will also rise. These developments need to be viewed in the context of other major environmental changes (e.g., industrial chemical pollution, biodiversity loss, reduced water and food security) as well as marked shifts in human demographics, including aging of the population. To identify, prevent, mitigate, and adapt to potential threats, one needs to be aware of the major factors underlying changes in the use of pharmaceuticals and their subsequent release, deliberately or unintentionally, into the environment. This review explores the likely consequences of climate change upon the use of medical pharmaceuticals in the Northern Hemisphere.The European Centre for Environment and Human Health (part of the University of Exeter Medical School) is partly financed by the European Regional Development Fund Programme 2007 to 2013 and European Social Fund Convergence Programme for Cornwall and the Isles of Scilly

Measures of satisfaction with care during labour and birth: a comparative review

Background Satisfaction is the one of the most frequently reported outcome measures for quality of care. Assessment of satisfaction with maternity services is crucial, and psychometrically sound measures are needed if this is to inform health practices. This paper comparatively reviews current measures of satisfaction with care during labour and birth. Methods A review of the literature was conducted. Studies were located through computerised databases and hand searching references of identified articles and reviews. Inclusion criteria were that the questionnaire was a multi-item scale of satisfaction with care during labour and birth, and some form of psychometric information (either information about questionnaire construction, or reliability, or validity) had to be reported. Results Nine questionnaires of satisfaction with care during labour and birth were identified. Instruments varied in psychometric properties and dimensions. Most described questionnaire construction and tested some form of reliability and validity. Measures were generally not based on the main theoretical models of satisfaction and varied in scope and application to different types of samples (e.g. satisfaction following caesarean section). For an in-depth measure of satisfaction with intrapartum care, the Intrapartal-Specific Quality from the Patient’s Perspective questionnaire (QPP-I) is recommended. Brief measures with good reliability and validity are provided by the Six Simple Questions (SSQ) or Perceptions of Care Adjective Checklist (PCACL-R). Conclusions Despite the interest in measures of satisfaction there are only a small number of validated measures of satisfaction with care during labour and birth. It is important that brief, reliable and valid measures are available for use in general and specific populations in order to assist research and inform practice

Why don't the British eat locally harvested shellfish? The role of misconceptions and knowledge gaps

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record Although the UK consumes a substantial amount of shellfish, most is imported (e.g. prawns), while locally harvested molluscs and crustaceans (e.g. mussels, crab) tend to be exported. This study aimed to investigate whether a low rate of local shellfish consumption in the UK is due to misunderstandings or knowledge gaps about the potential health and environmental risks and benefits of consumption. Following the Mental Models Approach, the present paper reveals: 1) qualitative results from 26 stakeholder/public interviews which identified 10 key misunderstandings and knowledge gaps, including incorrect beliefs about health risks and a lack of knowledge about the relative environmental benefits compared to other foods (key misunderstandings included some parts of a crab are poisonous if eaten, and the majority of UK shellfish is farmed), and 2) quantitative results from a survey (n = 1,433) that explored the degree to which these misunderstandings and knowledge gaps may influence consumption intentions in the wider UK population. Survey results suggested the number of misunderstandings and knowledge gaps significantly predicted shellfish consumption intentions even after controlling for demographics, food related values, and past consumption behaviour. Path analyses revealed their impact on intentions was partially mediated via Theory of Planned Behaviour variables. Results could inform information campaigns supporting consumers to make more informed decisions regarding a group of foods that are potentially both healthy and relatively environmentally friendly.European Regional Development Fund ProgrammeEuropean Social Fund Convergence Programme for Cornwall and the Isles of Scill

Nano-Crystalline &Amorphous Silicon PhotoTransistor Performance Analysis

In this thesis, we compared electrical performance and stability of a novel nanocrystalline Si (nc-Si) thin film phototransistor (TFT) phototransistor and a regular amorphous silicon (a-Si:H) TFT phototransistor for large area imaging applications. The electrical performance parameters of nc-Si TFT phototransistor were extracted from the electrical (current-voltage) testing in dark and under illumination. The field-effect mobility is found to be around 1.2 cm2V-1s-1, the threshold voltage around 3.9V and the sub-threshold voltage slope around 0.47V/Dec. Optical properties of nc-Si TFT phototransistor have been evaluated under the green light illumination in the range of 1014 – 1017 lum, and the photocurrent gain and the external quantum efficiency were extracted from the experimental results. By comparing the results with those for a-Si:H TFTs measured under the same conditions, we found that nc-Si TFT has higher photo current gain under low illumination intensity, 5 ×1014 to 7 ×1015 lum. This thesis shows the relations bewteen the photo current gain, the external quantum efficiency, TFT drain and TFT gate bias; the photo current gain and the external quantum efficiency can be controlled by the Vds and the Vgs