Looking beyond eruptions for an explanation of volcanic disasters: vulnerability in volcanic environments

A thesis submitted to the Centre for Volcanic Studies, University of Luton, in partial fulfilment of the requirements for the degree of Doctor of Philosophy.'Natural' disasters have traditionally been viewed as the result of an extreme physical environment. A radical backlash against this dominant view, in the nineteen seventies and eighties, moved the debate to the opposite extreme and in doing so replaced physical with social determinism. Vulnerability analysis is proposed as a methodology that bridges these extremes. It takes into account individual decision making, social milieu and physical hazard when describing human habitation in areas of volcanic activity. It is argued that vulnerability should be defined in terms of universal human needs in order to avoid it simply being a measure of the chance of death and injury or losing its meaning in the uncertainty of cultural relativism. Once vulnerability is identified it is important to explore why it has come to exist. A contextual theory of vulnerability change is presented. Vulnerability to volcanic activity was explored in the area around Mt. Etna in Sicily (Italy) and Furnas volcano San Miguel in the Azores (Portugal) using a case study methodology. This included: collecting data through interviews (semistructured and structured) and field surveying, utilising census and other secondary data sources, and examining historical documents and texts. The volcanic hazard on Mt. Etna is related to regular (4-7 years) effusive lava flows which threaten property and land rather than people. Living in a European state, it is likely that a victim of Mt. Etna will have their basic needs provided for in the long-term and therefore they are not vulnerable. In contrast the irregular explosive eruptions of Furnas, last eruption 1630, not only damage property and land but also endanger lives. The limited ability of individuals to protect themselves in the event of an eruption and organisations to aid them in this means that, in spite of state insurance, many around Furnas are vulnerable. The production of vulnerability around Etna and Furnas is strongly related to the socio-economic nature of the region and wider European and global contexts. Opportunities and constraints that exist across socio-physical space encourage behaviour and forms of life which, in tum, produce various levels of vulnerability. Individuals seem to cognitively diminish their perceptions of this threat within a context of social representations of low risk. They, and society as a whole, rarely seem to engage directly with the risk itself

Housing tenure and hospital admissions for acute lower respiratory tract infections in children less than 2 years: A Scottish birth cohort (2010-2012)

Objective To estimate the association between household tenure and the odds of hospital admission for acute lower respiratory tract infections (LRTI) in children under age 2 years. Methods We developed a birth cohort of all singleton children born in Scotland 2010-2012, using linked birth registration records and maternal Census 2011 data. Further linkage to hospital admission records provided information on acute LRTI (pneumonia, bronchitis, bronchiolitis, influenza, unspecified LRTI) admissions in children aged less than 2 years. Using logistic regression models, we estimated the association between housing tenure at birth (owned, social rented, private rented/lives rent free) with odds of hospital admission for LRTI before and after adjustment for parental occupational class (household reference), family type and highest qualification level. Results From the cohort of all 174,279 births in 2010-2012, 84.1% linked to a maternal census record. Children whose parents were married or had a UK-born mother were more likely to link to a Census record. In the final linked cohort of 141,336 children, 7,486 (5.3%) were admitted to hospital for one or more LRTI during the 2 years of follow up. We found an association between housing tenure and LRTI admissions, with children residing in social rented, compared to owned housing having higher odds of an LRTI admission, OR: 1.40 (1.32-1.47); and children living in private rented/rent free housing, compared to owned, OR: 1.18 (1.11-1.26). After adjustment for household socioeconomic circumstances, these estimates attenuated to OR: 1.18 (1.11-1.27) and OR: 1.10 (1.03-1.18) respectively. Conclusion After accounting for household socioeconomic circumstances, children living in social and private tenured accommodation, compared to children living in owned accommodation were more likely to be hospitalised for an acute LRTI during the first 2 years of life. Further research to understand the contribution specific housing circumstances make to inequalities in LRTI hospitalisations early in life is needed

The epidemiology, healthcare and societal burden and costs of asthma in the UK and its member nations: analyses of standalone and linked national databases

Background There are a lack of reliable data on the epidemiology and associated burden and costs of asthma. We sought to provide the first UK-wide estimates of the epidemiology, healthcare utilisation and costs of asthma. Methods We obtained and analysed asthma-relevant data from 27 datasets: these comprised national health surveys for 2010–11, and routine administrative, health and social care datasets for 2011–12; 2011–12 costs were estimated in pounds sterling using economic modelling. Results The prevalence of asthma depended on the definition and data source used. The UK lifetime prevalence of patient-reported symptoms suggestive of asthma was 29.5 % (95 % CI, 27.7–31.3; n = 18.5 million (m) people) and 15.6 % (14.3–16.9, n = 9.8 m) for patient-reported clinician-diagnosed asthma. The annual prevalence of patient-reported clinician-diagnosed-and-treated asthma was 9.6 % (8.9–10.3, n = 6.0 m) and of clinician-reported, diagnosed-and-treated asthma 5.7 % (5.7–5.7; n = 3.6 m). Asthma resulted in at least 6.3 m primary care consultations, 93,000 hospital in-patient episodes, 1800 intensive-care unit episodes and 36,800 disability living allowance claims. The costs of asthma were estimated at least £1.1 billion: 74 % of these costs were for provision of primary care services (60 % prescribing, 14 % consultations), 13 % for disability claims, and 12 % for hospital care. There were 1160 asthma deaths. Conclusions Asthma is very common and is responsible for considerable morbidity, healthcare utilisation and financial costs to the UK public sector. Greater policy focus on primary care provision is needed to reduce the risk of asthma exacerbations, hospitalisations and deaths, and reduce costs

Health trajectories in regeneration areas in England:the impact of the New Deal for Communities intervention

BACKGROUND: A large body of evidence documents the adverse relationship between concentrated deprivation and health. Among the evaluations of regeneration initiatives to tackle these spatial inequalities, few have traced the trajectories of individuals over time and fewer still have employed counterfactual comparison. We investigate the impact of one such initiative in England, the New Deal for Communities (NDC), which ran from 1999 to 2011, on socioeconomic inequalities in health trajectories. METHODS: Latent Growth Curve modelling of within-person changes in self-rated health, mental health and life satisfaction between 2002 and 2008 of an analytical cohort of residents of 39 disadvantaged areas of England in which the NDC was implemented, compared with residents of comparator, non-intervention areas, focusing on: (1) whether differences over time in outcomes can be detected between NDC and comparator areas and (2) whether interventions may have altered socioeconomic differences in outcomes. RESULTS: No evidence was found for an overall improvement in the three outcomes, or for significant differences in changes in health between respondents in NDC versus comparator areas. However, we found a weakly significant gap in life satisfaction and mental health between high and low socioeconomic status individuals in comparator areas which widened over time to a greater extent than in NDC areas. Change over time in the three outcomes was non-linear: individual improvements among NDC residents were largest before 2006. CONCLUSIONS: There is limited evidence that the NDC moderated the impact of socioeconomic factors on mental health and life satisfaction trajectories. Furthermore, any NDC impact was strongest in the first 6 years of the programmes

Preterm birth associated with maternal fine particulate matter exposure : A global, regional and national assessment

Reduction of preterm births (< 37 completed weeks of gestation) would substantially reduce neonatal and infant mortality, and deleterious health effects in survivors. Maternal fine particulate matter (PM2.5) exposure has been identified as a possible risk factor contributing to preterm birth. The aim of this study was to produce the first estimates of ambient PM2.5-associated preterm births for 183 individual countries and globally. To do this, national, population-weighted, annual average ambient PM2.5 concentration, preterm birth rate and number of livebirths were combined to calculate the number of PM2.5-associated preterm births in 2010 for 183 countries. Uncertainty was quantified using Monte-Carlo simulations, and analyses were undertaken to investigate the sensitivity of PM2.5-associated preterm birth estimates to assumptions about the shape of the concentration-response function at low and high PM2.5 exposures, inclusion of provider-initiated preterm births, and exposure to indoor air pollution. Globally, in 2010, the number of PM2.5-associated preterm births was estimated as 2.7 million (1.8–3.5 million, 18% (12–24%) of total preterm births globally) with a low concentration cut-off (LCC) set at 10 μg m− 3, and 3.4 million (2.4–4.2 million, 23% (16–28%)) with a LCC of 4.3 μg m− 3. South and East Asia, North Africa/Middle East and West sub-Saharan Africa had the largest contribution to the global total, and the largest percentage of preterm births associated with PM2.5. Sensitivity analyses showed that PM2.5-associated preterm birth estimates were 24% lower when provider-initiated preterm births were excluded, 38–51% lower when risk was confined to the PM2.5 exposure range in the studies used to derive the effect estimate, and 56% lower when mothers who live in households that cook with solid fuels (and whose personal PM2.5 exposure is likely dominated by indoor air pollution) were excluded. The concentration-response function applied here derives from a meta-analysis of studies, most of which were conducted in the US and Europe, and its application to the areas of the world where we estimate the greatest effects on preterm births remains uncertain. Nevertheless, the substantial percentage of preterm births estimated to be associated with anthropogenic PM2.5 (18% (13%–24%) of total preterm births globally) indicates that reduction of maternal PM2.5 exposure through emission reduction strategies should be considered alongside mitigation of other risk factors associated with preterm births

The role of administrative data in the big data revolution in social science research

The term big data is currently a buzzword in social science, however its precise meaning is ambiguous. In this paper we focus on administrative data which is a distinctive form of big data. Exciting new opportunities for social science research will be afforded by new administrative data resources, but these are currently under appreciated by the research community. The central aim of this paper is to discuss the challenges associated with administrative data. We emphasise that it is critical for researchers to carefully consider how administrative data has been produced. We conclude that administrative datasets have the potential to contribute to the development of high-quality and impactful social science research, and should not be overlooked in the emerging field of big data

DataSHIELD: taking the analysis to the data, not the data to the analysis

Research in modern biomedicine and social science requires sample sizes so large that they can often only be achieved through a pooled co-analysis of data from several studies. But the pooling of information from individuals in a central database that may be queried by researchers raises important ethico-legal questions and can be controversial. In the UK this has been highlighted by recent debate and controversy relating to the UK's proposed 'care.data' initiative, and these issues reflect important societal and professional concerns about privacy, confidentiality and intellectual property. DataSHIELD provides a novel technological solution that can circumvent some of the most basic challenges in facilitating the access of researchers and other healthcare professionals to individual-level data. Commands are sent from a central analysis computer (AC) to several data computers (DCs) storing the data to be co-analysed. The data sets are analysed simultaneously but in parallel. The separate parallelized analyses are linked by non-disclosive summary statistics and commands transmitted back and forth between the DCs and the AC. This paper describes the technical implementation of DataSHIELD using a modified R statistical environment linked to an Opal database deployed behind the computer firewall of each DC. Analysis is controlled through a standard R environment at the AC. Based on this Opal/R implementation, DataSHIELD is currently used by the Healthy Obese Project and the Environmental Core Project (BioSHaRE-EU) for the federated analysis of 10 data sets across eight European countries, and this illustrates the opportunities and challenges presented by the DataSHIELD approach. DataSHIELD facilitates important research in settings where: (i) a co-analysis of individual-level data from several studies is scientifically necessary but governance restrictions prohibit the release or sharing of some of the required data, and/or render data access unacceptably slow; (ii) a research group (e.g. in a developing nation) is particularly vulnerable to loss of intellectual property-the researchers want to fully share the information held in their data with national and international collaborators, but do not wish to hand over the physical data themselves; and (iii) a data set is to be included in an individual-level co-analysis but the physical size of the data precludes direct transfer to a new site for analysis

Leaving the city for the suburbs - The dominance of 'ordinary' decision making over volcanic risk perception in the production of volcanic risk on Mt Etna, Sicily

The belief that perception plays a central role in the production of risk has tended to dominate research on 'natural' hazards. Critics have commented on its lack of explanatory power in situations where individuals are heavily constrained in their actions but less has been said about how it might also be a weak form of explanation in contexts where individuals have more choices, albeit ultimately bounded. On Etna (Italy), in the last fifty years, the expansion of towns to accommodate the city of Catania's population has taken place despite very obvious threats from volcanic activity and alternative, 'safer', sites for building being available. People are moving into these towns for the same reasons people across the world are moving out of cities, to improve their quality of life. Individuals living in one of these expanded towns, Trecastagni, appear to cognitively diminish their perceptions of volcanic threat within a context of social representations of low risk. This is especially true of those who have moved into the town. It is concluded that the production of risk within society on Etna is strongly related to the socio-economic nature of the region and wider European and global contexts that create opportunities and constraints across socio-physical space encouraging behaviour and forms of life that are higher risk. Risk perception appears to play little or no role in this process. (c) 2008 Elsevier B.V. All rights reserved.</p