Peer support in small towns: A decentralized mobile Hepatitis C virus clinic for people who inject drugs

Background & aims: New models of HCV care are needed to reach people who inject drugs (PWID). The primary aim was to evaluate HCV treatment uptake among HCV RNA positive individuals identified by point-of-care (POC) testing and liver disease assessment in a peer-driven decentralized mobile clinic. Methods: This prospective study included consecutive patients assessed in a mobile clinic visiting 32 small towns in Southern Norway from November 2019 to November 2020. The clinic was staffed by a bus driver and a social educator offering POC HCV RNA testing (GeneXpert®), liver disease staging (FibroScan® 402) and peer support. Viremic individuals were offered prompt pan-genotypic treatment prescribed by local hospital-employed specialists following a brief telephone assessment. Results: Among 296 tested individuals, 102 (34%) were HCV RNA positive (median age 51 years, 77% male, 24% advanced liver fibrosis/cirrhosis). All participants had a history of injecting drug use, 71% reported past 3 months injecting, and 37% received opioid agonist treatment. Treatment uptake within 6 months following enrolment was achieved in 88%. Treatment uptake was negatively associated with recent injecting (aHR 0.60; 95% CI 0.36-0.98), harmful alcohol consumption (aHR 0.44; 95% CI 0.20-0.99), and advanced liver fibrosis/cirrhosis (aHR 0.44; 95% CI 0.25-0.80). HCV RNA prevalence increased with age (OR 1.81 per 10-year increase; 95% 1.41-2.32), ranging from 3% among those <30 years to 55% among those ≥60 years. Conclusions: A peer-driven mobile HCV clinic is an effective and feasible model of care that should be considered for broader implementation to reach PWID outside the urban centres. Keywords: hepatitis C virus; peer support; people who inject drugs; point of care; treatment. © 2022 The Authors. Liver International published by John Wiley & Sons Ltd.publishedVersio

Collision risk in white-tailed eagles. Modelling collision risk using vantage point observations in Smøla wind-power plant

May, R., Hoel, P.L., Langston, R., Dahl, E.L., Bevanger, K., Reitan, O., Nygård, T., Pedersen, H.C., Røskaft, E. & Stokke, B.G. 2010. Collision risk in white-tailed eagles. Modelling collision risk using vantage point observations in Smøla wind-power plant. – NINA Report 639. 25 pp. Large soaring birds of prey, such as the white-tailed eagle, are recognized to be perhaps the most vulnerable bird group regarding risk of collisions with turbines in wind-power plants. Their mortalities have called for methods capable of modelling collision risks in connection with the planning of new wind-power developments. The so-called “Band model” estimates collision risk based on the number of birds flying through the rotor swept zone and the probability of being hit by the passing rotor blades. In the calculations for the expected collision mortality a correction factor for avoidance behaviour is included. The overarching objective of this study was to use actual flight data and actual mortality to back-calculate the correction factor for white-tailed eagles. The Smøla wind-power plant consists of 68 turbines, over an area of approximately 18 km2. Since autumn 2006 number of collisions has been recorded on a weekly basis. The analyses were based on observational data from 12 vantage points collected in spring 2008; of which six vantage points were placed inside the wind-power plant. The results were verified using observational data from 10 vantage points within the wind-power plant from May 2009. In total, five white-tailed eagles have collided with wind turbines during the vantage point periods, between mid-March and the end of May 2008. In May 2009, only one white-tailed eagle was found dead. Given the vantage point observations data the correction factor (i.e. “avoidance rate”) used within the Band collision risk model for white-tailed eagles was 96.4 and 97.1% for 11 and 16 RPM, respectively. These values, however, assume that the wind turbines operated continuously with the respective RPMs. The correction factor adjusted for the actual wind speed distribution at Smøla WPA was 95.8%. We also derived uncertainty levels in the modelling, which resulted in a mean correction factor of 92.5% ± 9.7 SD. This may be due to the wind speed distribution during the period of interest, affecting both bird speed and flight activity. This would decrease the total period of interest; and lower the expected number of bird transits through the rotor swept zone. Although this modelling took into account variation in wind and bird speed, daylight and flight activity, there may exist possible sources of error, such as observer bias. These have been assessed. The correction factor was slightly lower using an independent vantage point data set from May 2009. The relatively low correction factor including uncertainty levels presented here, compared to that for most other raptor species, probably results from high levels of flight and breeding display activity, as demonstrated at the Smøla wind-power plant, where numerous collisions have occurred. Norway, Smøla wind-power plant White-tailed eagle, collision risk modelling, Norge, Smøla vindpark, havørn, kollisjonsrisikomodellerin

Collision risk in white-tailed eagles. Modelling collision risk using vantage point observations in Smøla wind-power plant

May, R., Hoel, P.L., Langston, R., Dahl, E.L., Bevanger, K., Reitan, O., Nygård, T., Pedersen, H.C., Røskaft, E. & Stokke, B.G. 2010. Collision risk in white-tailed eagles. Modelling collision risk using vantage point observations in Smøla wind-power plant. – NINA Report 639. 25 pp. Large soaring birds of prey, such as the white-tailed eagle, are recognized to be perhaps the most vulnerable bird group regarding risk of collisions with turbines in wind-power plants. Their mortalities have called for methods capable of modelling collision risks in connection with the planning of new wind-power developments. The so-called “Band model” estimates collision risk based on the number of birds flying through the rotor swept zone and the probability of being hit by the passing rotor blades. In the calculations for the expected collision mortality a correction factor for avoidance behaviour is included. The overarching objective of this study was to use actual flight data and actual mortality to back-calculate the correction factor for white-tailed eagles. The Smøla wind-power plant consists of 68 turbines, over an area of approximately 18 km2. Since autumn 2006 number of collisions has been recorded on a weekly basis. The analyses were based on observational data from 12 vantage points collected in spring 2008; of which six vantage points were placed inside the wind-power plant. The results were verified using observational data from 10 vantage points within the wind-power plant from May 2009. In total, five white-tailed eagles have collided with wind turbines during the vantage point periods, between mid-March and the end of May 2008. In May 2009, only one white-tailed eagle was found dead. Given the vantage point observations data the correction factor (i.e. “avoidance rate”) used within the Band collision risk model for white-tailed eagles was 96.4 and 97.1% for 11 and 16 RPM, respectively. These values, however, assume that the wind turbines operated continuously with the respective RPMs. The correction factor adjusted for the actual wind speed distribution at Smøla WPA was 95.8%. We also derived uncertainty levels in the modelling, which resulted in a mean correction factor of 92.5% ± 9.7 SD. This may be due to the wind speed distribution during the period of interest, affecting both bird speed and flight activity. This would decrease the total period of interest; and lower the expected number of bird transits through the rotor swept zone. Although this modelling took into account variation in wind and bird speed, daylight and flight activity, there may exist possible sources of error, such as observer bias. These have been assessed. The correction factor was slightly lower using an independent vantage point data set from May 2009. The relatively low correction factor including uncertainty levels presented here, compared to that for most other raptor species, probably results from high levels of flight and breeding display activity, as demonstrated at the Smøla wind-power plant, where numerous collisions have occurred. Norway, Smøla wind-power plant White-tailed eagle, collision risk modelling, Norge, Smøla vindpark, havørn, kollisjonsrisikomodellerin

Pre- and post-construction studies of conflicts between birds and wind turbines in coastal Norway (BirdWind). Report on findings 2007-2010

The BirdWind project (2007-2010) is now concluded. This report summarises the main findings. Several scientific papers are in the process of preparation for publication in international peer re-view journals; this report only provides a brief overview. The main project objective has been to study species-, site- and seasonal-specific bird mortality; and to identify vulnerable species and site-specific factors that should be considered to improve the basis for future pre- and post con-struction EIAs in connection with wind power-plant constructions. To reach these goals work pack-ages and sub-projects have focused on behavioural and response studies at individual and popu-lation levels, for selected model species. The white-tailed eagle has been a focal species during the studies, as several fatalities were recorded in connection with the Smøla Wind-Power Plant (SWPP) even before the project started; the SWPP has been the main arena for project fieldwork. Modelling the WTE collision risk and making a WTE population model were important elements of the project activities. The development of methodologies and technical tools for data collection and mitigating measures has also been an important part of the project. For practical convenience the project was divided into eight subprojects focusing on 1) bird mortality, 2) willow ptarmigan, 3) breeding waders and smaller passerines, 4) white-tailed eagle, 5) bird radar, 6) mitigating technol-ogy, 7) data flow and storage systems and 8) GIS, visualization and terrain modelling. Results and preliminary conclusions related to each of these subtasks are reported

Pre- and post-construction studies of conflicts between birds and wind turbines in coastal Norway (BirdWind). Report on findings 2007-2010

Bevanger, K., Berntsen, F., Clausen, S., Dahl, E.L., Flagstad, Ø. Follestad, A., Halley, D., Hanssen, F., Johnsen, L., Kvaløy, P., Lund-Hoel, P., May, R., Nygård, T., Pedersen, H.C., Reitan, O., Røskaft, E., Steinheim, Y., Stokke, B. & Vang, R. 2010. Pre- and post-construction studies of conflicts between birds and wind turbines in coastal Norway (BirdWind). Report on findings 2007-2010. – NINA Report 620. 152 pp. The BirdWind project (2007-2010) is now concluded. This report summarises the main findings. Several scientific papers are in the process of preparation for publication in international peer re-view journals; this report only provides a brief overview. The main project objective has been to study species-, site- and seasonal-specific bird mortality; and to identify vulnerable species and site-specific factors that should be considered to improve the basis for future pre- and post con-struction EIAs in connection with wind power-plant constructions. To reach these goals work pack-ages and sub-projects have focused on behavioural and response studies at individual and popu-lation levels, for selected model species. The white-tailed eagle has been a focal species during the studies, as several fatalities were recorded in connection with the Smøla Wind-Power Plant (SWPP) even before the project started; the SWPP has been the main arena for project fieldwork. Modelling the WTE collision risk and making a WTE population model were important elements of the project activities. The development of methodologies and technical tools for data collection and mitigating measures has also been an important part of the project. For practical convenience the project was divided into eight subprojects focusing on 1) bird mortality, 2) willow ptarmigan, 3) breeding waders and smaller passerines, 4) white-tailed eagle, 5) bird radar, 6) mitigating technol-ogy, 7) data flow and storage systems and 8) GIS, visualization and terrain modelling. Results and preliminary conclusions related to each of these subtasks are reported