Stream water age distributions controlled by storage dynamics and nonlinear hydrologic connectivity : Modeling with high-resolution isotope data

Peer reviewedPublisher PD

Review of Two Decades of Cholera Diagnostics – How Far Have We Really Come?

BACKGROUND Cholera, an ancient scourge, continues to inflict high rates of mortality today. The rising incidence of epidemics in areas of poor sanitation and crowding highlight the need for better epidemic prevention and early response. Such interventions require the availability of rapid and accurate diagnostic techniques to trigger timely response and mitigate the scale of the outbreak. The current gold standard of bacterial culture is inadequate for rapid diagnosis, highlighting the overarching neglect of field diagnostic needs. This paper was written to support the World Health Organisation's Global Task Force on Cholera Control mandated Cholera and diarrhoeal disease laboratory Network (CholdiNet) in devising a protocol for the validation of Rapid Diagnostic Tests (RDTs) for Vibrio cholerae. The status of diagnostic tools for Vibrio cholerae is assessed, describing products that have been commercialised over the last two decades and discussing their peer-reviewed evaluation. METHOD Review of post-1990 peer-reviewed and grey literature on rapid diagnostic tests for Vibrio cholerae. RESULTS Since 1990, twenty four diagnostic tests have been developed for the detection of Vibrio cholerae in human faecal samples. Fourteen of these have also been described in the literature, with rapid chromatographic-immuno assays (CIA) featuring strongly. Polymerase chain reaction (PCR) assays maintain the ability to detect the lowest amount of bacteria; however CIAs achieve both low detection thresholds and high sensitivity and specificity, making them possible candidates for use in field conditions. Field and laboratory studies were performed in a wide range of settings demonstrating variability in performance, however only a few of these studies were sufficiently stringent, highlighting five RDTs that showed promise in field conditions; COAT, IP cholera dipstick, SMART, IP dipstick and Medicos. In light of non-independent reporting, the authors would like to see these five products undergoing additional studies, with further technical improvements if needed and commercial production. The authors hope that public health use of such a RDT in limited-resource field conditions on stool samples may contribute to effective reduction in cholera epidemic spread.This work was supported by an ANU Vice Chancellor’s travel grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscrip

Variation in referrals from primary care to scheduled paediatric services in North and East Scotland:A cross-sectional study

Acknowledgements The authors are grateful to colleagues in the health information departments of NHS Grampian, Highland and Tayside. Availability of data and materials The datasets generated during the current study are available from the corresponding author on reasonable request.Peer reviewedPublisher PD

Interventions to reduce acute paediatric hospital admissions:a systematic review

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.Peer reviewedPostprin

Improving coherence of ecosystem service provision between scales

© 2014 Elsevier B.V. High-level consensus about safeguarding ecosystem services for optimal benefits to society is not yet matched by transposition to field scale. Various 'societal levers' - markets, statutory legislation, common/civil law, market-based instruments and protocols - have evolved as a fragmented policy environment of incentives and constraints, influencing the freedoms of resource owners. This has produced mosaic landscapes reflecting both natural conditions and landowner aspirations. The Principles of the Ecosystem Approach serve as a framework to consider three case study sites: an English lowland estuary and two in Scotland. Societal levers today safeguard some socially valuable services, but the present policy environment is neither sufficient nor sufficiently integrated to achieve coherence between the choices of resource owners and wider societal aspirations for ecosystem service provision. The heterogeneity of societal levers protects freedom of choice, enables adaptive decision-making related to the properties of the natural resource, and makes allowance for changes in societal preferences. Resultant mosaic landscapes provide flexibility and resilience in ecosystem service production. However, further evolution of societal levers is required to bring about greater coherence of ecosystem service production from local to national/international scales. This paper explores how issues of scale, regulation and variability manifest in the ecosystem service framework

Digital interventions in alcohol and drug prevention, treatment and recovery: Systematic maps of international research and interventions available in England

Executive Summary Background Digital interventions in alcohol and drug prevention, treatment and recovery have the potential to overcome barriers faced by non-digital interventions. However, we lack a clear understanding of the types of digital interventions that have been evaluated and where gaps in the evidence base exist. We also need to understand the effectiveness of different types of digital alcohol and drug interventions for various population groups. Further, we do not know which digital alcohol and drug interventions are being used in England, and whether the interventions in use align with those that have been evaluated. Research questions To address the above concerns, we sought to address the following questions: • RQ1: What is the possible range of digital alcohol and drug interventions? • RQ2: Which types of digital alcohol and drug interventions are currently available for use in England? • RQ3: What systematic reviews provide findings for digital alcohol and drug intervention strategies within a prevention/treatment/recovery pathway? • RQ4: Which types of digital alcohol and drug interventions have been evaluated in primary research? • RQ5: To what extent does the evaluation evidence overlap with digital alcohol and drug interventions that are currently available for use in England? • RQ6: What evidence is there that certain types of digital alcohol and drug interventions are (cost-) effective or ineffective for specific population groups or in particular contexts? This report covers our findings in relation to questions RQ1 - RQ5. Based on these findings we also provide suggestions as to what could be the focus of further work to answer RQ6. Methods To address RQ1 an initial typology was drafted, adapting and building on existing typologies of digital interventions. Through this process it became clear to OHID/PHE that a pathway, presenting a route through services, with different types of interventions recommended for use at different times would be more helpful than a typology of intervention characteristics. This pathway was then developed by OHID/PHE and trialled by the research team, with refinements made over time with discussions between the study team and PHE. To address RQ2 we contacted people in England in 2019, who were involved in developing, commissioning, prescribing, recommending or evaluating digital alcohol/drug interventions. Using an online survey, we asked them to describe the interventions they were involved with. To address RQ3, RQ4 and RQ5 we conducted systematic searching and screening to identify and describe existing systematic reviews (RQ3) and primary studies (RQ4). Included systematic reviews were appraised for quality and detailed information was extracted from full reports. For primary studies we extracted basic details using the information contained within the title and abstract. The pathway developed for RQ1 was employed to code and describe the nature of available interventions (RQ2), systematic reviews (RQ3) and primary studies (RQ4). EPPI-Mapper software was used to produce online interactive maps to visually display the findings

Strategy Selection versus Flexibility:Using Eye-trackers to Investigate Strategy Use during Mental Rotation

Spatial researchers have been arguing over the optimum cognitive strategy for spatial problem-solving for several decades. The current article aims to shift this debate from strategy dichotomies to strategy flexibility-a cognitive process, which although alluded to in spatial research, presents practical methodological challenges to empirical testing. In the current study, participants' eye movements were tracked during a mental rotation task (MRT) using the Tobii x60 eye-tracker. Results of a latent profile analysis, combining different eye movement parameters, indicated two distinct eye-patterns-fixating and switching patterns. The switching eye-pattern was associated with high mental rotation performance. There were no sex differences in eye-patterns. To investigate strategy flexibility, we used a novel application of the changepoint detection algorithm on eye movement data. Strategy flexibility significantly predicted mental rotation performance. Male participants demonstrated higher strategy flexibility than did female participants. Our findings highlight the importance of strategy flexibility in spatial thinking and have implications for designing spatial training techniques. The novel approaches to analyzing eye movement data in the current paper can be extended to research beyond the spatial domain