570 research outputs found
Community Perspective on Consultation on Urban Stormwater Management: Lessons from Brownhill Creek, South Australia
This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC-BY) license (http://creativecommons.org/licenses/by/4.0/).There are salutary lessons from contrasting community consultation efforts in 2011 and
2015 to develop and gain support for an urban stormwater management plan for the Brownhill Creek
catchment in Adelaide, South Australia. The 2011 process was a failure in the human dimension,
precipitating loss of community confidence, unnecessarily entrained thousands of hours of time of
residents who initiated a community action group for environmental conservation and caused a
three-year delay to decision making. By contrast, the 2015 process was vastly improved, resulted in a
landslide level of support for an obvious option not previously offered, achieved the required level of
flood protection, saved Aus$5 million (14%) on the previously proposed option and protected a highly
valued natural environment from an unnecessary dam. This paper presents a rarely heard perspective
on these community consultation processes from a participating community environmental and
heritage conservation action group (the Brownhill Creek Association) that was deeply engaged in
reforming the Draft Brown Hill Keswick Creek Stormwater Management Plan. This reveals that the
community needs to see that all options are considered and to have access to accurate information
with which to assess them. It is also necessary that the proposed plan is consistent with existing
agreed plans and policies developed through public consultation. Community concerns need to
be heard, acknowledged and acted upon or responded to, and the consultation process needs to
be transparently fair and democratic to win community support. A major contributor to success in
the second consultation was that all community action groups were invited to meetings to discuss
the purpose of the consultation and the methods to be used. Feedback was subsequently received
before the process commenced to show what had changed and why any suggestions concerning the
consultation process were not being adopted. This openness helped to mend the distrust of the first
consultation process and is recommended as an essential early step in any public consultation process
Thermal Interface Materials Selection and Application Guidelines: In Perspective of Xilinx Virtex-5QV Thermal Management
The heat from high-power microdevices for space, such as Xilinx Virtex 4 and 5 (V4 and V5), has to be removed mainly through conduction in the space vacuum environment. The class-Y type packages are designed to remove the heat from the top of the package, and the most effective method to remove heat from the class-Y type packages is to attach a heat transfer device on the lid of the package and to transfer the heat to frame or chassis. When a heat transfer device is attached to the package lid, the surfaces roughness of the package lid and the heat transfer device reduces the effective contact area between the two. The reduced contact area results in increased thermal contact resistance, and a thermal interface material is required to reduce the thermal contact resistance by filling in the gap between the surfaces of the package lid and the heat transfer device. The current report describes JPL's FY14 NEPP task study on property requirements of TIM and impact of TIM properties on the packaging reliability. The current task also developed appratuses to investigate the performances of TIMs in the actual mission environment
The prevalence and impact of thrombocytopenia, anaemia and leucopenia on sustained virological response in patients receiving hepatitis C therapy: evidence from a large ‘real world’ cohort
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Antimicrobial Resistance in Neisseria gonorrhoeae: Proceedings of the STAR Sexually Transmitted Infection-Clinical Trial Group Programmatic Meeting.
The goal of the Sexually Transmitted Infection Clinical Trial Group's Antimicrobial Resistance (AMR) in Neisseria gonorrhoeae (NG) meeting was to assemble experts from academia, government, nonprofit and industry to discuss the current state of research, gaps and challenges in research and technology and priorities and new directions to address the continued emergence of multidrug-resistant NG infections. Topics discussed at the meeting, which will be the focus of this article, include AMR NG global surveillance initiatives, the use of whole genome sequencing and bioinformatics to understand mutations associated with AMR, mechanisms of AMR, and novel antibiotics, vaccines and other methods to treat AMR NG. Key points highlighted during the meeting include: (i) US and International surveillance programs to understand AMR in NG; (ii) the US National Strategy for combating antimicrobial-resistant bacteria; (iii) surveillance needs, challenges, and novel technologies; (iv) plasmid-mediated and chromosomally mediated mechanisms of AMR in NG; (v) novel therapeutic (eg, sialic acid analogs, factor H [FH]/Fc fusion molecule, monoclonal antibodies, topoisomerase inhibitors, fluoroketolides, LpxC inhibitors) and preventative (eg, peptide mimic) strategies to combat infection. The way forward will require renewed political will, new funding initiatives, and collaborations across academic and commercial research and public health programs
Developing Gradient Metal Alloys through Radial Deposition Additive Manufacturing
Interest in additive manufacturing (AM) has dramatically expanded in the last several years, owing to the paradigm shift that the process provides over conventional manufacturing. Although the vast majority of recent work in AM has focused on three-dimensional printing in polymers, AM techniques for fabricating metal alloys have been available for more than a decade. Here, laser deposition (LD) is used to fabricate multifunctional metal alloys that have a strategically graded composition to alter their mechanical and physical properties. Using the technique in combination with rotational deposition enables fabrication of compositional gradients radially from the center of a sample. A roadmap for developing gradient alloys is presented that uses multi-component phase diagrams as maps for composition selection so as to avoid unwanted phases. Practical applications for the new technology are demonstrated in low-coefficient of thermal expansion radially graded metal inserts for carbon-fiber spacecraft panels
Characterising the risk interplay between alcohol intake and body mass index on cirrhosis morbidity
Evidence of continued injecting drug use after attaining sustained treatment-induced clearance of the hepatitis C virus: implications for reinfection
Background:
People who inject drugs (PWID) are at the greatest risk of hepatitis C virus (HCV) infection, yet are often denied immediate treatment due to fears of on-going risk behaviour. Our principal objective was to examine evidence of continued injecting drug use among PWID following successful treatment for HCV and attainment of a sustained viral response (SVR).
Methods:
PWID who attained SVR between 1992 and June 2012 were selected from the National Scottish Hepatitis C Clinical Database. Hospitalisation and mortality records were sourced for these patients using record linkage techniques. Our primary outcome variable was any hospitalisation or death, which was indicative of injecting drugs post-SVR.
Results:
The cohort comprised 1170 PWID (mean age at SVR 39.6y; 76% male). The Kaplan Meier estimate of incurring the primary outcome after three years of SVR was 10.59% (95% CI, 8.75–12.79) After adjusting for confounding, the risk of an injection related hospital episode or death post-SVR was significantly increased with advancing year of SVR: AHR:1.07 per year (95% CI, 1.01–1.14), having a pre-SVR acute alcohol intoxication-related hospital episode: AHR:1.83 (95% CI, 1.29–2.60), and having a pre-SVR opiate or injection-related hospital episode: AHR:2.59 (95% CI, 1.84–3.64).
Conclusion:
Despite attaining the optimal treatment outcome, these data indicate that an increasing significant minority of PWID continue to inject post-SVR at an intensity which leads to either hospitalisation or death and increased risk of reinfection
Mortality in hepatitis C patients who achieve a sustained viral response compared to the general population
Background & Aims:
The number of people living with previous hepatitis C infection that have attained a sustained viral response (SVR) is expected to grow rapidly. So far, the prognosis of this group relative to the general population is unclear.
Methods:
Individuals attaining SVR in Scotland in 1996–2011 were identified using a national database. Through record-linkage, we obtained cause-specific mortality data complete to Dec 2013. We calculated standardised mortality ratios (SMRs) to compare the frequency of mortality in SVR patients to the general population. In a parallel analysis, we used Cox regression to identify modifiable patient characteristics associated with post-SVR mortality.
Results:
We identified 1824 patients, followed on average for 5.2 years after SVR. In total, 78 deaths were observed. Overall, all-cause mortality was 1.9 times more frequent for SVR patients than the general population (SMR: 1.86; 95% confidence interval (CI): 1.49–2.32). Significant cause-specific elevations were seen for death due to primary liver cancer (SMR: 23.50; 95% CI: 12.23–45.16), and death due to drug-related causes (SMR: 6.58, 95% CI: 4.15–10.45). Together these two causes accounted for 66% of the total excess death observed. All of the modifiable characteristics associated with increased mortality were markers either of heavy alcohol use or injecting drug use. Individuals without these behavioural markers (32.8% of cohort) experienced equivalent survival to the general population (SMR: 0.70; 95% CI: 0.41–1.18)
Conclusions:
Mortality in Scottish SVR patients is higher overall than the general population. The excess was driven by death from drug-related causes and liver cancer. Health risk behaviours emerged as important modifiable determinants of mortality in this population.
Lay summary:
Patients cured of hepatitis C through treatment had a higher mortality rate overall than the general population. Most of the surplus mortality was due to drug-related causes and death from liver cancer. A history of heavy alcohol and injecting drug use were associated with a higher mortality risk
Genome-to-genome analysis highlights the effect of the human innate and adaptive immune systems on the hepatitis C virus
Outcomes of hepatitis C virus (HCV) infection and treatment depend on viral and host genetic factors. Here we use human genome-wide genotyping arrays and new whole-genome HCV viral sequencing technologies to perform a systematic genome-to-genome study of 542 individuals who were chronically infected with HCV, predominantly genotype 3. We show that both alleles of genes encoding human leukocyte antigen molecules and genes encoding components of the interferon lambda innate immune system drive viral polymorphism. Additionally, we show that IFNL4 genotypes determine HCV viral load through a mechanism dependent on a specific amino acid residue in the HCV NS5A protein. These findings highlight the interplay between the innate immune system and the viral genome in HCV control
Hepatitis C reinfection following treatment induced viral clearance among people who have injected drugs
Background:
Although people who inject drugs (PWID) are an important group to receive Hepatitis C Virus (HCV) antiviral therapy, initiation onto treatment remains low. Concerns over reinfection may make clinicians reluctant to treat this group. We examined the risk of HCV reinfection among a cohort of PWID (encompassing all those reporting a history of injecting drug use) from Scotland who achieved a sustained virological response (SVR).
Methods:
Clinical and laboratory data were used to monitor RNA testing among PWID who attained SVR following therapy between 2000 and 2009. Data were linked to morbidity and mortality records. Follow-up began one year after completion of therapy, ending on 31st December, 2012. Frequency of RNA testing during follow-up was calculated and the incidence of HCV reinfection estimated. Cox proportional hazards regression was used to examine factors associated with HCV reinfection.
Results:
Among 448 PWID with a SVR, 277 (61.8%) were tested during follow-up, median 4.5 years; 191 (69%) received one RNA test and 86 (31%) received at least two RNA tests. There were seven reinfections over 410 person years generating a reinfection rate of 1.7/100 py (95% CI 0.7–3.5). For PWID who have been hospitalised for an opiate or injection related cause post SVR (11%), the risk of HCV reinfection was greater [AHR = 12.9, 95% CI 2.2–76.0, p = 0.002] and the reinfection rate was 5.7/100 py (95% CI 1.8–13.3).
Conclusion:
PWID who have been tested, following SVR, for HCV in Scotland appear to be at a low risk of reinfection. Follow-up and monitoring of this population are warranted as treatment is offered more widely
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