Addressing water poverty under climate crisis: implications for social policy

Access to safe, clean and affordable water is a basic human right and a global goal towards which climate change poses new challenges that heavily impact the health and wellbeing of people across the globe and exacerbate or create new inequalities. These challenges are shaped by a number of geographical and social conditions that, apart from the risks of weather-driven impacts on water, include water governance and management arrangements in place, including pricing tariffs, and the interplay of social and economic inequalities. Building on examples from Australia, Scotland and England and Wales that illustrate access to water in different types of water provision systems, and regarding to aspects of access, quality and affordability, this paper explores the types of challenges related to water poverty in the context of climate crisis and reflects on the multiple dimensions of water poverty oriented social policy at the interplay of climate change associated risks

Cognitive tests used in chronic adult human randomised controlled trial micronutrient and phytochemical intervention studies

In recent years there has been a rapid growth of interest in exploring the relationship between nutritional therapies and the maintenance of cognitive function in adulthood. Emerging evidence reveals an increasingly complex picture with respect to the benefits of various food constituents on learning, memory and psychomotor function in adults. However, to date, there has been little consensus in human studies on the range of cognitive domains to be tested or the particular tests to be employed. To illustrate the potential difficulties that this poses, we conducted a systematic review of existing human adult randomised controlled trial (RCT) studies that have investigated the effects of 24 d to 36 months of supplementation with flavonoids and micronutrients on cognitive performance. There were thirty-nine studies employing a total of 121 different cognitive tasks that met the criteria for inclusion. Results showed that less than half of these studies reported positive effects of treatment, with some important cognitive domains either under-represented or not explored at all. Although there was some evidence of sensitivity to nutritional supplementation in a number of domains (for example, executive function, spatial working memory), interpretation is currently difficult given the prevailing 'scattergun approach' for selecting cognitive tests. Specifically, the practice means that it is often difficult to distinguish between a boundary condition for a particular nutrient and a lack of task sensitivity. We argue that for significant future progress to be made, researchers need to pay much closer attention to existing human RCT and animal data, as well as to more basic issues surrounding task sensitivity, statistical power and type I error

Applying phylogenomics to understand the emergence of Shiga Toxin producing Escherichia coli O157:H7 strains causing severe human disease in the United Kingdom

Shiga Toxin producing Escherichia coli (STEC) O157:H7 is a recently emerged zoonotic pathogen with considerable morbidity. Since the serotype emerged in the 1980s, research has focussed on unravelling the evolutionary events from the E. coli O55:H7 ancestor to the contemporaneous globally dispersed strains. In this study the genomes of over 1000 isolates from human clinical cases and cattle, spanning the history of STEC O157:H7 in the United Kingdom were sequenced. Phylogenetic analysis reveals the ancestry, key acquisition events and global context of the strains. Dated phylogenies estimate the time to the most recent common ancestor of the current circulating global clone to 175 years ago, followed by rapid diversification. We show the acquisition of specific virulence determinates occurred relatively recently and coincides with its recent detection in the human population. Using clinical outcome data from 493 cases of STEC O157:H7 we assess the relative risk of severe disease including HUS from each of the defined clades in the population and show the dramatic effect Shiga toxin complement has on virulence. We describe two strain replacement events that have occurred in the cattle population in the UK over the last 30 years; one resulting in a highly virulent strain that has accounted for the majority of clinical cases in the UK over the last decade. This work highlights the need to understand the selection pressures maintaining Shiga-toxin encoding bacteriophages in the ruminant reservoir and the study affirms the requirement for close surveillance of this pathogen in both ruminant and human populations

Red Sea fish market assessments indicate high species diversity and potential overexploitation

In many parts of the world, particularly remote and underdeveloped regions, reports of fisheries catch, effort, and landing data are limited. In order to implement effective fishing regulations to protect natural stocks, understanding fishing pressure, key target species, catch composition, and value of each species is vital. In regions where published data is limited, and the sampling of numerous small boats and landing sites is not feasible, fish market surveys represent an opportunity to obtain key fisheries data. This study therefore aims to obtain species-specific prices and market composition for fish landed in the central Red Sea by surveying local fish markets. We conducted 11 surveys at two major Red Sea fish markets to ascertain key fisheries metrics using market data as a proxy for catch data. Results indicate that a high proportion of the market composition is generated by 46 species from six family-level groups, Serranidae, Labridae, scarine labrids, Carangidae, Lethrinidae, and Lutjanidae, contributing to 87 % of the total market biomass. Species-specific values ranged from 4.50 USD/kg to 26.44 USD/kg, with market surveys highlighting the economic value of three local serranid species: Plectropomus pessuliferus marisrubri, Plectropomus areolatus and Variola louti, all valued at more than 25 USD/kg, and a labrid: Cheilinus undulatus, valued at 26.44 USD/kg. The Serranidae family represents 47 % of the total biomass and 55 % of the potential revenue in the market, while also indicating potentially overfished reefs due to the high occurrence of smaller species and undersized individuals of higher priced serranid species. Many of the high-valued serranids were below the size at sexual maturity. Target species exhibited small body size and decreasing abundance, potentially indicating a “shrinking baseline” scenario occurring in the Saudi Arabian artisanal coral reef fishery. These results indicate that introducing effective fisheries legislation and management is necessary for the longevity and sustainability of the reef-based fishery in the Saudi Arabian Red Sea. Implementing catch quotas, size limits, and seasonal restrictions are potential mechanisms that could be used to facilitate positive change within this vulnerable fishery

Retinal GABAergic alterations in adults with autism spectrum disorder

Alterations in γ-aminobutyric acid (GABA) have been implicated in sensory differences in individuals with autism spectrum disorder (ASD). Visual signals are initially processed in the retina and in this study we explored the hypotheses that the GABA-dependent retinal response to light is altered in individuals with ASD. Light-adapted electroretinograms (ERGs) were recorded from 61 adults (38 males and 23 females; n = 22 ASD) in response to three stimulus protocols: i) the standard white flash; ii) the standard 30-Hz flickering protocol; iii) the photopic negative response (PhNR) protocol. Participants were administered an oral dose of placebo, 15 or 30 mg of arbaclofen (STX209, GABABagonist) in a randomized, double-blind, cross-over order before the test. At baseline (placebo), the a-wave amplitudes in response to single white flashes were more prominent in ASD, relative to typically developed (TD) participants. Arbaclofen was associated with decrease in the a-wave amplitude in ASD, but an increase in TD, eliminating the group difference observed at baseline. The extent of this arbaclofen-elicited shift significantly correlated with the arbaclofen-elicited shift in cortical responses to auditory stimuli as measured by electroencephalogram in our prior study, and with broader autistic traits measured with the Autism Quotient across the whole cohort. Hence, GABA-dependent differences in retinal light processing in ASD appear to be an accessible component of a wider autistic difference in central processing of sensory information, which may be upstream of more complex autistic phenotypes. Significance StatementOur current study provides the first direct in vivo experimental confirmation that autistic alterations in central GABA function extend to the retina. We show that arbaclofen was associated with reduced flash elicited a-wave amplitude in the electroretinogram (ERG) of autistic individuals but increased amplitude in non-autistic people. The retinal arbaclofen response correlated with previously reported arbaclofen effects on cortical visual and auditory responses in the same individuals. The extent of this differential GABAergic function correlated with the extent of autistic traits captured using the Autism Quotient. Thus, sensory processing differences in autism appear to be upstream of more complex autistic traits and the ERG from the retina is a potentially useful proxy for cross-domain brain GABA function and target engagement

A prospective cohort study assessing clinical referral management & workforce allocation within a UK regional medical genetics service

Abstract Ensuring patient access to genomic information in the face of increasing demand requires clinicians to develop innovative ways of working. This paper presents the first empirical prospective observational cohort study of UK multi-disciplinary genetic service delivery. It describes and explores collaborative working practices including the utilisation and role of clinical geneticists and non-medical genetic counsellors. Six hundred and fifty new patients referred to a regional genetics service were tracked through 850 clinical contacts until discharge. Referral decisions regarding allocation of lead health professional assigned to the case were monitored, including the use of initial clinical contact guidelines. Significant differences were found in the cases led by genetic counsellors and those led by clinical geneticists. Around a sixth, 16.8% (109/650) of referrals were dealt with by a letter back to the referrer or re-directed to another service provider and 14.8% (80/541) of the remaining patients chose not to schedule an appointment. Of the remaining 461 patients, genetic counsellors were allocated as lead health professional for 46.2% (213/461). A further 61 patients did not attend. Of those who did, 86% (345/400) were discharged after one or two appointments. Genetic counsellors contributed to 95% (784/825) of total patient contacts. They provided 93.7% (395/432) of initial contacts and 26.8% (106/395) of patients were discharged at that point. The information from this study informed a planned service re-design. More research is needed to assess the effectiveness and efficiency of different models of collaborative multi-disciplinary working within genetics services. Keywords (MeSH terms) Genetic Services, Genetic Counseling, Interdisciplinary Communication, Cohort Studies, Delivery of Healthcare, Referral and Consultation

Radial deformation measurement of a cylinder under compression using multicore fibre

A multicore fibre (MCF) sensor to measure the radial deformation of a compliant cylinder under compression is presented. The sensor is connectorised and need not be permanently bonded to the test object. A differential measurement technique using FBGs written into the MCF makes the sensor temperature insensitive. FBG measurement of axial strain of a cylinder under compression is also reported

Global analysis of depletion and recovery of seabed biota after bottom trawling disturbance

Bottom trawling is the most widespread human activity affecting seabed habitats. Here, we collate all available data for experimental and comparative studies of trawling impacts on whole communities of seabed macroinvertebrates on sedimentary habitats and develop widely applicable methods to estimate depletion and recovery rates of biota after trawling. Depletion of biota and trawl penetration into the seabed are highly correlated. Otter trawls caused the least depletion, removing 6% of biota per pass and penetrating the seabed on average down to 2.4 cm, whereas hydraulic dredges caused the most depletion, removing 41% of biota and penetrating the seabed on average 16.1 cm. Median recovery times posttrawling (from 50 to 95% of unimpacted biomass) ranged between 1.9 and 6.4 y. By accounting for the effects of penetration depth, environmental variation, and uncertainty, the models explained much of the variability of depletion and recovery estimates from single studies. Coupled with large-scale, high-resolution maps of trawling frequency and habitat, our estimates of depletion and recovery rates enable the assessment of trawling impacts on unprecedented spatial scales

Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study.

National Coordinating Centre for Research Methodology; Medical Research Council, UK Department of Health; Chief Scientist OfficeNot peer reviewedPublisher PD