Development and testing of a risk indexing framework to determine field-scale critical source areas of faecal bacteria on grassland.

This paper draws on lessons from a UK case study in the management of diffuse microbial pollution from grassland farm systems in the Taw catchment, south west England. We report on the development and preliminary testing of a field-scale faecal indicator organism risk indexing tool (FIORIT). This tool aims to prioritise those fields most vulnerable in terms of their risk of contributing FIOs to water. FIORIT risk indices were related to recorded microbial water quality parameters (faecal coliforms [FC] and intestinal enterococci [IE]) to provide a concurrent on-farm evaluation of the tool. There was a significant upward trend in Log[FC] and Log[IE] values with FIORIT risk score classification (r2 =0.87 and 0.70, respectively and P<0.01 for both FIOs). The FIORIT was then applied to 162 representative grassland fields through different seasons for ten farms in the case study catchment to determine the distribution of on-farm spatial and temporal risk. The high risk fields made up only a small proportion (1%, 2%, 2% and 3% for winter, spring, summer and autumn, respectively) of the total number of fields assessed (and less than 10% of the total area), but the likelihood of the hydrological connection of high FIO source areas to receiving watercourses makes them a priority for mitigation efforts. The FIORIT provides a preliminary and evolving mechanism through which we can combine risk assessment with risk communication to end-users and provides a framework for prioritising future empirical research. Continued testing of FIORIT across different geographical areas under both low and high flow conditions is now needed to initiate its long term development into a robust indexing tool

Molecular tools for bathing water assessment in Europe:Balancing social science research with a rapidly developing environmental science evidence-base

The use of molecular tools, principally qPCR, versus traditional culture-based methods for quantifying microbial parameters (e.g., Fecal Indicator Organisms) in bathing waters generates considerable ongoing debate at the science-policy interface. Advances in science have allowed the development and application of molecular biological methods for rapid (~2 h) quantification of microbial pollution in bathing and recreational waters. In contrast, culture-based methods can take between 18 and 96 h for sample processing. Thus, molecular tools offer an opportunity to provide a more meaningful statement of microbial risk to water-users by providing near-real-time information enabling potentially more informed decision-making with regard to water-based activities. However, complementary studies concerning the potential costs and benefits of adopting rapid methods as a regulatory tool are in short supply. We report on findings from an international Working Group that examined the breadth of social impacts, challenges, and research opportunities associated with the application of molecular tools to bathing water regulations

Tourism in sub-global assessments of ecosystem services

Published in 2005, the United Nations Millennium Ecosystem Assessment (MA) stressed that influencing governments, businesses and communities to address the supra-national challenge of limiting biodiversity loss and ecosystem degradation requires a fuller understanding of the range of values and benefits people derive from ecosystems, including tourism. The MA was informed by, and has shaped, several conceptually and methodologically distinctive sub-global assessments (SGAs) of ecosystem services. Through content analysis, this paper is the first detailed examination of how tourism features in 14 extant SGAs identified in a database held by a major supra-national environmental organization. Although the SGAs should have incorporated the widest range of specialist subject expertise, tourism scholars played only peripheral roles in producing them even for territories where tourism is a significant land use. The SGAs examined did not benefit from the extensive body of knowledge relating to sustainable tourism. Limited portrayals of tourism restrict the capacity of SGAs in their current format as management solutions. It is also contradictory to the ethos, principles and purpose of ecosystem assessments. With the ecosystem services perspective set to become more important to policy and decision making, the paper argues for greater incorporation of recent progress in sustainable tourism in ecosystem assessment

Improving the efficiency and effectiveness of an industrial SARS-CoV-2 diagnostic facility.

On 11th March 2020, the UK government announced plans for the scaling of COVID-19 testing, and on 27th March 2020 it was announced that a new alliance of private sector and academic collaborative laboratories were being created to generate the testing capacity required. The Cambridge COVID-19 Testing Centre (CCTC) was established during April 2020 through collaboration between AstraZeneca, GlaxoSmithKline, and the University of Cambridge, with Charles River Laboratories joining the collaboration at the end of July 2020. The CCTC lab operation focussed on the optimised use of automation, introduction of novel technologies and process modelling to enable a testing capacity of 22,000 tests per day. Here we describe the optimisation of the laboratory process through the continued exploitation of internal performance metrics, while introducing new technologies including the Heat Inactivation of clinical samples upon receipt into the laboratory and a Direct to PCR protocol that removed the requirement for the RNA extraction step. We anticipate that these methods will have value in driving continued efficiency and effectiveness within all large scale viral diagnostic testing laboratories

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

A cross-disciplinary toolkit to assess the risk of faecal indicator loss from grassland farm systems to surface waters.

Diffuse microbial pollution from agriculture is a key contributor to water quality impairment. Reducing the risk of microbial contamination of watercourses from agricultural sources requires both environmentally appropriate and socially acceptable mitigation and management approaches. A cross-disciplinary toolkit for on-farm microbial risk assessment is presented that can represent both social and environmental factors promoting or preventing the accumulation of faecal indicator organisms (FIOs) within the farm environment, and also their subsequent transfer to watercourses. Four key risk criteria were identified as governing FIO loss from land to water. These were ‘accumulating E. coli burden to land’, ‘landscape transfer potential’, ‘infrastructure’ and ‘social and economical obstacles to taking action’. The toolkit can be used to determine (i) the relative risk of a farm enterprise contributing to microbial watercourse pollution and (ii) appropriate and targeted mitigation to reduce the risk of FIO loss from land to water. A comparison of the toolkit output with microbiological water quality draining from three contrasting grassland farm enterprises provided a preliminary evaluation of the prototype approach. When applied to 31 grassland farm enterprises the toolkit suggested that 0% were categorised as negligible risk, 32% low, 65% medium, 3% high and 0% very high risk. Such qualitative risk-based tools can assist the policy community not only to target high risk areas, but also to develop mitigation strategies that are sensitive to the different ways in which risk is produced. Capacity for long-term cross-disciplinary research is argued to be the means by which these integrated and more sustainable solutions may emerge

Integrating water and agricultural management: Collaborative governance for a complex policy problem

This paper examines governance requirements for integrating water and agricultural management (IWAM) The institutional arrangements for the agriculture and water sectors are complex and multi-dimensional, and integration cannot therefore be achieved through a simplistic 'additive' policy process Effective integration requires the development of a new collaborative approach to governance that is designed to cope with scale dependencies and interactions, uncertainty and contested knowledge, and interdependency among diverse and unequal interests. When combined with interdisciplinary research, collaborative governance provides a viable normative model because of its emphasis on reciprocity, relationships, learning and creativity. Ultimately, such an approach could lead to the sorts of system adaptations and transformations that are required for IWAM (C) 2009 Elsevier B V. All rights reserved

Scale appropriate modelling of diffuse microbial pollution from agriculture.

The prediction of microbial concentrations and loads in receiving waters is a key requirement for informing policy decisions in order to safeguard human health. However, modelling the fate and transfer dynamics of faecally-derived microorganisms at different spatial scales poses a considerable challenge to the research and policy community. The objective of this paper is to critically evaluate the complexities and associated uncertainties attributed to the development of models for assessing agriculturally derived microbial pollution of watercourses. A series of key issues with respect to scale appropriate modelling of diffuse microbial pollution from agriculture are presented and include: (i) appreciating inadequacies in baseline sampling to underpin model development; (ii) uncertainty in the magnitudes of microbial pollutants attributed to different faecal sources; (iii) continued development of the empirical evidence base in line with other agricultural pollutants; (iv) acknowledging the added-value of interdisciplinary working; and (v) beginning to account for economics in model development. It is argued that uncertainty in model predictions produces a space for meaningful scrutiny of the nature of evidence and assumptions underpinning model applications around which pathways towards more effective model development may ultimately emerge