The impact of agricultural activities on water quality: A case for collaborative catchment-scale management using integrated wireless sensor networks

The challenge of improving water quality is a growing global concern, typified by the European Commission Water Framework Directive and the United States Clean Water Act. The main drivers of poor water quality are economics, poor water management, agricultural practices and urban development. This paper reviews the extensive role of non-point sources, in particular the outdated agricultural practices, with respect to nutrient and contaminant contributions. Water quality monitoring (WQM) is currently undertaken through a number of data acquisition methods from grab sampling to satellite based remote sensing of water bodies. Based on the surveyed sampling methods and their numerous limitations, it is proposed that wireless sensor networks (WSNs), despite their own limitations, are still very attractive and effective for real-time spatio-temporal data collection for WQM applications. WSNs have been employed for WQM of surface and ground water and catchments, and have been fundamental in advancing the knowledge of contaminants trends through their high resolution observations. However, these applications have yet to explore the implementation and impact of this technology for management and control decisions, to minimize and prevent individual stakeholder’s contributions, in an autonomous and dynamic manner. Here, the potential of WSN-controlled agricultural activities and different environmental compartments for integrated water quality management is presented and limitations of WSN in agriculture and WQM are identified. Finally, a case for collaborative networks at catchment scale is proposed for enabling cooperation among individually networked activities/stakeholders (farming activities, water bodies) for integrated water quality monitoring, control and management

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The role of sensory feedback mechanisms on sway size during rotating bipedal stance

Sway was examined during standing on a rotating platform. Sway increased significantly when standing on a firm rotating platform and increased further if standing on a compliant rotating platform. Medio-lateral (ML) sway was smaller than anterio-posterior (AP) sway when not rotating. When rotating, ML sway increased to similar levels as AP sway. Findings suggested that vestibular feedback is significantly impaired when the body is rotating. Conclusions Sway is increased when standing on a rotating platform, with the greatest increase seen in ML sway, mostly due to impaired vestibular sensory function

Healthy, regenerative and just: Guiding the development of a national strategy on climate, health and well-being for Australia

This case report is a reflective narrative, documenting the methods used to develop a policy framework for a National Strategy on Climate, Health and Well-being for Australia. The report aims to guide advocates, communities of practice, and governments in developing a comprehensive policy response to climate change and its health impacts.</p

Healthy, regenerative and just: Guiding the development of a national strategy on climate, health and well-being for Australia

This case report is a reflective narrative, documenting the methods used to develop a policy framework for a National Strategy on Climate, Health and Well-being for Australia. The report aims to guide advocates, communities of practice, and governments in developing a comprehensive policy response to climate change and its health impacts

Optimally capturing latency dynamics in models of tuberculosis transmission

Although different structures are used in modern tuberculosis (TB) models to simulate TB latency, it remains unclear whether they are all capable of reproducing the particular activation dynamics empirically observed. We aimed to determine which of these structures replicate the dynamics of progression accurately. We reviewed 88 TB-modelling articles and classified them according to the latency structure employed. We then fitted these different models to the activation dynamics observed from 1352 infected contacts diagnosed in Victoria (Australia) and Amsterdam (Netherlands) to obtain parameter estimates. Six different model structures were identified, of which only those incorporating two latency compartments were capable of reproducing the activation dynamics empirically observed. We found important differences in parameter estimates by age. We also observed marked differences between our estimates and the parameter values used in many previous models. In particular, when two successive latency phases are considered, the first period should have a duration that is much shorter than that used in previous studies. In conclusion, structures incorporating two latency compartments and age-stratification should be employed to accurately replicate the dynamics of TB latency. We provide a catalogue of parameter values and an approach to parameter estimation from empiric data for calibration of future TB-models

Mental models of sea-level change: A mixed methods analysis on the Severn Estuary, UK

Global average sea levels are expected to rise by up to a metre by the end of the century. This long-term rise will combine with shorter-term changes in sea level (e.g. high tides, storm surges) to increase risks of flooding and erosion in vulnerable coastal areas. As communities become increasingly exposed to these risks, understanding their beliefs and responses becomes more important. While studies have explored public responses to climate change, less research has focused on perceptions of the specific risks associated with sea-level change. This paper presents the results of a mental models study that addressed this knowledge gap by exploring expert and public perceptions of sea-level change on the Severn Estuary, a threatened coastal environment in the southwest of the United Kingdom. A model was developed from the literature and expert interviews (N = 11), and compared with public perceptions elicited via interviews (N = 20) and a quantitative survey (N = 359). Whilst we find a high degree of consistency between expert and public understandings, there are important differences that have implications for how sea level risks are interpreted and for what are perceived as appropriate mitigation and adaptation practices. We also find a number of potential barriers to engaging with the issue: individuals express low concern about sea-level change in relation to other matters; they feel detached from the issue, seeing it as something that will happen in future to other people; and many perceive that neither the causes of nor responses to sea-level change are their responsibility. We point to areas upon which future risk communications should therefore concentrate