Assessing vulnerability and modelling assistance: using demographic indicators of vulnerability and agent-based modelling to explore emergency flooding relief response

Flooding is a significant concern for much of the UK and is recognised as a primary threat by most local councils. Those in society most often deemed vulnerable: the elderly, poor or sick, for example, often see their level of vulnerability increase during hazard events. A greater knowledge of the spatial distribution of vulnerability within communities is key to understanding how a population may be impacted by a hazard event. Vulnerability indices are regularly used – in conjunction with needs assessments and on-the-ground research – to target service provision and justify resource allocation. Past work on measuring and mapping vulnerability has been limited by a focus on income-related indicators, a lack of consideration of accessibility, and the reliance on proprietary data. The Open Source Vulnerability Index (OSVI) encompasses an extensive range of vulnerability indicators supported by the wider literature and expert validation and provides data at a sufficiently fine resolution that can identify vulnerable populations. Findings of the OSVI demonstrate the potential cascading impact of a flood hazard as it impacts an already vulnerable population: exacerbating pre-existing vulnerabilities, limiting capabilities and restricting accessibility and access to key services. The OSVI feeds into an agent-based model (ABM) that explores the capacity of the British Red Cross (BRC) to distribute relief during flood emergencies using strategies based upon the OSVI. A participatory modelling approach was utilised whereby the BRC were included in all aspects of the model development. The major contribution of this work is the novel synthesis of demographics analysis, vulnerability mapping and geospatial simulation. The project contributes to the growing understanding of vulnerability and response management within the NGO sector. It is hoped that the index and model produced will allow responder organisations to run simulations of similar emergency events and adjust strategic response plans accordingly

Media, Representation, Persistence and Relief: the Role of the Internet in Understanding the Physical and Social Dynamics of Catastrophic Natural Hazards.

The number of recorded natural hazards has increased throughout the past four decades and recent events such as the L’Aquila, Italy earthquake and the Sichuan, China earthquake demonstrate the persistent threat posed by such events. When a natural hazard occurs, the ensuing disruption to society is more often than not captured and reported by the news media. Thus, the news media is a valuable source of natural hazard event information. However, much of the previous work utilising natural hazard news media has focused on manual collation and examination of printed news media on a country- or event-specific basis. The Internet allows for real-time communication and broadcasting of natural hazards information and provides an ever-growing archive of the temporal and spatial patterns within natural hazard event occurrence. Thus, an alternative technique of news media collation, using web-based news media sources, is presented throughout this study. Two web-based natural hazard news media databases were created and information pertaining to the temporal and spatial occurrence of earthquakes, floods and landslides over a five year period (2005-2009) was collated. This thesis will examine the data generated by both databases and will focus upon the understanding of the temporal and spatial variability in news media coverage of natural hazard events. Statistical analysis of temporal and spatial trends within recorded news media coverage of hazard events is presented. Analysis of long-term time series data is coupled with an in-depth short-term analysis of individual hazard event coverage. In addition to the statistical analysis of identified trends, this study will explore the characteristics of media response to natural hazards within the context of the wider socio-political climate. It is proposed that the geophysical processes involved within each hazard event type, coupled with event-specific characteristics (fatalities, location etc.), control the subsequent news media coverage of an individual event. A series of natural hazard news media models are presented to show the inherent differences within recorded coverage of natural hazard event types

Clinical profiling of specific diagnostic subgroups of women with chronic pelvic pain

Introduction: Chronic pelvic pain (CPP) is a common condition affecting up to 26.6% of women, with many suffering for several years before diagnosis and/or treatment. Its clinical presentation is varied and there are frequently comorbid conditions both within and outside the pelvis. We aim to explore whether specific subgroups of women with CPP report different clinical symptoms and differing impact of pain on their quality of life (QoL). Methods: The study is part of the Translational Research in Pelvic Pain (TRiPP) project which is a cross-sectional observational cohort study. The study includes 769 female participants of reproductive age who completed an extensive set of questions derived from standardised WERF EPHect questionnaires. Within this population we defined a control group (reporting no pelvic pain, no bladder pain syndrome, and no endometriosis diagnosis, N = 230) and four pain groups: endometriosis-associated pain (EAP, N = 237), interstitial cystitis/bladder pain syndrome (BPS, N = 72), comorbid endometriosis-associated pain and BPS (EABP, N = 120), and pelvic pain only (PP, N = 127). Results: Clinical profiles of women with CPP (13–50 years old) show variability of clinical symptoms. The EAP and EABP groups scored higher than the PP group (p p p p p p p  Discussion: Our results demonstrate the negative impact that chronic pain has on CPP patients' QoL and reveal an increased negative impact of pain on the comorbid EABP group. Furthermore, it demonstrates the importance of dyspareunia in women with CPP. Overall, our results demonstrate the need for further exploration of interventions targeting QoL more broadly and suggest that novel approaches to classifying women with CPP are needed

Clinical profiling of specific diagnostic subgroups of women with chronic pelvic pain

IntroductionChronic pelvic pain (CPP) is a common condition affecting up to 26.6% of women, with many suffering for several years before diagnosis and/or treatment. Its clinical presentation is varied and there are frequently comorbid conditions both within and outside the pelvis. We aim to explore whether specific subgroups of women with CPP report different clinical symptoms and differing impact of pain on their quality of life (QoL).MethodsThe study is part of the Translational Research in Pelvic Pain (TRiPP) project which is a cross-sectional observational cohort study. The study includes 769 female participants of reproductive age who completed an extensive set of questions derived from standardised WERF EPHect questionnaires. Within this population we defined a control group (reporting no pelvic pain, no bladder pain syndrome, and no endometriosis diagnosis, N = 230) and four pain groups: endometriosis-associated pain (EAP, N = 237), interstitial cystitis/bladder pain syndrome (BPS, N = 72), comorbid endometriosis-associated pain and BPS (EABP, N = 120), and pelvic pain only (PP, N = 127).ResultsClinical profiles of women with CPP (13–50 years old) show variability of clinical symptoms. The EAP and EABP groups scored higher than the PP group (p < 0.001) on the pain intensity scales for non-cyclical pelvic pain and higher than both the BPS and PP groups (p < 0.001) on the dysmenorrhoea scale. The EABP group also had significantly higher scores for dyspareunia (p < 0.001), even though more than 50% of sexually active participants in each pain group reported interrupting and/or avoiding sexual intercourse due to pain in the last 12 months. Scores for the QoL questionnaire (SF-36) reveal that CPP patients had significantly lower QoL across all SF-36 subscales (p < 0.001). Significant effects were also observed between the pain groups for pain interference with their work (p < 0.001) and daily lives (p < 0.001), with the EABP suffering more compared to the EAP and PP groups (p < 0.001).DiscussionOur results demonstrate the negative impact that chronic pain has on CPP patients' QoL and reveal an increased negative impact of pain on the comorbid EABP group. Furthermore, it demonstrates the importance of dyspareunia in women with CPP. Overall, our results demonstrate the need for further exploration of interventions targeting QoL more broadly and suggest that novel approaches to classifying women with CPP are needed

Protocol for a longitudinal, prospective cohort study investigating the biology of uterine fibroids and endometriosis, and patients' quality of life: the FENOX study

INTRODUCTION:Millions of women suffer from the consequences of endometriosis and uterine fibroids, with fibroids the cause for over 50% of hysterectomies in the USA, and direct costs for their treatment estimated at between US$4 and US$9 billion. Endometriosis commonly affects millions of women worldwide predominantly during reproductive age, with severe menstrual and non-menstrual pain and subfertility the main symptoms. Due to the 'unhappy triad' of endometriosis-lack of awareness, lack of clinically relevant biomarkers and the unspecific nature of symptoms-women wait on average for 8-12 years before the definitive endometriosis diagnosis is made. Treatment options for both conditions are not satisfactory at the moment, especially with a view to preserving fertility for the women and families affected. In the Fibroids and Endometriosis Oxford (FENOX) study, we combine the investigation of fibroids and endometriosis, and plan to collect high-quality tissue samples and medical data of participants over a time frame of 5 years after surgical intervention. METHODS AND ANALYSIS:Biological samples such as blood, saliva, urine, fat, peritoneal fluid and-if found-endometrial tissue or fibroids as well as detailed clinical and intraoperative data will be collected from women undergoing surgery and participating in the study after informed consent. We plan to recruit up to 1200 participants per disease arm (ie, endometriosis and uterine fibroids) over 5 years. Participants will fill in detailed and validated questionnaires on their medical history and quality of life, with follow-ups for 5 years. Enrolment started on 2 April 2018, and FENOX will close on 31 March 2028. We will analyse the biological samples using state-of-the-art molecular biology methods and correlate the findings with the medical records and questionnaire data. ETHICS AND DISSEMINATION:The findings will be published in high-ranking journals in the field and presented at national and international conferences. TRIAL REGISTRATION NUMBER:ISRCTN13560263

Stressful experiences impact clinical symptoms in people with endometriosis

Endometriosis is a chronic condition that affects ~10% of women globally. Its symptoms include chronic pelvic pain, heavy periods and tiredness/fatigue, which have been associated with poorer quality of life and mental health. We aim to explore the impact of the COVID-19 pandemic on pain and fatigue symptoms and their interactions with the impact on mental health in people with endometriosis. This global cross-sectional online survey study collected data from 4717 adults with self-reported surgical/radiological diagnosis of endometriosis between May and June 2020. The survey included questions on the current status and changes of endometriosis symptoms (pelvic pain, tiredness/fatigue, and bleeding patterns), mental health, pain catastrophising, and the impact of the COVID-19 pandemic on the respondents’ lives. Compared to 6 months earlier, Respondents reported a marked worsening of their endometriosis symptoms (endometriosis-associated pain (39.3%; 95% CI: 37.7, 40.5), tiredness/fatigue (49.9%; 95% CI: 48.4, 51.2) and bleeding patterns (39.6%; 95% CI: 38.2, 41)) and mental health (38.6%; 95% CI: 37.2, 39.9). Those with a pre-existing mental health diagnosis (38.8%) were more likely to report their symptoms worsening. Worsening of pain and tiredness/fatigue was significantly correlated with worsening of mental health (P