Syndromic surveillance of influenza-like illness in Scotland during the influenza A H1N1v pandemic and beyond

Syndromic surveillance refers to the rapid monitoring of syndromic data to highlight and follow outbreaks of infectious diseases, increasing situational awareness. Such systems are based upon statistical models to described routinely collected health data. We describe a working exception reporting system (ERS) currently used in Scotland to monitor calls received to the NHS telephone helpline, NHS24. We demonstrate the utility of the system to describe the time series data from NHS24 both at an aggregated Scotland level and at the individual health board level for two case studies, firstly during the initial phase of the 2009 Influenza A H1N1v and secondly for the emergence of seasonal influenza in each winter season from 2006/07 and 2010/11. In particular, we focus on a localised cluster of infection in the Highland health board and the ability of the system to highlight this outbreak. Caveats of the system, including the effect of media reporting of the pandemic on the results and the associated statistical issues, will be discussed. We discuss the adaptability and timeliness of the system and how this continues to form part of a suite of surveillance used to give early warnings to public health decision makers

Investment in Cellulosic Biofuel Refineries: Do Waivable Biofuel Mandates Matter?

We develop a conceptual model to study the impact of mandate policies on stimulating investment in cellulosic biofuel refineries. In a two-period framework, we compare the first-period investment level (FIL) under three scenarios: laissez-faire, non-waivable mandate (NWM) policy, and waivable mandate (WM) policy. Results show that when plant-level marginal costs are increasing then both NWM policy and WM policy may stimulate FIL. The WM policy has a smaller impact than does the NWM policy. When the plant-level marginal costs are constants, however, WM policy does not increase FIL but does increase the expected profit of more efficient investors

Fair Inputs and Fair Outputs: The Incompatibility of Fairness in Privacy and Accuracy

Fairness concerns about algorithmic decision-making systems have been mainly focused on the outputs (e.g., the accuracy of a classifier across individuals or groups). However, one may additionally be concerned with fairness in the inputs. In this paper, we propose and formulate two properties regarding the inputs of (features used by) a classifier. In particular, we claim that fair privacy (whether individuals are all asked to reveal the same information) and need-to-know (whether users are only asked for the minimal information required for the task at hand) are desirable properties of a decision system. We explore the interaction between these properties and fairness in the outputs (fair prediction accuracy). We show that for an optimal classifier these three properties are in general incompatible, and we explain what common properties of data make them incompatible. Finally we provide an algorithm to verify if the trade-off between the three properties exists in a given dataset, and use the algorithm to show that this trade-off is common in real data

Pylons in the back yard: local planning and perceived risks to health

Health fears arising from the presence of high-voltage power lines in residential areas have received recent attention in spatial planning. A study of stances taken by planning authorities in England and Wales shows their willingness to give expression to the concerns of local communities through precautionary measures, and the difficulties encountered in the face of official statements and industry opposition. These attempts to embody local feeling in patterns of development are illustrative of the increasing prevalence of a sense of risk in contemporary society. The spatial patterns of risk are also revealed, which owe much to the presence and distribution of industrial infrastructure in the landscape and to the associated contested use of land.</p

A review of the pesticide MCPA in the land-water environment and emerging research needs

peer-reviewedDue to its high solubility and poor adsorption to the soil matrix, the postemergence herbicide 2-methyl-4-chlorophenoxyacetic acid (MCPA) is susceptible to transport into surface and groundwater bodies, where it can result in compromised water quality and breaches of legislative standards. However, there is still poor understanding of catchment scale dynamics and transport, particularly across heterogeneous hydrogeological settings. While it is known that MCPA degrades under aerobic conditions, negligible breakdown can occur in anaerobic environments, potentially creating a legacy in saturated soils. Fast runoff pathways post application are likely transport routes, but the relative contribution from the mobilization of legacy MCPA from anaerobic zones has yet to be quantified, making the delineation of MCPA sources encountered during monitoring programs challenging. While ecotoxicological effects have been examined, little is known about the interaction of MCPA (and its degradation products) with other pesticides, with nutrients or with colloids, and how this combines with environmental conditions to contribute to multiple stressor effects. We examine the state of MCPA knowledge, using case study examples from Ireland, and consider the implications of its widespread detection in waterbodies and drinking water supplies. Research themes required to ensure the sustainable and safe use of MCPA in an evolving agricultural, social and political landscape are identified here. These include the need to identify mitigation measures and/or alternative treatments, to gain insights into the conditions governing mobilization and attenuation, to map pathways of migration and to identify direct, synergistic and antagonistic ecotoxicological effects

Fish Consumption and Mercury Exposure among Louisiana Recreational Anglers

Ba c k g r o u n d: Methylmercury (MeHg) exposure assessments among average fish consumers in the United States may underestimate exposures among U.S. subpopulations with high intakes of region-ally specific fish. obj e c t i v e s: We examined relationships among fish consumption, estimated mercury (Hg) intake, and measured Hg exposure within one such potentially highlyexposed group, recreational anglers in the state of Louisiana, USA. Me t h o d s: We surveyed 534 anglers in 2006 using interviews at boat launches and fishing tourna-ments combined with an Internet-based survey method. Hair samples from 402 of these anglers were collected and analyzed for total Hg. Questionnaires provided information on species-specific fish consumption during the 3 months before the survey. re s u l t s: Anglers’ median hairHg concentration was 0.81 μg/g (n = 398; range, 0.02–10.7 μg/g);40% of participants had levels >1 μg/g, which approximately corresponds to the U.S. Environmental Protection Agency’s reference dose. Fish consumption and Hg intake were significantly positively associated with hairHg. Participants reported consuming nearly 80 different fish types, many of which are specific to the region. Unlike the general U.S. population, which acquires most of its Hg from commercial seafood sources, approximately 64% of participants’ fish meals and 74% of their estimated Hg intake came from recreationally caught seafood. co n c l u s i o n s: Study participants had relatively elevated hairHg concentrations and reported con-sumption of a wide variety of fish, particularly locally caught fish. This group represents a highlyexposed subpopulation with an exposure profile that differs from fish consumers in other regions of the United States, suggesting a need for more regionallyspecific exposure estimates and public health advisories.ISSN:1552-9924ISSN:0091-676

Exposure and impact of a mass media campaign targeting sexual health amongst Scottish men who have sex with men: an outcome evaluation

Background: This paper explores the exposure and impact of a Scottish mass media campaign: Make Your Position Clear. It ran from October 2009 to July 2010, targeted gay men and other men who have sex with men (MSM), and had two key aims: to promote regular sexual health and HIV testing every 6 months, and to promote the use of appropriate condoms and water-based lubricant with each episode of anal intercourse. Methods: A cross-sectional survey (anonymous and self-report) was conducted 10 months after the campaign was launched (July 2010). Men were recruited from commercial venues. Outcome measures included use of lubricant, testing for sexually transmitted infections and HIV, and intentions to seek HIV testing within the following six months. Linear-by-linear chi-square analysis and binary logistic regressions were conducted to explore the associations between the outcome measures and campaign exposure. Results: The total sample was 822 men (62.6% response rate). Men self-identifying as HIV positive were excluded from the analysis (n = 38). Binary logistic analysis indicated that those with mid or high campaign exposure were more likely to have been tested for HIV in the previous six months when adjusted for age, area of residence and use of the “gay scene” (AOR = 1.96, 95% CI = 1.26 to 3.06, p = .003), but were not more likely to be tested for STIs (AOR = 1.37, 95% CI = 0.88 to 2.16, p = .167). When adjusted for previous HIV testing, those with mid or high campaign exposure were not more likely to indicate intention to be tested for HIV in the following six months (AOR = 1.30, 95% CI = 0.73 to 2.32, p = .367). Those with no campaign exposure were less likely than those with low exposure to have used appropriate lubricant with anal sex partners in the previous year (AOR = 0.42, 95% CI = 0.23 to 0.77, p = .005). Conclusions: The campaign had demonstrable reach. The analysis showed partial support for the role of mass media campaigns in improving sexual health outcomes. This suggests that a role for mass media campaigns remains within combination HIV prevention

Examination of the risk of reinfection with hepatitis C among injecting drug users who have been tested in Glasgow

Unsafe injecting practices put injecting drug users (IDUs) at repeat exposure to infection with the hepatitis C virus (HCV). It has not yet been determined if spontaneously clearing one's primary infection influences the risk of reinfection; our aim was to estimate the relative risk of reinfection in IDUs who have cleared the virus. We conducted a retrospective study using a large database of HCV test results covering Greater Glasgow Health Board during 1993–2007 to calculate rates of infection and reinfection in current/former IDUs. The relative risk of (re)infection in previously infected compared with never-infected IDUs was estimated using Poisson regression, adjusting for age at study entry, sex, and calendar period of test. Although the rate of reinfection in IDUs who were HCV antibody-positive, RNA-negative at baseline was lower (7/100 person-years, 95% CI: 5–9) than the rate of acute infection in IDUs who were HCV antibody-negative at baseline (10/100 person-years, 95% CI: 9–12), the risk of reinfection was not significantly different than the risk of initial infection (adjusted rate ratio = 0.78, 95% CI: 0.57–1.08). We found only weak evidence for a reduced risk of HCV reinfection in IDUs who had cleared their previous infection. Further research among those who have cleared infection through antiviral therapy is needed to help inform decisions regarding treatment of IDUs

Precautionary Regulation in Europe and the United States: A Quantitative Comparison

Much attention has been addressed to the question of whether Europe or the United States adopts a more precautionary stance to the regulation of potential environmental, health, and safety risks. Some commentators suggest that Europe is more risk-averse and precautionary, whereas the US is seen as more risk-taking and optimistic about the prospects for new technology. Others suggest that the US is more precautionary because its regulatory process is more legalistic and adversarial, while Europe is more lax and corporatist in its regulations. The flip-flop hypothesis claims that the US was more precautionary than Europe in the 1970s and early 1980s, and that Europe has become more precautionary since then. We examine the levels and trends in regulation of environmental, health, and safety risks since 1970. Unlike previous research, which has studied only a small set of prominent cases selected non-randomly, we develop a comprehensive list of almost 3,000 risks and code the relative stringency of regulation in Europe and the US for each of 100 risks randomly selected from that list for each year from 1970 through 2004. Our results suggest that: (a) averaging over risks, there is no significant difference in relative precaution over the period, (b) weakly consistent with the flip-flop hypothesis, there is some evidence of a modest shift toward greater relative precaution of European regulation since about 1990, although (c) there is a diversity of trends across risks, of which the most common is no change in relative precaution (including cases where Europe and the US are equally precautionary and where Europe or the US has been consistently more precautionary). The overall finding is of a mixed and diverse pattern of relative transatlantic precaution over the period