Measuring temperature-related mortality using endogenously determined thresholds

© 2018, Springer Nature B.V. Heat-related mortality tends to be associated with heatwaves that do not allow for sufficient acclimatisation to hot temperatures. In contrast, damage functions and most heatwave emergency response plans do not account for acclimatisation. Using an excess heat measure that accounts for acclimatisation, this paper produces estimates of temperature-related mortality for the five largest Australian capital cities. Fixed effects panel threshold regressions are applied to establish the thresholds that coincide with heightened mortality during extreme temperature events. The estimated parameters associated with these thresholds are then used to develop hindcast estimates for cold temperatures, moderate temperatures, hot temperatures and extreme heat. The estimated thresholds coincide with a notable impact of hot temperatures on mortality, but a limited cold temperature impact. This shows that the burden of risk associated with mortality related to future temperatures and climate change within Australia coincides with heatwaves rather than coldwaves. This is in contrast to recent studies that found that cold temperature-related mortality within Australian capital cities has and will continue to be notable. These studies also found a net benefit from climate change in Australia due to reduced cold temperature deaths

The impact of near-term climate policy choices on technology and emission transition pathways

This paper explores the implications of delays (to 2030) in implementing optimal policies for long-term transition pathways to limit climate forcing to 450 ppm CO2e on the basis of the AMPERE Work Package 2 model comparison study. The paper highlights the critical importance of the period 2030-2050 for ambitious mitigation strategies. In this period, the most rapid shift to low greenhouse gas emitting technology occurs. In the delayed response emission mitigation scenarios, an even faster transition rate in this period is required to compensate for the additional emissions before 2030. Our physical deployment measures indicate that the availability of CCS technology could play a critical role in facilitating the attainment of ambitious mitigation goals. Without CCS, deployment of other mitigation technologies would become extremely high in the 2030-2050 period. Yet the presence of CCS greatly alleviates the challenges to the transition particularly after the delayed climate policies, lowering the risk that the long-term goal becomes unattainable. The results also highlight the important role of bioenergy with CO2 capture and storage (BECCS), which facilitates energy production with negative carbon emissions. If BECCS is available, transition pathways exceed the emission budget in the mid-term, removing the excess with BECCS in the long term. Excluding either BE or CCS from the technology portfolio implies that emission reductions need to take place much earlier

Dynamic Rearrangement of Cell States Detected by Systematic Screening of Sequential Anticancer Treatments

Signaling networks are nonlinear and complex, involving a large ensemble of dynamic interaction states that fluctuate in space and time. However, therapeutic strategies, such as combination chemotherapy, rarely consider the timing of drug perturbations. If we are to advance drug discovery for complex diseases, it will be essential to develop methods capable of identifying dynamic cellular responses to clinically relevant perturbations. Here, we present a Bayesian dose-response framework and the screening of an oncological drug matrix, comprising 10,000 drug combinations in melanoma and pancreatic cancer cell lines, from which we predict sequentially effective drug combinations. Approximately 23% of the tested combinations showed high-confidence sequential effects (either synergistic or antagonistic), demonstrating that cellular perturbations of many drug combinations have temporal aspects, which are currently both underutilized and poorly understood

Evaluation of the Victorian Healthy Homes Program: protocol for a randomised controlled trial.

INTRODUCTION: The evaluation of the Victorian Healthy Homes Program (VHHP) will generate evidence about the efficacy and cost-effectiveness of home upgrades to improve thermal comfort, reduce energy use and produce health and economic benefits to vulnerable households in Victoria, Australia. METHODS AND ANALYSIS: The VHHP evaluation will use a staggered, parallel group clustered randomised controlled trial to test the home energy intervention in 1000 households. All households will receive the intervention either before (intervention group) or after (control group) winter (defined as 22 June to 21 September). The trial spans three winters with differing numbers of households in each cohort. The primary outcome is the mean difference in indoor average daily temperature between intervention and control households during the winter period. Secondary outcomes include household energy consumption and residential energy efficiency, self-reported respiratory symptoms, health-related quality of life, healthcare utilisation, absences from school/work and self-reported conditions within the home. Linear and logistic regression will be used to analyse the primary and secondary outcomes, controlling for clustering of households by area and the possible confounders of year and timing of intervention, to compare the treatment and control groups over the winter period. Economic evaluation will include a cost-effectiveness and cost-benefit analysis. ETHICS AND DISSEMINATION: Ethical approval was received from Victorian Department of Human Services Human Research Ethics Committee (reference number: 04/17), University of Technology Sydney Human Research Ethics Committee (reference number: ETH18-2273) and Australian Government Department of Veterans Affairs. Study results will be disseminated in a final report and peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12618000160235

The use of an ‘acclimatisation’ heatwave measure to compare temperature-related demand for emergency services in Australia, Botswana, Netherlands, Pakistan, and USA

Background: Heatwaves have been linked to increased risk of mortality and morbidity and are projected to increase in frequency and intensity due to climate change. The current study uses emergency department (ED) data from Australia, Botswana, Netherlands, Pakistan, and the United States of America to evaluate the impact of heatwaves on ED attendances, admissions and mortality.Methods: Routinely collected time series data were obtained from 18 hospitals. Two separate thresholds (≥4 and ≥7) of the acclimatisation excess heat index (EHIaccl) were used to define hot days . Analyses included descriptive statistics, independent samples T-tests to determine differences in case mix between hot days and other days, and threshold regression to determine which temperature thresholds correspond to large increases in ED attendances.Findings: In all regions, increases in temperature that did not coincide with time to acclimatise resulted in increases in ED attendances, and the EHIaccl performed in a similar manner. During hot days in California and The Netherlands, significantly more children ended up in the ED, while in Pakistan more elderly people attended. Hot days were associated with more patient admissions in the ages 5-11 in California, 65-74 in Karachi, and 75-84 in The Hague. During hot days in The Hague, patients with psychiatric symptoms were more likely to die. The current study did not identify a threshold temperature associated with particularly large increases in ED demand.Interpretation: The association between heat and ED demand differs between regions. A limitation of the current study is that it does not consider delayed effects or influences of other environmental factors. Given the association between heat and ED use, hospitals and governmental authorities should recognise the demands that heat can place on local health care systems. These demands differ substantially between regions, with Pakistan being the most heavily affected within our study sample

Assessing the Impact and Effectiveness of Hearing Voices Network Self-Help Groups

The Hearing Voices Network (HVN) is an influential service-user led organisation that promotes self-help as an important aspect of recovery. This study presents the first systematic assessment of the impact and effectiveness of HVN self-help groups. A customized 45-item questionnaire, the Hearing Voices Groups Survey, was sent to 62 groups affiliated with the English HVN. 101 responses were received. Group attendance was credited with a range of positive emotional, social and clinical outcomes. Aspects that were particularly valued included: opportunities to meet other voice hearers, provision of support that was unavailable elsewhere, and the group being a safe and confidential place to discuss difficult issues. Participants perceived HVN groups to facilitate recovery processes and to be an important resource for helping them cope with their experiences. Mental health professionals can use their expertise to support the successful running of these groups

Biogeochemical signatures in the lichen Hypogymnia physodes in the mid Urals

Abstract Multi-element content and uranium (U) isotopes were investigated in the lichen Hypogymnia physodes (native and transplants) sampled across a 60-km transect, centred on Karabash smelter town, from Turgoyak Lake (SW) to Kyshtym (NE) to investigate the origin of U. Kyshtym was the site of a major nuclear accident in 1957. 234 U/ 238 U activity ratios in native thalli sampled during July 2001 were within the natural isotopic ratio in minerals. Uranium/thorium (U/Th) ratios were higher in native thalli towards the NE (average 0.73) than those in the SW (average 0.57). Element signatures in native thalli and transplants suggest U was derived from fossil fuel combustion from Karabash and sources lying further to the east. Systematic and significant U enrichment indicative of a nuclear fuel cycle source was not detected in any sample. Element signatures in epiphytic lichen transplants and native thalli provide a powerful method to evaluate U deposition

The Importance of Social Support Structures for Retention and Success

As a policy goal, widening participation is increasingly associated with retention and completion. For those who are concerned with equity or social mobility, it makes little sense to recruit new types of student if they do not then qualify for a graduate profession. There has been growing interest in retention and completion among researchers and policymakers, with much attention centring on the extent to which new students can be helped to integrate into the institution. Drawing on a study of undergraduates in the UK, this chapter explores the extent to which student support services and wider informal support networks feature in students' narratives of retention. Conceptually, we are interested here in the ways in which students feel themselves to be legitimate members of the ‘imagined community' of higher education, a concept that we have adapted from Anderson's treatment of nationalisms (Anderson, 1991)