Steps towards comprehensive Bayesian decision analysis in fisheries and environmental management

A typical decision problem in an environmental field includes a complex system with countless uncertain factors of both nature and human behavior. There are many stakeholders with conflicting objectives and a lot of decision alternatives, and results need to be communicated clearly to decision makers and stakeholders. Organized analysis is needed to tackle these challenges. In an ideal situation, we should analyze the objectives of every stakeholder and the responses from different parts of the ecosystem within one framework, which integrates the expertise and efforts of many different disciplines. Bayesian inference, especially the influence diagram, is a perfect tool to be used in such decision problems. The main contribution of this thesis is in developing methods for the modeling of uncertainties in environmental decision problems. The focus is on having more complete decision analyses where more uncertainties are realistically modeled. By including more stochastic variables in the analysis, the decision makers get a more realistic picture of the uncertainties involved and can account for them in the decision making. The thesis consists of five separate research articles, which all contribute to the different parts of the Bayesian decision process presented in this summary. The process is divided into four steps: (1.) building a decision model, (2.) data gathering and processing, (3.) using the model, and (4.) post analysis. The summary presents the research articles and their contributions and critically reviews the tools and methods needed in the process. The articles include a model for oil spill management, a spatial multispecies stock assessment model, a model for the stock assessment of data-poor species, a model to estimate uncertainties in environmental valuation and an influence diagram for value of information analysis. The methods used cover many aspects of the Bayesian decision process, outlining the problem, different ways to define prior distributions, utility functions, and finding maximum utility policies and value of information analysis. Hence, the tools used are diverse, too. In the models, I have used graphical Bayesian networks, numerical MCMC estimation, and Gaussian processes. In conclusion, the results found in this thesis are small but important steps toward better and more comprehensive Bayesian decision analyses in environmental and fisheries management. They show that significant uncertainties exist in many parts of the system. Another important factor was the cooperation of scientists from many different disciplines with a variety of backgrounds, which is needed in the modeling of complex environmental problems.Ympäristöalan päätösongelmiin liittyy paljon epävarmuuksia, jotka johtuvat sekä monimutkaisesta ekosysteemistä että ihmisen toiminnasta. Ongelmiin liittyy useita asianosaisia, joilla on monesti risteäviä tavoitteita, joten myös eri päätösvaihtoehtojen määrä on suuri. Päätösanalyysin tuloksien pitää olla selkeitä ja asianosaisten sekä päätöksentekijän helposti tulkittavissa. Näiden haasteiden ratkaisemiseksi tarvitaan epävarmuudet huomioivaa organisoitua lähestymistapaa. Ihanteellisessa tapauksessa päätösanalyysi voitaisiin tehdä yhdellä työkalulla, joka huomioi niin luontoon kuin ihmistoimintaankin liittyvät seikat epävarmuuksineen. Bayes-verkot, ja etenkin vaikutuskaaviot, ovat menetelmiä, jotka soveltuvat erinomaisesti juuri tämän tyylisiin päätösongelmiin. Tässä työssä kehitetään menetelmiä päätösanalyysiin liittyvien epävarmuuksien mallintamiseen. Sovelluskohteet ovat ympäristön hallinnassa ja kalataloudessa. Tavoitteena ovat entistä kattavammat päätösanalyysit, joissa epävarmuudet on huomioitu realistisesti. Kun malleihin ja analyyseihin sisällytetään enemmän epävarmoja muuttujia, päätöksentekijät saavat paremman kuvan päätöksiin liittyvistä epävarmuuksista ja voivat huomioida ne päätöksenteossa. Tämä väitöskirja koostuu viidestä eri tutkimusartikkelista, jotka liittyvät epävarmuudet huomioivan päätösanalyysiprosessin eri vaiheisiin. Prosessi, joka on kuvattu tässä tiivistelmässä, on jaettu neljään osaan: 1) päätösmallin rakentaminen, 2) tiedon keruu ja käsittely, 3) mallin käyttö ja 4) jälkianalyysi. Tutkimusartikkelien aiheina ovat: malli öljyvahinkojen hallintaan, spatiaalinen monilajimalli kalakantojen arvioimiseksi, kalakantamalli tilanteisiin, joissa kannan tilasta, kalastuksesta ja lajin biologiasta on hyvin vähän tietoa, malli jolla voidaan arvioida ympäristön arvottamiseen liittyviä epävarmuuksia sekä vaikutuskaavio informaation arvoanalyysiä varten. Osajulkaisujen aiheet liittyvät osaltaan kaikkiin eri päätösanalyysiprosessin vaiheisiin, ongelman määrittelystä erilaisiin tapoihin kerätä ja käyttää aiempaa olemassa olevaa tietoa sekä hyötyfunktioista hyödynmaksimointiin ja informaation arvoanalyysiin. Täten myös käytetyt työkalut ovat erilaisia. Mallintamisessa on käytetty graafisia Bayes-verkkoja, numeerista Markovin ketju Monte Carlo -simulointia ja Gaussisia prosesseja. Työn tulokset ovat pieniä mutta tärkeitä askeleita kohti kattavampaa epävarmuudet huomioivaa päätösanalyysiä ympäristön ja kalakantojen hallinnassa ja käytössä. Tulokset osoittavat miten huomattavia epävarmuuksia pieniinkin päätösanalyysin osiin sisältyy. Tärkeää on myös yhteistyö eri tieteenalojen välillä, mitä tarvitaan mallinnettaessa monimutkaisia luonnonprosesseja ja niihin liittyvää laajempaa päätöskokonaisuutta

Factors associated with cervical cancer screening participation among immigrants of Russian, Somali and Kurdish origin : a population-based study in Finland

Background: Previous studies revealed low participation in cervical cancer screening among immigrants compared with non-immigrants. Only a few studies about factors associated with immigrants' lower participation rates have been conducted in European countries that have universal access for all eligible women. Our study aimed to explore factors associated with cervical screening participation among women of Russian, Somali, and Kurdish origin in Finland. Methods: We used data from the Migrant Health and Well-being Survey, 2010-2012. Structured face-to-face interviews of groups of immigrants aged 25-60 yielded 620 responses concerning screening participation in the previous five years. Statistical analysis employed logistic regression. Results: The age-adjusted participation rates were as follows: among women of Russian origin 73.9% (95% CI 68.1-79.7), for Somalis 34.7% (95% CI 26.4-43.0), and for Kurds 61.3% (95% CI 55.0-67.7). Multiple logistic regressions showed that the most significant factor increasing the likelihood of screening participation among all groups was having had at least one gynecological check-up in the previous five years (Odds ratio [OR] = 6.54-26.2; p <0.001). Other factors were higher education (OR = 2.63; p = 0.014), being employed (OR = 4.31; p = 0.007), and having given birth (OR = 9.34; p= 0.014), among Kurds; and literacy in Finnish/Swedish (OR = 3.63; p = 0.003) among Russians. Conclusions: Our results demonstrate that women who refrain from using reproductive health services, those who are unemployed and less educated, as well as those with poor language proficiency, might need more information on the importance of screening participation. Primary and occupational healthcare services may have a significant role in informing immigrant women about this importance.Peer reviewe

High-sensitivity lateral flow immunoassay with a fluorescent lanthanide nanoparticle label

Lateral flow (LF) immunoassays are commonly used for point-of-care testing and typically incorporate visually read reporters, such as gold particles. To improve sensitivity and develop quantitative LF immunoassays, visual reporters can be replaced by fluorescent reporters detected by an instrument. In this study, we used fluorescent europium(III) chelate doped nanoparticle (Eu-np) reporters to develop a quantitative high-sensitivity LF immunoassay for free prostate specific antigen (fPSA). Furthermore, we tested different simplified formats of the assay and the effect of different modifiable parameters on the detection limit of the assay: dynamic range, assay duration and number of assay steps. The molar detection limits of the different assay formats were compared with published detection limits of LF immunoassays with different reporters. The cutoff was calculated from 11 female serum samples. The detection limit of the sensitivity optimized fPSA assay with fPSA spiked into pooled female serum was 0.01 ng/ml, which is approximately 100-fold lower than the most sensitive gold particle LF assays and 10-fold lower than other Eu-np and carbon nanoparticle based LF immunoassays. Thus, Eu-np reporters can be used to develop highly sensitive and quantitative LF immunoassays.</p

Enhancing Survey Participation among Foreign-Born Populations: Experiences from the Finnish Migrant Health and Wellbeing Study (Maamu)

Peer reviewe

Microparticle - based platform for point-of-care immunoassays

There is a need for quantitative and sensitive, yet simple point-of-care immunoassays: We have developed a point-of-care microparticle-based immunoassay platform which combines the performance of a microliter well based assay with the usability of a rapid assay. The platform contained a separate reaction and detection chambers and microparticles for the solid-phase. Photoluminescent up-converting nanoparticles (UCNPs) were used as labels. The platform was tested with a cardiac troponin I assay, and a limit of detection of 19.7 ng/L was obtained. This study demonstrates the feasibility of developing point-of-care assays on the new platform for various analytes of interests

Kuntien väliset erot sairastavuudessa : THL:n sairastavuusindeksin tuloksia

Kuntien välillä oli merkittäviä eroja sairastavuudessa jaksolla 2009–2011. Myös perinteinen itä-länsijako sairaamman Itä-Suomen ja terveemmän Länsi-Suomen välillä oli edelleen näkyvissä. Yli 50 000 asukkaan kaupunkien vertailussa suurinta sairastavuus oli Kotkassa, Kuopiossa, Oulussa, Turussa ja Joensuussa, ja korkein indeksiarvo oli yli puolet suurempi kuin matalin (Kotka 124 – Espoo 76). Suurimmat sairausryhmittäiset alue-erot havaittiin sydän- ja verisuonisairauksissa, tuki- ja liikuntaelinsairauksissa, vakavissa mielenterveyden häiriöissä sekä dementiassa. Vaikka suurimman sairastavuuden kaupunkien tilanne näyttää johtuvan osittain eri sairauksista, yhteistä niille on se, että mielenterveyden häiriöt ovat niissä keskimääräistä yleisempiä. THL:n sairastavuusindeksi soveltuu hyvin kuntien sairastavuuserojen arviointiin ja terveystyön kehittämistarpeiden tunnistamiseen. Ikävakioimaton indeksi kuvaa kuntien todellista sairaustaakkaa, johon myös ikärakenne vaikuttaa, kun taas ikävakioitu luku soveltuu kuntien väliseen vertailuun

Double-Antigen Lateral Flow Immunoassay for the Detection of Anti-HIV-1 and -2 Antibodies Using Upconverting Nanoparticle Reporters

Rapid diagnostic tests (RDTs) are often used for the detection of anti-human immunodeficiency virus (HIV) antibodies in remote locations in low- and middle-income countries (LMIC) with low or limited access to central laboratories. The typical format of an RDT is a lateral flow assay (LFA) with visual interpretation prone to subjectivity. This risk of misinterpretation can be overcome with luminescent upconverting nanoparticle reporters (UCNPs) measured with a miniaturized easy-to-use reader instrument. An LFA with UCNPs for anti-HIV-1/2 antibodies was developed and the assay performance was evaluated extensively with challenging patient sample panels. Sensitivity (n = 145) of the UCNP-LFA was 96.6% (95% CI: 92.1–98.8%) and specificity (n = 309) was 98.7% (95% CI: 96.7–99.7%). Another set of samples (n = 200) was used for a comparison between the UCNP-LFA and a conventional visual RDT. In this comparison, the sensitivities for HIV-1 were 96.4% (95% CI: 89.8–99.3%) and 97.6% (95% CI: 91.6–99.7%), for the UCNP-LFA and conventional RDT, respectively. The specificity was 100% (95% CI: 96.4–100%) for both assays. The developed UCNP-LFA demonstrates the applicability of UCNPs for the detection of anti-HIV antibodies. The signal measurement is done by a reader instrument, which may facilitate automated result interpretation, archiving and transfer of data from de-centralized locations.</p

The association between mental health symptoms and mobility limitation among Russian, Somali and Kurdish migrants: a population based study

Background Research has demonstrated a bidirectional relationship between physical function and depression, but studies on their association in migrant populations are scarce. We examined the association between mental health symptoms and mobility limitation in Russian, Somali and Kurdish migrants in Finland. Methods We used data from the Finnish Migrant Health and Wellbeing Study (Maamu). The participants comprised 1357 persons of Russian, Somali or Kurdish origin aged 18–64 years. Mobility limitation included self-reported difficulties in walking 500 m or stair climbing. Depressive and anxiety symptoms were measured using the Hopkins Symptom Checklist-25 (HSCL-25) and symptoms of somatization using the somatization subscale of the Symptom Checklist-90 Revised (SCL-90-R). A comparison group of the general Finnish population was selected from the Health 2011 study. Results Anxiety symptoms were positively associated with mobility limitation in women (Russians odds ratio [OR] 2.98; 95% confidence interval [CI] 1.28–6.94, Somalis OR 6.41; 95% CI 2.02–20.29 and Kurds OR 2.67; 95% CI 1.41–5.04), after adjustment for socio-demographic factors, obesity and chronic diseases. Also somatization increased the odds for mobility limitation in women (Russians OR 4.29; 95% CI 1.76–10.44, Somalis OR 18.83; 95% CI 6.15–57.61 and Kurds OR 3.53; 95% CI 1.91–6.52). Depressive symptoms were associated with mobility limitation in Russian and Kurdish women (Russians OR 3.03; 95% CI 1.27–7.19 and Kurds OR 2.64; 95% CI 1.39–4.99). Anxiety symptoms and somatization were associated with mobility limitation in Kurdish men when adjusted for socio-demographic factors, but not after adjusting for obesity and chronic diseases. Finnish women had similar associations as the migrant women, but Finnish men and Kurdish men showed varying associations. Conclusions Mental health symptoms are significantly associated with mobility limitation both in the studied migrant populations and in the general Finnish population. The joint nature of mental health symptoms and mobility limitation should be recognized by health professionals, also when working with migrants. This association should be addressed when developing health services and health promotion.BioMed Central open acces

Upconverting nanoparticle reporter–based highly sensitive rapid lateral flow immunoassay for hepatitis B virus surface antigen

Detection of hepatitis B Virus surface antigen (HBsAg) is an established method for diagnosing both acute and chronic hepatitis B virus (HBV) infection. In addition to enzyme immunoassays (EIAs), rapid diagnostic tests (RDTs) are available for the detection of HBsAg in resource-poor settings. However, the available RDTs have inadequate sensitivity and therefore are not suitable for diagnosis of patients with low levels of HBsAg and for blood screening. To provide a high-sensitivity RDT, we developed a lateral flow immunoassay (LFIA) for HBsAg utilizing upconverting nanoparticle (UCNP) reporter. The UCNP-LFIA can use whole blood, serum, or plasma and the results can be read in 30 min using a reader device. When compared with a commercial conventional visually read LFIA, the developed UCNP-LFIA had a Limit of Detection (LoD) of 0.1 IU HBsAg/ml in spiked serum, whereas the LoD of the conventional LFIA was 3.2 IU HBsAg/ml. The developed UCNP-LFIA fulfills the WHO criterion for blood screening (LoD ≤ 0.13 IU HBsAg/ml) in terms of LoD. The UCNP-LFIA and conventional LFIA were evaluated with well-characterized sample panels. The UCNP-LFIA detected 20/24 HBsAg-positive samples within the HBsAg Performance Panel and 8/10 samples within the Mixed Titer Performance Panel, whereas the conventional LFIA detected 8/24 and 4/10 samples in these panels, respectively. The performance of the assays was further evaluated with HBsAg-positive (n = 108) and HBsAg-negative (n = 315) patient samples. In comparison with a central laboratory test, UCNP-LFIA showed 95.4% (95% CI: 89.5–98.5%) sensitivity whereas sensitivity of the conventional LFIA was 87.7% (95%CI: 79.9–93.3%).</p