Time and travel costs incurred by women attending antenatal tests: A costing study

OBJECTIVE: to estimate the costs to women, their friends and family for different antenatal tests in the Down's syndrome (DS) screening pathway. DESIGN: questionnaire-based costing study. SETTING: eight maternity clinics across the UK. PARTICIPANTS: pregnant women (n=574) attending an appointment for DS screening, NIPT or invasive testing between December 2013 and September 2014. MEASUREMENTS: using data collected from the questionnaires we calculated the total costs to women by multiplying the time spent at the hospital and travelling to and from it by the opportunity costs of the women and accompanying person and adding travel and childcare costs. Assumptions about the value of opportunity costs were tested in one-way sensitivity analyses. The main outcome measure was the mean cost to the women and friends/family for each test (DS screening, NIPT, and invasive testing). FINDINGS: mean costs to women and their family/friend were £33.96 per visit, of which £22.47 were time costs, £9.15 were travel costs and £2.34 were childcare costs. Costs were lowest for NIPT (£22), £32 for DS screening (£44 if combined with NIPT), and highest for invasive testing (£60). Sensitivity analysis revealed that variations around the value of leisure time opportunity costs had the largest influence on the results. KEY CONCLUSIONS: there are considerable costs to women, their friends and family when attending different tests in the DS screening pathway. IMPLICATIONS FOR PRACTICE: when assessing the cost-effectiveness of changes to this pathway, costs to women should be considered

Determination of the gas diffusion coefficient of a peat grassland soil

Peatland habitats are important carbon stocks that also have the potential to be significant sources of greenhouse gases, particularly when subject to changes such as artificial drainage and application of fertilizer. Models aiming to estimate greenhouse gas release from peatlands require an accurate estimate of the diffusion coefficient of gas transport through soil (Ds). The availability of specific measurements for peatland soils is currently limited. This study measured Ds for a peat soil with an overlying clay horizon and compared values with those from widely available models. The Ds value of a sandy loam reference soil was measured for comparison. Using the Currie (1960) method, Ds was measured between an air-filled porosity (ϵ) range of 0 and 0.5 cm3 cm−3. Values of Ds for the peat cores ranged between 3.2 × 10−4 and 4.4 × 10−3 m2 hour−1, for loamy clay cores between 0 and 4.7 × 10−3 m2 hour−1 and for the sandy reference soil they were between 5.4 × 10−4 and 3.4 × 10−3 m2 hour−1. The agreement of measured and modelled values of relative diffusivity (Ds/D0, with D0 the diffusion coefficient through free air) varied with soil type; however, the Campbell (1985) model provided the best replication of measured values for all soils. This research therefore suggests that the use of the Campbell model in the absence of accurately measured Ds and porosity values for a study soil would be appropriate. Future research into methods to reduce shrinkage of peat during measurement and therefore allow measurement of Ds for a greater range of ϵ would be beneficial

Application of Sentinel-2A data for pasture biomass monitoring using a physically based radiative transfer model

A large proportion of the global land surface is covered by pasture. The advent of the Sentinel satellites program provides free datasets with good spatiotemporal resolution that can be a valuable source of information for monitoring pasture resources. We combined optical remote sensing data (proximal hyperspectral and Sentinel 2A) with a radiative transfer model (PROSAIL) to estimate leaf area index (LAI), and biomass, in a dairy farming context. Three sites in Southern England were used: two pasture farms that differed in pasture type and management, and a set of small agronomy trial plots with different mixtures of grasses, legumes and herbs, as well as pure perennial ryegrass. The proximal and satellite spectral data were used to retrieve LAI via PROSAIL model inversion, which were compared against field observations of LAI. The potential of bands of Sentinel 2A that corresponded with a 10 m resolution was studied by convolving narrow spectral bands (from a handheld hyperspectral sensor) into Sentinel 2A bands (10 m). Retrieved LAI, using these spectrally resampled S2A data, compared well with measured LAI, for all sites, even for those with mixed species cover (although retrieved LAI was somewhat overestimated for pasture mixtures with high LAI). This proved the suitability of 10 m Sentinel 2A spectral bands for capturing LAI dynamics for different types of pastures. We also found that inclusion of 20 m bands in the inversion scheme did not lead to any further improvement in retrieved LAI. Sentinel 2A image based retrieval yielded good agreement with LAI measurements obtained for a typical perennial ryegrass based pasture farm. LAI retrieved in this way was used to create biomass maps (that correspond to indirect biomass measurements by Rising Plate Meter (RPM)), for mixed-species paddocks for a farm for which limited field data were available. These maps compared moderately well with farmer-collected RPM measurements for this farm. We propose that estimates of paddock-averaged and within-paddock variability of biomass are more reliably obtained from a combined Sentinel 2A-PROSAIL approach, rather than by manual RPM measurements. The physically based radiative transfer model inversion approach outperformed the Normalised Difference Vegetation Index based retrieval method, and does not require site specific calibrations of the inversion scheme

Non-invasive prenatal diagnosis (NIPD) for single gene disorders: cost analysis of NIPD and invasive testing pathways

OBJECTIVE: Evaluate the costs of offering non-invasive prenatal diagnosis (NIPD) for single gene disorders compared to traditional invasive testing to inform NIPD implementation into clinical practice. METHOD: Total costs of diagnosis using NIPD or invasive testing pathways were compared for a representative set of single gene disorders. RESULTS: For autosomal dominant conditions, where NIPD molecular techniques are straightforward, NIPD cost £314 less than invasive testing. NIPD for autosomal recessive and X-linked conditions requires more complicated technical approaches and total costs were more than invasive testing, e.g. NIPD for spinal muscular atrophy was £1090 more than invasive testing. Impact of test uptake on costs was assessed using sickle cell disorder as an example. Anticipated high uptake of NIPD resulted in an incremental cost of NIPD over invasive testing of £48 635 per 100 pregnancies at risk of sickle cell disorder. CONCLUSIONS: Total costs of NIPD are dependent upon the complexity of the testing technique required. Anticipated increased demand for testing may have economic implications for prenatal diagnostic services. Ethical issues requiring further consideration are highlighted including directing resources to NIPD when used for information only and restricting access to safe tests if it is not cost-effective to develop NIPD for rare conditions

Impact of the representation of the infiltration on the river flow during intense rainfall events in JULES

Intense rainfall can lead to flash flooding and may cause disruption, damage and loss of life. Since flooding from intense rainfall (FFIR) events are of a short duration and occur within a limited area, they are generally poorly predicted by Numerical Weather Prediction (NWP) models. This is because of the high spatio-temporal resolution required and because of the way the convective rainfall is described in the model. Moreover, the hydrological process descriptions of Land Surface Models (LSMs) are not necessarily suitable to deal with cases of intense rainfall. In this study different representations of infiltration into the soil were developed in the JULES land surface scheme with the aim of improving prediction of the amount of surface runoff, and thus ultimately river flow. Infiltration and surface runoff are explored in a test case of intense rainfall with a variable maximum infiltration. The modelled hydraulic conductivity profile is modified with depth to reduce the rate of outgoing fluxes. The new infiltration scheme is then applied to different UK catchments. The resulting river flow is evaluated against a benchmark river flow calculated using default infiltration in JULES and also observations. The results demonstrate improved representation of the highest flows with this new variable maxiumum infiltration scheme in some catchments but limited improvement elsewhere. This scheme shows best improvement in the wettest areas of the UK where the annual mean precipitation is above 1200 mm. This work highlights the requirement for substantial further work on the hydrological process representation in JULES