Fracking bad language – hydraulic fracturing and earthquake risks

We thank all conference and event organis- ers for supporting our work, as well as survey participants. We also thank Stella Pytharouli, James Verdon, and Stephen Hicks, for their insights into earthquake magnitudes and seismological terminology, and Juan Alcalde for comments about language nuance and trans- lation. We would also like to thank Brigitte Nerlich for the early discussion about the relevance of this work.Peer reviewedPublisher PD

Healthy living and cancer: evidence from UK Biobank.

CONTEXT: UK Biobank is a prospective study of half a million subjects, almost all aged 40-69 years, identified in 22 centres across the UK during 2006-2010. OBJECTIVE: A healthy lifestyle has been described as 'better than any pill, and no side effects [5]. We therefore examined the relationships between healthy behaviours: low alcohol intake, non-smoking, healthy BMI, physical activity and a healthy diet, and the risk of all cancers, colon, breast and prostate cancers in a large dataset. METHOD: Data on lifestyle behaviours were provided by 343,150 subjects, and height and weight were measured at recruitment. 14,285 subjects were diagnosed with cancer during a median of 5.1 years of follow-up. RESULTS: Compared with subjects who followed none or a single healthy behaviour, a healthy lifestyle based on all five behaviours was associated with a reduction of about one-third in incident cancer (hazard ratio [HR] 0.68; 95% confidence intervals [CI] 0.63-0.74). Colorectal cancer was reduced in subjects following the five behaviours by about one-quarter (HR 0.75; 95% CI 0.58-0.97), and breast cancer by about one-third (HR 0.65; 95% CI 0.52-0.83). The association between a healthy lifestyle and prostate cancer suggested a significant increase in risk, but this can be attributed to bias consequent on inequalities in the uptake of the prostate specific antigen screening test. CONCLUSIONS: Taken together with reported reductions in diabetes, vascular disease and dementia, it is clearly important that every effort is taken to promote healthy lifestyles throughout the population, and it is pointed out that cancer and other screening clinics afford 'teachable moments' for the promotion of a healthy lifestyle

Spatial and temporal variability of net primary production on the Agulhas Bank, 1998–2018

Despite the importance of Agulhas Bank (AB) marine productivity in supporting South African coastal fisheries and shelf ecosystems, there are relatively few regional-scale assessments of its spatial and temporal variability, and most productivity studies have been limited in scale. Here we use satellite-derived Net Primary Production (NPP) rates calculated using the Vertically Generalized Production Model (VGPM) to examine the spatial and temporal dynamics of NPP over the 21-year satellite record (1998–2018) on the AB. In calculating VGPM NPP we used the OCCI Chlorophyll-a product, SST from Operational-Sea-Surface-Temperature-and-Sea-Ice-Analysis (OSTIA) and PAR from GlobColour level-3 mapped products as these represent the longest datasets that fit our extended study period. We examine spatial trends between the eastern and central AB, as well as three areas of the bank (around Port Alfred, the Tsitsikamma coast, and the ‘cold ridge’) that have been previously identified as contributing significantly to the overall productivity of the AB. The AB shows only a moderate degree of seasonality in NPP calculated from the VGPM, with NPP being highest in austral summer (1.7–1.8 g C m−2 d−1) and lowest in winter (0.9–1.0 g C m−2 d−1), and remains relatively high (>1 g C m−2 d−1) throughout the year, contrasting sharply with other shelf systems. Considered annually, NPP on the bank was 516 g C m−2 yr−1 (38 Mt C yr−1 when scaled to the total shelf area) which is higher than many other shelf systems though lower than the neighbouring Benguela system and is indicative of a moderately productive shelf system fuelled by perennial NPP. Comparing different sections of the AB from east to central bank, and including the three upwelling areas, highlighted that spatial differences in NPP were relatively limited; that these three upwelling areas made similar contributions to their relative proportion of the total shelf area, and that average rates of NPP are spatially similar across the bank, though notable high rates occur in some coastal upwelling areas. Interannual variability in NPP was relatively modest, varying between years by only ∼15% over the two decades assessed. Over the 21-year data set, there was a slight (∼0.26% yr−1) statistically-significant decline in calculated NPP over time for the AB as a whole, which, when examined on a pixel-by-pixel basis, indicated that most of the decline was on the central bank between 100 m and 200 m isobaths. In summer, an increase in NPP occurred on the EAB (26.5–28°E). In conclusion, the AB is a significant site of perennial moderate levels of NPP, varying little interannually and with only a slight decline in NPP over time. These factors lead to a stable environment in terms of ecosystem productivity so that the AB makes a significant contribution to the productivity of South African regional fisheries

Interannual monsoon wind variability as a key driver of East African small pelagic fisheries

Small pelagic fisheries provide food security, livelihood support and economic stability for East African coastal communities—a region of least developed countries. Using remotely- sensed and field observations together with modelling, we address the biophysical drivers of this important resource. We show that annual variations of fisheries yield parallel those of chlorophyll-a (an index of phytoplankton biomass). While enhanced phytoplankton biomass during the Northeast monsoon is triggered by wind-driven upwelling, during the Southeast monsoon, it is driven by two current induced mechanisms: coastal “dynamic uplift” upwelling; and westward advection of nutrients. This biological response to the Southeast monsoon is greater than that to the Northeast monsoon. For years unaffected by strong El-Niño/La-Niña events, the Southeast monsoon wind strength over the south tropical Indian Ocean is the main driver of year-to-year variability. This has important implications for the predictability of fisheries yield, its response to climate change, policy and resource management

Unravelling links between squid catch variations and biophysical mechanisms in South African waters

Using satellite observations, this study uncovers the biophysical drivers of the lucrative chokka squid fishery in South Africa over the last two decades (1998–2017) and addresses their potential links with low squid catches. Chokka squid fishing is crucial to the economic wellbeing of local communities. However, the squid biomass is prone to considerable fluctuations, including abrupt declines with negative socio-economic impacts. We show that the squid catch is significantly and positively correlated with satellite-derived chlorophyll-a (Chl-a, an index of phytoplankton biomass) from year to year in South African coastal waters. Two main phytoplankton blooms are observed to occur seasonally in the austral spring and autumn, peaking in October and April, respectively. From October to April, phytoplankton abundance is influenced by the occurrence of wind-driven upwelling over the South African west coast (southern Benguela) and the central Agulhas Bank (so-called Cold Ridge upwelling), while the surface currents appear more important for shelf edge processes and advection along the Cold Ridge on shorter timescales. Low squid catches are observed in 2001 and 2013 and linked to declines in Chl-a induced by weak winds and relaxed negative wind stress curl over the southwest coast in 2001, and over the southwest coast and the central Agulhas Bank in 2013. Phytoplankton phenology (bloom timing) analysis reveals absent, or shorter and delayed blooms, over the Benguela upwelling region in 2001 and both the Benguela and Cold Ridge upwelling areas in 2013. In contrast, the high catch years of 2004 and 2009, associated with elevated Chl-a, coincide with early and/or prolonged seasonal blooms. These are induced by strong winds over the Benguela upwelling and Cold Ridge areas in 2004, and by intensified negative wind stress curl over the Benguela upwelling area in 2009. These results show that the squid catch fluctuations are potentially predictable and could support policymakers seeking to improve their planning of adaptation strategies and risk mitigation

The challenge of equipoise: qualitative interviews exploring the views of health professionals and women with multiple ipsilateral breast cancer on recruitment to a surgical randomised controlled feasibility trial

Background- A multicentre feasibility trial (MIAMI), comparing outcomes and quality of life of women with multiple ipsilateral breast cancer randomised to therapeutic mammoplasty or mastectomy, was conducted from September 2018 to March 2020. The MIAMI surgical trial aimed to investigate recruitment of sufficient numbers of women. Multidisciplinary teams at 10 breast care centres in the UK identified 190 with MIBC diagnosis; 20 were eligible for trial participation but after being approached only four patients were recruited. A nested qualitative study sought to understand the reasons for this lack of recruitment. Methods- Interviews were conducted from November 2019 to September 2020 with 17 staff from eight hospital-based breast care centres that recruited and attempted to recruit to MIAMI; and seven patients from four centres, comprising all patients who were recruited to the trial and some who declined to take part. Interviews were audio-recorded, anonymised and analysed using thematic methods of building codes into themes and sub-themes using the process of constant comparison. Results- Overarching themes of (1) influences on equipoise and recruitment and (2) effects of a lack of equipoise were generated. Within these themes, health professional themes described the barriers to recruitment as ‘the treatment landscape has changed’, ‘staff preferences and beliefs’ which influenced equipoise and patient advice; and how different the treatments were for patients. Patient themes of ‘altruism and timing of trial approach’, ‘influences from consultants and others’ and ‘diagnostic journey doubts’ all played a part in whether patients agreed to take part in the trial. Conclusions- Barriers to recruiting to breast cancer surgical trials can be significant, especially where there are substantial differences between the treatments being offered and a lack of equipoise communicated by healthcare professionals to patients. Patients can become overwhelmed by numerous requests for participation in research trials and inappropriate timing of trial discussions. Alternative study designs to the gold standard randomised control trial for surgical interventions may be required to provide the high-quality evidence on which to base practice

The basic income for care leavers in Wales pilot evaluation: Protocol of a quasi-experimental evaluation

Background: This study will evaluate the Basic Income for Care Leavers in Wales pilot (BIP), which is the most generous basic income scheme in the world. A cohort of care-experienced young people who become aged 18 during a 12-month enrolment period (July 2022-June 2023) are receiving £1,600 (before tax) per month for two years, and the Welsh Government intends this to have a range of benefits. This evaluation will examine the impact of BIP, the implementation of the pilot and how it is experienced, and its value for money. Methods: The study is a theory-based quasi-experimental evaluation, and the design and methods are informed by ongoing co-production with care-experienced young people. We will estimate the impact of BIP on participants using self-reported survey data and routinely collected administrative data. This will include outcomes across a range of domains, including psychological wellbeing, physical and mental health, financial impact, education, training and volunteering. Comparisons between temporal (Welsh) and geographical (English, using administrative data) controls will be done using coarsened exact matching and difference in differences analysis. The process evaluation will examine how BIP is implemented and experienced, primarily through monitoring data (quantitative) and interview, observational, and focus group data (qualitative). The economic evaluation will take a public sector and a societal perspective to identify, measure and value the costs and outcomes of BIP, and to synthesise the evidence to inform a social cost-benefit analysis at 24 months post-intervention. Discussion: BIP is unusual in that it targets a wide range of outcomes and is available to an entire national cohort of participants. The evaluation also has several practical constraints. Therefore, the study will use a range of methods and triangulate between different analyses to assess how successful it is. Findings will inform policy in relation to care leavers, social security and basic income studies worldwide

A Major Ecosystem Shift in Coastal East African Waters During the 1997/98 Super El Niño as Detected Using Remote Sensing Data

Under the impact of natural and anthropogenic climate variability, upwelling systems are known to change their properties leading to associated regime shifts in marine ecosystems. These often impact commercial fisheries and societies dependent on them. In a region where in situ hydrographic and biological marine data are scarce, this study uses a combination of remote sensing and ocean modelling to show how a stable seasonal upwelling off the Kenyan coast shifted into the territorial waters of neighboring Tanzania under the influence of the unique 1997/98 El Niño and positive Indian Ocean Dipole event. The formation of an anticyclonic gyre adjacent to the Kenyan/Tanzanian coast led to a reorganization of the surface currents and caused the southward migration of the Somali–Zanzibar confluence zone and is attributed to anomalous wind stress curl over the central Indian Ocean. This caused the lowest observed chlorophyll-a over the North Kenya banks (Kenya), while it reached its historical maximum off Dar Es Salaam (Tanzanian waters). We demonstrate that this situation is specific to the 1997/98 El Niño when compared with other the super El-Niño events of 1972,73, 1982–83 and 2015–16. Despite the lack of available fishery data in the region, the local ecosystem changes that the shift of this upwelling may have caused are discussed based on the literature. The likely negative impacts on local fish stocks in Kenya, affecting fishers’ livelihoods and food security, and the temporary increase in pelagic fishery species’ productivity in Tanzania are highlighted. Finally, we discuss how satellite observations may assist fisheries management bodies to anticipate low productivity periods, and mitigate their potentially negative economic impacts

Australian and New Zealand Pulmonary Rehabilitation Guidelines

Background and objective: The aim of the Pulmonary Rehabilitation Guidelines (Guidelines) is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts. Methods: The Guideline methodology adhered to the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria. Nine key questions were constructed in accordance with the PICO (Population, Intervention, Comparator, Outcome) format and reviewed by a COPD consumer group for appropriateness. Systematic reviews were undertaken for each question and recommendations made with the strength of each recommendation based on the GRADE (Gradings of Recommendations, Assessment, Development and Evaluation) criteria. The Guidelines were externally reviewed by a panel of experts. Results: The Guideline panel recommended that patients with mild-to-severe COPD should undergo PR to improve quality of life and exercise capacity and to reduce hospital admissions; that PR could be offered in hospital gyms, community centres or at home and could be provided irrespective of the availability of a structured education programme; that PR should be offered to patients with bronchiectasis, interstitial lung disease and pulmonary hypertension, with the latter in specialized centres. The Guideline panel was unable to make recommendations relating to PR programme length beyond 8 weeks, the optimal model for maintenance after PR, or the use of supplemental oxygen during exercise training. The strength of each recommendation and the quality of the evidence are presented in the summary. Conclusion: The Australian and New Zealand Pulmonary Rehabilitation Guidelines present an evaluation of the evidence for nine PICO questions, with recommendations to provide guidance for clinicians and policymakers

The cost-effectiveness of adding an ultrasound corticosteroid and local anaesthetic injection to advice and education for hip osteoarthritis.

ObjectivesEvidence for the comparative cost-effectiveness of intra-articular corticosteroid injection in people with hip osteoarthritis (OA) remains unclear. This study investigated the cost-effectiveness of best current treatment (BCT) comprising advice and education plus a single ultrasound-guided intra-articular hip injection (USGI) of 40 mg triamcinolone acetonide and 4 ml 1% lidocaine hydrochloride (BCT+US-T) versus BCT alone.MethodsA trial-based cost-utility analysis of BCT+US-T compared with BCT was undertaken over 6 months. Patient-level cost data were obtained, and effectiveness was measured in terms of quality-adjusted life years (QALYs), allowing the calculation of cost per QALY gained from a United Kingdom (UK) National Health Service (NHS) perspective.ResultsBCT+US-T was associated with lower mean NHS costs (BCT+US-T minus BCT: £-161.6, 95% CI: £-583.95 to £54.18) and small but significantly higher mean QALYs than BCT alone over 6 months (BCT+US-T minus BCT: 0.0487, 95% CI: 0.0091, 0.0886). In the base case, BCT+US-T was the most cost-effective and dominated BCT alone. Differences in total costs were driven by number of visits to NHS consultants, private physiotherapists, and chiropractors, and hip surgery, which were more common with BCT alone than BCT+US-T.ConclusionIntra-articular corticosteroid injection plus BCT (BCT+US-T) for patients with hip OA results in lower costs and better outcomes, and is highly cost-effective, compared with BCT alone.Trial registrationEudraCT: 2014-003412-37 (August 8, 2015) and registered with Current Controlled Trials: ISRCTN 50550256 (July 28, 2015).Trial protocolFull details of the trial protocol can be found in the Supplementary Appendix, available with the full text of this article at https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-018-2153-0#citeas.Doidoi.org/10.1186/s12891-018-2153-0