Assessing vulnerability and modelling assistance: using demographic indicators of vulnerability and agent-based modelling to explore emergency flooding relief response

Flooding is a significant concern for much of the UK and is recognised as a primary threat by most local councils. Those in society most often deemed vulnerable: the elderly, poor or sick, for example, often see their level of vulnerability increase during hazard events. A greater knowledge of the spatial distribution of vulnerability within communities is key to understanding how a population may be impacted by a hazard event. Vulnerability indices are regularly used – in conjunction with needs assessments and on-the-ground research – to target service provision and justify resource allocation. Past work on measuring and mapping vulnerability has been limited by a focus on income-related indicators, a lack of consideration of accessibility, and the reliance on proprietary data. The Open Source Vulnerability Index (OSVI) encompasses an extensive range of vulnerability indicators supported by the wider literature and expert validation and provides data at a sufficiently fine resolution that can identify vulnerable populations. Findings of the OSVI demonstrate the potential cascading impact of a flood hazard as it impacts an already vulnerable population: exacerbating pre-existing vulnerabilities, limiting capabilities and restricting accessibility and access to key services. The OSVI feeds into an agent-based model (ABM) that explores the capacity of the British Red Cross (BRC) to distribute relief during flood emergencies using strategies based upon the OSVI. A participatory modelling approach was utilised whereby the BRC were included in all aspects of the model development. The major contribution of this work is the novel synthesis of demographics analysis, vulnerability mapping and geospatial simulation. The project contributes to the growing understanding of vulnerability and response management within the NGO sector. It is hoped that the index and model produced will allow responder organisations to run simulations of similar emergency events and adjust strategic response plans accordingly

Protocol for a longitudinal, prospective cohort study investigating the biology of uterine fibroids and endometriosis, and patients' quality of life: the FENOX study

INTRODUCTION:Millions of women suffer from the consequences of endometriosis and uterine fibroids, with fibroids the cause for over 50% of hysterectomies in the USA, and direct costs for their treatment estimated at between US$4 and US$9 billion. Endometriosis commonly affects millions of women worldwide predominantly during reproductive age, with severe menstrual and non-menstrual pain and subfertility the main symptoms. Due to the 'unhappy triad' of endometriosis-lack of awareness, lack of clinically relevant biomarkers and the unspecific nature of symptoms-women wait on average for 8-12 years before the definitive endometriosis diagnosis is made. Treatment options for both conditions are not satisfactory at the moment, especially with a view to preserving fertility for the women and families affected. In the Fibroids and Endometriosis Oxford (FENOX) study, we combine the investigation of fibroids and endometriosis, and plan to collect high-quality tissue samples and medical data of participants over a time frame of 5 years after surgical intervention. METHODS AND ANALYSIS:Biological samples such as blood, saliva, urine, fat, peritoneal fluid and-if found-endometrial tissue or fibroids as well as detailed clinical and intraoperative data will be collected from women undergoing surgery and participating in the study after informed consent. We plan to recruit up to 1200 participants per disease arm (ie, endometriosis and uterine fibroids) over 5 years. Participants will fill in detailed and validated questionnaires on their medical history and quality of life, with follow-ups for 5 years. Enrolment started on 2 April 2018, and FENOX will close on 31 March 2028. We will analyse the biological samples using state-of-the-art molecular biology methods and correlate the findings with the medical records and questionnaire data. ETHICS AND DISSEMINATION:The findings will be published in high-ranking journals in the field and presented at national and international conferences. TRIAL REGISTRATION NUMBER:ISRCTN13560263