Respiratory syncytial viral infections in young children : risk assessment and prevention

Respiratory syncytial virus is the main cause of lower respiratory tract infections in infants and young children. Although almost all children are infected before the age of two years, less than 2% develop severe disease necessitating hospitalisation. Risk factors for severe RSV disease include prematurity, chronic lung disease (CLD), young age, low birth weight, congenital heart disease (CHD), and immunodeficiencies. The aims of the studies described in this thesis were to develop a clinical prediction rule to estimate the individual monthly risk of hospitalisation for severe RSV disease in young children (chapter 2.1 ), and to assess the role of the average seasonal RSV pattern in the performance of this prediction rule (chapter 2.2). Furthermore, we aimed to perform a cost-effectiveness analysis of passive immunisation against RSV. Therefore we determined RSV hospitalisation costs in infants and young children and developed a prediction model that estimated anticipated mean RSV hospitalisation costs in children at-risk, based on several child characteristics (chapter 3.1). Then we assessed the incremental costs to prevent one RSV hospitalisation in high-risk children from a societal perspective, using a novel individualised monthly approach for decision making on passive immunisation (chapter 3.2). In addition we aimed to quantify the loss of health related quality of life (HRQoL) in children during the first months after RSV hospitalisation (chapter 4), study the association of severe RSV disease with polymorphisms located in the promoter region of the IL-4 gene and in the IL-4Ra gene (chapter 5), and explore the safety, tolerability, and immunogenicity of BBG2Na, a recombinant RSV vaccine constructed from a G protein sequence, in healthy young adults (chapter 6)

FLOODING RISK AND HOUSING VALUES: AN ECONOMIC ASSESSMENT OF ENVIRONMENTAL HAZARD

Climate change, the ‘boom and bust’ cycles of rivers, and altered water resource management practice have caused significant changes in the spatial distribution of the risk of flooding. Hedonic pricing studies, predominantly for the US, have assessed the spatial incidence of risk and the associated implicit price of flooding risk. Using these implicit price estimates and their associated standard errors, we perform a meta-analysis and find that houses located in the 100-year floodplain have a –0.3 to –0.8% lower price. The actual occurrence of a flooding event or increased stringency in disclosure rules causes ex ante prices to differ from ex post prices, but these effects are small. The marginal willingness to pay for reduced risk exposure has increased over time, and it is slightly lower for areas with a higher per capita income. We show that obfuscating amenity effects and risk exposure associated with proximity to water causes systematic bias in the implicit price of flooding risk.Manufactured Housing; valuation, environmental risk, meta-analysis, hedonic pricing

Cavitating Langmuir Turbulence in the Terrestrial Aurora

Langmuir cavitons have been artificially produced in the earth's ionosphere, but evidence of naturally-occurring cavitation has been elusive. By measuring and modeling the spectra of electrostatic plasma modes, we show that natural cavitating, or strong, Langmuir turbulence does occur in the ionosphere, via a process in which a beam of auroral electrons drives Langmuir waves, which in turn produce cascading Langmuir and ion-acoustic excitations and cavitating Langmuir turbulence. The data presented here are the first direct evidence of cavitating Langmuir turbulence occurring naturally in any space or astrophysical plasma.Comment: 4 pages, 4 figures, published in PRL on 9 March 2012 http://link.aps.org/doi/10.1103/PhysRevLett.108.10500