Alternative objectives : time extensions and less stringent objectives

The Water Framework Directive (2000/60/EC) (WFD) establishes a suite of environmental objectives for groundwater. In implementing the Directive and producing the first River Basin Management Plans, Member States have had to identify whether the these objectives are being met. If this assessment has shown that one or more of the objectives for groundwater is not being met, or is at risk of being failed, programmes of measures must be implemented to ensure that all relevant environmental objectives are met within six years – the publication date of the next River Basin Management Plan (22nd December, 2015). In reality, especially for groundwater, achieving all the relevant objectives in such a short timescale may not be possible or practical. The WFD recognises this and allows for an extension of the deadline (beyond 2015) for the purposes of a phased achievement of the environmental objectives. This is provided that there is no further deterioration in status (Article 4.4). Any such extension is limited to a maximum of two further river basin cycles (12 years) except where natural conditions mean that objectives can still not be achieved. A further provision is made for the situation where a water body is so badly affected by human activity or where natural conditions mean that achievement of the objectives(s) would be infeasible or disproportionally expensive. In these cases less stringent objectives (relative to those defined in Article 4.1) can be set, provided that there is the least possible deviation from good status conditions. Where extended deadlines or less stringent objectives have been proposed, Member States must provide an explanation and justification in the River Basin Management Plan. In the case of extended deadlines, a timetable for implementation of measures and the achievement of objectives must also be provided. This paper provides an overview of the approach used in England and Wales for identifying programmes of measures for groundwater, predicting outcomes and setting alternative objectives in relation to groundwater quality. Similar approaches were used for quantitative (water resource) aspects and also for surface water bodies

Is point of care testing for anaemia (HB) and microalbumin feasible in people with type 2 diabetes attending diabetes outpatient clinics?

Introduction: Diabetes is the major cause of chronic kidney disease (CKD) in Australia. Anaemia of CKD occurs earlier than in non-diabetics and is often insidious and undetected.Aim: A large, prospective, single-centre study was undertaken to determine the feasibility of point of care testing (POCT) haemoglobin (Hb) and microalbumin in people with type 2 diabetes (T2DM) attending routine outpatient clinic appointments (OPC).Method: Clinic nurses measured Hb and microalbumin using the HemoCue Haemoglobin Capillary Analyser and the HemoCue Urine Albumin Analyser (Medipac Scientific), respectively when they tested blood glucose, weight and blood pressure. The nurses were trained to use the analysers before the study commenced. Standard demographic data, duration of diabetes, treatment mode, and presence of complications, comorbidities, and HbA1c were ascertained from patients&rsquo; medical records.Results: Five hundred and fifty-four (80%) patients were screened. The nurses were able to perform the tests competently but testing, especially microalbumin, was time-consuming. Patients&rsquo; mean age was 62 years (11 SD): 230 females, mean blood glucose (BG) 10 (3.9 SD) mmol/L, mean haemoglobin 127.2 (16.3 SD) g/L; mean microalbumin 47.8 (58.7 SD) mg/L: 324 were males, mean BG 10.2 (3.9 SD) mmol/L, mean Hb 138.6 (18.8 SD) gm/L, and mean microalbumin 67.9 (73.9 SD) mg/L. 27% of males and 22% of females were anaemic. Of those with anaemia, 27% of females and 29% of males had microalbuminuria.Conclusions: POCT is feasible in routine outpatient clinics but is time-consuming. One in four T2DM attending OPC were anaemic. POCT Hb testing in OPC is feasible and could identify T2DM who need full haematological assessment.<br /

Bayesian Modeling of Dynamic Behavioral Change During an Epidemic

For many infectious disease outbreaks, the at-risk population changes their behavior in response to the outbreak severity, causing the transmission dynamics to change in real-time. Behavioral change is often ignored in epidemic modeling efforts, making these models less useful than they could be. We address this by introducing a novel class of data-driven epidemic models which characterize and accurately estimate behavioral change. Our proposed model allows time-varying transmission to be captured by the level of "alarm" in the population, with alarm specified as a function of the past epidemic trajectory. We investigate the estimability of the population alarm across a wide range of scenarios, applying both parametric functions and non-parametric functions using splines and Gaussian processes. The model is set in the data-augmented Bayesian framework to allow estimation on partially observed epidemic data. The benefit and utility of the proposed approach is illustrated through applications to data from real epidemics.Comment: 20 pages, 10 figure

Challenges of modelling a complex multi-aquifer groundwater system at a national scale: case study from the UK

Modelling of the UK groundwater system, composed of multiple discrete aquifers, is undertaken to help assess water resources at the national scale. This groundwater system is made of the major aquifers that overlie each other in some places but which are nonetheless not in a hydraulic contact, and the minor aquifers formed in the superficial deposits. While the major aquifers are not in the direct contact, they are linked by the river network and may exchange water thanks to the aquifer-river interaction processes. In this paper we present a numerical model of this complex system, which is not as demanding to build and run as a fully distributed multi-layered model. The model represents the three most important UK aquifers: Chalk, Jurassic Limestone, and Permo-Triassic Sandstone as separate layers discretized using square buckets that are connected horizontally. These layers are connected to the river network and receive recharge through the buckets that represent their outcrops. An extra layer is also added to represent the minor and non-aquifers. The model was tested at 37 gauging stations distributed across the country. Good fit to the observations was obtained in the steady state run. Further work will include incorporation of abstractions and additional model refinement to represent spatial heterogeneity