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Hampson D, Crowther J, Bateman I, Kay D, Posen P, Stapleton C, Wyer M, Fezzi C, Jones P, Tzanopoulos J. Predicting microbial pollution concentrations in UK rivers in response to land use change. WATER RESEARCH 2010; 44:4748-4759. [PMID: 20708770 DOI: 10.1016/j.watres.2010.07.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 07/10/2010] [Accepted: 07/20/2010] [Indexed: 05/29/2023]
Abstract
The Water Framework Directive has caused a paradigm shift towards the integrated management of recreational water quality through the development of drainage basin-wide programmes of measures. This has increased the need for a cost-effective diagnostic tool capable of accurately predicting riverine faecal indicator organism (FIO) concentrations. This paper outlines the application of models developed to fulfil this need, which represent the first transferrable generic FIO models to be developed for the UK to incorporate direct measures of key FIO sources (namely human and livestock population data) as predictor variables. We apply a recently developed transfer methodology, which enables the quantification of geometric mean presumptive faecal coliforms and presumptive intestinal enterococci concentrations for base- and high-flow during the summer bathing season in unmonitored UK watercourses, to predict FIO concentrations in the Humber river basin district. Because the FIO models incorporate explanatory variables which allow the effects of policy measures which influence livestock stocking rates to be assessed, we carry out empirical analysis of the differential effects of seven land use management and policy instruments (fiscal constraint, production constraint, cost intervention, area intervention, demand-side constraint, input constraint, and micro-level land use management) all of which can be used to reduce riverine FIO concentrations. This research provides insights into FIO source apportionment, explores a selection of pollution remediation strategies and the spatial differentiation of land use policies which could be implemented to deliver river quality improvements. All of the policy tools we model reduce FIO concentrations in rivers but our research suggests that the installation of streamside fencing in intensive milk producing areas may be the single most effective land management strategy to reduce riverine microbial pollution.
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Chalmers RM, Robinson G, Elwin K, Hadfield SJ, Thomas E, Watkins J, Casemore D, Kay D. Detection of Cryptosporidium species and sources of contamination with Cryptosporidium hominis during a waterborne outbreak in north west Wales. JOURNAL OF WATER AND HEALTH 2010; 8:311-325. [PMID: 20154394 DOI: 10.2166/wh.2009.185] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Accepted: 08/15/2009] [Indexed: 05/28/2023]
Abstract
As part of investigations into the cause of a waterborne outbreak of Cryptosporidium hominis infection linked to a mains water supply, surface waters and wastewater treatment plants were tested for Cryptosporidium spp. Oocyst counts in base flow surface water samples ranged from nil to 29 per 10 l. Oocyst counts in effluent from a community wastewater treatment plant were up to 63 fold higher and breakout from one septic tank five logs higher. There were no peak (storm) flow events during the investigation. C. hominis, four named genotypes (cervine, muskrat II, rat, W19) and six new small subunit ribosomal RNA gene sequences were identified. Four of the new sequences were closely related to Cryptosporidium muskrat genotype I, one was closely related to the fox genotype and one to Cryptosporidium canis. C. hominis was found extensively in the catchment, but only at sites contaminated by wastewater, and in the treated water supply to the affected area. All were gp60 subtype IbA10G2, the outbreak subtype. Multiple routes of contamination of the reservoir were identified, resulting in persistent detection of low numbers of oocysts in the final water. This work demonstrates the utility of genotyping Cryptosporidium isolates in environmental samples during outbreak investigations.
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Dangerfield C, Kay D, Burrage K. Stochastic models and simulation of ion channel dynamics. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.procs.2010.04.178] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Payami H, Kay D, Stevens C, Montimurro J, Hamza T, Zabetian C, Factor S, Higgins D, Moses L, Zareparsi S, Schellenberg G, Nutt J. P2.067 Resolving mode-of-inheritance and association of PRKN with PD in a comprehensive sequence and copy-number-variation (CNV) analysis of 3800 subjects. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70418-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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80
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Kay D, Montimurro J, Schlossmacher M, Bresnick E, Stevens C, Zabetian C, Factor S, Higgins D, Scherzer C, Payami H. P3.039 Polymorphisms in the transcription factor gene GATA2 and GATA-2 target region in a-synuclein (SNCA) are associated with Parkinson's disease (PD). Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70603-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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81
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Stapleton CM, Kay D, Wyer MD, Davies C, Watkins J, Kay C, McDonald AT, Porter J, Gawler A. Evaluating the operational utility of a Bacteroidales quantitative PCR-based MST approach in determining the source of faecal indicator organisms at a UK bathing water. WATER RESEARCH 2009; 43:4888-99. [PMID: 19783026 DOI: 10.1016/j.watres.2009.09.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 08/28/2009] [Accepted: 09/06/2009] [Indexed: 05/11/2023]
Abstract
Microbial source tracking techniques are used in the UK to provide an evidence-base to guide major expenditure decisions and/or regulatory action relating to sewage disposal. Consequently, it is imperative that the techniques used robustly index faecal indicator organisms (FIOs) that are the regulatory parameters for bathing and shellfish harvesting areas. This study reports a 'field-scale' test of microbial source tracking (MST) based on the quantitative PCR analyses of Bacteroidales 16S rRNA genetic marker sequences. The project acquired data to test the operational utility of quantitative Bacteroidales MST data, comparing it with FIO concentrations in streams, effluents and bathing waters. Overall, the data did not exhibit a consistent pattern of significant correlations between Bacteroidales MST parameters and FIOs within the different sample matrices (i.e. rivers, bathing waters and/or effluents). Consequently, there was little evidence from this study that reported concentrations and/or percentages of human and/or ruminant faecal loadings (that are based on Bacteroidales MST gene copy numbers) offer a credible evidence-base describing FIO contributions to receiving water 'non-compliance'. The study also showed (i) there was no significant attenuation of the Bacteroidales gene copy number 'signal' through the UV disinfection process; and (ii) single non-compliant samples submitted for Bacteroidales MST analysis, do not reliably characterise the balance of faecal loadings due to the high variability in the MST signal observed. At this stage in the development of the MST tool deployed, it would be imprudent to use the percentage human and/or ruminant contributions (i.e. as indicated by MST data acquired at a bathing water) as the sole or principal element in the evidence-base used to guide major expenditure decisions and/or regulatory action.
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Bebbington D, Binch H, Charrier JD, Everitt S, Fraysse D, Golec J, Kay D, Knegtel R, Mak C, Mazzei F, Miller A, Mortimore M, O’Donnell M, Patel S, Pierard F, Pinder J, Pollard J, Ramaya S, Robinson D, Rutherford A, Studley J, Westcott J. The discovery of the potent aurora inhibitor MK-0457 (VX-680). Bioorg Med Chem Lett 2009; 19:3586-92. [DOI: 10.1016/j.bmcl.2009.04.136] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 04/24/2009] [Accepted: 04/27/2009] [Indexed: 11/28/2022]
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83
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Lee J, Niederer S, Nordsletten D, Le Grice I, Smaill B, Kay D, Smith N. Coupling contraction, excitation, ventricular and coronary blood flow across scale and physics in the heart. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2009; 367:2311-2331. [PMID: 19414457 DOI: 10.1098/rsta.2008.0311] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In this study, we review the development and application of multi-physics and multi-scale coupling in the construction of whole-heart physiological models. Through an examination of recent computational modelling developments, we analyse the significance of coupling mechanisms for the increased understanding of cardiac function in the areas of excitation-contraction, coronary blood flow and ventricular fluid mechanical coupling. Within these physiological domains, we demonstrate and discuss the importance of model parametrization, imaging-based model anatomy and computational implementation.
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Kay D, Falconer R. Hydro-epidemiology: the emergence of a research agenda. ENVIRONMENTAL FLUID MECHANICS (DORDRECHT, NETHERLANDS : 2001) 2008; 8:451-459. [PMID: 32214917 PMCID: PMC7087672 DOI: 10.1007/s10652-008-9096-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 08/21/2008] [Indexed: 06/10/2023]
Abstract
There is a growing international awareness of the health risks associated with water, and particularly in developing countries. For example: (i) a child dies in Africa every 30s due to malaria-a disease related to stagnant water, (ii) every year flooding causes many deaths world-wide, with infant mortality due to diarrhea from contaminated flood waters posing the biggest threat, and (iii) poor sanitation and its relation to hepatitis A continues to be a serious problem. A revealing measure of the extent of such global problems is that more than half of the hospital beds in the world today are occupied by people with water-related diseases. Addressing these issues mandates an interdisciplinary approach by the world's scientific and engineering community. In this spirit a workshop was held in Phoenix to provide a forum where epidemiologists, hydraulics researchers and other stakeholders of varied backgrounds (e.g., policy makers, environmental groups etc.) could all participate in a debate on a future agenda for hydro-epidemiology. The principal outcome of the workshop was a significant appreciation of the potential for interdisciplinary research and development in hydro-epidemiology and the major contribution that hydraulics professionals could offer, in partnership with the public health community, in addressing such water related disease control and prevention challenges.
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Bak R, Tumu P, Hui C, Kay D, Peng D. A review of delusions of parasitosis, part 2: treatment options. Cutis 2008; 82:257-264. [PMID: 19055169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Delusions of parasitosis (DOP), a psychiatric disorder in which patients erroneously insist that they are infested with parasites, remains a treatment problem for dermatologists. Generally, these patients are resistant to psychiatric referral and treatment with psychotropic medications. We discuss treatment options and management recommendations. Pimozide, along with judicious patient communication, remains the treatment of choice for DOP.
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Bak R, Tumu P, Hui C, Kay D, Burnett J, Peng D. A review of delusions of parasitosis, part 1: presentation and diagnosis. Cutis 2008; 82:123-130. [PMID: 18792544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Delusions of parasitosis (DOP), a psychiatric disorder in which patients erroneously insist that they are infested with parasites, remains a fascinating entity with elusive origins. Typically, these patients are resistant to psychiatric referral and treatment with psychotropic medications. We discuss the classification, epidemiology, clinical presentation, etiology, associated features, and differential diagnosis of this disorder. The authors reviewed case reports and clinical trials and tabulated the epidemiologic data, which show DOP is more common than previously thought.
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Edwards AC, Kay D, McDonald AT, Francis C, Watkins J, Wilkinson JR, Wyer MD. Farmyards, an overlooked source for highly contaminated runoff. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2008; 87:551-559. [PMID: 18179860 DOI: 10.1016/j.jenvman.2006.06.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2006] [Revised: 06/19/2006] [Accepted: 06/24/2006] [Indexed: 05/25/2023]
Abstract
Summer sampling of storm runoff generated from areas of roofs and hardstanding situated on four dairy/beef farms has provided novel information regarding its microbiological and chemical quality. All farm hardstandings generated runoff that was contaminated with respect to those pollutants (faecal coliforms, FC, and faecal streptococci, FS, major nutrients, organic carbon) that are ubiquitously associated with faecal matter and urine. The separate analysis of roof runoff indicated that these can contribute significant concentrations of FS, phosphorus (P) and potentially toxic elements such as zinc (Zn), and suggests a level of 'background' contamination originating from wash-off of bird droppings and in the case of Zn galvanised surfaces. On average hardstanding runoff showed enhanced concentrations of >4 orders of magnitude for FC and 2-3 for major nutrients and carbon relative to roof runoff. Organic forms of nitrogen (N) and P contributed significantly (averaging >40%) to the total dissolved fraction in both roof and hardstanding runoff. Part of the substantial variability in composition of runoff samples could be attributed to differences between farms as well as the timing of sample collection during individual storms. Where situations allowed, a comparison of water upstream and downstream of the farmyard demonstrated they acted as a source of multiple contaminants not only during hydrologically active storm events but also during dry periods. Contamination pathways included a combination of both point (e.g., septic overflows) and non-point (e.g., seepage from livestock housing) sources. Farmyards situated within intensive livestock farming areas such as SW Scotland, would be expected to have significant local and accumulated downstream impacts on the aquatic environment. Localised impacts would be particularly important for headwaters and low order streams.
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Kay D, Kershaw S, Lee R, Wyer MD, Watkins J, Francis C. Results of field investigations into the impact of intermittent sewage discharges on the microbiological quality of wild mussels (Mytilus edulis) in a tidal estuary. WATER RESEARCH 2008; 42:3033-3046. [PMID: 18490045 DOI: 10.1016/j.watres.2008.03.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Revised: 03/03/2008] [Accepted: 03/25/2008] [Indexed: 05/26/2023]
Abstract
Field surveys were designed to examine the effects of sewage contamination from storm overflow effluent on faecal coliform and Escherichia coli concentrations in the flesh of wild mussels (Mytilus edulis). Bags containing 30 mussels each were fixed at known inter-tidal locations and retrieved at intervals following discharge from a nearby combined sewer overflow (CSO). Concentrations of faecal coliform bacteria and E. coli were measured in the shellfish flesh and in samples of overlying water prior to collection of the mussel samples. Faecal coliform and E. coli concentrations in shellfish increased rapidly after CSO discharge. E. coli concentrations exceeded the European shellfish hygiene class C limit of 46,000 100g(-1), and decayed during subsequent CSO discharge-free periods. The concentration and depuration response was independent of the magnitude of CSO spill volume. First-order exponential decay functions were fitted to the data. Decay rates were lower than those found in corresponding microcosm experiments. This relates to the repeated pattern of inundation and exposure associated with the tidal cycles in the estuary. Relationships between E. coli and faecal coliform concentrations in the shellfish and overlying water samples were relatively weak (r<0.60), a pattern often seen with data from uncontrolled environmental experiments.
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Stapleton CM, Wyer MD, Crowther J, McDonald AT, Kay D, Greaves J, Wither A, Watkins J, Francis C, Humphrey N, Bradford M. Quantitative catchment profiling to apportion faecal indicator organism budgets for the Ribble system, the UK's sentinel drainage basin for Water Framework Directive research. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2008; 87:535-550. [PMID: 18082929 DOI: 10.1016/j.jenvman.2006.11.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Revised: 10/26/2006] [Accepted: 11/01/2006] [Indexed: 05/25/2023]
Abstract
Under the EU Water Framework Directive (WFD) 20/60/EC and the US Federal Water Pollution Control Act 2002 management of water quality within river drainage basins has shifted from traditional point-source control to a holistic approach whereby the overall contribution of point and diffuse sources of pollutants has to be considered. Consequently, there is a requirement to undertake source-apportionment studies of pollutant fluxes within catchments. The inclusion of the Bathing Water Directive (BWD), under the list of 'protected areas' in the WFD places a requirement to control sources of faecal indicator organisms within catchments in order to achieve the objectives of both the BWD (and its revision - 2006/7/EC) and the WFD. This study was therefore initiated to quantify catchment-derived fluxes of faecal indicator compliance parameters originating from both point and diffuse sources. The Ribble drainage basin is the single UK sentinel WFD research catchment and discharges to the south of the Fylde coast, which includes a number of high profile, historically non-compliant, bathing waters. Faecal indicator concentrations (faecal coliform concentrations are reported herein) were measured at 41 riverine locations, the 15 largest wastewater treatment works (WwTWs) and 15 combined sewer overflows (CSOs) across the Ribble basin over a 44-day period during the 2002 bathing season. The sampling programme included targeting rainfall-induced high flow events and sample results were categorised as either base flow or high flow. At the riverine sites, geometric mean faecal coliform concentrations showed statistically significant elevation at high flow compared to base flow. The resultant faecal coliform flux estimates revealed that over 90% of the total organism load to the Ribble Estuary was discharged by sewage related sources during high flow events. These sewage sources were largely related to the urban areas to the south and east of the Ribble basin, with over half the load associated with the relatively small subcatchment of the River Douglas. The majority of this load was attributed to two WwTWs that discharge through a common outfall close to the tidal limit of this catchment. Budgets adjusted to accommodate the impact of proposed UV disinfection of these effluents showed that the load from these sources would be reduced significantly during base flow conditions. However, during high flow events loads would still remain high due to the operation of storm sewage overflows from stormwater retention tanks. The study identified untreated storm sewage spills from urban infrastructure and WwTW stormwater retention tanks as the dominant component of the high flow flux of faecal indicators to receiving waters of the Fylde coast and the associated bathing waters.
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McDonald AT, McDonald ADJ, Kay D, Watkins J. Characteristics and significance of liquid effluent from woodchip corrals in Scotland. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2008; 87:582-590. [PMID: 18096300 DOI: 10.1016/j.jenvman.2007.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 03/30/2007] [Accepted: 04/10/2007] [Indexed: 05/25/2023]
Abstract
Woodchip corrals are increasingly used as cost effective means of over-wintering livestock in temperate regions but there is little information on their potential environmental impact. Four woodchip corrals of varying characteristics were instrumented to capture and quantify the flows reaching the base, where pollutant fluxes may move either vertically to groundwater, or laterally to a water course. Samples for chemical analysis were collected daily by auto-sampler. Samples for bacterial analysis were aseptically hand-sampled. Sampling frequency was increased during high flow events and sampling was conducted over a 12-month period. Microbiological samples were analysed for total coliform (TC), presumptive Escherichia coli (EC) and intestinal enterococci (IE). Leachate was also analysed for total phosphorus, phosphate, total nitrogen, ammonium, total oxidised nitrogen, nitrite and nitrate. Each corral had a recording rain gauge sited within 10 m of the corral surface. Mean total nitrogen concentration in leachate was 339.5 mg l(-1), of which ammoniacal-N comprised approximately 57%. Mean total phosphorus concentration was 94.7 mg l(-1). Geometric mean concentrations of TC, EC and IE were 95,461, 94,983 and 55,552 cfu100 ml(-1), respectively. Significant flows of leachate occurred at the base of the corrals on most days during the 1-year sampling period and flow rate increased with stocking density. Strong positive linear relationships were found between the concentrations of the nutrient parameters and discharge. Strong positive curvilinear relations were found between faecal indicator concentrations and discharge. Different relationships were observed in the stocked and unstocked corrals. The resulting fluxes are sufficient to give concern and to indicate that corral development is worthy of regulatory attention.
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Kay D, Crowther J, Stapleton CM, Wyer MD, Fewtrell L, Anthony S, Bradford M, Edwards A, Francis CA, Hopkins M, Kay C, McDonald AT, Watkins J, Wilkinson J. Faecal indicator organism concentrations and catchment export coefficients in the UK. WATER RESEARCH 2008; 42:2649-2661. [PMID: 18295819 DOI: 10.1016/j.watres.2008.01.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Revised: 01/02/2008] [Accepted: 01/17/2008] [Indexed: 05/25/2023]
Abstract
Characterisation of faecal indicator organism (FIO) concentrations and export coefficients for catchments with particular combinations of land use and under specific climatic regimes is critical in developing models to predict daily loads and apportion sources of the microbial parameters used to regulate water quality. Accordingly, this paper presents a synthesis of FIO concentration and export coefficient data for the summer bathing season, with some comparative winter data, for 205 river/stream sampling points widely distributed across mainland UK. In terms of both geometric mean (GM) FIO concentrations and export coefficients (expressed as cfu km(-2) h(-1)), the results reveal (1) statistically significant elevations at high flow compared with base flow, with concentrations typically increasing by more than an order of magnitude and export coefficients by about two orders; (2) significantly higher values in summer than in winter under high-flow conditions; and (3) extremely wide variability between the catchments (e.g. four orders of magnitude range for GM faecal coliform concentrations), which closely reflects land use-with urban areas and improved pastures identified as key FIO sources. Generally, these two most polluting land uses are concentrated in lowland areas where runoff (m3 km(-2) h(-1)) is low compared with upland areas, which in the UK are dominated by rough grazing and forestry. Consequently, contrasts in export coefficients between land use types are less than for FIO concentrations. The GMs reported for most land use categories are based on 13 sites and exhibit quite narrow confidence intervals. They may therefore be applied with some confidence to other catchments in the UK and similar geographical regions elsewhere. Examples are presented to illustrate how the results can be used to estimate daily summer base- and high-flow FIO loads for catchments with different land use types, and to assess the likely effectiveness of certain strategies for reducing FIO pollutant loadings in areas with extensive areas of lowland improved pasture.
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Fewtrell L, Kay D. An attempt to quantify the health impacts of flooding in the UK using an urban case study. Public Health 2008; 122:446-51. [PMID: 18222511 DOI: 10.1016/j.puhe.2007.09.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Revised: 08/14/2007] [Accepted: 09/26/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To quantify, so far as possible, the health effects of flooding in the UK to allow comparison between different flooding events. METHODS The health effects resulting from flooding events were determined through an extensive literature search, where information existed to enable the quantification of these effects. Disability-adjusted life years (DALYs) were used to enable the comparison between different health impacts and different flood events and populations, using two sites subject to pluvial flooding in the Bradford area, UK. RESULTS Relatively few properties (and hence people) were affected by flooding in the case study areas and there were no predicted deaths or serious injuries; these results were supported by anecdotal knowledge of the events. Mental health problems, characterized as psychological distress, were estimated for adults; these were found to dominate the calculated health impacts, being considerably greater than the combined physical symptoms in the case study examples. CONCLUSIONS While it was not possible to quantify every flood-related health impact, this method does allow comparisons to be made between different flood events and mitigation strategies.
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Cannon J, Kay D, Tarpenning KM, Marino FE. Reproducibility and changes in twitch properties associated with age and resistance training in young and elderly women. Scand J Med Sci Sports 2008; 18:627-35. [DOI: 10.1111/j.1600-0838.2007.00709.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kay D, Crowther J, Stapleton CM, Wyer MD, Fewtrell L, Edwards A, Francis CA, McDonald AT, Watkins J, Wilkinson J. Faecal indicator organism concentrations in sewage and treated effluents. WATER RESEARCH 2008; 42:442-54. [PMID: 17709126 DOI: 10.1016/j.watres.2007.07.036] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Revised: 06/25/2007] [Accepted: 07/23/2007] [Indexed: 05/16/2023]
Abstract
The importance of faecal indicator organism (FIO) fluxes within drainage basins is increasing as the European Union (EU) Water Framework Directive and the United States Clean Water Act place requirements on regulators to manage point and diffuse sources of microbial pollution causing non-compliance (EU) or impairment (US) of receiving waters. Central to this management task is knowledge of the likely FIO concentrations in raw sewage and treated effluents, but few empirical data have been published in the peer-reviewed literature. Accordingly, this paper presents results for 1933 samples from 162 different sewage discharge sites in the UK and Jersey, which encompass 12 types of sewage-related discharge, representative of untreated sewage and primary-, secondary- and tertiary-treated effluents. Geometric means (GMs) and 95% confidence intervals (CIs) have been used to characterise base- and high-flow FIO concentrations. The data sets and sub-sets are mostly quite large (n 40) and may therefore be applied with some confidence to comparable discharge sites in similar geographical regions. Very marked, statistically significant reductions in GM FIO concentrations result from secondary and tertiary treatment, and there are statistically significant differences between some secondary and some tertiary treatments. Flow conditions are also shown to be important: untreated sewage and effluent from primary treatment plant have lower concentrations at high flow, due to dilution within combined sewerage systems, whereas some treated effluents (e.g. from activated sludge plant) have higher concentrations at high flow because of the shorter residence time within the plant. Under base-flow conditions, secondary treatments result in estimated GM FIO reductions of 95.22-99.29% (cf. primary-treated effluent). Corresponding figures for tertiary treatment plants (cf. secondary-treated effluent) are 93.24-96.59% for reedbed/grass plots and 99.71-99.92% for UV disinfection. Results suggest that secondary and tertiary treatment plants are less effective under high-flow conditions, but further high-flow sampling is required to confirm this.
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Kay D, Watkins J, Francis CA, Wyn-Jones AP, Stapleton CM, Fewtrell L, Wyer MD, Drury D. The microbiological quality of seven large commercial private water supplies in the United Kingdom. JOURNAL OF WATER AND HEALTH 2007; 5:523-38. [PMID: 17878565 DOI: 10.2166/wh.2007.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Some 1% of the UK population derives their potable water from 140,000 private water supplies (PWSs) regulated by Local Authorities. The overwhelming majority of these are very small domestic supplies serving a single property or a small number of properties. Treatment for such supplies is rudimentary or non-existent and their microbiological quality has been shown to be poor in every published study to date. Private water supplies serving commercial enterprises such as hotels, restaurants, food production premises and factories are more frequently treated and subject to closer regulation in the United Kingdom. As a result, it has been assumed that these larger commercial supplies are less likely to experience elevated faecal indicator and pathogen concentrations at the consumer tap which have been observed at small domestic supplies.This paper reports on intensive monitoring at seven commercial private water supplies (six of which were treated) spread throughout the UK serving hotels, holiday parks and food production enterprises. Daily sampling of 'potable' water, both at the consumer tap and using large volume filtration for Giardia and Cryptosporidium spp. was conducted over two six week periods in the spring and autumn of 2000. This allowed the effects of short term episodic peaks in faecal indicator and pathogen concentration to be quantified. All the supplies experienced intermittent pathogen presence and only one, a chlorinated deep borehole supply, fully complied with UK water quality regulations during both periods of sampling.Poor microbiological water quality typically followed periods of heavy rainfall. This suggests that the design and installation of such systems should be undertaken only after the likely range of raw water quality has been characterised, which requires a thorough understanding of the effects of flow and seasonality on raw water quality. There is no reason to suspect that the monitored sites are uncharacteristic of other commercial supplies and the results reinforce public health concerns related to domestic supplies. Furthermore, the pattern of contamination is highly episodic, commonly lasting only a few days. Thus, the relatively infrequent regulatory monitoring of such supplies would be unlikely to identify the poor water quality episodes and does not provide the data necessary for public health protection. Although some statistical relationship was found between faecal indicator organisms and the presence of pathogens, the use of FIOs in assessments of regulatory compliance may not always provide a reliable measure of public health risk, i.e. indicator absence does not preclude pathogen presence. The results of this study suggest that a risk assessment system similar to the WHO 'Water Safety Planning' approach might offer a more appropriate regulatory paradigm for private water supplies.
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Woloschuk W, Gorsche R, Kay D, Hnatuik J, Kohlhammer M, Betzner M. General emergency medicine skills (GEMS) training for rural physicians: evaluation of a pilot project. CAHIERS DE SOCIOLOGIE ET DE DEMOGRAPHIE MEDICALES 2007; 47:491-510. [PMID: 18251461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The objective of GEMS (General Emergency Medicine Skills) is to deliver an emergency skills program relevant to rural physicians. The cognitive component was disseminated by four interactive CD-ROM modules while the practice component consisted of skill practice on a human patient simulator (HPS) at a rural hospital. During the pilot year, 16 participants completed the program and filled in an evaluation survey to collect participant feedback. Modules facilitated maintenance of current knowledge, new knowledge acquisition, and confidence in dealing with emergencies. The HPS reinforced module knowledge, allowed practice of skills, and was necessary to fully benefit from the modules. The application process was easy and program administration was good. GEMS positively affected participants' delivery of emergency medicine and their willingness to continue the practice of rural emergency medicine. GEMS provides rural physicians relevant, interactive skills training at a rural setting.
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Kay D, Aitken M, Crowther J, Dickson I, Edwards AC, Francis C, Hopkins M, Jeffrey W, Kay C, McDonald AT, McDonald D, Stapleton CM, Watkins J, Wilkinson J, Wyer MD. Reducing fluxes of faecal indicator compliance parameters to bathing waters from diffuse agricultural sources: the Brighouse Bay study, Scotland. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2007; 147:138-49. [PMID: 17055631 DOI: 10.1016/j.envpol.2006.08.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2006] [Accepted: 08/10/2006] [Indexed: 05/09/2023]
Abstract
The European Water Framework Directive requires the integrated management of point and diffuse pollution to achieve 'good' water quality in 'protected areas'. These include bathing waters, which are regulated using faecal indicator organisms as compliance parameters. Thus, for the first time, European regulators are faced with the control of faecal indicator fluxes from agricultural sources where these impact on bathing water compliance locations. Concurrently, reforms to the European Union (EU) Common Agricultural Policy offer scope for supporting on-farm measures producing environmental benefits through the new 'single farm payments' and the concept of 'cross-compliance'. This paper reports the first UK study involving remedial measures, principally stream bank fencing, designed to reduce faecal indicator fluxes at the catchment scale. Considerable reduction in faecal indicator flux was observed, but this was insufficient to ensure bathing water compliance with either Directive 76/160/EEC standards or new health-evidence-based criteria proposed by WHO and the European Commission.
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Abstract
Since the mid-19th century central Europe had been the cradle of conceptual thinking in clinical psychiatry. Following the turbulence and persecution in the 1920s and 1930s some of a later generation of mid-European psychiatrists emigrated to Britain, bringing with them the traditions of meticulous and detailed observation, a broad clinical perspective and fresh ways of looking at problems. Among those individuals making significant contributions were Willy Mayer-Gross, Erich Guttman, Erwin Stengel, Felix Post, F. Kraupl Taylor, Max Hamilton and Martin Roth. Roth, who was born in Budapest in 1917, the last survivor of this extraordinarily gifted group, died on 26 September 2006 at the age of 88.
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D'Arcy BJ, McLean N, Heal KV, Kay D. Riparian wetlands for enhancing the self-purification capacity of streams. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2007; 56:49-57. [PMID: 17710999 DOI: 10.2166/wst.2007.435] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Best Management Practices (BMPs) are increasingly used to restore river water quality but design guidance is limited. An alternative approach to remediating diffuse pollution loads is to identify the most polluting high flows from pollutographs and hydrographs and spill these flows into riparian treatment wetlands for treatment before drainage back into the watercourse. The approach is demonstrated for two contrasting catchments in Scotland impacted by diffuse pollution. The Caw Burn receives industrial estate drainage with high suspended solids, hydrocarbons, BOD and ammoniacal-nitrogen concentrations. Applying the proposed design criteria demonstrated that the existing retrofit BMP system at the site is undersized (4950 m2) compared to the required wetland area (11,800 m2), but accommodating the additional area is likely to be expensive. The second case-study is Brighouse Bay where bathing waters are impacted by faecal indicator organisms derived primarily from livestock runoff. In this catchment the riparian wetland area required to retain runoff so that E. coli bacteria would die-off to concentrations below bathing water standards was estimated to be 3-6ha (0.5-1% of catchment area). Further refinement and testing of the design approach is required, including consideration of other factors such as vegetation type, ownership and maintenance, to develop a more holistic approach to river restoration.
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Stapleton CM, Wyer MD, Kay D, Crowther J, McDonald AT, Walters M, Gawler A, Hindle T. Microbial source tracking: a forensic technique for microbial source identification? ACTA ACUST UNITED AC 2007; 9:427-39. [PMID: 17492088 DOI: 10.1039/b617059e] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
As the requirements of the Water Framework Directive (WFD) and the US Clean Water Act (USCWA) for the maintenance of microbiological water quality in 'protected areas' highlight, there is a growing recognition that integrated management of point and diffuse sources of microbial pollution is essential. New information on catchment microbial dynamics and, in particular, the sources of faecal indicator bacteria found in bathing and shellfish harvesting waters is a pre-requisite for the design of any 'programme of measures' at the drainage basin scale to secure and maintain compliance with existing and new health-based microbiological standards. This paper reports on a catchment-scale microbial source tracking (MST) study in the Leven Estuary drainage basin, northwest England, an area for which quantitative faecal indicator source apportionment empirical data and land use information were also collected. Since previous MST studies have been based on laboratory trials using 'manufactured' samples or analyses of spot environmental samples without the contextual microbial flux data (under high and low flow conditions) and source information, such background data are needed to evaluate the utility of MST in USCWA total maximum daily load (TMDL) assessments or WFD 'Programmes of Measures'. Thus, the operational utility of MST remains in some doubt. The results of this investigation, using genotyping of Bacteroidetes using polymerase chain reaction (PCR) and male-specific ribonucleic acid coliphage (F + RNA coliphage) using hybridisation, suggest some discrimination is possible between livestock- and human-derived faecal indicator concentrations but, in inter-grade areas, the degree to which the tracer picture reflected the land use pattern and probable faecal indicator loading were less distinct. Interestingly, the MST data was more reliable on high flow samples when much of the faecal indicator flux from catchment systems occurs. Whilst a useful supplementary tool, the MST information did not provide quantitative source apportionment for the study catchment. Thus, it could not replace detailed empirical measurement of microbial flux at key catchment outlets to underpin faecal indicator source apportionment. Therefore, the MST techniques reported herein currently may not meet the standards required to be a useful forensic tool, although continued development of the methods and further catchment scale studies could increase confidence in such methods for future application.
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