Predictors of fuel poverty and the equity of local fuel poverty support: secondary analysis of data from Bradford, England

AIMS

Addressing fuel poverty is a critical public health issue given its recent rise in prevalence across Europe. Although previous research identifies national risk markers of fuel poverty, evidence is lacking on whether these are consistent across local geographies, and the equity of local interventions. In the UK's current economic climate, it is more crucial than ever that services benefit households in greatest need. This study aimed to determine significant predictors of fuel poverty among households in Bradford, England, comparing them to national-level predictors, and evaluate if households possessing significant fuel poverty predictors were equitably referred to a local fuel poverty service (Warm Homes Healthy People, WHHP).

METHODS

A multivariate logistic regression model determined significant fuel poverty predictors in Bradford using household-level data from the Energy Saving Trust and the Low Income High Costs fuel poverty definition. Statistical testing highlighted significant differences in predictors of fuel poverty between households referred to WHHP and all Bradford households.

RESULTS

Significant (p < .05) predictors of fuel poverty included: living in an area with lower average household incomes and higher proportion of ethnic minority individuals, and living in a property with a lower energy efficiency rating. Households living in a detached or older property, and homeowners were more likely to be fuel poor. Differences in the direction of the relationship with fuel poverty were identified between some national and local predictors. Most predictors were significantly (p < .05) overrepresented among WHHP households, suggesting equitable service reach. Ethnic minorities, younger people, and multiperson households were underrepresented.

CONCLUSIONS

Local fuel poverty predictors were similar to many national-level predictors, but identified differences in the direction of the relationship between some national and local predictors reaffirm the value of locally focused research. WHHP successfully targeted households possessing key predictors, but should ensure that ethnic minorities, younger people, and multiperson households are equitably referred.

Gender Equality Training for Students in Higher Education: Protocol for a Scoping Review

BACKGROUND

The principles of gender equality are integral to the goals, targets, and indicators of all sustainable development goals. Higher education institutes can be powerful agents for promoting gender equality, diversity, and inclusion not only in the higher education context but also in society as a whole. To address and overcome gender inequality in the higher education environment, experts posit that change needs to occur from day 1 of the student's academic experience. To this end, training is required. A preliminary review of the literature indicates that multiple gender equality-based training programs or initiatives for students have been designed and evaluated in second and third-level education settings. Examples of educational activities undertaken include delivery of didactic teaching, participation in a face-to-face collaboration project, site visits, case studies, and coaching. Yet, our initial search indicated that, to date, a comprehensive review collating the available evidence on gender equality training for third-level students has not yet been carried out.

OBJECTIVE

Our review seeks to identify and explore the existing literature on gender equality training interventions for third-level students, with a particular emphasis on training content, methodology, and outcome evaluation.

METHODS

This scoping review will be structured using the Arskey and O'Malley's 5-stage framework and will consider empirical research and other relevant published works that address gender equality training. Systematic searches will be carried out in 6 research databases and the gray literature using key search terms. Inclusion and exclusion criteria have been defined, and a data charting tool created to methodically extract information from selected literature. The free web software Rayyan will be used for primary screening where each reference will be screened in duplicate first by title, then abstract, and finally by full text.

RESULTS

This review forms part of the LIBRA (Balance) study and has received peer-reviewed grant funding from the Irish Higher Education Authority. LIBRA aims to use simulation-based education to develop a gender equality leadership training program for student leaders in higher education. The findings will be summarized in tabular form, and a narrative synthesis produced to inform curriculum development.

CONCLUSIONS

This review seeks to inform curriculum design by reporting on the gender equality-enabling skills and leadership skills necessary to foster gender equality. This paper should inform recommendations for training and catalyze future research in this rapidly evolving area.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/44584.

Seasonal consumption of terrestrial prey by a threatened stream fish is influenced by riparian vegetation

The consumption of terrestrial prey by fishes highlights the functional value of terrestrial habitats, but such consumption is not well documented for many small-bodied species. We determined the diet and consumption of terrestrial prey by a threatened fish, silver shiner Notropis photogenis, using stomach content and stable isotope analyses to better understand the functional role of riparian habitat for the species. Results indicate silver shiner is a generalist drift feeder that consumes a wide range of aquatic and terrestrial prey. Both stomach content and stable isotope analyses indicated that terrestrial prey was commonly exploited and that terrestrial prey consumption was both seasonally and spatially variable. Based on stomach contents, the contribution of terrestrial prey was (average ± SD) 41.53 ± 32.35% in fall and 20.45 ± 20.45% in summer; based on stable isotopes it was 35.24 ± 4.41% in fall and 39.88 ± 12.34% in summer. During fall, when bankside terrestrial invertebrates were more abundant, silver shiner stomachs contained significantly more terrestrial prey in reaches where riparian vegetation cover was highest, indicating that intact riparian cover may facilitate access to high-quality prey. The consumption of terrestrial prey may be particularly important in fall, as it may promote increased growth and survival leading to more successful overwintering. Our findings suggest that terrestrial subsidies are ecologically valuable for silver shiner and that the protection of reaches with intact riparian habitats would likely improve conservation and recovery efforts by helping ensure access to key prey resources.

Occurrence of Salmonella enterica in grey-headed flying foxes from New South Wales

Salmonella enterica and Campylobacter jejuni are significant foodborne zoonotic pathogens causing gastroenteritis in humans. Domestic animals are commonly implicated as reservoirs of S. enterica and C. jejuni, but both are also detected in wild animals. Salmonella enterica serovar Typhimurium is the most common cause of human salmonellosis in Australia; however, Salmonella enterica serovar Wangata is associated with sporadic human outbreaks in New South Wales and wild animals may be a potential reservoir. To determine if wild grey-headed flying foxes (GHFF; Pteropus poliocephalus) are reservoirs of Salmonella and Campylobacter, faecal samples were collected from three GHFF colonies in New South Wales and cultured for the presence of Salmonella and Campylobacter. One Salmonella isolate was cultured from 254 GHFF faecal samples (0.39%). Whole genome sequencing was used to genetically characterise the Salmonella isolate and perform phylogenetic analysis. The GHFF isolate was determined to be Salmonella Typhimurium ST19. The GHFF isolate carried a virulence plasmid and other virulence factors, but did not exhibit antimicrobial resistance. Phylogenetic analysis determined that the GHFF isolate was most closely related to a cluster of six isolates: four from human salmonellosis cases in Queensland and two from Australian livestock. Neither Campylobacter nor Salmonella Wangata were cultured from the 254 GHFF faecal samples. This study concluded that wild GHFF in New South Wales are not major reservoirs for Salmonella, and the zoonotic risks associated with S. enterica carriage by urban GHFF are low for the general public.

Field-based oxygen isotope fractionation for the conservation of imperilled fishes: an application with the threatened silver shiner Notropis photogenis

Identifying the realized thermal habitat of animals is important for understanding life history and population processes, yet methods to estimate realized thermal use are lacking for many small-bodied organisms, including imperilled fishes. Analysis of oxygen isotopes provides one solution, but requires the development of species-specific fractionation equations. To date, such equations have generally been limited to commercial or game fish species. Here, we developed a field-based fractionation equation for the threatened silver shiner Notropis photogenis to better understand the thermal ecology of the species in an urban watershed. Archived otoliths were analyzed for oxygen isotope values (δ18O). There was a significant linear relationship between otolith isotope fractionation and water temperature, described by δ18Ootolith(VPBD) - δ18Owater(VPBD) = 32.03 - 0.21(°C). Results indicate that otolith isotope techniques can be used to identify the average relative temperature occupied by silver shiner, representing the first investigation of oxygen isotopes to understand thermal occupancy of the species. This field-based equation provides an opportunity to understand how silver shiner may respond to alterations in stream temperatures resulting from urbanization and climate effects and may be useful in identifying thermal refugia for the species. Field-based, species-specific fractionation equations can provide insights into the thermal ecology of many small-bodied fishes, which are increasingly imperilled due to thermal stressors.

Reproductive Microbiomes in Wild Animal Species: A New Dimension in Conservation Biology

Communities of microbes have coevolved in animal organisms and are found in almost every part of the body. Compositions of those communities (microbiota) as well as their genomes and genes (microbiomes) are critical for functional regulations of the body organ systems-the digestive or 'gut' microbiome being the most described so far. Based on extensive research in humans, microbiomes in the reproductive tract may play a role in reproductive functions and pregnancy. However, in wild animal species, those microbiomes have been poorly studied, and as a result, little is known about their involvement in fertility or parental/offspring health. This emerging research area is highly relevant to conservation biology from captive breeding management to successful reintroduction or maintenance of wild populations. The objective of this chapter is to review current knowledge about reproductive microbiomes in healthy wild animal species. While recognizing the current technical limits of microbial identification in all animal species, we also explore the link between microbial communities (within female or male reproductive systems) and fertility, from conception to birth outcome. In addition, it is critical to understanding how reproductive microbiomes are affected by environmental factors (including captivity, contact with other individuals, or changes in the ecosystem) to optimize conservation efforts. Thus, reproductive microbiomes represent a novel dimension in conservation biology that will likely gain importance in the future.

Tests of size and growth effects on Arctic charr (Salvelinus alpinus) otolith δ18 O and δ13 C values

RATIONALE

Otolith δ¹⁸ O and δ¹³ C values have been used extensively to reconstruct thermal and diet histories. Researchers have suggested that individual growth rate and size may have an effect on otolith isotope ratios and subsequently confound otolith-based thermal and diet reconstructions. As few explicit tests of the effect on fish in freshwater environments exist, here we determine experimentally the potential for related growth rate and size effects on otolith δ¹⁸ O and δ¹³ C values.

METHODS

Fifty Arctic charr were raised in identical conditions for two years after which their otoliths were removed and analyzed for their δ¹⁸ O and δ¹³ C values. The potential effects of final length and the Thermal Growth Coefficient (TGC) on otolith isotope ratios were tested using correlation and regression analysis to determine if significant effects were present and to quantify effects when present.

RESULTS

The analyses indicated that TGC and size had significant and similar positive non-linear relationships with δ¹³ C values and explained 35% and 42% of the variability, respectively. Conversely, both TGC and size were found to have no significant correlation with otolith δ¹⁸ O values. There was no significant correlation between δ¹⁸ O and δ¹³ C values.

CONCLUSIONS

The investigation indicated the presence of linked growth rate and size effects on otolith δ¹³ C values, the nature of which requires further study. Otolith δ¹⁸ O values were unaffected by individual growth rate and size, confirming the applicability of these values to thermal reconstructions of fish habitat.

Evaluating a neonatal intensive care unit MRSA surveillance programme using agent-based network modelling

BACKGROUND

Surveillance for meticillin-resistant Staphylococcus aureus (MRSA) in neonatal intensive care units (NICUs) is a commonplace infection prevention strategy, yet the optimal frequency with which to monitor the unit is unknown.

AIM

To compare various surveillance frequencies using simulation modelling.

METHODS

One hundred NICU networks of 52 infants were simulated over a six-month period to assess MRSA transmission. Unit-wide surveillance occurred every N weeks where N={1,2,3,4}, and was compared with the current NICU policy of dynamic surveillance (i.e. weekly when at least one positive screen, otherwise every three weeks). For each surveillance period, colonized infants received a decolonization regimen (56% effective) and were moved to isolation rooms, if available.

FINDINGS

As the surveillance frequency increased, the mean number of MRSA-colonized infants decreased, from a high of 2.9 (four-weekly monitoring) to a low of 0.6 (weekly monitoring) detected per episode. The mean duration of colonization decreased from 307 h (four-weekly monitoring) to 61 h (weekly monitoring). Meanwhile, the availability of isolation rooms followed an inverse relationship: as surveillance frequency increased, the availability of isolation rooms decreased (61% isolation success rate for four-weekly monitoring vs 49% success rate for weekly monitoring). The dynamic policy performed similar to a biweekly programme.

CONCLUSIONS

An effective MRSA surveillance programme needs to balance resource availability with potential for harm due to longer colonization periods and opportunity for development of invasive disease. While more frequent monitoring led to greater use of a decolonization regimen, it also reduced the likelihood of isolation rooms being available.

An Approach to Policy Analysis and Development of Medical Informatics

There are three grand challenges for medical informatics policy: (1) What is it? (2) What should it be? (3) How can we influence its development? To address these challenges requires: (1) an historical analysis of medical informatics policies in a representative sample of countries. This should include an account of major events, the roles of technology, individuals, culture and social settings. Pioneers have been led by visions of what medical informatics should achieve. The role of these visions and the reactions to unmet expectations thus also need to be analysed; (2) a generally applicable medical informatics policy that places the needs of its stake-holders and clients first. Top priorities are to support quality health care delivery and quality management of health care facilities; (3) an explanation of how policies in medical informatics are created and implemented together with a strategy to guide medical informatics professionals in their lobbying efforts.

Cost implications for the NHS of using the Alere™ i Influenza A & B near patient test with nasal swabs

BACKGROUND

Influenza is an acute viral infection of the respiratory tract. A rapid confirmatory diagnosis of influenza is important, since it is highly transmissible and outbreaks of influenza within the hospital setting increase morbidity and mortality. The objective of this study was to evaluate the cost implications, from the perspective of the UK NHS, of using on-label nasal swabs with the Alere™ i Influenza A & B test in a near patient setting.

METHODS

A cost consequence model was developed. The time horizon of the model was from hospital admission on suspicion of influenza until the end of treatment (following a diagnosis of influenza or discharge from hospital). Data on the prevalence of influenza and the sensitivity and specificity of the Alere™ i Influenza A & B test came from two prospective observational diagnostic accuracy studies. Costs were obtained from published resources. Uncertainties in the model data were investigated using deterministic, one-way sensitivity analyses.

RESULTS

Using the Alere™ i Influenza A & B point of care test with nasal swabs (on label) in NHS medical assessment units and emergency departments could save approximately £242,730 per 1000 adults presenting with influenza-like symptoms. The main cause for this was reduced times to availability of the result compared with the laboratory RT-PCR test. Other key drivers of savings were the cost of isolation, the prevalence of influenza, the specificity of the test, and the availability of isolation resources.

CONCLUSIONS

The Alere™ i Influenza A & B point of care test would have greatest impact in hospitals that have extensive delays in the time to receive a result. Sensitivity analyses identified the model parameters which would have greatest effect on the result and confirmed that assumptions were conservative, i.e. did not change key results.

Diagnostic accuracy and cost analysis of the Alere™ i Influenza A&B near-patient test using throat swabs

BACKGROUND

Clinical diagnostic sensitivity alone is inadequate in the diagnosis of influenza. Polymerase chain reaction (PCR) testing is sensitive but the inherent delays in result availability potentially prolong time to isolation and treatment. Until recently no near-patient test (NPT) has demonstrated adequate sensitivity for routine clinical use.

AIM

To evaluate diagnostic accuracy, time to result availability, clinical impact, and cost consequences of Alere™ i Influenza A&B NPT (Alere Inc., Waltham, MA, USA) using off-label throat swabs.

METHODS

Prospective, multi-centre [four UK National Health Service (NHS) hospitals], diagnostic accuracy cohort study with cost modelling. Throat swab samples from suspected influenza patients were tested for influenza using the reference standard of PCR; a second throat swab was tested using NPT.

FINDINGS

A total of 827 participants were recruited; 589 were suitable for analysis: sensitivity was 75.8% [95% confidence interval (CI): 67.0-84.6]; specificity was 96.8% (95% CI: 95.2-98.3). Sensitivity varied between Sheffield (Northern General Hospital: 82.1%; Royal Hallamshire Hospital: 83.3%) and other sites (Doncaster Royal Infirmary: 71.4%; Newcastle's Royal Victoria Infirmary: 50.0%) whereas specificity was high (92-100%). Positive predictive value (PPV) was 81.2% (95% CI: 72.9-89.5) with negative predictive value 95.6% (95% CI: 93.9-97.4) with observed prevalence of 15.4%. Median time to result for PCR was 1.1 days (on-site laboratories) and 5.2 days (remote laboratories). Isolation findings: 75% influenza positive not isolated; 69% of isolated participants did not have influenza. For a cohort of 1000 participants, annual estimated non-diagnostic cost savings with NPT are £215,040.

CONCLUSION

This first prospective study of the Alere i NPT using throat swabs demonstrates high specificity, high PPV during seasonal epidemics, and rapid result availability which could lead to substantial cost savings.

Temporal plasticity in thermal-habitat selection of burbot Lota lota a diel-migrating winter-specialist

In this study, animal-borne telemetry with temperature sensors was coupled with extensive habitat temperature monitoring in a dimictic reservoir, to test the following hypotheses: behavioural thermoregulation occurs throughout the year and temperature selection varies on a diel and seasonal basis, in a winter-specialist diel-migrating fish. Burbot Lota lota demonstrated nightly behavioural thermoregulation throughout the year, with a large seasonal shift between selection for very cold temperatures (<2° C) optimal for reproduction during the spawning period and selection for warmer temperatures (12-14° C) optimal for hunting and feeding during non-reproductive periods. During daylight hours, while L. lota avoided habitats warmer than optimal for reproduction and feeding during the spawning and non-reproductive periods, respectively, active selection was limited to selection for 4-6° C habitat during the prespawning period. Although behavioural thermoregulation explained the night-time migration, behavioural thermoregulation only partially explained daytime behaviour, indicating that diel migration is best explained by a combination of factors. Thus, thermal-habitat selection was a good predictor of night-time habitat occupancy in a diel-migrating species. Together, these results show that thermal-habitat selection by fishes may be important throughout the year and a more seasonally plastic behaviour than previously recognized.

Interactive effects of sex and body size on the movement ecology of adfluvial bull trout (Salvelinus confluentus)

Animal movement occurs as a function of many factors including changing environmental conditions (e.g., seasonality) and the internal state (e.g., phenotypic traits) of the focal organism. Identifying how these factors interact can reveal behavioral patterns that would otherwise go undiscovered. Given a large sample size of individuals (n = 187), we used acoustic biotelemetry to examine the spatial ecology of adfluvial bull trout (Salvelinus confluentus (Suckley, 1859)) in a large hydropower reservoir in British Columbia, Canada. Dependent variables, including home-range size and lateral movement, were analysed as a function of interactive relationships among seasons (over a 2-year period) and phenotypic traits. Mixed models indicated relationships between home-range size and season, whereas variation in lateral movement was explained by month and a two-way interaction between sex and body size. Large females (765 mm total length) were estimated to move laterally up to five times greater than females half their length, whereas movements between large and small males were not significantly different. This study shows how body size and sex can have a profound and possible interactive effect on animal movement. In addition, the results offer new information on the spatial ecology and conservation of adfluvial bull trout.

Comparing mercury concentrations across a thirty year time span in anadromous and non-anadromous Arctic charr from Labrador, Canada

Anadromous and non-anadromous Arctic charr (Salvelinus alpinus) from multiple sample sites in Labrador, Canada were used to investigate possible differences in total mercury concentration ([THg]) between 1977-78 and 2007-09. The mean [THg] of anadromous Arctic charr was 0.03 μg/g wet weight (ww) in 1977-78 and 0.04 μg/g ww in 2007-09, while mean concentrations in non-anadromous conspecifics were 0.18 μg/g ww in 1977-78 and 0.14 μg/g ww in 2007-09. After correcting for the effects of fish age and fork-length, there was no widespread difference in the mean [THg] of anadromous or non-anadromous fish between the two time periods. However, at individual sites sampled during both time periods, [THg] increased, decreased, or did not change. The mean age of sampled fish declined from 9.0 years in 1977-78 to 8.2 years in 2007-09 for anadromous fish, and from 11.7 years to 10.5 years in non-anadromous Arctic charr. Similarly, mean fork-lengths decreased from 450 mm to 417 mm in anadromous and from 402 mm to 335 mm in non-anadromous fish between 1977-78 and 2007-09. The mean annual temperature at four Labrador weather stations increased by 1.6°C to 2.9°C between the two sampling periods. The lack of an overall trend in anadromous or non-anadromous Arctic charr [THg] despite warming temperatures that favour increased mercury methylation suggests that regional changes in climate-driven factors have had limited impacts on mercury exposure in Labrador freshwater or marine fish.

Total mercury concentrations in anadromous Northern Dolly Varden from the northwestern Canadian Arctic: a historical baseline study

Previous research has documented the significance of total mercury (THg) as a northern contaminant in general and of fish in particular. While much research has been devoted to documenting both spatial and temporal changes in THg in consumed fish, little effort has been directed at understanding patterns of THg in Dolly Varden (Salvelinus malma), a prized subsistence species throughout the western North American Arctic. Here we report historical THg concentrations for anadromous Dolly Varden from 10 populations in the Yukon and Northwest Territories sampled across a range of latitudes (67-69°N) and longitudes (136-141°W) between the years 1988-91. Unadjusted mean THg concentrations ranged from 15 to 254 ng/g wet weight. Length-adjusted THg concentrations were significantly different among sites, but were not related to latitude or longitude. Within and among populations, THg was significantly related to fork-length, age, δ(15)N, and δ(13)C, with the variation in THg found among populations being best explained by size. The data serve as an important baseline against which future changes in THg levels in this important subsistence fishery may be compared to determine the significance of any observed trends.

A multi-sample changer coupled to an electron cyclotron resonance source for accelerator mass spectrometry experiments

A new multi-sample changer has been constructed allowing rapid changes between samples. The sample changer has 20 positions and is capable of moving between samples in 1 min. The sample changer is part of a project using Accelerator Mass Spectrometry (AMS) at the Argonne Tandem Linac Accelerator System (ATLAS) facility to measure neutron capture rates on a wide range of actinides in a reactor environment. This project will require the measurement of a large number of samples previously irradiated in the Advanced Test Reactor at Idaho National Laboratory. The AMS technique at ATLAS is based on production of highly charged positive ions in an electron cyclotron resonance ion source followed by acceleration in the ATLAS linac. The sample material is introduced into the plasma via laser ablation chosen to limit the dependency of material feed rates upon the source material composition as well as minimize cross-talk between samples.

Sexual and seasonal dimorphism in adult adfluvial bull trout (Salvelinus confluentus)

Sexual dimorphism in fishes may be obvious during the reproductive period and less clear during the nonreproductive periods. Despite being difficult to discern during the nonreproductive period, sex-related differences in body condition and shape can yield important insights into a species’ behaviour and ecology. The purpose of this study was to test hypotheses about body condition and shape variation related to sex and season (nonreproductive and reproductive periods) in a population of adult adfluvial bull trout (Salvelinus confluentus (Suckley, 1859)), which is a poorly understood and imperiled species across much of its range. Geometric morphometric samples were collected by angling in the spring and late summer in a reservoir in British Columbia. Principal components analysis identified two principal components (PC) that were related to body condition and that varied according to season and sex. Spring-caught females were in better body condition than spring-caught males. There was a significant sex × season interaction on body condition such that late-summer males were not different from late-summer females. Spawning bull trout exhibited a decline in body condition during the summer season. An additional PC that described head size was found to vary significantly between sexes; however, an assignment test showed that it failed to reliably distinguish between the sexes. We hypothesized that the ecology of these animals, including sex-specific behaviour, is responsible for sexual and seasonal differences in bull trout body condition and morphology. This study offers new insight into the ecology of bull trout and shows that shape data for fishes can be obtained nonlethally, which is particularly important for species that are imperiled.

Phase-sensitive frequency conversion of quadrature modulated signals

Two mechanisms that can make frequency conversion based on nonlinear mixing dependent on the phase of the input signal are identified. A novel phase-to-polarization converter that converts the orthogonal phase components of an input signal to two orthogonally polarized outputs is proposed. The operation of this scheme and a previously reported scheme at an increased symbol rate are simulated with semiconductor optical amplifiers (SOAs) as the nonlinear devices. Experimental results demonstrate the effectiveness of SOAs for nonlinear mixing over a wide range of wavelengths and difference frequencies and confirm the accuracy of the numerical model.

Comparative analysis of total mercury concentrations in anadromous and non-anadromous Arctic charr (Salvelinus alpinus) from eastern Canada

Previous research has documented that total mercury concentrations ([THg]) are lower in anadromous Arctic charr than in non-anadromous conspecifics, but the two life-history forms have rarely been studied together. Here, data from nine pairs of closely-located anadromous and non-anadromous Arctic charr populations were used to explore the impact of biological and life-history factors on individual [THg] across a range of latitudes (49-81° N) in eastern Canada. Unadjusted mean [THg] ranged from 20 to 114 ng/g wet weight (ww) in anadromous populations, and was significantly higher in non-anadromous populations, ranging from 111 to 227 ng/g ww. Within-population variations in [THg] were best explained by fish age, and were often positively related to fork-length and δN-inferred trophic level. Differences in [THg] were not related to differences in length-at-age (i.e., average somatic growth rate) among populations of either life-history type. Mercury concentrations were not related to site latitude in either the anadromous or non-anadromous fish. We conclude that the difference in Arctic charr [THg] with life-history type could not be explained by differences in fish age, fork-length, trophic position, or length-at-age, and discuss possible factors contributing to low mercury concentrations in anadromous, relative to freshwater, fish.

Ontogenetic shifts in morphology and resource use of cisco Coregonus artedi

Two previously described lacustrine cisco Coregonus spp. morphs [i.e. a small (<300 mm fork length, L(F)), low-gillraker (≤44) morph and a large (≥300 mm L(F) ), high-gillraker (≥45) morph] from Great Slave Lake, NT, Canada, were found to be synonymous with cisco Coregonus artedi. Geometric body shape did not differ between the two size classes nor could they be differentiated by 24 size-corrected linear measurements, indicating that the two groups had similar phenotypes. Strong, positive correlations between all linear characters and geometric centroid size (a composite variable of fish body length, mass and age) suggested that body morphology changed with age as fish grew. Total gillraker number (N(GR)) increased with L(F) according to: N(GR) = 36.3 + 0.034L(F). Differences in gillraker number and phenotype with age and size were explained by shifts in habitat and trophic resource use. Relative abundance within 0-30, 30-60, 60-90 and >90 m depth strata differed between size classes suggesting that morphology changed when fish shifted their habitat as they grew older. Large C. artedi had lower δ(13)C and slightly higher δ(15)N, indicating greater reliance on pelagic prey resources (i.e. more or larger zooplankton, such as Mysis spp.), compared to small C. artedi, which relied slightly more on benthic prey. Gillraker shape and number have always been used as key diagnostic characters in coregonine taxonomy; based on the findings presented here, ontogenetic shifts should be accounted for in resulting classifications.

Basal mercury concentrations and biomagnification rates in freshwater and marine food webs: effects on Arctic charr (Salvelinus alpinus) from eastern Canada

Patterns of total Hg (THg) and methyl Hg (MeHg) biomagnification were investigated in six pairs of co-located lacustrine and marine food webs supporting a common predator, Arctic charr. Mercury biomagnification rates (the slope of log Hg concentration versus δ(15)N-inferred trophic level) did not differ significantly between the two feeding habitats for either THg or MeHg, but THg and MeHg concentrations at the base of the food web were higher in the lacustrine environment than in the marine environment. The proportion of THg as MeHg was related to trophic level, and the relationship was statistically similar in the lacustrine and marine habitats. The biomagnification rate of MeHg exceeded that of THg in both habitats. We conclude that the known difference in Hg concentration between anadromous and non-anadromous Arctic charr is driven by differential Hg concentrations at the base of the lacustrine and marine foodwebs, and not by differential biomagnification rates.

The 2010 British Association of Stroke Physicians Survey of interventional treatments for stroke in the United Kingdom

INTRODUCTION

The UK National Stroke Strategy (Department of Health 2007) states that patients should have access to a stroke service with neurointerventional capacity. This survey was conducted by the Clinical Standards Committee of the British Association of Stroke Physicians to get a snapshot of the availability of interventional treatments for stroke in the United Kingdom.

METHODS

Questionnaires covering availability of endovascular treatments for stroke, e.g. intra-arterial thrombolysis and mechanical thrombectomy, were emailed to all British Association of Stroke Physicians members in October 2010. Where more than one response was received from the same hospital, the data were only entered once. If there was a discrepancy between different respondents for the same hospital, details were cross-checked with the respondents to ensure accuracy.

RESULTS

Responses were received from 58 hospitals in England, Scotland, Wales, and Northern Ireland. Intra-arterial thrombolysis and/or mechanical thrombectomy were available in 23 hospitals. Of these, three had not performed any procedures in 2010. Twenty centres had conducted a mean (range) of eight (2-20) procedures during the 10-month period. Thirty-five hospitals were not offering endovascular treatments. Sixteen of these were not referring patients to centres which could provide interventional treatments. Hospitals offering endovascular treatments had a mean (range) of 5.2 (2-12) stroke physicians, 2.3 (0-4) interventional neuroradiologists, and 3.6 (0-9) noninterventional neuroradiologists. Only two hospitals providing interventions had four or more interventional neuroradiologists.

CONCLUSIONS

Only a small number of hospitals in the United Kingdom provide interventional treatments for stroke. Almost 50% of hospitals not providing interventions had no processes in place for referral to providers.

Carbapenemase-producing Enterobacteriaceae in Irish critical care units: results of a pilot prevalence survey, June 2011

The epidemiology of carbapenemase-producing Enterobacteriaceae (CPE) in Ireland is changing, with an increase in the number of reported cases in late 2010 and early 2011. Reported cases were predominantly linked to critical care units. In June 2011, a four-week national pilot survey took place in 40 Irish critical care units (37 adult and three paediatric) to examine the prevalence of rectal carriage of CPE and inform national CPE screening guidelines. A total of 760 screening swabs were taken over the study period, and CPE were not detected in any of the participating critical care units.

Global major histocompatibility class II β (mh-IIβ)-polymorphism in Arctic charr Salvelinus alpinus

This study explored the use of the gene encoding the β subunit of the major histocompatibility (MH) receptor as a population marker in Arctic charr Salvelinus alpinus. The use of this polymorphic marker allowed differentiation of the S. alpinus lineages previously defined using mitochondrial DNA (mtDNA) but also allowed differentiation between the populations studied within those lineages. The majority of the variation observed here occurred prior to the last glaciation event. Nevertheless, all S. alpinus populations were differentiated using both MH Class II β (mh-IIβ) sequences and allelic frequencies. The fact that all the populations studied presented high rates of non-synonymous: synonymous substitutions and high levels of interpopulation variation, suggested mh-IIβ as an ideal marker to assess differentiation among S. alpinus populations in ways that may represent divergence both by genetic drift and natural adaptation to the local environment.

The response scale for the intellectual disability module of the WHOQOL: 5-point or 3-point?

OBJECTIVE

To deal with the question of whether a 5-point response Likert scale should be changed to a 3-point scale when used in the field testing of people with intellectual disabilities (IDs), which was raised after the pilot study of World Health Organization Quality of Life (WHOQOL)-DIS, a module being developed with the World Health Organization measure of quality of life for disabilities.

METHODS

Three possible ways were used to generate hypothetical data by merging a 5-point scale into a 3-point scale. The analyses were based on both item response theory and classical measurement theory. The partial credit model for polytomous response was performed for item evaluation; the confirmatory factor analysis was used to check construct validity, the Cronbach's alpha for domain reliability, and correlation analyses for the relationship between the 5-point scale and the generated 3-point scale.

RESULTS

Most items with a 5-point response scale had disordered response options and/or unequal-length intervals between successive response options; these deficiencies were removed or improved without decline of validity and reliability in the hypothetical data of 3-point scales.

CONCLUSION

Instead of the 5-point scale, a 3-point scale could be used for IDs in the field test of developing the module WHOQOL-DIS.

Extra-corporeal membrane oxygenation in the management of 2009 influenza A (H1N1) refractory respiratory failure

Rapidly progressive acute respiratory failure attributed to 2009 H1N1 influenza A infection has been reported worldwide-3. Refractory hypoxaemia despite conventional mechanical ventilation and lung protective strategies has resulted in the use a combination of rescue therapies, such as conservative fluid management, prone positioning, inhaled nitric oxide, high frequency oscillatory ventilation and extracorporeal membrane oxygenation (ECMO)4. ECMO allows for pulmonary or cardiopulmonary support as an adjunct to respiratory and cardiac failure, minimising ventilator-associated lung injury (VALI). This permits treatment of the underlying disease process, while concurrently allowing for recovery of the acute lung injury. This case documents a previously healthy twenty-two year old Asian male patient with confirmed pandemic (H 1N1) 2009 influenza A who was successfully managed with ECMO in the setting of severe refractory hypoxaemia and progressive hypercapnia.

Automated anatomical demarcation using an active shape model for videofluoroscopic analysis in swallowing

The current gold standard method in the clinical assessment of swallowing is the visual inspection of videofluoroscopic frames. Specific clinical measurements are estimated based on various anatomical and bolus positional information with respect to time (or frame number). However, due to the subjective nature of visual inspection clinicians face intra- and inter-observer repeatability issues and bias when making these estimations. The correct demarcations of reference lines highlighting the positions of important anatomical landmarks would serve as a visual aid and could also be used in conjunction with bolus detection methods to objectively determine these desirable measurements. In this paper, we introduce and test the reliability of applying a 16-point Active Shape Model as a deformable template to demarcate the boundaries of salient anatomical boundaries with minimal user input. A robust end and corner point detection algorithm is also used to provide image information for the suggested movement of the template during the fitting stage. Results show the model deformation constraints calculated from a training set of images are clinically coherent. The Euclidean distances between the fitted model points against their corresponding target points were measured. Test images were taken from two different data sets from frames acquired using two different videofluoroscopy units. Overall, fitting was found to be more reliable on the vertebrae and inferior points of the larynx compared to the superior laryngeal points and hyoid bone, with the model always fitting the C7 vertebra with discrepancies no higher than a distance of 23 pixels (3.2% of the image width, approximately 7.6mm).

Factors associated with acute fatigue in primary care

BACKGROUND

To examine the role of psychological distress, negative life events, social support and lack of fitness (using breathlessness on exertion as a proxy) in the development of new onset fatigue in a primary care population.

METHOD

Adults between the ages of 18 and 45 years who were registered with five general practices in South East England were asked to complete a fatigue questionnaire and the 12-item General Health Questionnaire. Between 1 and 12 months later, subjects who visited the general practitioner (GP) with a suspected viral infection were recruited to the study and asked to complete measures of fatigue, psychological distress, life events, social support and allergies (stage 2). The next person to present to the GP with a complaint other than a viral illness was recruited as a control. Factors assessed at stage 2 that were associated with the development of fatigue were examined with stepwise logistic regression.

RESULTS

Acute fatigue was not associated with a viral illness. Negative life events and breathlessness on exertion (interpreted as lack of fitness) were associated with incident cases of fatigue. However, when controlling for concurrent psychological distress, the independent association of negative life events disappeared.

CONCLUSIONS

Psychological distress was strongly associated with new onset fatigue and hence emphasizes the significance of psychological distress as a concomitant complaint in fatigue. Further, the salient association between breathlessness and fatigue may indicate the need to recommend exercise as a therapeutic strategy to improve physical fitness in the primary care setting.

A comparison of Rasch item-fit and Cronbach's alpha item reduction analysis for the development of a Quality of Life scale for children and adolescents

OBJECTIVE

This study compares item reduction analysis based on classical test theory (maximizing Cronbach's alpha - approach A), with analysis based on the Rasch Partial Credit Model item-fit (approach B), as applied to children and adolescents' health-related quality of life (HRQoL) items. The reliability and structural, cross-cultural and known-group validity of the measures were examined.

METHODS

Within the European KIDSCREEN project, 3019 children and adolescents (8-18 years) from seven European countries answered 19 HRQoL items of the Physical Well-being dimension of a preliminary KIDSCREEN instrument. The Cronbach's alpha and corrected item total correlation (approach A) were compared with infit mean squares and the Q-index item-fit derived according to a partial credit model (approach B). Cross-cultural differential item functioning (DIF ordinal logistic regression approach), structural validity (confirmatory factor analysis and residual correlation) and relative validity (RV) for socio-demographic and health-related factors were calculated for approaches (A) and (B).

RESULTS

Approach (A) led to the retention of 13 items, compared with 11 items with approach (B). The item overlap was 69% for (A) and 78% for (B). The correlation coefficient of the summated ratings was 0.93. The Cronbach's alpha was similar for both versions [0.86 (A); 0.85 (B)]. Both approaches selected some items that are not strictly unidimensional and items displaying DIF. RV ratios favoured (A) with regard to socio-demographic aspects. Approach (B) was superior in RV with regard to health-related aspects.

CONCLUSION

Both types of item reduction analysis should be accompanied by additional analyses. Neither of the two approaches was universally superior with regard to cultural, structural and known-group validity. However, the results support the usability of the Rasch method for developing new HRQoL measures for children and adolescents.

Phylogeography and sympatric differentiation of the Arctic charr Salvelinus alpinus (L.) complex in Siberia as revealed by mtDNA sequence analysis

Sequence variation in the mtDNA control region of Arctic charr Salvelinus alpinus and Dolly Varden Salvelinus malma from 56 Siberian and North American populations was analysed to assess their phylogeographic relationships and the origins of sympatric forms. Phylogenetic trees confirm the integrity of phylogroups reported in previous mtDNA studies except that the Siberian group does not separate as a single cluster. Haplotype network analysis indicates the proximity of Siberian and Atlantic haplotypes. These are considered as one Eurasian group represented by the Atlantic, east Siberian (interior Siberia including Transbaikalia, Taimyr) and Eurosiberian (Finland, Spitsbergen, Taimyr) sub-groups. Salvelinus alpinus with presumably introgressed Bering group (malma) haplotypes were found along eastern Siberian coasts up to the Olenek Bay and the Lena Delta region, where they overlap with the Eurasian group and in the easternmost interior region. It is proposed that Siberia was colonized by S. alpinus in two stages: from the west by the Eurasian group and later from the east by the Bering group. The high diversity of Eurasian group haplotypes in Siberia indicates its earlier colonization by S. alpinus as compared with the European Alps. This colonization was rapid, proceeded from a diverse gene pool, and was followed by differential survival of ancestral mtDNA lineages in different basins and regions, and local mutational events in isolated populations. The results presented here support a northern origin of Transbaikalian S. alpinus, the dispersion of S. alpinus to the Lake Baikal Basin from the Lena Basin, segregation of S. alpinus between Lena tributaries and their restricted migration over the divides between sub-basins. These results also support sympatric origin of intralacustrine forms of S. alpinus.

Environmental factors affecting growth of eastern sand darter (Ammocrypta pellucida)

Environmental factors affecting growth of the threatened eastern sand darter ( Ammocrypta pellucida (Putnam, 1863)) were examined using specimens sampled from the northern edge of its range to determine the species’ critical habitat. Length-at-age increments were determined from scale samples as surrogates for growth rates based on back-calculated lengths using the Fraser–Lee method. During the first year of life, 82% of total length is attained, suggesting considerable energetic partitioning towards reproduction following age-0. Positive relationships between age-0 length increments and sand substrates and between age-0 length increments and mean annual channel discharge indicated greatest first-year growth within sand-dominated, high-discharge habitats. Environmental factors that occurred at coarse spatial and temporal levels (i.e., mean annual channel discharge) explained more of the growth variability among eastern sand darters than those occurring at fine levels (i.e., site-level substrate composition). This study indicates that environmental factors can be used to explain variability in cohort-structured population and site-level growth of eastern sand darters.

Effects of formalin and ethanol preservation on otolith delta18O stable isotope signatures

The use of preserved otoliths for stable isotope analysis assumes handling and preservation procedures do not alter the isotopic composition of the otolith. Otoliths from wild and hatchery-reared salmonids (brook charr, Salvelinus fontinalis, and Atlantic salmon, Salmo salar) were used to test for possible delta(18)O preservation effects in ethanol and formalin preservation experiments at varying temperatures. Analysis of variance (ANOVA) demonstrated a significant interaction effect between species and preservative during preservation. Possible causes for the observed effect are discussed in relation to species-specific differences in otolith chemistry related to growth and environment including: (1) chemical mechanisms of dissolution-recrystallisation involving the precipitation of secondary minerals within and at the otolith surface; (2) adsorption of ions at available binding sites on the otolith surface; and (3) isotopic exchange during otolith surface dissolution and/or reprecipitation processes. Differential occurrence of vaterite and aragonite in otoliths is believed to account for some of the observed effects as a result of otolith density differences. Isotopic exchange is also argued to cause much of the observed variation in species-specific preservation effects. Biologically, study findings imply that preserved otoliths should not be used for baseline paleoclimatic or individual fish thermal reconstructions, or the development of delta(18)O-fractionation equations, without the prior use of pilot studies to determine preservation effects.