Operationalizing risk perception and preparedness behavior research for a multi-hazard context

Increasingly, citizens are being asked to take a more active role in disaster risk reduction (DRR), as decentralization of hazard governance has shifted greater responsibility for hazard preparedness actions onto individuals. Simultaneously, the taxonomy of hazards considered for DRR has expanded to include medical and social crises alongside natural hazards. Risk perception research emerged to support decision-makers with understanding how people characterize and evaluate different hazards to anticipate behavioral response and guide risk communication. Since its inception, the risk perception concept has been incorporated into many behavioral theories, which have been applied to examine preparedness for numerous hazard types. Behavioral theories have had moderate success in predicting or explaining preparedness behaviors; however, they are typically applied to a single hazard type and there is a gap in understanding which theories (if any) are suited for examining multiple hazard types simultaneously. This paper first reviews meta-analyses of behavioral theories to better understand performance. Universal lessons learnt are summarized for survey design. Second, theoretically based preparedness studies for floods, earthquakes, epidemics, and terrorism are reviewed to assess the conceptual requirements for a ‘multi-hazard’ preparedness approach. The development of an online preparedness self-assessment and learning platform is discussed

Adrenal lesions found incidentally: how to improve clinical and cost-effectiveness

Introduction Adrenal incidentalomas are lesions that are incidentally identified while scanning for other conditions. While most are benign and hormonally non-functional, around 20% are malignant and/or hormonally active, requiring prompt intervention. Malignant lesions can be aggressive and life-threatening, while hormonally active tumours cause various endocrine disorders, with significant morbidity and mortality. Despite this, management of patients with adrenal incidentalomas is variable, with no robust evidence base. This project aimed to establish more effective and timely management of these patients. Methods We developed a web-based, electronic Adrenal Incidentaloma Management System (eAIMS), which incorporated the evidence-based and National Health Service–aligned 2016 European guidelines. The system captures key clinical, biochemical and radiological information necessary for adrenal incidentaloma patient management and generates a pre-populated outcome letter, saving clinical and administrative time while ensuring timely management plans with enhanced safety. Furthermore, we developed a prioritisation strategy, with members of the multidisciplinary team, which prioritised high-risk individuals for detailed discussion and management. Patient focus groups informed process-mapping and multidisciplinary team process re-design and patient information leaflet development. The project was partnered by University Hospital of South Manchester to maximise generalisability. Results Implementation of eAIMS, along with improvements in the prioritisation strategy, resulted in a 49% reduction in staff hands-on time, as well as a 78% reduction in the time from adrenal incidentaloma identification to multidisciplinary team decision. A health economic analysis identified a 28% reduction in costs. Conclusions The system’s in-built data validation and the automatic generation of the multidisciplinary team outcome letter improved patient safety through a reduction in transcription errors. We are currently developing the next stage of the programme to proactively identify all new adrenal incidentaloma cases

The XMM-Newton serendipitous ultraviolet source survey catalogue

The XMM-Newton Serendipitous Ultraviolet Source Survey (XMM-SUSS) is a catalogue of ultraviolet (UV) sources detected serendipitously by the Optical Monitor (XMM-OM) on-board the XMM-Newton observatory. The catalogue contains ultraviolet-detected sources collected from 2,417 XMM-OM observations in 1-6 broad band UV and optical filters, made between 24 February 2000 and 29 March 2007. The primary contents of the catalogue are source positions, magnitudes and fluxes in 1 to 6 passbands, and these are accompanied by profile diagnostics and variability statistics. The XMM-SUSS is populated by 753,578 UV source detections above a 3 sigma signal-to-noise threshold limit which relate to 624,049 unique objects. Taking account of substantial overlaps between observations, the net sky area covered is 29-54 square degrees, depending on UV filter. The magnitude distributions peak at 20.2, 20.9 and 21.2 in UVW2, UVM2 and UVW1 respectively. More than 10 per cent of sources have been visited more than once using the same filter during XMM-Newton operation, and > 20 per cent of sources are observed more than once per filter during an individual visit. Consequently, the scope for science based on temporal source variability on timescales of hours to years is broad. By comparison with other astrophysical catalogues we test the accuracy of the source measurements and define the nature of the serendipitous UV XMM-OM source sample. The distributions of source colours in the UV and optical filters are shown together with the expected loci of stars and galaxies, and indicate that sources which are detected in multiple UV bands are predominantly star-forming galaxies and stars of type G or earlier.Comment: Accepted for publication in MNRA

Ecofeminism in the 21st Century

This paper considers the influence of ecofeminism on policy concerning gender (in)equality and the environment during the past 20 years. It reviews the broad contours of the ecofeminist debate before focusing on the social construction interpretation of women's relationship with the environment. It will argue that there have been substantial policy shifts in Europe and the UK in both the environmental and equalities fields, and that this is in part a result of lobbying at a range of scales by groups informed by ecofeminist debates. Nevertheless, the paper cautions that these shifts are largely incremental and operate within existing structures, which inevitably limit their capacity to create change. As policy addresses some of the concerns highlighted by ecofeminism, academic discourse and grass roots activity have been moving on to address other issues, and the paper concludes with a brief consideration of contemporary trajectories of ecofeminism and campaigning on issues that link women's, feminist and environment concerns

Minactivin expression in human monocyte and macrophage populations

Adherent monolayer cultures of human blood monocytes, peritoneal macrophages, bone marrow macrophages, and colonic mucosa macrophages were examined for their ability to produce and secrete minactivin, a specific inactivator of urokinase-type plasminogen activator. All except colonic mucosa macrophages produced and secreted appreciable amounts of minactivin, but only blood monocytes were stimulated by muramyl dipeptide (adjuvant peptide) to increase production. The minactivin from each of these populations could be shown to preferentially inhibit urokinase-type plasminogen activator and not trypsin, plasmin, or 'tissue'-type plasminogen activator (HPA66). A plasminogen-activating enzyme present in monocyte cultures appeared unaffected by the presence of minactivin and could be shown to be regulated independently by dexamethasone

Stimulation of colonic motility by oral PEG electrolyte bowel preparation assessed by MRI : comparison of split vs single dose

Peer reviewe

Taking Foreign Policy Personally: Personal Values and Foreign Policy Attitudes

Previous research has shown that on issues of foreign policy, individuals have “general stances,” “postures,” “dispositions” or “orientations” that inform their beliefs toward more discrete issues in international relations. While these approaches delineate the proximate sources of public opinion in the foreign policy domain, they evade an even more important question: what gives rise to these foreign policy orientations in the first place? Combining an original survey on a nationally representative sample of Americans with Schwartz’s theory of values from political psychology, we show that people take foreign policy personally: the same basic values we know people use to guide choices in their daily lives also travel to the domain of foreign affairs, offering one potential explanation why people who are otherwise uninformed about world politics nonetheless express coherent foreign policy beliefs

Test Characteristics of Urinary Lipoarabinomannan and Predictors of Mortality among Hospitalized HIV-Infected Tuberculosis Suspects in Tanzania.

Tuberculosis is the most common cause of death among patients with HIV infection living in tuberculosis endemic countries, but many cases are not diagnosed pre-mortem. We assessed the test characteristics of urinary lipoarabinomannan (LAM) and predictors of mortality among HIV-associated tuberculosis suspects in Tanzania. We prospectively enrolled hospitalized HIV-infected patients in Dar es Salaam, with ≥2 weeks of cough or fever, or weight loss. Subjects gave 2 mLs of urine to test for LAM using a commercially available ELISA, ≥2 sputum specimens for concentrated AFB smear and solid media culture, and 40 mLs of blood for culture. Among 212 evaluable subjects, 143 (68%) were female; mean age was 36 years; and the median CD4 count 86 cells/mm(3). 69 subjects (33%) had culture confirmation of tuberculosis and 65 (31%) were LAM positive. For 69 cases of sputum or blood culture-confirmed tuberculosis, LAM sensitivity was 65% and specificity 86% compared to 36% and 98% for sputum smear. LAM test characteristics were not different in patients with bacteremia but showed higher sensitivity and lower specificity with decreasing CD4 cell count. Two month mortality was 64 (53%) of 121 with outcomes available. In multivariate analysis there was significant association of mortality with absence of anti-retroviral therapy (p = 0.004) and a trend toward association with a positive urine LAM (p = 0.16). Among culture-negative patients mortality was 9 (75%) of 12 in LAM positive patients and 27 (38%) of 71 in LAM negative patients (p = 0.02). Urine LAM is more sensitive than sputum smear and has utility for the rapid diagnosis of culture-confirmed tuberculosis in this high-risk population. Mortality data raise the possibility that urine LAM may also be a marker for culture-negative tuberculosis

The XMM-Newton Optical/UV Monitor Telescope

The XMM-OM instrument extends the spectral coverage of the XMM-Newton observatory into the ultraviolet and optical range. It provides imaging and time-resolved data on targets simultaneously with observations in the EPIC and RGS. It also has the ability to track stars in its field of view, thus providing an improved post-facto aspect solution for the spacecraft. An overview of the XMM-OM and its operation is given, together with current information on the performance of the instrument

Photometric Calibration of the Swift Ultraviolet/Optical Telescope

We present the photometric calibration of the Swift UltraViolet/Optical Telescope (UVOT) which includes: optimum photometric and background apertures, effective area curves, colour transformations, conversion factors for count rates to flux, and the photometric zero points (which are accurate to better than 4 per cent) for each of the seven UVOT broadband filters. The calibration was performed with observations of standard stars and standard star fields that represent a wide range of spectral star types. The calibration results include the position dependent uniformity, and instrument response over the 1600-8000A operational range. Because the UVOT is a photon counting instrument, we also discuss the effect of coincidence loss on the calibration results. We provide practical guidelines for using the calibration in UVOT data analysis. The results presented here supersede previous calibration results.Comment: Minor improvements after referees report. Accepted for publication in MNRA