The relationship between fructose consumption and risk of obesity in two Aboriginal populations

Résumé La prédominance de l'obésité qui touche les enfants et les adultes a augmenté dans le monde entier ces dernières décennies. Les différentes études épidémiologiques ont prouvé que l'obésité est devenue une préoccupation profonde de santé aux États-Unis et au Canada. Il a été montré que l'obésité a beaucoup d’effets sur la santé ainsi il serait important de trouver différentes causes pour le gain de poids. Il est clair que l'obésité soit la condition de multiples facteurs et implique des éléments génétiques et environnementaux. Nous nous concentrons sur les facteurs diététiques et particulièrement le fructose où sa consommation a parallèlement augmenté avec l'augmentation du taux d'obésité. La forme principale du fructose est le sirop de maïs à haute teneur en fructose (HFCS) qui est employé en tant qu'édulcorant primordial dans la plupart des boissons et nourritures en Amérique du Nord. Il a été suggéré que la prise du fructose serait probablement un facteur qui contribue à l’augmentation de la prédominance de l'obésité. L'objectif de cette étude était d'évaluer s'il y a un rapport entre la consommation du fructose et le risque d'obésité. Nous avons travaillé sur deux bases de données des nations Cree et Inuit. Nous avons eu un groupe de 522 adultes Cree, (263 femmes et 259 hommes) dans deux groupes d'âge : les personnes entre 20 et 40 ans, et les personnes de 40 à 60 ans. Nous les avons classés par catégorie en quatre groupes d'indice de masse corporelle (IMC). L'outil de collecte de données était un rappel de 24 heures. En revanche, pour la base de données d'Inuit nous avons eu 550 adultes (301 femmes et 249 hommes) dans deux groupes d'âge semblables à ceux du Cree et avec 3 catégories d’indice de masse corporelle. Les données dans la base d'Inuit ont été recueillies au moyen de deux rappels de 24 heures. Nous avons extrait la quantité de fructose par 100 grammes de nourriture consommés par ces deux populations et nous avons créé des données de composition en nourriture pour les deux. Nous avons pu également déterminer les sources principales du fructose pour ces populations. Aucun rapport entre la consommation du fructose et l’augmentation de l’indice de masse corporelle parmi les adultes de Cree et d'Inuit n’a été détecté. Nous avons considéré l’apport énergétique comme facteur confondant potentiel et après ajustement, nous avons constaté que l'indice de masse corporelle a été associé à l’apport énergétique total et non pas à la consommation du fructose. Puisque dans les études qui ont trouvé une association entre la consommation de fructose et l’obésité, le niveau de la consommation de fructose était supérieure à 50 grammes par jour et comme dans cette étude ce niveau était inférieur à cette limite (entre 20.6 et 45.4 g/jour), nous proposons que des effets negatifs du fructose sur la masse corporelle pourraient être testés dans des populations à plus haute consommation. Les essais cliniques randomisés et éventuelles études cohortes avec différents niveaux de consommation de fructose suivis à long terme pourraient aussi être utiles. Mots clés : fructose, sirop de maïs à haute teneur en fructose (HFCS), obésité et poids excessif

Follow-up of three large community-based programs to reduce anaemia among children 24-59 months in Ghana, Malawi and Tanzania

L'anémie de l'enfant reste un problème d'importance pour la santé mondiale, malgré les décennies de recherche visant à comprendre son étiologie et à développer des interventions efficaces pour réduire sa prévalence et ses conséquences. Bien que les facteurs de risque individuels de l'anémie soient connus, y compris les facteurs liés à la malnutrition et à la morbidité, l'interaction entre lesdits facteurs est moins documentée dans des contextes où les enfants sont fréquemment exposés à plusieurs facteurs en même temps. Cette étude vise à documenter les efforts de lutte contre l'anémie du programme MICAH qui a été mis en oeuvre au Ghana, au Malawi et en Tanzanie. Ensuite, en utilisant les données relatives à la fois au processus et à l'évaluation colligées au cours du programme, elle vise à mieux comprendre les facteurs de risque d'anémie chez les jeunes enfants dans ces contextes et à comprendre comment les relations entre ces facteurs peuvent avoir changé au fil du temps lors de l'intervention. Spécifiquement, cette étude vérifie s‘il y a des preuves d'une réduction de la vulnérabilité des enfants aux facteurs de risque associés à l'anémie dans chaque contexte. Un examen de la documentation a été réalisé afin de caractériser le contexte du programme et des interventions, leur l'intensité et étendue. Les données transversales sur la nutrition et l'état de santé des enfants âgés de 24 à 59 mois (N = 2405) obtenues en 2000 et 2004 à partir des enquêtes d'évaluation du programme MICAH au Ghana, au Malawi et en Tanzanie, ont été utilisées pour décrire la prévalence de l'anémie. Les modèles polynomiaux de régression logistique et linéaire ont été utilisés pour estimer les risques d'anémie légère et d'anémie modérée / sévère et les niveaux d‘hémoglobine associés à des groupes de variables. Les estimations du risque attribuable à une population (RAP) ont aussi été calculées. Une anémie (Hb <110 g/L) a touché au moins 60% des enfants dans les trois pays; l'anémie modérée / sévère (<100 g/L) constituait la majorité des cas. Une forte diminution de l'anémie a été observée entre 2000 et 2004 au Ghana, mais seulement une légère baisse au Malawi et en Tanzanie. Le risque d'anémie modérée / sévère était associé au retard de croissance chez les enfants du Ghana (OR 2,68, IC 95% 1,70-4,23) et du Malawi (OR 1,71; 1,29-2,27) mais pas de la Tanzanie (OR 1,29; 0,87- 1,92). Le paludisme et les maladies récentes étaient associées à une hémoglobine plus basse. Une atténuation de cette association en 2004 a été observée seulement au Malawi pour le paludisme et au Ghana pour les maladies récentes. Le risque d'anémie modérée / sévère était 44% moindre chez les enfants âgés de 48 à 59 mois comparativement aux enfants de 24 à 35 mois dans les trois pays et cela n'a pas changé entre 2000 et 2004. Les RAP estimés ont montré qu‘environ un cinquième des cas d‘anémie modérée à sévère était attribuable au retard de croissance au Ghana et Malawi, mais pas en Tanzanie. Des RAP moindres et dépendants des contextes ont été trouvés pour le paludisme et les maladies récentes. Dans ces zones d‘intervention intégrées de santé et de nutrition la relation de certains facteurs de risque à l'anémie se modifia avec le temps. Le retard de croissance est resté toutefois un facteur de risque indépendant et non mitigé de l'anémie. Une réduction efficace des causes de la malnutrition chronique est nécessaire afin de réduire la vulnérabilité des enfants et de garantir un impact maximum des programmes de lutte contre l'anémie. Une mitigation de l'impact du paludisme peut par contre être visée dans les régions endémiques.

Parental separation and child adjustment : longitudinal perspective and risk factors

Malgré de nombreuses études qui soutiennent l'idée que les enfants ayant vécu la rupture de leurs parents rencontrent un plus haut niveau de difficultés affectives et comportementales que les enfants de familles intactes, certaines questions restent à éclaircir. Notamment, les données empiriques existantes ne conduisent pas à des conclusions précises quant au moment exact de l’apparition de ces difficultés. De plus, ce n'est pas clair si ces difficultés sont associées à la séparation en soi, ou à bien d'autres facteurs liés à la séparation. Cette thèse est constituée de deux articles empiriques. Le premier examine l’adaptation de l’enfant avant et après la séparation en fonction du sexe et de l'âge au moment de la séparation. Le second article présente une étude qui a pour objectif de départager l’importance des facteurs parentaux et contextuels et celle de la séparation parentale pour expliquer l’adaptation de l’enfant. Les participants proviennent de l'Étude Longitudinale du Développement des Enfants du Québec (ÉLDEQ, 1998-2006). À chaque enquête de l'ÉLDEQ, une entrevue structurée réalisée auprès de la mère a permis d'évaluer les niveaux d’hyperactivité/impulsivité, d’anxiété et d’agressivité physique de l’enfant. Pendant cette entrevue, les mères ont également répondu à des questions sur la qualité de leurs pratiques parentales et sur le revenu du ménage. Finalement, un questionnaire auto-administré à la mère a permis d'évaluer ses propres symptômes de dépression et d'anxiété. La première étude inclus 143 enfants de familles séparées et 1705 enfants de familles intactes. Deux sous-groupes ont été créés selon que l’enfant ait vécu la séparation entre 2 et 4 ans, ou entre 4 et 6 ans. L’adaptation de l'enfant a été évaluée à un temps de mesure avant la séparation et à deux temps de mesure après la séparation. Les résultats de cette première étude démontrent qu’avant la séparation, les enfants de familles intactes et séparées ne se distinguent pas significativement quant à leurs niveaux d’hyperactivité/impulsivité et d’anxiété. Par contre, ces difficultés deviennent significativement plus élevées chez les enfants de familles séparées après la rupture des parents. D’autres parts, le niveau d’agressivité physique est plus élevé chez les enfants de la séparation indépendamment du temps de mesure. Finalement, les différences entre les deux groupes d’enfants ne dépendent pas du sexe ou de l’âge au moment de la séparation. La deuxième étude inclus 358 enfants de 8 ans qui ont vécu la séparation de leurs parents, et 1065 enfants du même âge provenant de familles intactes. Après avoir contrôlé pour le sexe de l’enfant, les résultats ont démontré que lorsqu’on tient compte de la contribution des symptômes maternels de dépression et d'anxiété, de la qualité des pratiques parentales et du revenu du ménage dans l’adaptation de l’enfant, la séparation parentale ne demeurent plus liée aux niveaux d’anxiété et d'agressivité physique de l’enfant. Par contre, la relation entre la séparation parentale et l’hyperactivité/impulsivité de l’enfant demeure significative. Les résultats présentés dans les articles sont discutés ainsi que leurs implications.

Scoliosis Follow-Up Using Noninvasive Trunk Surface Acquisition

Adolescent idiopathic scoliosis (AIS) is a musculoskeletal pathology. It is a complex spinal curvature in a 3-D space that also affects the appearance of the trunk. The clinical follow-up of AIS is decisive for its management. Currently, the Cobb angle, which is measured from full spine radiography, is the most common indicator of the scoliosis progression. However, cumulative exposure to X-rays radiation increases the risk for certain cancers. Thus, a noninvasive method for the identification of the scoliosis progression from trunk shape analysis would be helpful. In this study, a statistical model is built from a set of healthy subjects using independent component analysis and genetic algorithm. Based on this model, a representation of each scoliotic trunk from a set of AIS patients is computed and the difference between two successive acquisitions is used to determine if the scoliosis has progressed or not. This study was conducted on 58 subjects comprising 28 healthy subjects and 30 AIS patients who had trunk surface acquisitions in upright standing posture. The model detects 93% of the progressive cases and 80% of the nonprogressive cases. Thus, the rate of false negatives, representing the proportion of undetected progressions, is very low, only 7%. This study shows that it is possible to perform a scoliotic patient's follow-up using 3-D trunk image analysis, which is based on a noninvasive acquisition technique.

Nonparametric Estimation of Survivor Function in Bivariate Competing Risk Models’

So far, in the bivariate set up, the analysis of lifetime (failure time) data with multiple causes of failure is done by treating each cause of failure separately. with failures from other causes considered as independent censoring. This approach is unrealistic in many situations. For example, in the analysis of mortality data on married couples one would be interested to compare the hazards for the same cause of death as well as to check whether death due to one cause is more important for the partners’ risk of death from other causes. In reliability analysis. one often has systems with more than one component and many systems. subsystems and components have more than one cause of failure. Design of high-reliability systems generally requires that the individual system components have extremely high reliability even after long periods of time. Knowledge of the failure behaviour of a component can lead to savings in its cost of production and maintenance and. in some cases, to the preservation of human life. For the purpose of improving reliability. it is necessary to identify the cause of failure down to the component level. By treating each cause of failure separately with failures from other causes considered as independent censoring, the analysis of lifetime data would be incomplete. Motivated by this. we introduce a new approach for the analysis of bivariate competing risk data using the bivariate vector hazard rate of Johnson and Kotz (1975).

River ecosystems at risk

Worldwide water managers are increasingly challenged to allocate sufficient and affordable water supplies to different water use sectors without further degrading river ecosystems and their valuable services to mankind. Since 1950 human population almost tripled, water abstractions increased by a factor of four, and the number of large dam constructions is about eight times higher today. From a hydrological perspective, the alteration of river flows (temporally and spatially) is one of the main consequences of global change and further impairments can be expected given growing population pressure and projected climate change. Implications have been addressed in numerous hydrological studies, but with a clear focus on human water demands. Ecological water requirements have often been neglected or addressed in a very simplistic manner, particularly from the large-scale perspective. With his PhD thesis, Christof Schneider took up the challenge to assess direct (dam operation and water abstraction) and indirect (climate change) impacts of human activities on river flow regimes and evaluate the consequences for river ecosystems by using a modeling approach. The global hydrology model WaterGAP3 (developed at CESR) was applied and further developed within this thesis to carry out several model experiments and assess anthropogenic river flow regime modifications and their effects on river ecosystems. To address the complexity of ecological water requirements the assessment is based on three main ideas: (i) the natural flow paradigm, (ii) the perception that different flows have different ecological functions, and (iii) the flood pulse concept. The thesis shows that WaterGAP3 performs well in representing ecologically relevant flow characteristics on a daily time step, and therefore justifies its application within this research field. For the first time a methodology was established to estimate bankfull flow on a 5 by 5 arc minute grid cell raster globally, which is a key parameter in eFlow assessments as it marks the point where rivers hydraulically connect to adjacent floodplains. Management of dams and water consumption pose a risk to floodplains and riparian wetlands as flood volumes are significantly reduced. The thesis highlights that almost one-third of 93 selected Ramsar sites are seriously affected by modified inundation patterns today, and in the future, inundation patterns are very likely to be further impaired as a result of new major dam initiatives and climate change. Global warming has been identified as a major threat to river flow regimes as rising temperatures, declining snow cover, changing precipitation patterns and increasing climate variability are expected to seriously modify river flow regimes in the future. Flow regimes in all climate zones will be affected, in particular the polar zone (Northern Scandinavia) with higher river flows during the year and higher flood peaks in spring. On the other side, river flows in the Mediterranean are likely to be even more intermittent in the future because of strong reductions in mean summer precipitation as well as a decrease in winter precipitation, leading to an increasing number of zero flow events creating isolated pools along the river and transitions from lotic to lentic waters. As a result, strong impacts on river ecosystem integrity can be expected. Already today, large amounts of water are withdrawn in this region for agricultural irrigation and climate change is likely to exacerbate the current situation of water shortages.

Envisioning (starting the project)2: User Stories, Sprint Planning, Risk Assessment

Second in a two part set of lectures on Agile Envisioning. The lectures describe the process of starting up a project. 1) creating a shared understanding amongst the team and customers using Stakeholder Analysis, Personas and User stories 2) Sprint planning and using a burndown chart 3) Risk assessment

Organic solvents as risk factor for autoimmune diseases: a systematic review and meta-analysis

Background: Genetic and epigenetic factors interacting with the environment over time are the main causes of complex diseases such as autoimmune diseases (ADs). Among the environmental factors are organic solvents (OSs), which are chemical compounds used routinely in commercial industries. Since controversy exists over whether ADs are caused by OSs, a systematic review and meta-analysis were performed to assess the association between OSs and ADs. Methods and Findings: The systematic search was done in the PubMed, SCOPUS, SciELO and LILACS databases up to February 2012. Any type of study that used accepted classification criteria for ADs and had information about exposure to OSs was selected. Out of a total of 103 articles retrieved, 33 were finally included in the meta-analysis. The final odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by the random effect model. A sensitivity analysis confirmed results were not sensitive to restrictions on the data included. Publication bias was trivial. Exposure to OSs was associated to systemic sclerosis, primary systemic vasculitis and multiple sclerosis individually and also to all the ADs evaluated and taken together as a single trait (OR: 1.54; 95% CI: 1.25-1.92; p-value, 0.001). Conclusion: Exposure to OSs is a risk factor for developing ADs. As a corollary, individuals with non-modifiable risk factors (i.e., familial autoimmunity or carrying genetic factors) should avoid any exposure to OSs in order to avoid increasing their risk of ADs.

Use of airborne remote sensing to detect riverside Brassica rapa to aid in risk assessment of transgenic crops

High resolution descriptions of plant distribution have utility for many ecological applications but are especially useful for predictive modelling of gene flow from transgenic crops. Difficulty lies in the extrapolation errors that occur when limited ground survey data are scaled up to the landscape or national level. This problem is epitomized by the wide confidence limits generated in a previous attempt to describe the national abundance of riverside Brassica rapa (a wild relative of cultivated rapeseed) across the United Kingdom. Here, we assess the value of airborne remote sensing to locate B. rapa over large areas and so reduce the need for extrapolation. We describe results from flights over the river Nene in England acquired using Airborne Thematic Mapper (ATM) and Compact Airborne Spectrographic Imager (CASI) imagery, together with ground truth data. It proved possible to detect 97% of flowering B. rapa on the basis of spectral profiles. This included all stands of plants that occupied >2m square (>5 plants), which were detected using single-pixel classification. It also included very small populations (<5 flowering plants, 1-2m square) that generated mixed pixels, which were detected using spectral unmixing. The high detection accuracy for flowering B. rapa was coupled with a rather large false positive rate (43%). The latter could be reduced by using the image detections to target fieldwork to confirm species identity, or by acquiring additional remote sensing data such as laser altimetry or multitemporal imagery.

Uptake of a free coronary heart disease risk screening programme in community pharmacy: the Healthy Heart Assessment service

Introduction Health promotion (HP) aims to enhance good health while preventing ill-health at three levels of activity; primary (preventative), secondary (diagnostic) and tertiary (management).1 It can range from simple provision of health education to ongoing support, but the effectiveness of HP is ultimately dependent on its ability to influence change. HP as part of the Community Pharmacy Contract (CPC) aims to increase public knowledge and target ‘hard-to-reach’ individuals by focusing mainly on primary and tertiary HP. The CPC does not include screening programmes (secondary HP) as a service. Coronary heart disease (CHD) is a significant cause of morbidity and mortality in the UK. While there is evidence to support the effectiveness of some community pharmacy HP strategies in CHD, there is paucity of research in relation to screening services.2 Against this background, Alliance Pharmacy introduced a free CHD risk screening programme to provide tailored HP advice as part of a participant–pharmacist consultation. The aim of this study is to report on the CHD risk levels of participants and to provide a qualitative indication of consultation outcomes. Methods Case records for 12 733 people who accessed a free CHD risk screening service between August 2004 and April 2006 offered at 217 community pharmacies were obtained. The service involved initial self-completion of the Healthy Heart Assessment (HHA) form and measurement of height, weight, body mass index, blood pressure, total cholesterol and highdensity lipoprotein levels by pharmacists to calculate CHD risk.3 Action taken by pharmacists (lifestyle advice, statin recommendation or general practitioner (GP) referral) and qualitative statements of advice were recorded, and a copy provided to the participants. The service did not include follow-up of participants. All participants consented to taking part in evaluations of the service. Ethical committee scrutiny was not required for this service development evaluation. Results Case records for 10 035 participants (3658 male) were evaluable; 5730 (57%) were at low CHD risk (<15%); 3636 (36%) at moderate-to-high CHD risk (≥15%); and 669 (7%) had existing heart disease. A significantly higher proportion of male (48% versus 30% female) participants were at moderate- to-high risk of CHD (chi-square test; P < 0.005). A range of outcomes resulted from consultations. Lifestyle advice was provided irrespective of participants’ CHD risk or existing disease. In the moderate-to-high-risk group, of which 52% received prescribed medication, lifestyle advice was recorded for 62%, 16% were referred and 34% were advised to have a re-assessment. Statin recommendations were made in 1% of all cases. There was evidence of supportive and motivational statements in the advice recorded. Discussion Pharmacists were able to identify individuals’ level of CHD risk and provide them with bespoke advice. Identification of at-risk participants did not automatically result in referrals or statin recommendation. One-third of those accessing the screening service had moderate-to-high risk of CHD, a significantly higher proportion of whom were men. It is not known whether these individuals had been previously exposed to HP but presumably by accessing this service they may have contemplated change. As effectiveness of HP advice will depend among other factors on ability to influence change, future consultations may need to explore patients’ attitude towards change in relation to the Trans Theoretical Model4 to better tailor HP advice. The high uptake of the service by those at moderate-to-high CHD risk indicates a need for this type of screening programme in community pharmacy, perhaps specifically to reach men who access medical services less.

Categories of GM risk-benefit perceptions and their antecedents

The stated benefits and perceived risks of genetic modification (GM) cover very diverse issues, such as food safety, world food security, and the environment, that may differentially affect consumer acceptance. In this research, we hypothesize that consumers perceive up to eight dimensions: risks to business (farmers, agribusiness, etc.), benefits to business, risks and benefits to the environment, risks and benefits to the developing world, and risks and benefits to self and family. Moral concerns are also recognized. Using data collected in 2002 in the United States, France, and the UK, we investigate these different dimensions. Second, we analyze the extent to which the dimensions of risk-benefit perceptions can be explained by general attitudes widely used to explain food purchase behavior (such as general attitude to the environment, to technology, etc.), as well as by perceived knowledge of GM, level of education, and trust in various sources of information. In all locations, the majority of consumers only perceive a medium level of risk from GM products. Attitude to technology is the most important attitude variable—those with a positive attitude to technology in general also have a positive attitude to GM technology. More Americans than Europeans fall into this category. Those who trust government and the food industry tend to think GM technology is less risky, whereas those who trust activists believe the opposite. Americans are more trusting of the former, Europeans of the latter. Level of education is positively associated with benefit perceptions and negatively associated with moral concerns. Location continues to play a limited independent role in explaining perceptions even after these factors have been taken into account.

Use of airborne remote sensing to detect riverside Brassica rapa to aid in risk assessment of transgenic crops

High resolution descriptions of plant distribution have utility for many ecological applications but are especially useful for predictive modeling of gene flow from transgenic crops. Difficulty lies in the extrapolation errors that occur when limited ground survey data are scaled up to the landscape or national level. This problem is epitomized by the wide confidence limits generated in a previous attempt to describe the national abundance of riverside Brassica rapa (a wild relative of cultivated rapeseed) across the United Kingdom. Here, we assess the value of airborne remote sensing to locate B. rapa over large areas and so reduce the need for extrapolation. We describe results from flights over the river Nene in England acquired using Airborne Thematic Mapper (ATM) and Compact Airborne Spectrographic Imager (CASI) imagery, together with ground truth data. It proved possible to detect 97% of flowering B. rapa on the basis of spectral profiles. This included all stands of plants that occupied >2m square (>5 plants), which were detected using single-pixel classification. It also included very small populations (<5 flowering plants, 1-2m square) that generated mixed pixels, which were detected using spectral unmixing. The high detection accuracy for flowering B. rapa was coupled with a rather large false positive rate (43%). The latter could be reduced by using the image detections to target fieldwork to confirm species identity, or by acquiring additional remote sensing data such as laser altimetry or multitemporal imagery.

Self-exclusion from health care in women at high risk for postpartum depression

Background A significant proportion of women who are vulnerable to postnatal depression refuse to engage in treatment programmes. Little is known about them, other than some general demographic characteristics. In particular, their access to health care and their own and their infants' health outcomes are uncharted. Methods We conducted a nested cohort case-control study, using data from computerized health systems, and general practitioner (GP) and maternity records, to identify the characteristics, health service contacts, and maternal and infant health outcomes for primiparous antenatal clinic attenders at high risk for postnatal depression who either refused (self-exclusion group) or else agreed (take-up group) to receive additional Health Visiting support in pregnancy and the first 2 months postpartum. Results Women excluding themselves from Health Visitor support were younger and less highly educated than women willing to take up the support. They were less likely to attend midwifery, GP and routine Health Visitor appointments, but were more likely to book in late and to attend accident and emergency department (A&E). Their infants had poorer outcome in terms of gestation, birthweight and breastfeeding. Differences between the groups still obtained when age and education were taken into account for midwifery contacts, A&E attendance and gestation;the difference in the initiation of breast feeding was attenuated, but not wholly explained, by age and education. Conclusion A subgroup of psychologically vulnerable childbearing women are at particular risk for poor access to health care and adverse infant outcome. Barriers to take-up of services need to be understood in order better to deliver care.

The price of risk in construction projects: contingency approximation model (CAM)

Little attention has been focussed on a precise definition and evaluation mechanism for project management risk specifically related to contractors. When bidding, contractors traditionally price risks using unsystematic approaches. The high business failure rate our industry records may indicate that the current unsystematic mechanisms contractors use for building up contingencies may be inadequate. The reluctance of some contractors to include a price for risk in their tenders when bidding for work competitively may also not be a useful approach. Here, instead, we first define the meaning of contractor contingency, and then we develop a facile quantitative technique that contractors can use to estimate a price for project risk. This model will help contractors analyse their exposure to project risks; and help them express the risk in monetary terms for management action. When bidding for work, they can decide how to allocate contingencies strategically in a way that balances risk and reward.

A review of climate risk information for adaptation and development planning

Although the use of climate scenarios for impact assessment has grown steadily since the 1990s, uptake of such information for adaptation is lagging by nearly a decade in terms of scientific output. Nonetheless, integration of climate risk information in development planning is now a priority for donor agencies because of the need to prepare for climate change impacts across different sectors and countries. This urgency stems from concerns that progress made against Millennium Development Goals (MDGs) could be threatened by anthropogenic climate change beyond 2015. Up to this time the human signal, though detectable and growing, will be a relatively small component of climate variability and change. This implies the need for a twin-track approach: on the one hand, vulnerability assessments of social and economic strategies for coping with present climate extremes and variability, and, on the other hand, development of climate forecast tools and scenarios to evaluate sector-specific, incremental changes in risk over the next few decades. This review starts by describing the climate outlook for the next couple of decades and the implications for adaptation assessments. We then review ways in which climate risk information is already being used in adaptation assessments and evaluate the strengths and weaknesses of three groups of techniques. Next we identify knowledge gaps and opportunities for improving the production and uptake of climate risk information for the 2020s. We assert that climate change scenarios can meet some, but not all, of the needs of adaptation planning. Even then, the choice of scenario technique must be matched to the intended application, taking into account local constraints of time, resources, human capacity and supporting infrastructure. We also show that much greater attention should be given to improving and critiquing models used for climate impact assessment, as standard practice. Finally, we highlight the over-arching need for the scientific community to provide more information and guidance on adapting to the risks of climate variability and change over nearer time horizons (i.e. the 2020s). Although the focus of the review is on information provision and uptake in developing regions, it is clear that many developed countries are facing the same challenges. Copyright © 2009 Royal Meteorological Society