The potential consequences of climate variability and change on coastal areas and marine resources: report of the Coastal Areas and Marine Resources Sector Team, U.S. National Assessment of the Potential Consequences of Climate Variability and Change, U.S. Global Change Research Program

Coastal and marine ecosystems support diverse and important fisheries throughout the nation’s waters, hold vast storehouses of biological diversity, and provide unparalleled recreational opportunities. Some 53% of the total U.S. population live on the 17% of land in the coastal zone, and these areas become more crowded every year. Demands on coastal and marine resources are rapidly increasing, and as coastal areas become more developed, the vulnerability of human settlements to hurricanes, storm surges, and flooding events also increases. Coastal and marine environments are intrinsically linked to climate in many ways. The ocean is an important distributor of the planet’s heat, and this distribution could be strongly influenced by changes in global climate over the 21st century. Sea-level rise is projected to accelerate during the 21st century, with dramatic impacts in low-lying regions where subsidence and erosion problems already exist. Many other impacts of climate change on the oceans are difficult to project, such as the effects on ocean temperatures and precipitation patterns, although the potential consequences of various changes can be assessed to a degree. In other instances, research is demonstrating that global changes may already be significantly impacting marine ecosystems, such as the impact of increasing nitrogen on coastal waters and the direct effect of increasing carbon dioxide on coral reefs. Coastal erosion is already a widespread problem in much of the country and has significant impacts on undeveloped shorelines as well as on coastal development and infrastructure. Along the Pacific Coast, cycles of beach and cliff erosion have been linked to El Niño events that elevate average sea levels over the short term and alter storm tracks that affect erosion and wave damage along the coastline. These impacts will be exacerbated by long-term sea-level rise. Atlantic and Gulf coastlines are especially vulnerable to long-term sea-level rise as well as any increase in the frequency of storm surges or hurricanes. Most erosion events here are the result of storms and extreme events, and the slope of these areas is so gentle that a small rise in sea level produces a large inland shift of the shoreline. When buildings, roads and seawalls block this natural migration, the beaches and shorelines erode, threatening property and infrastructure as well as coastal ecosystems.

Ecological condition of coastal ocean waters of the U.S. continental shelf off South Florida: 2007

A study was initiated with field work in May 2007 to assess the status of ecological condition and stressor impacts throughout the U.S. continental shelf off South Florida, focusing on soft-bottom habitats, and to provide this information as a baseline for evaluating future changes due to natural or human-induced disturbances. The boundaries of the study region extended from Anclote Key on the western coast of Florida to West Palm Beach on the eastern coast of Florida, inclusive of the Florida Keys National Marine Sanctuary (FKNMS), and from navigable depths along the shoreline seaward to the shelf break (~100m). The study incorporated standard methods and indicators applied in previous national coastal monitoring programs — U.S. Environmental Protection Agency’s (EPA) Environmental Monitoring and Assessment Program (EMAP) and National Coastal Assessment (NCA) — including multiple measures of water quality, sediment quality, and biological condition. Synoptic sampling of the various indicators provided an integrative weight-of-evidence approach to assessing condition at each station and a basis for examining potential associations between presence of stressors and biological responses. A probabilistic sampling design, which included 50 stations distributed randomly throughout the region, was used to provide a basis for estimating the spatial extent of condition relative to the various measured indicators and corresponding assessment endpoints (where available). The study was conducted through a large cooperative effort by National Oceanic and Atmospheric Administration (NOAA)/National Centers for Coastal Ocean Science (NCCOS), EPA, U.S. Geological Survey (USGS), NOAA/Oceanic and Atmospheric Research (OAR)/Atlantic Oceanographic and Meteorological Laboratory in Miami, FKNMS, and the Florida Fish and Wildlife Conservation Commission (FWC). The majority of the South Florida shelf had high levels of dissolved oxygen (DO) in near-bottom water (> 5 mg L-1) indicative of “good” water quality.. DO levels in bottom waters exceeded this upper threshold at 98.8% throughout the coastal-ocean survey area. Only 1.2% of the region had moderate DO levels (2-5 mg/L) and no part of the survey area had DO <2.0 mg/L. In addition, offshore waters throughout the region had relatively low levels of total suspended solids (TSS), nutrients, and chlorophyll a indicative of oligotrophic conditions. Results suggested good sediment quality as well. Sediments throughout the region, which ranged from sands to intermediate muddy sands, had low levels of total organic carbon (TOC) below bioeffect guidelines for benthic organisms. Chemical contaminants in sediments were also mostly at low, background levels. For example, none of the stations had chemicals in excess of corresponding Effects-Range Median (ERM) probable bioeffect values or more than one chemical in excess of lower-threshold Effects-Range Low (ERL) values. Cadmium was the only chemical that occurred at moderate concentrations between corresponding ERL and ERM values. Sixty fish samples from 28 stations were collected and analyzed for chemical contaminants. Eleven of these samples (39% of sites) had moderate levels of contaminants, between lower and upper non-cancer human-health thresholds, and ten (36% of sites) had high levels of contaminants above the upper threshold.

National summary of NOAA's shallow-water benthic habitat mapping of U.S. coral reef ecosystems

Coral reef ecosystems are some of the most complex and important ecosystems in the marine environment. They are also among the most biologically diverse and economically valuable ecosystems on earth, producing billions of dollars in food, as well as providing a suite of ecological services, such as recreation and tourism activities and coastal protection from storm and wave action. Yet, despite their value and importance, these fragile ecosystems are declining at an alarming rate (Waddell and Clarke (eds.) 2008) due to a myriad of threats both natural and manmade, including climate change, fishing pressure, and runoff and sedimentation. In response, the Unites States Coal Reef Task Force was established in 1998 by Presidential Executive Order 13089 to lead U.S. efforts to preserve and protect the nation’s coral reef ecosystems. In order to better understand the current state of coral reef ecosystems and successfully mitigate the impacts of stressors, informational products, such as benthic (or sea floor) habitat maps, are critical. Benthic habitat maps support the ability to prioritize areas for further study and protection, and offer a baseline to evaluate the changes in ecosystems over time. In 2000, the United States Coral Reef Task Force charged NOAA with leading federal efforts to produce comprehensive digital maps of all U.S. shallow-water (approximately 0 to 30 m in depth) coral reef ecosystem habitats.

Spatial and temporal patterns of coral bleaching around Buck Island Reef National Monument, St. Croix, U.S. Virgin Islands

Since 2001, biannual fish and habitat monitoring has been conducted for the shallow (> 30 m), colonized pavement and gorgonian dominated Buck Island Reef National Monument (BIRNM) St. Croix, USVI and adjacent waters. during October, 2005, widespread coral bleaching was observed within the ∼50 square-kilometer study area that was preceded by 10 wks of higher than average water temperatures (28.9–30.1 °C). Random transects (100 square meters) were conducted on linear reefs, patch reefs, bedrock, pavement, and scattered coral/rock habitats during October 2005, and April and October 2006, and species specific bleaching patterns were documented. During October 2005 approximately 51% of live coral cover was bleached. Nineteen of 23 coral species within 16 genera and two hydrocoral species exhibited signs of bleaching. Coral cover for Montastraea annularis and species of the genus Agaricia were the most affected, while other species exhibited variability in their susceptibility to bleaching. Bleaching was evident at all depths (1.5–28 m), was negatively correlated with depth, and positively correlated with habitat complexity. Bleaching was less prevalent at all depths and habitat types upon subsequent monitoring during April (15%) and October (3%) 2006. Four species and one genus did not exhibit signs of bleaching throughout the study period (Dendrogyra cylindrus, Eusmilia fastigata, Mussa angulosa, Mycetophyllia aliciae, Scolymia spp.).

Spatial and temporal patterns of coral bleaching around Buck Island Reef National Monument, St. Croix, U.S. Virgin Islands [poster]

Limited information currently exists on the recovery periods of bleached corals as well as the spatial extent, causative factors, and the overall impact of bleaching on coral reef ecosystems. During October, 2005, widespread coral bleaching was observed within Buck Island Reef National Monument (BUIS) St. Croix, USVI. The bleaching event was preceded by 10 weeks of higher than average water temperatures (28.9-30.1°C). Random transects (100 square meters) over hard bottom habitats (N=94) revealed that approximately 51% of live coral cover was bleached. Nineteen of 23 coral species within 16 genera and two hydrocoral species exhibited signs of bleaching; species-specific bleaching patterns were variable throughout the study area. Coral cover for Montastraea annularisand species of the genus Agariciawere the most affected, while other species exhibited variability to bleaching. Although a weak but significant negative relationship (r2=0.10, P=0.0220) was observed, bleaching was evident at all depths (1.5-28 m). Bleaching was spatially autocorrelated (P=0.001) and hot-spot analysis identified a cluster of high bleaching stations northeast of Buck Island. Bleaching was significantly reduced within all depth zones and habitat types upon subsequent monitoring during April (15%) and October (3%) 2006.

An assessment of polybrominated diphenyl ethers (PBDEs) in sediments and bivalves of the U.S. coastal zone

NOAA’s Mussel Watch Program was designed to monitor the status and trends of chemical contamination of U.S. coastal waters, including the Great Lakes. The Program began in 1986 and is one of the longest running, continuous coastal monitoring programs that is national in scope. NOAA established Mussel Watch in response to a legislative mandate under Section 202 of Title II of the Marine Protection, Research and Sanctuaries Act (MPRSA) (33 USC 1442). In addition to monitoring contaminants throughout the Nation’s coastal shores, Mussel Watch stores samples in a specimen bank so that trends can be determined retrospectively for new and emerging contaminants of concern. In recent years, flame retardant chemicals, known as polybrominated diphenyl ethers (PBDEs), have generated international concern over their widespread distribution in the environment, their potential to bioaccumulate in humans and wildlife, and concern for suspected adverse human health effects. The Mussel Watch Program, with additional funding provided by NOAA’s Oceans and Human Health Initiative, conducted a study of PBDEs in bivalve tissues and sediments. This report, which represents the first national assessment of PBDEs in the U.S. coastal zone, shows that they are widely distributed. PBDE concentrations in both sediment and bivalve tissue correlate with human population density along the U.S. coastline. The national and watershed perspectives given in this report are intended to support research, local monitoring, resource management, and policy decisions concerning these contaminants.

Evaluation of the Specialist Libraries/Communities of Practice. Report for National Library for Health

Cooper, J., Spink, S., Thomas, R. & Urquhart, C. (2005). Evaluation of the Specialist Libraries/Communities of Practice. Report for National Library for Health. Aberystwyth: Department of Information Studies, University of Wales Aberystwyth. Sponsorship: National Library for Health (NLH)

Effects of a demand-led evidence briefing service on the uptake and use of research evidence by commissioners of health services: protocol for a controlled before and after study

Background: Clinical Commissioning Groups (CCGs) are mandated to use research evidence effectively to ensure optimum use of resources by the National Health Service (NHS), both in accelerating innovation and in stopping the use of less effective practices and models of service delivery. We intend to evaluate whether access to a demand-led evidence service improves uptake and use of research evidence by NHS commissioners compared with less intensive and less targeted alternatives. 

Methods/design: This is a controlled before and after study involving CCGs in the North of England. Participating CCGs will receive one of three interventions to support the use of research evidence in their decision-making:1) consulting plus responsive push of tailored evidence; 2) consulting plus an unsolicited push of non-tailored evidence; or 3) standard service unsolicited push of non-tailored evidence. Our primary outcome will be changed at 12 months from baseline of a CCGs ability to acquire, assess, adapt and apply research evidence to support decision-making. Secondary outcomes will measure individual clinical leads and managers’ intentions to use research evidence in decision making. Documentary evidence of the use of the outputs of the service will be sought. A process evaluation will evaluate the nature and success of the interactions both within the sites and between commissioners and researchers delivering the service. 

Discussion: The proposed research will generate new knowledge of direct relevance and value to the NHS. The findings will help to clarify which elements of the service are of value in promoting the use of research evidence.Those involved in NHS commissioning will be able to use the results to inform how best to build the infrastructure they need to acquire, assess, adapt and apply research evidence to support decision-making and to fulfil their statutory duties under the Health and Social Care Act.

The Role and Effectiveness of Public – Private Partnerships (NHS LIFT) in the Development of Enhanced Primary Care Premises and Services:Report for the National Institute for Health Research Service Delivery and Organisation programme

The research project analysed the role and effectiveness of LIFT via a multi-method study which included semi-structured interviews with policy elites and users, as well as case studies and an exploratory analysis of the financial characteristics of three LIFT Companies. While the team felt that it was able to identify key aspects relating to the advantages and drawbacks surrounding LIFT, some aspects relating to the representativeness of the study was adversely affected by a reluctance of PCTs to participate in the case study analysis and commercial confidentiality restrictions. The study was nonetheless able to identify important issues in relation to the funding and procurement of primary care premises and services.

Investigating active transportation to and from school : identification of predictors and health benefits

Funding support for this doctoral thesis has been provided by the Canadian Institutes of Health Research-Public Health Agency of Canada, QICSS matching grant, and la Faculté des études supérieures et postdoctorales-Université de Montréal.

Calidad de vida en personas con hemofilia: una revisión de la literatura

Introducción: La hemofilia es una enfermedad poco frecuente; no obstante, los avances en los tratamientos de pacientes hemofílicos en las últimas décadas han generado cambios en su calidad de vida. Esto ha motivado el desarrollo de múltiples investigaciones al respecto. Objetivo: Revisar la literatura sobre la calidad de vida en el paciente hemofílico, producida en el periodo 2008-2012. Método: Se consultaron algunas bases de datos científicas utilizando como palabras clave “hemofilia” y “calidad de vida”. Se recopiló la información encontrada y se organizó según los objetivos propuestos en “factores negativos” y “factores protectores” de la calidad de vida a nivel fisiológico, psicosocial y cultural; “instrumentos para la evaluación de la calidad de vida” a nivel específico y general; y antecedentes empíricos de los últimos cinco años en los que se evaluara la calidad de vida o se realizara alguna intervención en la misma. Resultados: En general la información disponible sobre el comportamiento epidemiológico de la hemofilia es limitada. El interés por factores protectores y negativos es principalmente de tipo fisiológico, aunque se encontraron factores de tipo psicosocial y cultural, lo que indica la importancia de profundizar en esta temática. Existen pocos instrumentos especializados para la evaluación de la calidad de vida en hemofílicos. La evidencia empírica se centra en la evaluación. Conclusión: El estudio de la calidad de vida en pacientes hemofílicos amerita ser abordado de manera interdisciplinaria.

Obsessive Compulsive Treatment Efficacy Trial (OCTET) comparing the clinical and cost effectiveness of self-managed therapies: study protocol for a randomised controlled trial

Background: UK National Institute of Health and Clinical Excellence guidelines for obsessive compulsive disorder (OCD) specify recommendations for the treatment and management of OCD using a stepped care approach. Steps three to six of this model recommend treatment options for people with OCD that range from low-intensity guided self-help (GSH) to more intensive psychological and pharmacological interventions. Cognitive behavioural therapy (CBT), including exposure and response prevention, is the recommended psychological treatment. However, whilst there is some preliminary evidence that self-managed therapy packages for OCD can be effective, a more robust evidence base of their clinical and cost effectiveness and acceptability is required. Methods/Design: Our proposed study will test two different self-help treatments for OCD: 1) computerised CBT (cCBT) using OCFighter, an internet-delivered OCD treatment package; and 2) GSH using a book. Both treatments will be accompanied by email or telephone support from a mental health professional. We will evaluate the effectiveness, cost and patient and health professional acceptability of the treatments. Discussion: This study will provide more robust evidence of efficacy, cost effectiveness and acceptability of self-help treatments for OCD. If cCBT and/or GSH prove effective, it will provide additional, more accessible treatment options for people with OCD.