Projecting future air pollution-related mortality under a changing climate: Progress, uncertainties and research needs

Background Climate change may affect mortality associated with air pollutants, especially for fine particulate matter (PM2.5) and ozone (O3). Projection studies of such kind involve complicated modelling approaches with uncertainties. Objectives We conducted a systematic review of researches and methods for projecting future PM2.5-/O3-related mortality to identify the uncertainties and optimal approaches for handling uncertainty. Methods A literature search was conducted in October 2013, using the electronic databases: PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search was limited to peer-reviewed journal articles published in English from January 1980 to September 2013. Discussion Fifteen studies fulfilled the inclusion criteria. Most studies reported that an increase of climate change-induced PM2.5 and O3 may result in an increase in mortality. However, little research has been conducted in developing countries with high emissions and dense populations. Additionally, health effects induced by PM2.5 may dominate compared to those caused by O3, but projection studies of PM2.5-related mortality are fewer than those of O3-related mortality. There is a considerable variation in approaches of scenario-based projection researches, which makes it difficult to compare results. Multiple scenarios, models and downscaling methods have been used to reduce uncertainties. However, few studies have discussed what the main source of uncertainties is and which uncertainty could be most effectively reduced. Conclusions Projecting air pollution-related mortality requires a systematic consideration of assumptions and uncertainties, which will significantly aid policymakers in efforts to manage potential impacts of PM2.5 and O3 on mortality in the context of climate change.

Evidencing reflective practice in social work education: Theoretical uncertainties and practical challenges

Reflective practice has become an increasingly influential idea in social work education and, in the UK context, it has recently been acknowledged as key to ensuring that social workers are better equipped to engage in complex decision making and effective practice. However, there remains a lack of clarity about how this concept is defined and operationalised in teaching and learning and there has been little systematic empirical examination of its utility in facilitating professional development. Drawing on research with undergraduates at Queen's University Belfast, this paper aims to develop understanding of students' experience of reflective practice. The results suggest that agency systems that have become over-reliant on rules and procedures present formidable obstacles to learning both at an individual and at an organisational level. The paper argues that the relationship between how reflective practice is taught and how it is enacted in practice needs to be better understood if such obstacles are to be overcome. The paper concludes by considering the implications of the findings for developing reflective practice in social work education and practice and highlights the challenges that need to be addressed if reflection and critical thinking are to become more firmly embedded within agency systems and practice cultures.

UV index measurement and model agreement: uncertainties and limitations

En les últimes dècades, l'increment dels nivells de radiació solar ultraviolada (UVR) que arriba a la Terra (principalment degut a la disminució d'ozó estratosfèric) juntament amb l'augment detectat en malalties relacionades amb l'exposició a la UVR, ha portat a un gran volum d'investigacions sobre la radiació solar en aquesta banda i els seus efectes en els humans. L'índex ultraviolat (UVI), que ha estat adoptat internacionalment, va ser definit amb el propòsit d'informar al públic general sobre els riscos d'exposar el cos nu a la UVR i per tal d'enviar missatges preventius. L'UVI es va definir inicialment com el valor màxim diari. No obstant, el seu ús actual s'ha ampliat i té sentit referir-se a un valor instantani o a una evolució diària del valor d'UVI mesurat, modelitzat o predit. El valor concret d'UVI està afectat per la geometria Sol-Terra, els núvols, l'ozó, els aerosols, l'altitud i l'albedo superficial. Les mesures d'UVI d'alta qualitat són essencials com a referència i per estudiar tendències a llarg termini; es necessiten també tècniques acurades de modelització per tal d'entendre els factors que afecten la UVR, per predir l'UVI i com a control de qualitat de les mesures. És d'esperar que les mesures més acurades d'UVI s'obtinguin amb espectroradiòmetres. No obstant, com que els costs d'aquests dispositius són elevats, és més habitual trobar dades d'UVI de radiòmetres eritemàtics (de fet, la majoria de les xarxes d'UVI estan equipades amb aquest tipus de sensors). Els millors resultats en modelització s'obtenen amb models de transferència radiativa de dispersió múltiple quan es coneix bé la informació d'entrada. No obstant, habitualment no es coneix informació d'entrada, com per exemple les propietats òptiques dels aerosols, la qual cosa pot portar a importants incerteses en la modelització. Sovint, s'utilitzen models més simples per aplicacions com ara la predicció d'UVI o l'elaboració de mapes d'UVI, ja que aquests són més ràpids i requereixen menys paràmetres d'entrada. Tenint en compte aquest marc de treball, l'objectiu general d'aquest estudi és analitzar l'acord al qual es pot arribar entre la mesura i la modelització d'UVI per condicions de cel sense núvols. D'aquesta manera, en aquest estudi es presenten comparacions model-mesura per diferents tècniques de modelització, diferents opcions d'entrada i per mesures d'UVI tant de radiòmetres eritemàtics com d'espectroradiòmeters. Com a conclusió general, es pot afirmar que la comparació model-mesura és molt útil per detectar limitacions i estimar incerteses tant en les modelitzacions com en les mesures. Pel que fa a la modelització, les principals limitacions que s'han trobat és la falta de coneixement de la informació d'aerosols considerada com a entrada dels models. També, s'han trobat importants diferències entre l'ozó mesurat des de satèl·lit i des de la superfície terrestre, la qual cosa pot portar a diferències importants en l'UVI modelitzat. PTUV, una nova i simple parametrització pel càlcul ràpid d'UVI per condicions de cel serens, ha estat desenvolupada en base a càlculs de transferència radiativa. La parametrització mostra una bona execució tant respecte el model base com en comparació amb diverses mesures d'UVI. PTUV ha demostrat la seva utilitat per aplicacions particulars com ara l'estudi de l'evolució anual de l'UVI per un cert lloc (Girona) i la composició de mapes d'alta resolució de valors d'UVI típics per un territori concret (Catalunya). En relació a les mesures, es constata que és molt important saber la resposta espectral dels radiòmetres eritemàtics per tal d'evitar grans incerteses a la mesura d'UVI. Aquest instruments, si estan ben caracteritzats, mostren una bona comparació amb els espectroradiòmetres d'alta qualitat en la mesura d'UVI. Les qüestions més importants respecte les mesures són la calibració i estabilitat a llarg termini. També, s'ha observat un efecte de temperatura en el PTFE, un material utilitzat en els difusors en alguns instruments, cosa que potencialment podria tenir implicacions importants en el camp experimental. Finalment, i pel que fa a les comparacions model-mesura, el millor acord s'ha trobat quan es consideren mesures d'UVI d'espectroradiòmetres d'alta qualitat i s'usen models de transferència radiativa que consideren les millors dades disponibles pel que fa als paràmetres òptics d'ozó i aerosols i els seus canvis en el temps. D'aquesta manera, l'acord pot ser tan alt dins un 0.1º% en UVI, i típicament entre menys d'un 3%. Aquest acord es veu altament deteriorat si s'ignora la informació d'aerosols i depèn de manera important del valor d'albedo de dispersió simple dels aerosols. Altres dades d'entrada del model, com ara l'albedo superficial i els perfils d'ozó i temperatura introdueixen una incertesa menor en els resultats de modelització.

Uncertainties and assessments of chemistry-climate models of the stratosphere

In recent years a number of chemistry-climate models have been developed with an emphasis on the stratosphere. Such models cover a wide range of time scales of integration and vary considerably in complexity. The results of specific diagnostics are here analysed to examine the differences amongst individual models and observations, to assess the consistency of model predictions, with a particular focus on polar ozone. For example, many models indicate a significant cold bias in high latitudes, the “cold pole problem”, particularly in the southern hemisphere during winter and spring. This is related to wave propagation from the troposphere which can be improved by improving model horizontal resolution and with the use of non-orographic gravity wave drag. As a result of the widely differing modelled polar temperatures, different amounts of polar stratospheric clouds are simulated which in turn result in varying ozone values in the models. The results are also compared to determine the possible future behaviour of ozone, with an emphasis on the polar regions and mid-latitudes. All models predict eventual ozone recovery, but give a range of results concerning its timing and extent. Differences in the simulation of gravity waves and planetary waves as well as model resolution are likely major sources of uncertainty for this issue. In the Antarctic, the ozone hole has probably reached almost its deepest although the vertical and horizontal extent of depletion may increase slightly further over the next few years. According to the model results, Antarctic ozone recovery could begin any year within the range 2001 to 2008. The limited number of models which have been integrated sufficiently far indicate that full recovery of ozone to 1980 levels may not occur in the Antarctic until about the year 2050. For the Arctic, most models indicate that small ozone losses may continue for a few more years and that recovery could begin any year within the range 2004 to 2019. The start of ozone recovery in the Arctic is therefore expected to appear later than in the Antarctic.

Leading brazilian multinational enterprises: trends in an era of significant uncertainties and challenges

Escola de Administração de Empresas de São Paulo

Transient Earth system responses to cumulative carbon dioxide emissions: linearities, uncertainties, and probabilities in an observation-constrained model ensemble

Information on the relationship between cumulative fossil CO2 emissions and multiple climate targets is essential to design emission mitigation and climate adaptation strategies. In this study, the transient response of a climate or environmental variable per trillion tonnes of CO2 emissions, termed TRE, is quantified for a set of impact-relevant climate variables and from a large set of multi-forcing scenarios extended to year 2300 towards stabilization. An  ∼ 1000-member ensemble of the Bern3D-LPJ carbon–climate model is applied and model outcomes are constrained by 26 physical and biogeochemical observational data sets in a Bayesian, Monte Carlo-type framework. Uncertainties in TRE estimates include both scenario uncertainty and model response uncertainty. Cumulative fossil emissions of 1000 Gt C result in a global mean surface air temperature change of 1.9 °C (68 % confidence interval (c.i.): 1.3 to 2.7 °C), a decrease in surface ocean pH of 0.19 (0.18 to 0.22), and a steric sea level rise of 20 cm (13 to 27 cm until 2300). Linearity between cumulative emissions and transient response is high for pH and reasonably high for surface air and sea surface temperatures, but less pronounced for changes in Atlantic meridional overturning, Southern Ocean and tropical surface water saturation with respect to biogenic structures of calcium carbonate, and carbon stocks in soils. The constrained model ensemble is also applied to determine the response to a pulse-like emission and in idealized CO2-only simulations. The transient climate response is constrained, primarily by long-term ocean heat observations, to 1.7 °C (68 % c.i.: 1.3 to 2.2 °C) and the equilibrium climate sensitivity to 2.9 °C (2.0 to 4.2 °C). This is consistent with results by CMIP5 models but inconsistent with recent studies that relied on short-term air temperature data affected by natural climate variability.

Reduction of setup uncertainties and tumor motion in the radiation therapy of lung tumors

Because the goal of radiation therapy is to deliver a lethal dose to the tumor, accurate information on the location of the tumor needs to be known. Margins are placed around the tumor to account for variations in the daily position of the tumor. If tumor motion and patient setup uncertainties can be reduced, margins that account for such uncertainties in tumor location in can be reduced allowing dose escalation, which in turn could potentially improve survival rates. ^ In the first part of this study, we monitor the location of fiducials implanted in the periphery of lung tumors to determine the extent of non-gated and gated fiducial motion, and to quantify patient setup uncertainties. In the second part we determine where the tumor is when different methods of image-guided patient setup and respiratory gating are employed. In the final part we develop, validate, and implement a technique in which patient setup uncertainties are reduced by aligning patients based upon fiducial locations in projection images. ^ Results from the first part indicate that respiratory gating reduces fiducial motion relative to motion during normal respiration and setup uncertainties when the patients were aligned each day using externally placed skin marks are large. The results from the second part indicate that current margins that account for setup uncertainty and tumor motion result in less than 2% of the tumor outside of the planning target volume (PTV) when the patient is aligned using skin marks. In addition, we found that if respiratory gating is going to be used, it is most effective if used in conjunction with image-guided patient setup. From the third part, we successfully developed, validated, and implemented on a patient a technique for aligning a moving target prior to treatment to reduce the uncertainties in tumor location. ^ In conclusion, setup uncertainties and tumor motion are a significant problem when treating tumors located within the thoracic region. Image-guided patient setup in conjunction with treatment delivery using respiratory gating reduces these uncertainties in tumor locations. In doing so, margins around the tumor used to generate the PTV can be reduced, which may allow for dose escalation to the tumor. ^

Improving Cervical Cancer Nodal Boost Radiation Therapy by Quantifying Uncertainties and Exploring Advanced Radiation Therapy Modalities

Radiation therapy for patients with intact cervical cancer is frequently delivered using primary external beam radiation therapy (EBRT) followed by two fractions of intracavitary brachytherapy (ICBT). Although the tumor is the primary radiation target, controlling microscopic disease in the lymph nodes is just as critical to patient treatment outcome. In patients where gross lymphadenopathy is discovered, an extra EBRT boost course is delivered between the two ICBT fractions. Since the nodal boost is an addendum to primary EBRT and ICBT, the prescription and delivery must be performed considering previously delivered dose. This project aims to address the major issues of this complex process for the purpose of improving treatment accuracy while increasing dose sparing to the surrounding normal tissues. Because external beam boosts to involved lymph nodes are given prior to the completion of ICBT, assumptions must be made about dose to positive lymph nodes from future implants. The first aim of this project was to quantify differences in nodal dose contribution between independent ICBT fractions. We retrospectively evaluated differences in the ICBT dose contribution to positive pelvic nodes for ten patients who had previously received external beam nodal boost. Our results indicate that the mean dose to the pelvic nodes differed by up to 1.9 Gy between independent ICBT fractions. The second aim is to develop and validate a volumetric method for summing dose of the normal tissues during prescription of nodal boost. The traditional method of dose summation uses the maximum point dose from each modality, which often only represents the worst case scenario. However, the worst case is often an exaggeration when highly conformal therapy methods such as intensity modulated radiation therapy (IMRT) are used. We used deformable image registration algorithms to volumetrically sum dose for the bladder and rectum and created a voxel-by-voxel validation method. The mean error in deformable image registration results of all voxels within the bladder and rectum were 5 and 6 mm, respectively. Finally, the third aim explored the potential use of proton therapy to reduce normal tissue dose. A major physical advantage of protons over photons is that protons stop after delivering dose in the tumor. Although theoretically superior to photons, proton beams are more sensitive to uncertainties caused by interfractional anatomical variations, and must be accounted for during treatment planning to ensure complete target coverage. We have demonstrated a systematic approach to determine population-based anatomical margin requirements for proton therapy. The observed optimal treatment angles for common iliac nodes were 90° (left lateral) and 180° (posterior-anterior [PA]) with additional 0.8 cm and 0.9 cm margins, respectively. For external iliac nodes, lateral and PA beams required additional 0.4 cm and 0.9 cm margins, respectively. Through this project, we have provided radiation oncologists with additional information about potential differences in nodal dose between independent ICBT insertions and volumetric total dose distribution in the bladder and rectum. We have also determined the margins needed for safe delivery of proton therapy when delivering nodal boosts to patients with cervical cancer.

Modal analysis of buildings : quantification of uncertainties and model updating

Una estructura vibra con la suma de sus infinitos modos de vibración, definidos por sus parámetros modales (frecuencias naturales, formas modales y coeficientes de amortiguamiento). Estos parámetros se pueden identificar a través del Análisis Modal Operacional (OMA). Así, un equipo de investigación de la Universidad Politécnica de Madrid ha identificado las propiedades modales de un edificio de hormigón armado en Madrid con el método Identificación de los sub-espacios estocásticos (SSI). Para completar el estudio dinámico de este edificio, se ha desarrollado un modelo de elementos finitos (FE) de este edificio de 19 plantas. Este modelo se ha calibrado a partir de su comportamiento dinámico obtenido experimentalmente a través del OMA. Los objetivos de esta tesis son; (i) identificar la estructura con varios métodos de SSI y el uso de diferentes ventanas de tiempo de tal manera que se cuantifican incertidumbres de los parámetros modales debidos al proceso de estimación, (ii) desarrollar FEM de este edificio y calibrar este modelo a partir de su comportamiento dinámico, y (iii) valorar la bondad del modelo. Los parámetros modales utilizados en esta calibración han sido; espesor de las losas, densidades de los materiales, módulos de elasticidad, dimensiones de las columnas y las condiciones de contorno de la cimentación. Se ha visto que el modelo actualizado representa el comportamiento dinámico de la estructura con una buena precisión. Por lo tanto, este modelo puede utilizarse dentro de un sistema de monitorización estructural (SHM) y para la detección de daños. En el futuro, podrá estudiar la influencia de los agentes medioambientales, tales como la temperatura o el viento, en los parámetros modales. A structure vibrates according to the sum of its vibration modes, defined by their modal parameters (natural frequencies, damping ratios and modal shapes). These parameters can be identified through Operational Modal Analysis (OMA). Thus, a research team of the Technical University of Madrid has identified the modal properties of a reinforced-concrete-frame building in Madrid using the Stochastic Subspace Identification (SSI) method and a time domain technique for the OMA. To complete the dynamic study of this building, a finite element model (FE) of this 19-floor building has been developed throughout this thesis. This model has been updated from its dynamic behavior identified by the OMA. The objectives of this thesis are to; (i) identify the structure with several SSI methods and using different time blocks in such a way that uncertainties due to the modal parameter estimation are quantified, (ii) develop a FEM of this building and tune this model from its dynamic behavior, and (iii) Assess the quality of the model, the modal parameters used in this updating process have been; thickness of slabs, material densities, modulus of elasticity, column dimensions and foundation boundary conditions. It has been shown that the final updated model represents the structure with a very good accuracy. Thus, this model might be used within a structural health monitoring framework (SHM). The study of the influence of changing environmental factors (such as temperature or wind) on the model parameters might be considered as a future work.

The psychotogenic effects of cannabis use: challenges in reducing residual uncertainties and communicating the risks

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