Iain Lake

@article{968e2f22939f497b9826f4de35828300,

title = {Animal and environmental risk factors for sporadic Shiga toxin-producing Escherichia coli (STEC) infection in England: A case control study for O157, O26 and other STEC serotypes},

author = {Erica Kintz and Julii Brainard and Mike Vanderes and Roberto Vivancos and Lisa Byrne and Saira Butt and Claire Jenkins and Richard Elson and Iain Lake and Paul Hunter},

doi = {10.1080/20477724.2023.2197672},

issn = {2047-7724},

year  = {2023},

date = {2023-09-01},

journal = {Pathogens and Global Health},

volume = {117},

number = {7},

pages = {655–663},

publisher = {Taylor and Francis},

abstract = {Most Shiga toxin-producing E. coli (STEC) infections are sporadic. Routine enhanced surveillance questionnaires of confirmed STEC cases in England contained promising data to conduct a case-control study to identify non-food exposures linked to the risk of becoming infected with different STEC serotypes, including O157, O26 and all others; this study pulled eligible cases from the recorded enhanced surveillance data. Controls were recruited from the general population and answered a comparable postal questionnaire. Logistic regression was performed to identify risk factors associated with STEC infection for O157, O26 and other serotype cases. In adjusted models, travel outside of the U.K. and childcare occupations raised the risk of infection for all serotypes. Day trips within the UK, exposure to dogs and contact with soil were linked to lower infection risk. Resident region within England was often linked to decreased risk. Summer season was linked to O157 and O26, but not other STEC. Swimming in the sea was linked to increased risk of infection by O157, but not other types of STEC. Correlations between exposures and infection were similar when the analysis was repeated excluding participants with a history of foreign travel. As the first case-control study in England to include sporadic non-O157 STEC, the varying risk factors between O157 and non-O157 cases suggest there are potentially unique reservoirs for different serotypes.},

note = {Funding information: The research was funded by the National Institute for Health Research Health Protection Research Units in Gastrointestinal Infections (IS-HPU-1112-10038), Emerging and Zoonotic Infections (IS-HPU-1112-10117) and Emergency Preparedness (IS-HPU-1112-10141) at Liverpool University, Kings College London and University of East Anglia, in partnership with the UK Health Security Agency.},

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}

@article{9516829378b140c5a1d9a4b1fca6de8b,

title = {Sustaining disaster aid in the onset of the COVID-19 pandemic},

author = {Natalia Jones and Roger Few and Iain Lake and Kelly Wooster},

doi = {10.5055/jem.0701},

issn = {1543-5865},

year  = {2023},

date = {2023-01-01},

journal = {Journal of Emergency Management},

volume = {21},

number = {7},

pages = {85–96},

publisher = {Weston Medical Publishing},

abstract = {The COVID-19 pandemic had a global reach and impact, introducing stay at home orders, social distancing, facemask wearing, and closing national and international borders. Yet, the need for international disaster aid as a result of previous disasters and ongoing crises remained present. Interviews with staff from United Kingdom aid agencies and their partner organizations examined how development and humanitarian activities changed during the first six months of the pandemic. Seven key themes were highlighted. The need to recognize individual country contexts and experiences when dealing with a pandemic was emphasized, together with appropriate strategic decisions around guidance and supporting staff and the value of learning from previous experiences. Restrictions limited agencies' ability to monitor programs and ensure accountability effectively, but relationships between partners adjusted, with a move to a greater reliance on local partners and increased empowerment in these groups. Trust was vital to allow for the continuation of programs and services during the first months of the pandemic. Most programs continued but with significant adaptations. An enhanced use of communication technology was a key adaptation, though caveats remained around access. Concern around safeguarding and stigmatization of vulnerable groups was reported as an increasing issue in some contexts. The impact of COVID-19 restrictions on ongoing disaster aid was rapid and extensive, forcing aid agencies at different scales to work swiftly to try to ensure as little disruption as possible, and generating important lessons for both the ongoing and future crises.},

note = {ACKNOWLEGMENTS: This study was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership among Public Health England, King’s College London, and the University of East Anglia. The views expressed are those of the author(s) and do not necessarily reflect those of the NIHR, Public Health England, or the Department of Health and Social Care},

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}

@article{34db64ed172549cb9e07819365af1589,

title = {Mental health presentations across healthcare setting during the first 9 months of the COVID-19 pandemic in England: Retrospective observational study},

author = {Gillian E. Smith and Sally E. Harcourt and Uy Hoang and Agnieszka Lemanska and Alex J. Elliott and Roger A. Morbey and Helen E. Hughes and Iain Lake and Obaghe Edeghere and Isabel Oliver and Julian Sherlock and Richard Amlôt and Simon Lusignan},

doi = {10.2196/32347},

issn = {1439-4456},

year  = {2022},

date = {2022-08-03},

journal = {Journal of Medical Internet Research},

volume = {8},

number = {8},

publisher = {JMIR Publications},

abstract = {Background: The COVID-19 pandemic has resulted in unprecedented impact on the day to day lives of people, with several features potentially adversely affecting mental health. There is growing evidence of the size of the impact of COVID-19 on mental health, but much of this is from ongoing population surveys using validated mental health scores. Objective: This study investigated the impact of the pandemic and control measures on mental health conditions presenting to a spectrum of national healthcare services monitored using real-time syndromic surveillance in England. Methods: We conducted a retrospective observational descriptive study of mental health presentations (those calling the national medical helpline, NHS 111, consulting general practitioners in and out-of-hours, calling ambulance services and attending emergency departments) between 1 January 2019 to 30 September 2020. Estimates for the impact of lockdown measures were provided using an interrupted time series analysis. Results: Mental health presentations showed a marked decrease during the early stages of the pandemic. Post-lockdown, attendances for mental health conditions reached higher than pre-pandemic levels across most systems; a rise of 10% compared to expected for NHS 111 and 21% for GP out-of-hours whilst the number of consultations to in-hours GPs was 13% lower compared to the same time last year. Increases were observed in calls to NHS 111 for sleep problems. Conclusions: These analyses showed marked changes in the healthcare attendances and prescribing for common mental health issues, across a spectrum of healthcare provision, with some of these changes persisting. The reasons for such changes are likely to be complex and multifactorial. The impact of the pandemic on mental health may not be fully understood for some time, and therefore these syndromic indicators should continue to be monitored.},

note = {Funding: GES, AJE, RM, IRL and RA receive support from the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King's College London in partnership with UK Health Security Agency (UKHSA), in collaboration with the University of East Anglia. IO receives support from the NIHR HPRU in Behavioural Science and Evaluation at the University of Bristol. GES, AJE, HH, IRL and OE receive support from the NIHR HPRU in Gastrointestinal Infections at the University of Liverpool. AL received support from the National Physical Laboratory (NPL), UK through the cross-theme National Measurement Strategy under the Life Sciences & Healthcare theme (Digital Health [122471] Data Curation programme) which was funded by the Department for Business, Energy and Industrial Strategy (BEIS). The views expressed are those of the author(s) and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care.},

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}

@article{efc25503c42944f4b05c7064556ea0c7,

title = {A multi-variate time series clustering approach based on intermediate fusion: A case study in air pollution data imputation},

author = {Wedad Alahamade and Iain Lake and Claire E. Reeves and Beatriz De La Iglesia},

doi = {10.1016/j.neucom.2021.09.079},

issn = {0925-2312},

year  = {2022},

date = {2022-06-14},

journal = {Neurocomputing},

volume = {490},

pages = {229–245},

publisher = {Elsevier},

abstract = {Multivariate Time Series Clustering (MVTS) is an essential task, especially for large and complex dataset, but it has received limited attention in the literature. We are motivated by a real-world problem: the need to cluster air pollution data to produce plausible imputations for missing measurements for some pollutants. Our main focus will be on the UK air quality assessments, the study uses data collected from automatic monitoring stations during four-year period (2015–2018).In this work, we propose a MVTS clustering method followed by an imputation methods for the whole Time Series (TS). We compare two approaches to cluster the stations: univariate TS clustering using Shape-Based Distance (SBD) for individual pollutants, and MVTS clustering using the fused similarity that combines the SBD for all the pollutants. We run a k-means algorithm to produce clusters with each approach on the same dataset.Our analysis shows that using MVTS clustering produces the best clusters as measured by various quality indexes and by the imputations they help to reduce the error average between imputed and real values based on the Root Mean Squared Error (RMSE) and its standard deviation (Std).},

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}

@article{2ce9eb65f74e4a81a7aebaeaf19ed231,

title = {The lived experience of implementing infection control measures in care homes during two waves of the COVID-19 pandemic. A mixed-methods study},

author = {Diane Bunn and Julii Brainard and Kathleen Lane and Charlotte Salter and Iain Lake},

doi = {10.31389/jltc.109},

issn = {2516-9122},

year  = {2021},

date = {2021-12-03},

journal = {Journal of Long-Term Care},

pages = {386–400},

publisher = {International Long Term Care Policy Network},

abstract = {Context: During COVID-19 care-homes had to implement strict Infection Control Measures (ICMs), impacting on care and staff morale.Objectives: To explore the lived experiences of care-home staff in implementing ICMs.Methods: Mixed-methods study comprising 238 online survey responses and 15 in-depth interviews with care-home staff, November 2020-January 2021 in England.Results: Three themes were identified: ‘Integrating COVID-19 ICMs with caring’, ‘Conveying knowledge and information’, ‘Professional and personal impacts of care-work during the pandemic’. Reported adherence to ICMs was high but fatalistic attitudes towards COVID-19 infection were present. Challenges of providing care using personal protective equipment (PPE), especially for residents with dementia, were highlighted. Interviewees reported dilemmas between strictly implementing ICMs and conflicts with providing best care to residents and preserving personal space. Nine months into COVID-19, official guidance was reported as confusing, constantly changing and poorly suited to care-homes. Care-home staff appreciated opportunities to work with other care-homes and experts to interpret and implement guidance. ICM training was undertaken using multiple techniques but with little evaluation of these or how to sustain behaviour change.Limitations: Results may not be generalizable to other countries. Implications COVID-19 has had a profound effect on well-being of care-home staff. Despite challenges, participants reported broadly good morale, potentially a consequence of supportive colleagues and management. Nevertheless, clear, concise and care-home focussed ICM guidance is still needed. This should include evidence-based assessments on implementing and sustaining adherence. Groups of care-home staff and ICM experts working together to co-create, interpret and implement guidance were viewed positively.},

note = {Published in Special Collection: COVID-19 and Long-Term Care Policy},

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pubstate = {published},

tppubtype = {article}

}

@article{f8f18d5e8fa34b39a7b232068b255737,

title = {The COVID University Challenge: A hazard analysis of critical control points assessment of the return of students to higher education establishments},

author = {Kelly L. Edmunds and Laura Bowater and Julii Brainard and Jean-Charles Coriolis and Iain Lake and Rimsha R. Malik and Lorraine Newark and Neil Ward and Kay Yeoman and Paul R. Hunter},

doi = {10.1111/risa.13741},

issn = {0272-4332},

year  = {2021},

date = {2021-12-01},

journal = {Risk Analysis},

volume = {41},

number = {12},

pages = {2286–2292},

publisher = {Wiley},

abstract = {The COVID-19 pandemic has disrupted economies and societies throughout the world since early 2020. Education is especially affected, with schools and universities widely closed for long periods. People under 25 years have the lowest risk of severe disease but their activities can be key to persistent ongoing community transmission. A challenge arose for how to provide education, including university level, without the activities of students increasing wider community SARS-CoV-2 infections. We used a Hazard Analysis of Critical Control Points (HACCP) framework to assess the risks associated with university student activity and recommend how to mitigate these risks. This tool appealed because it relies on multiagency collaboration and interdisciplinary expertise and yet is low cost, allowing rapid generation of evidence-based recommendations. We identified key critical control points associated with university student’ activities, lifestyle, and interaction patterns both on-and-off campus. Unacceptable contact thresholds and the most up-to-date guidance were used to identify levels of risk for potential SARS-CoV-2 transmission, as well as recommendations based on existing research and emerging evidence for strategies that can reduce the risks of transmission. Employing the preventative measures we suggest can reduce the risks of SARS-CoV-2 transmission among and from university students. Reduction of infectious disease transmission in this demographic will reduce overall community transmission, lower demands on health services and reduce risk of harm to clinically vulnerable individuals while allowing vital education activity to continue. HACCP assessment proved a flexible tool for risk analysis in a specific setting in response to an emerging infectious disease threat. Systematic approaches to assessing hazards and risk critical control points (#HACCP) enable robust strategies for protecting students and staff in HE settings during #COVID19 pandemic.},

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pubstate = {published},

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@article{5c6831411bb346d9a73b5d4f3453e440,

title = {Evaluation of multi-variate time series clustering for imputation of air pollution data},

author = {Wedad Alahamade and Iain Lake and Claire Reeves and Beatriz De La Iglesia},

doi = {10.5194/gi-2021-11},

issn = {2193-0856},

year  = {2021},

date = {2021-11-03},

journal = {Geoscientific Instrumentation, Methods and Data Systems},

volume = {10},

pages = {265–285},

publisher = {Copernicus Gesellschaft mbH},

abstract = {Air pollution is one of the world's leading risk factors for death, with 6.5 million deaths per year worldwide attributed to air pollution-related diseases. Understanding the behaviour of certain pollutants through air quality assessment can produce improvements in air quality management that will translate to health and economic benefits. However problems with missing data and uncertainty hinder that assessment.We are motivated by the need to enhance the air pollution data available. We focus on the problem of missing air pollutant concentration data either because a limited set of pollutants is measured at a monitoring site or because an instrument is not operating, so a particular pollutant is not measured for a period of time.In our previous work, we have proposed models which can impute a whole missing time series to enhance air quality monitoring. Some of these models are based on a Multivariate Time Series (MVTS) clustering method. Here, we apply our method to real data and show how different graphical and statistical model evaluation functions enable us to select the imputation model that produces the most plausible imputations. We then compare the Daily Air Quality Index (DAQI) values obtained after imputation with observed values incorporating missing data. Our results show that using an ensemble model that aggregates the spatial similarity obtained by the geographical correlation between monitoring stations and the fused temporal similarity between pollutants concentrations produced very good imputation results. Furthermore, the analysis enhances understanding of the different pollutant behaviours, and of the characteristics of different stations according to their environmental type.},

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pubstate = {published},

tppubtype = {article}

}

@article{cec656eb36184fd994ba347d11bd10b3,

title = {Human and environmental associates of local species-specific abundance in a multi-species deer assemblage},

author = {Valentina Zini and Kristin Wäber and Karen Hornigold and Iain Lake and Paul M. Dolman},

doi = {10.1007/s10344-021-01539-6},

issn = {1612-4642},

year  = {2021},

date = {2021-10-22},

journal = {European Journal of Wildlife Research},

volume = {67},

number = {6},

publisher = {Springer},

abstract = {Understanding how habitat, landscape context, and human disturbance influence local species-specific deer density provides evidence informing strategic management of increasing deer populations. Across an extensive (187 km 2) heterogeneous forest-mosaic landscape in eastern England, spatially explicit density surface models of roe deer Capreolus capreolus and introduced muntjac Muntiacus reevesi were calibrated by thermal imaging distance sampling (recording 1590 and 400 muntjac and roe deer groups, respectively, on 567 km of driven transects). Models related deer density to local habitat composition, recreational intensity, and deer density (roe deer models controlled for muntjac density and vice versa) at a local grain across 1162 composite transect segments, incorporating geographical coordinates accounting for spatial autocorrelation. Abundance of both species was lower in localities with more grasslands (inter-quartile, IQ, effect size: roe −2.9 deer/km 2; muntjac −2.9 deer/km 2). Roe abundance (mean = 7 deer/km},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{77095518111245148caf672202c741c9,

title = {Concentrations of organic contaminants in industrial and municipal bioresources recycled in agriculture in the UK},

author = {Hannah Rigby and Alan Dowding and Alwyn Fernandes and David Humphries and Natalia R. Jones and Iain Lake and Rupert G. Petch and Christopher K. Reynolds and Martin Rose and Stephen R. Smith},

doi = {10.1016/j.scitotenv.2020.142787},

issn = {0048-9697},

year  = {2021},

date = {2021-04-15},

journal = {Science of the Total Environment},

volume = {765},

publisher = {Elsevier},

abstract = {Many types of bioresource materials are beneficially recycled in agriculture for soil improvement and as alternative bedding materials for livestock, but they also potentially transfer contaminants into plant and animal foods. Representative types of industrial and municipal bioresources were selected to assess the extent of organic chemical contamination, including: (i) land applied materials: treated sewage sludge (biosolids), meat and bone meal ash (MBMA), poultry litter ash (PLA), paper sludge ash (PSA) and compost-like-output (CLO), and (ii) bedding materials: recycled waste wood (RWW), dried paper sludge (DPS), paper sludge ash (PSA) and shredded cardboard. The materials generally contained lower concentrations of polychlorinated dibenzo-p-dioxins/dibenzofurans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (PCBs) relative to earlier reports, indicating the decline in environmental emissions of these established contaminants. However, concentrations of polycyclic aromatic hydrocarbons (PAHs) remain elevated in biosolids samples from urban catchments. Polybrominated dibenzo-p dioxins/dibenzofurans (PBDD/Fs) were present in larger amounts in biosolids and CLO compared to their chlorinated counterparts and hence are of potentially greater significance in contemporary materials. The presence of non ortho polychlorinated biphenyls (PCBs) in DPS was probably due to non-legacy sources of PCBs in paper production. Flame retardent chemicals were one of the most significant and extensive groups of contaminants found in the bioresource materials. Decabromodiphenylether (deca-BDE) was the most abundant polybrominated diphenyl ether (PBDE) and may explain the formation and high concentrations of PBDD/Fs detected. Emerging flame retardant compounds, including: decabromodiphenylethane (DBDPE) and organophosphate flame retardants (OPFRs), were also detected in several of the materials. The profile of perfluoroalkyl substances (PFAS) depended on the type of waste category; perfluoroundecanoic acid (PFUnDA) was the most significant PFAS for DPS, whereas perfluorooctane sulfonate (PFOS) was dominant in biosolids and CLO. The concentrations of polychlorinated alkanes (PCAs) and di-2-ethylhexyl phthalate (DEHP) were generally much larger than the other contaminants measured, indicating that there are major anthropogenic sources of these potentially hazardous chemicals entering the environment. The study results suggest that continued vigilance is required to control emissions and sources of these contaminants to support the beneficial use of secondary bioresource materials.},

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@article{dc3ba34f59684acf849984a803a3c4e1,

title = {A scoping review of the use of Twitter for public health research},

author = {Osagioduwa Edo-Osagie and Beatriz De La Iglesia and Iain Lake and Obaghe Edeghere},

doi = {10.1016/j.compbiomed.2020.103770},

issn = {0010-4825},

year  = {2020},

date = {2020-07-01},

journal = {Computers in Biology and Medicine},

volume = {122},

publisher = {Elsevier},

abstract = {Public health practitioners and researchers have used traditional medical databases to study and understand public health for a long time. Recently, social media data, particularly Twitter, has seen some use for public health purposes. Every large technological development in history has had an impact on the behaviour of society. The advent of the internet and social media is no different. Social media creates public streams of communication, and scientists are starting to understand that such data can provide some level of access into the people’s opinions and situations. As such, this paper aims to review and synthesize the literature on Twitter applications for public health, highlighting current re- search and products in practice. A scoping review methodology was employed and four leading health, computer science and cross-disciplinary databases were searched. A total of 755 articles were retreived, 92 of which met the criteria for review. From the reviewed literature, six domains for the application of Twit- ter to public health were identified: (i) Surveillance; (ii) Event Detection; (iii) Pharmacovigilance; (iv) Forecasting; (v) Disease Tracking; and (vi) Geographic Identification. From our review, we were able to obtain a clear picture of the use of Twitter for public health. We gained insights into interesting observa- tions such as how the popularity of different domains changed with time, the diseases and conditions studied and the different approaches to understanding each disease, which algorithms and techniques were popular with each domain, and more.},

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pubstate = {published},

tppubtype = {article}

}

@article{1a31c3f7b9a147c9b386a717b5362391,

title = {Impact of air pollution on educational attainment for respiratory health treated students: A cross sectional data linkage study},

author = {Amy Mizen and Jane Lyons and Ai Milojevic and Ruth Doherty and Paul Wilkinson and David Carruthers and Ashley Akbari and Iain Lake and Gwyneth A. Davies and Mohammad Al Sallakh and Richard Fry and Lorraine Dearden and Sarah Rodgers},

doi = {10.1016/j.healthplace.2020.102355},

issn = {1353-8292},

year  = {2020},

date = {2020-05-01},

journal = {Health and Place},

volume = {63},

publisher = {Elsevier},

abstract = {Introduction: There is some evidence that exam results are worse when students are acutely exposed to air pollution. Studies investigating the association between air pollution and academic attainment have been constrained by small sample sizes.Methods: Cross sectional educational attainment data (2009–2015) from students aged 15–16 years in Cardiff, Wales were linked to primary health care data, modelled air pollution and measured pollen data, and analysed using multilevel linear regression models. Annual cohort, school and individual level confounders were adjusted for in single and multi-pollutant/pollen models. We stratified by treatment of asthma and/or Seasonal Allergic Rhinitis (SAR).Results: A unit (10μg/m3) increase of short-term exposure to NO2 was associated with 0.044 (95% CI: −0.079, −0.008) reduction of standardised Capped Point Score (CPS) after adjusting for individual and household risk factors for 18,241 students. This association remained statistically significant after controlling for other pollutants and pollen. There was no association of PM2.5, O3, or Pollen with standardised CPS remaining after adjustment. We found no evidence that treatment for asthma or SAR modified the observed NO2 effect on educational attainment.Conclusion: Our study showed that short-term exposure to traffic-related air pollution, specifically NO2, was associated with detrimental educational attainment for students aged 15–16. Longitudinal investigations in different settings are required to confirm this possible impact and further work may uncover the long-term economic implications, and degree to which impacts are cumulative and permanent.},

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@article{e6ffcd4477d94802a199cb591d3bd8ef,

title = {Water, sanitation and hygiene risk factors for the transmission of cholera in a changing climate: using a systematic review to develop a causal process diagram},

author = {Natalia Jones and Maha Bouzid and Roger Few and Paul Hunter and Iain Lake},

doi = {10.2166/wh.2020.088},

issn = {1477-8920},

year  = {2020},

date = {2020-04-01},

journal = {Journal of Water and Health},

volume = {18},

number = {2},

pages = {145–158},

publisher = {IWA Publishing},

abstract = {Cholera is a severe diarrhoeal disease affecting vulnerable communities. A long-term solution to cholera transmission is improved access to and uptake of water, sanitation and hygiene (WASH). Climate change threatens WASH. A systematic review and meta-analysis determined five overarching WASH factors incorporating 17 specific WASH factors associated with cholera transmission, focussing upon community cases. Eight WASH factors showed lower odds and six showed higher odds for cholera transmission. These results were combined with findings in the climate change and WASH literature, to propose a health impact pathway illustrating potential routes through which climate change dynamics (e.g. drought, flooding) impact on WASH and cholera transmission. A causal process diagram visualising links between climate change dynamics, WASH factors, and cholera transmission was developed. Climate change dynamics can potentially affect multiple WASH factors (e.g. drought-induced reductions in handwashing and rainwater use). Multiple climate change dynamics can influence WASH factors (e.g. flooding and sea-level rise affect piped water usage). The influence of climate change dynamics on WASH factors can be negative or positive for cholera transmission (e.g. drought could increase pathogen desiccation but reduce rainwater harvesting). Identifying risk pathways helps policymakers focus on cholera risk mitigation, now and in the future.},

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pubstate = {published},

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}

@article{991dafa6562b433483382581fdbeda38,

title = {Can syndromic surveillance help forecast winter hospital bed pressures in England?},

author = {Roger A. Morbey and Andre Charlett and Iain Lake and James Mapstone and Richard Pebody and James Sedgwick and Gillian E. Smith and Alex J. Elliot},

doi = {10.1371/journal.pone.0228804},

issn = {1932-6203},

year  = {2020},

date = {2020-02-10},

journal = {PLoS One},

volume = {15},

number = {2},

publisher = {Public Library of Science},

abstract = {BACKGROUND: Health care planners need to predict demand for hospital beds to avoid deterioration in health care. Seasonal demand can be affected by respiratory illnesses which in England are monitored using syndromic surveillance systems. Therefore, we investigated the relationship between syndromic data and daily emergency hospital admissions. METHODS: We compared the timing of peaks in syndromic respiratory indicators and emergency hospital admissions, between 2013 and 2018. Furthermore, we created forecasts for daily admissions and investigated their accuracy when real-time syndromic data were included. RESULTS: We found that syndromic indicators were sensitive to changes in the timing of peaks in seasonal disease, especially influenza. However, each year, peak demand for hospital beds occurred on either 29th or 30th December, irrespective of the timing of syndromic peaks. Most forecast models using syndromic indicators explained over 70% of the seasonal variation in admissions (adjusted R square value). Forecast errors were reduced when syndromic data were included. For example, peak admissions for December 2014 and 2017 were underestimated when syndromic data were not used in models. CONCLUSION: Due to the lack of variability in the timing of the highest seasonal peak in hospital admissions, syndromic surveillance data do not provide additional early warning of timing. However, during atypical seasons syndromic data did improve the accuracy of forecast intensity.},

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pubstate = {published},

tppubtype = {article}

}

@article{50a858101ca64b2a9d2535a3d3add62a,

title = {Climate change and epilepsy: Time to take action},

author = {Sanjay M. Sisodiya and Hayley J. Fowler and Iain Lake and Rosemary O. Nanji and Kinga Gawel and Camila V. Esguerra and Charles Newton and Aideen Foley},

doi = {10.1002/epi4.12359},

issn = {2470-9239},

year  = {2019},

date = {2019-12-01},

journal = {Epilepsia Open},

volume = {4},

number = {4},

pages = {524–536},

publisher = {Wiley},

abstract = {Climate change is the biggest challenge facing humanity today. The associated global warming and humidification, increases in the severity and frequency of extreme climate events, extension of the ranges of vector-borne diseases, and the consequent social and economic stresses and disruption will have major negative consequences on many aspects of health care. People whose resilience to change is already impaired may suffer disproportionately from these environmental changes, which are of unprecedented reach and magnitude. There has been little connection made so far between climate change and epilepsy. We briefly review the history of climate change science and the subsequent response of the global scientific community. We consider how climate change effects might in general affect health and disease. We consider some of the underlying complex interactions that, for example, favor the spread of vector-borne diseases and how climate models operate and may help plan for global and local changes. We then speculate specifically on how these generic ideas may apply specifically to epilepsy. We consider these impacts at levels from molecular to the epidemiological. Data are sparse, and there is undoubtedly a need for more information to enable better estimation of possible effects of climate change on care in epilepsy. We also consider how the professional activities of those involved in epilepsy health care might contribute to global carbon emissions, for example, through flying for conference attendance. Healthcare organizations across the world are already considering, and responding to, many of these issues. We argue for more research in this area, but also for action today. Actions today are likely to generate cobenefits for health care, including care in epilepsy, resulting from efforts to decarbonize, mitigate effects of climate change that has already happened, and plan for adaptation to climate change.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{10df0196cb95429391e67aad17d4d015,

title = {Twitter mining using semi-supervised classification for relevance filtering in syndromic surveillance},

author = {Oduwa Edo-Osagie and Gillian Smith and Iain Lake and Obaghe Edeghere and Beatriz De La Iglesia},

doi = {10.1371/journal.pone.0210689},

issn = {1932-6203},

year  = {2019},

date = {2019-07-18},

journal = {PLoS One},

volume = {14},

number = {7},

publisher = {Public Library of Science},

abstract = {We investigate the use of Twitter data to deliver signals for syndromic surveillance in order to assess its ability to augment existing syndromic surveillance efforts and give a better understanding of symptomatic people who do not seek healthcare advice directly. We focus on a specific syndrome—asthma/difficulty breathing. We outline data collection using the Twitter streaming API as well as analysis and pre-processing of the collected data. Even with keyword-based data collection, many of the tweets collected are not be relevant because they represent chatter, or talk of awareness instead of an individual suffering a particular condition. In light of this, we set out to identify relevant tweets to collect a strong and reliable signal. For this, we investigate text classification techniques, and in particular we focus on semi-supervised classification techniques since they enable us to use more of the Twitter data collected while only doing very minimal labelling. In this paper, we propose a semi-supervised approach to symptomatic tweet classification and relevance filtering. We also propose alternative techniques to popular deep learning approaches. Additionally, we highlight the use of emojis and other special features capturing the tweet’s tone to improve the classification performance. Our results show that negative emojis and those that denote laughter provide the best classification performance in conjunction with a simple word-level n-gram approach. We obtain good performance in classifying symptomatic tweets with both supervised and semi-supervised algorithms and found that the proposed semi-supervised algorithms preserve more of the relevant tweets and may be advantageous in the context of a weak signal. Finally, we found some correlation (r = 0.41},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{56baf6190b724ec5870b9debbd7ced7f,

title = {The potential of recycled materials used in agriculture to contaminate food through uptake by livestock},

author = {Alwyn Fernandes and Iain Lake and Alan Dowding and Martin Rose and Natalia Jones and R. Petch and Frankie Smith and Sean Panton},

doi = {10.1016/j.scitotenv.2019.02.211},

issn = {0048-9697},

year  = {2019},

date = {2019-06-01},

journal = {Science of the Total Environment},

volume = {667},

pages = {359–370},

publisher = {Elsevier},

abstract = {The potential for contaminant uptake from recycled materials used in livestock farming, to animal tissues and organs, was investigated in three practical modular studies involving broiler chickens, laying chickens and pigs. Six types of commercially available recycled materials were used either as bedding material for chickens or as fertilizer for cropland that later housed outdoor reared pigs. The contaminants studied included regulated contaminants e.g. polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs, dioxins) and polychlorinated biphenyls (PCBs), but related contaminants such as polybrominated diphenylethers (PBDEs), hexabrominated cyclododecane (HBCDD), polychlorinated naphthalenes (PCNs), polybrominated dioxins (PBDD/Fs) and perfluoroalkyl substances (PFAS) were also investigated. Contaminant occurrence in the recycled materials was verified prior to the studies and the relationship to tissue and egg concentrations in market ready animals was investigated using a weight of evidence approach. Contaminant uptake to animal tissues and eggs was observed in all the studies but the extent varied depending on the species and the recycled material. PCBs, PBDEs, PCDD/Fs, PCNs and PFAS showed the highest potential to transfer, with laying chickens showing the most pronounced effects. PBDD/Fs showed low concentrations in the recycled materials, making it difficult to evaluate potential transfer. Higher resulting occurrence levels in laying chickens relative to broilers suggests that period of contact with the materials may influence the extent of uptake in chickens. Bio-transfer factors (BTFs) estimated for PCDD/F and PCBs showed a greater magnitude for chicken muscle tissue relative to pigs with the highest values observed for PCBs in laying chickens. There were no significant differences between BTFs for the different chicken tissues which contrasted with the high BTF values for pigs liver relative to muscle. The study raises further questions which require investigation such as the effects of repeated or yearly application of recycled materials as fertilizers, and the batch homogeneity/consistency of available recycled materials.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{69b67aa635c4483181e861b323812840,

title = {Exploring Campylobacter seasonality across Europe (2008-2016) using The European Surveillance System TESSy},

author = {Iain Lake and Felipe De Jesus Colon Gonzalez and Johanna Takkinen and M Rossi and B Sudre and J Gomez Dias and L Tavoschi and Anuja Joshi and Jan Semenza and Gordon Nichols},

doi = {10.2807/1560-7917.ES.2019.24.13.180028},

issn = {1560-7917},

year  = {2019},

date = {2019-03-28},

journal = {Eurosurveillance},

volume = {24},

number = {13},

publisher = {Centre Europeen pour la Surveillance Epidemiologique du SIDA},

abstract = {Background: Campylobacteriosis is the most commonly reported food-borne infection in the European Union, with an annual number of cases estimated at around 9 million. In many countries, campylobacteriosis has a striking seasonal peak during early/ mid-summer. In the early 2000s, several publications reported on campylobacteriosis seasonality across Europe and associations with temperature and precipitation. Subsequently, many European countries have introduced new measures against this foodborne disease. Aim: To examine how the seasonality of campylobacteriosis varied across Europe from 2008–16, to explore associations with temperature and precipitation, and to compare these results with previous studies. We also sought to assess the utility of the European Surveillance System TESSy for cross-European seasonal analysis of campylobacteriosis. Methods: Ward’s Minimum Variance Clustering was used to group countries with similar seasonal patterns of campylobacteriosis. A two-stage multivariate meta-analysis methodology was used to explore associations with temperature and precipitation. Results: Nordic countries had a pronounced seasonal campylobacteriosis peak in mid-to late summer (weeks 29–32), while most other European countries had a less pronounced peak earlier in the year. The United Kingdom, Ireland, Hungary and Slovakia had a slightly earlier peak (week 24). Campylobacteriosis cases were positively associated with temperature and, to a lesser degree, precipitation. Conclusion: Across Europe, the strength and timing of campylobacteriosis peaks have remained similar to those observed previously. In addition, TESSy is a useful resource for cross-Euro-pean seasonal analysis of infectious diseases such as campylobacteriosis, but its utility depends upon each country’s reporting infrastructure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{adb3b5f0cf824fc8b47095f175dff3e1,

title = {Syndromic surveillance: two decades experience of sustainable systems – its people not just data!},

author = {Gillian E Smith and Alex J Elliot and Iain Lake and Obaghe Edeghere and Roger A Morbey and Mike Catchpole and David Heymann and Jeremy Hawker and Sue Ibbotson and Brian McCloskey and Richard Pebody and Public Health England Real-time Syndromic Surveillance Team},

doi = {10.1017/S0950268819000074},

issn = {0950-2688},

year  = {2019},

date = {2019-03-01},

journal = {Epidemiology and Infection},

volume = {147},

publisher = {Cambridge University Press},

abstract = {Syndromic surveillance is a form of surveillance that generates information for public health action by collecting, analysing and interpreting routine health-related data on symptoms and clinical signs reported by patients and clinicians rather than being based on microbiologically or clinically confirmed cases. In England, a suite of national real-time syndromic surveillance systems (SSS) have been developed over the last 20 years, utilising data from a variety of health care settings (a telehealth triage system, general practice and emergency departments). The real-time systems in England have been used for early detection (e.g. seasonal influenza), for situational awareness (e.g. describing the size and demographics of the impact of a heatwave) and for reassurance of lack of impact on population health of mass gatherings (e.g. the London 2012 Olympic and Paralympic Games).We highlight the lessons learnt from running SSS, for nearly two decades, and propose questions and issues still to be addressed. We feel that syndromic surveillance is an example of the use of ‘big data’, but contend that the focus for sustainable and useful systems should be on the added value of such systems and the importance of people working together to maximise the value for the public health of syndromic surveillance services.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{50e0d053e49448f7bc2f134e166aac15,

title = {Climate, human behaviour or environment: individual-based modelling of Campylobacter seasonality and strategies to reduce disease burden},

author = {Stephen Rushton and Roy Sanderson and Peter John Diggle and Mark Shirley and Alasdair Blain and Iain Lake and James Maas and William Reid and Jo Hardstaff and Nicola Williams and Natalia Jones and Daniel Rigby and Norval J. C. Strachan and Ken Forbes and Paul Hunter and Thomas J. Humphrey and Sarah O'Brien},

doi = {10.1186/s12967-019-1781-y},

issn = {1479-5876},

year  = {2019},

date = {2019-01-21},

journal = {Journal of Translational Medicine},

volume = {17},

publisher = {BioMed Central},

abstract = {Background: With over 800 million cases globally, campylobacteriosis is a major cause of food borne disease. In temperate climates incidence is highly seasonal but the underlying mechanisms are poorly understood, making human disease control difficult. We hypothesised that observed disease patterns reflect complex interactions between weather, patterns of human risk behaviour, immune status and level of food contamination. Only by understanding these can we find effective interventions. Methods: We analysed trends in human Campylobacter cases in NE England from 2004-2009, investigating the associations between different risk factors and disease using time-series models. We then developed an individual-based (IB) model of risk behaviour, human immunological responses to infection and environmental contamination driven by weather and land use. We parameterised the IB model for NE England and compared outputs to observed numbers of reported cases each month in the population in 2004-2009. Finally, we used it to investigate different community level disease reduction strategies.Results: Risk behaviours like countryside visits (t=3.665, P<0.001 and t= -2.18},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{12c3b4e742b146a88cbbc1e6b1376e71,

title = {A spatial and temporal analysis of risk factors associated with sporadic Shiga toxin-producing Escherichia coli O157 infection in England between 2009 and 2015},

author = {Richard Elson and Katherine Grace and Roberto Vivancos and Claire Jenkins and Goutam K. Adak and Sarah J. O'Brien and Iain Lake},

doi = {10.1017/S095026881800256X},

issn = {0950-2688},

year  = {2018},

date = {2018-11-01},

journal = {Epidemiology and Infection},

volume = {146},

number = {15},

pages = {1928–1939},

publisher = {Cambridge University Press},

abstract = {Infection with STEC O157 is relatively rare but has potentially serious sequelae, particularly for children. Large outbreaks have prompted considerable efforts designed to reduce transmission primarily from food and direct animal contact. Despite these interventions, numbers of infections have remained constant for many years and the mechanisms leading to many sporadic infections remain unclear. Here, we show that two-thirds of all cases reported in England between 2009 and 2015 were sporadic. Crude rates of infection differed geographically and were highest in rural areas during the summer months. Living in rural areas with high densities of cattle, sheep or pigs and those served by private water supplies were associated with increased risk. Living in an area of lower deprivation contributed to increased risk but this appeared to be associated with reported travel abroad. Fresh water coverage and residential proximity to the coast were not risk factors. To reduce the overall burden of infection in England, interventions designed to reduce the number of sporadic infections with STEC should focus on the residents of rural areas with high densities of livestock and the effective management of non-municipal water supplies. The role of sheep as a reservoir and potential source of infection in humans should not be overlooked.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{478bd862069845f0b6a2b3a34e7a7497,

title = {Climate change and water-related infectious diseases},

author = {Gordon Nichols and Iain Lake and Clare Heaviside},

doi = {10.3390/atmos9100385},

issn = {2073-4433},

year  = {2018},

date = {2018-10-02},

journal = {Atmosphere},

volume = {9},

number = {10},

publisher = {MDPI AG},

abstract = {Background: Water-related, including waterborne, diseases remain important sources of morbidity and mortality worldwide, but particularly in developing countries. The potential for changes in disease associated with predicted anthropogenic climate changes make water-related diseases a target for prevention. Methods: We provide an overview of evidence on potential future changes in water-related disease associated with climate change. Results: A number of pathogens are likely to present risks to public health, including cholera, typhoid, dysentery, leptospirosis, diarrhoeal diseases and harmful algal blooms (HABS). The risks are greatest where the climate effects drive population movements, conflict and disruption, and where drinking water supply infrastructure is poor. The quality of evidence for water-related disease has been documented. Conclusions: We highlight the need to maintain and develop timely surveillance and rapid epidemiological responses to outbreaks and emergence of new waterborne pathogens in all countries. While the main burden of waterborne diseases is in developing countries, there needs to be both technical and financial mechanisms to ensure adequate quantities of good quality water, sewage disposal and hygiene for all. This will be essential in preventing excess morbidity and mortality in areas that will suffer from substantial changes in climate in the future.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{78b2c4b50a69494c8931d5bcc1f35d86,

title = {Cognitive development Respiratory Tract Illness and Effects of eXposure (CORTEX) project: Data processing challenges in combining high spatial resolution pollution level data with individual level health and education data},

author = {Jane Lyons and Amy Mizen and Sarah Rodgers and Damon Berridge and Ashley Akbari and Paul Wilkinson and Ai Milojevic and Ruth Doherty and Lorraine Dearden and Iain Lake and David Carruthers and Sarah Strickland and Anna Mavrogianni and Gwyneth Davies},

doi = {10.23889/ijpds.v3i2.534},

issn = {2399-4908},

year  = {2018},

date = {2018-06-13},

journal = {International Journal of Population Data Science},

volume = {3},

number = {2},

publisher = {Swansea University},

abstract = {Background and Objectives: There is a lack of evidence of the adverse effects of air pollution and pollen on cognition for people with air quality-related health conditions. The CORTEX project combined routinely collected health and education data, high spatial resolution air pollution modelling, and daily pollen measurements for 18,241 pupils living in Cardiff, UK, between 2009 and 2015, to investigate the acute effects of air quality and respiratory conditions on education attainment. Datasets: Air pollutants PM2.5, PM10, NO2, and ozone levels were modelled for 157,361 home and school locations, anonymised into the Secure Anonymised Information Linkage (SAIL) Databank, and summarised into minimum, average and maximum readings for 4 daily time periods reflecting pupil home/school exposure. Adding a unique Residential Anonymised Linking Field (RALF) allowed linkage of pollution estimates to individual level data. Annual pollution datasets contained 369 columns and 472,083-rows, with one column per location, pollutant, daily time-period and day of year. Dataset transformation produced a 5 column, 3,446,205,900-row matrix per year. Methods and Conclusions: An algorithm using Structured Query Language (SQL) to manage data held within a relational database management system, was designed to reduce dimensionality from 24 billion to 18,241 rows of data. The algorithm calculated average means for each pollutant (PM2.5, PM10, NO2, and ozone levels) over the revision and examination periods, and summarised data into one row per pupil. The algorithm adjusted for weekends, school, and bank holidays, it calculated daily pollutant exposure for each pupil, and successfully linked 95% of pupil pollution exposures to their health and education data.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{91fa460a6ed14ae78c36000f74df81c4,

title = {A methodological framework for the evaluation of syndromic surveillance systems: A case study of England},

author = {Felipe J. Colon-Gonzalez and Iain Lake and Roger A. Morbey and Alex J. Elliot and Richard Pebody and Gillian E. Smith},

doi = {10.1186/s12889-018-5422-9},

issn = {1471-2458},

year  = {2018},

date = {2018-04-24},

journal = {BMC Public Health},

volume = {18},

publisher = {BioMed Central},

abstract = {Background: Syndromic surveillance complements traditional public health surveillance by collecting and analysing health indicators in near real time. The rationale of syndromic surveillance is that it may detect health threats faster than traditional surveillance systems permitting more timely, and hence potentially more effective public health action. The effectiveness of syndromic surveillance largely relies on the methods used to detect aberrations. Very few studies have evaluated the performance of syndromic surveillance systems and consequently little is known about the types of events that such systems can and cannot detect. Methods: We introduce a framework for the evaluation of syndromic surveillance systems that can be used in any setting based upon the use of simulated scenarios. For a range of scenarios this allows the time and probability of to be determined and uncertainty is fully incorporated. In addition, we demonstrate how such a framework can model the benefits of increases in the number of centres reporting syndromic data and also determine the minimum size of outbreaks that can or cannot be detected. Here, we demonstrate its utility using simulations of national influenza outbreaks and localised outbreaks of cryptosporidiosis. Results: Influenza outbreaks are consistently detected with larger outbreaks being detected in a more timely manner. Small cryptosporidiosis outbreaks (<1000 symptomatic individuals) are unlikely to be detected. We also demonstrate the advantages of having multiple syndromic data streams (e.g. emergency attendance data, telephone helpline data, general practice consultation data) as different streams are able to detect different types outbreaks with different efficacy (e.g. emergency attendance data are useful for the detection of pandemic influenza but not for outbreaks of cryptosporidiosis). We also highlight that for any one disease, the utility of data streams may vary geographically, and that the detection ability of syndromic surveillance varies seasonally (e.g. an influenza outbreak starting in July is detected sooner than one starting later in the year). We argue that our framework constitutes a useful tool for public health emergency preparedness in multiple settings. Conclusions: The proposed framework allows the exhaustive evaluation of any syndromic surveillance system and constitutes a useful tool for emergency preparedness and response.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{3187f8f8f03f46eca2beaea84ae49e8f,

title = {Climate change, foodborne pathogens, and illness in higher income countries},

author = {Iain Lake and Gary Barker},

doi = {10.1007/s40572-018-0189-9},

issn = {2196-5412},

year  = {2018},

date = {2018-03-01},

journal = {Current Environmental Health Reports},

volume = {5},

number = {1},

pages = {187–196},

publisher = {Springer},

abstract = {Purpose of review:We present a review of the likely consequences of climate change for foodborne pathogens and associated human illness in higher income countries. Recent findings:The relationships between climate and food are complex and hence the impacts of climate change uncertain. This makes it difficult to know which foodborne pathogens will be most affected, what the specific effects will be, and on what timescales changes might occur. Hence, a focus upon current capacity and adaptation potential against foodborne pathogens is essential. We highlight a number of developments that may enhance preparedness for climate change. These include:• Adoption of novel surveillance methods, such as syndromic methods, to speed up detection and increase the fidelity of intervention in foodborne outbreaks• Genotype based approaches to surveillance of food pathogens to enhance spatio-temporal resolution in tracing and tracking of illness• Ever increasing integration of plant, animal and human surveillance systems, one-health, to maximize potential for identifying threats• Increased commitment to cross-border (global) information initiatives (including big data)• Improved clarity regarding the governance of complex societal issues such as the conflict between food safety and food waste• Strong user centric (social) communications strategies to engage diverse stakeholder groupsSummary:The impact of climate change upon foodborne pathogens and associated illness is uncertain. This emphasises the need to enhance current capacity and adaptation potential against foodborne illness. A range of developments are explored in this paper to enhance preparedness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{2079,

title = {Health benefits of limiting global warming to 1.5textdegreeC above pre-industrial levels: dengue fever in Latin America},

author = {FJ Colón-González and I Harris and TJ Osborn and C Steiner Sao Bernado and CA Peres and PR Hunter and IR Lake},

doi = {https://doi.org/10.1073/pnas.1718945115},

year  = {2018},

date = {2018-01-01},

urldate = {2018-01-01},

journal = {PNAS},

abstract = {The Paris Climate Agreement aims to hold global-mean temperature well below 2 degrees and to pursue efforts to limit it to 1.5 textdegreeC above preindustrial levels. While it is recognized that there are benefits for human health in limiting global warming to 1.5 degrees, the magnitude with which those societal benefits will be accrued remains unquantified. Crucial to public health preparedness and response is the understanding and quantification of such impacts at different levels of warming. Using dengue in Latin America as a study case, a climate-driven dengue generalized additive mixed model was developed to predict global warming impacts using five different global circulation models, all scaled to represent multiple global-mean temperature assumptions. We show that policies to limit global warming to 2 textdegreeC could reduce dengue cases by about 2.8 (0.8–7.4) million cases per year by the end of the century compared with a no-policy scenario that warms by 3.7 degrees. Limiting warming further to 1.5 degrees produces an additional drop in cases of about 0.5 (0.2–1.1) million per year. Furthermore, we found that by limiting global warming we can limit the expansion of the disease toward areas where incidence is currently low. We anticipate our study to be a starting point for more comprehensive studies incorporating socioeconomic scenarios and how they may further impact dengue incidence. Our results demonstrate that although future climate change may amplify dengue transmission in the region, impacts may be avoided by constraining the level of warming.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{9538afb9d8d2410d9952afe043318c64,

title = {After the epidemic: Zika virus projections for Latin America and the Caribbean},

author = {Felipe De Jesus Colon Gonzalez and Carlos Peres and Christine São Bernardo and Paul Hunter and Iain Lake},

doi = {10.1371/journal.pntd.0006007},

issn = {1935-2727},

year  = {2017},

date = {2017-11-01},

journal = {PLoS Neglected Tropical Diseases},

volume = {11},

number = {1},

publisher = {Public Library of Science},

abstract = {Background: Zika is one of the most challenging emergent vector-borne diseases, yet its future public health impact remains unclear. Zika was of little public health concern until recent reports of its association with congenital syndromes. By 3 August 2017 ~217,000 Zika cases and ~3,400 cases of associated congenital syndrome were reported in Latin America and the Caribbean. Some modelling exercises suggest that Zika virus infection could become endemic in agreement with recent declarations from the The World Health Organisation. Methodology/Principal findings: We produced high-resolution spatially-explicit projections of Zika cases, associated congenital syndromes and monetary costs for Latin America and the Caribbean now that the epidemic phase of the disease appears to be over. In contrast to previous studies which have adopted a modelling approach to map Zika potential, we project case numbers using a statistical approach based upon reported dengue case data as a Zika surrogate. Our results indicate that ~12.3 (0.7–162.3) million Zika cases could be expected across Latin America and the Caribbean every year, leading to ~64.4 (0.2–5159.3) thousand cases of Guillain-Barré syndrome and ~4.7 (0.0–116.3) thousand cases of microcephaly. The economic burden of these neurological sequelae are estimated to be USD ~2.3 (USD 0–159.3) billion per annum. Conclusions/Significance: Zika is likely to have significant public health consequences across Latin America and the Caribbean in years to come. Our projections inform regional and federal health authorities, offering an opportunity to adapt to this public health challenge.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{17b50c93ca814c4d92a3076cecfab40e,

title = {Climate change and future pollen allergy in Europe},

author = {Iain Lake and Natalia Jones and Maureen Agnew and Clare Goodess and Filippo Giorgi and Lynda Hamaoui-Laguel and Mikhail Semenov and Fabien Solomin and Jonathan Storkey and Robert Vautard and Michelle Epstein},

doi = {10.1289/EHP173},

issn = {0091-6765},

year  = {2017},

date = {2017-03-01},

journal = {Environmental Health Perspectives},

volume = {125},

pages = {385–391},

publisher = {Public Health Services, US Dept of Health and Human Services},

abstract = {Background: Globally pollen allergy is a major public health problem, but a fundamental unknown is the likely impact of climate change. To our knowledge, this is the first study to quantify the consequences of climate change upon pollen allergy in humans. Objectives: To produce quantitative estimates of the potential impact of climate change upon pollen allergy in humans, focusing upon common ragweed (Ambrosia artemisiifolia) in Europe. Methods: A process-based model estimated the change in ragweed’s range under climate change. A second model simulated current and future ragweed pollen levels. These were translated into health burdens using a dose-response curve generated from a systematic review and current and future population data. Models considered two different suites of regional climate/pollen models,two greenhouse gas emissions scenarios (RCP4.5 and 8.5), and three different plant invasion scenarios. Results: Our primary estimates indicate that sensitization to ragweed will more than double in Europe, from 33 to 77 million people, by 2041-2060. According to our projections, while sensitization will increase in countries with an existing ragweed problem (e.g. Hungary, the Balkans), the greatest proportional increases will occur where sensitization is uncommon (e.g. Germany, Poland, France). Higher pollen concentrations and a longer pollen season may alsoincrease the severity of symptoms. Our model projections are driven predominantly by changes in climate (66%), but also are influenced by current trends in the spread of this invasive plant species. Assumptions about the rate at which ragweed spreads throughout Europe have a large influence upon the results. Conclusions: Our quantitative estimates indicate that ragweed pollen allergy will become a common health problem across Europe, expanding into areas where it is currently uncommon. Control of ragweed spread may be an important adaptation strategy in response to climate change.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{fee2e0313b6e42408b6ace77ba5c44bb,

title = {Recreational use of the countryside: No evidence that high nature value enhances a key ecosystem service},

author = {Karen Hornigold and Iain Lake and Paul Dolman},

doi = {10.1371/journal.pone.0165043},

issn = {1932-6203},

year  = {2016},

date = {2016-11-09},

journal = {PLoS One},

volume = {11},

number = {11},

publisher = {Public Library of Science},

abstract = {In Western Europe, recreational amenity is presented as an important cultural ecosystem service that, along with other values, helps justify policies to conserve biodiversity. However, whether recreational use by the public is enhanced at protected areas designated for nature conservation is unknown. This is the first study to model outdoor recreation at a national scale, examining habitat preferences with statutory designation (Site of Special Scientific Interest) as an indicator of nature conservation importance. Models were based on a massive, three year national household survey providing spatially-referenced recreational visits to the natural environment. Site characteristics including land cover were compared between these observed visit sites (n = 31,502) and randomly chosen control sites (n = 63,000). Recreationists preferred areas of coast, freshwater, broadleaved woodland and higher densities of footpaths and avoided arable, coniferous woodland and lowland heath. Although conservation designation offers similar or greater public access than undesignated areas of the same habitat, statutory designation decreased the probability of visitation to coastal and freshwater sites and gave no effect for broadleaved woodland. Thus general recreational use by the public did not represent an important ecosystem service of protected high-nature-value areas, so that intrinsic and existence values remain as the primary justifications for conservation of high nature value areas. Management of ‘green infrastructure’ sites of lower conservation value that offer desirable habitats and enhanced provision of footpaths, could mitigate recreational impacts on nearby valuable conservation areas.},

note = {© 2016 Hornigold et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{cf75bf2a712c4cb7adb29112047c3c56,

title = {The potential impact of media reporting in syndromic surveillance: an example using a possible Cryptosporidium exposure in North West England, August to September 2015},

author = {Alex J. Elliot and Helen E. Hughes and John Astbury and Grainne Nixon and Kate Brierley and Roberto Vivancos and Thomas Inns and Valerie Decraene and Katherine Platt and Iain Lake and Sarah J. O’Brien and Gillian E. Smith},

doi = {10.2807/1560-7917.ES.2016.21.41.30368},

issn = {1560-7917},

year  = {2016},

date = {2016-10-13},

journal = {Eurosurveillance},

volume = {21},

number = {41},

publisher = {Centre Europeen pour la Surveillance Epidemiologique du SIDA},

abstract = {During August 2015, a boil water notice (BWN) was issued across parts of North West England following the detection of Cryptosporidium oocysts in the public water supply. Using prospective syndromic surveillance, we detected statistically significant increases in the presentation of cases of gastroenteritis and diarrhoea to general practitioner services and related calls to the national health telephone advice service in those areas affected by the BWN. In the affected areas, average in-hours general practitioner consultations for gastroenteritis increased by 24.8% (from 13.49 to 16.84) during the BWN period; average diarrhoea consultations increased by 28.5% (from 8.33 to 10.71). Local public health investigations revealed no laboratory reported cases confirmed as being associated with the water supply. These findings suggest that the increases reported by syndromic surveillance of cases of gastroenteritis and diarrhoea likely resulted from changes in healthcare seeking behaviour driven by the intense local and national media coverage of the potential health risks during the event. This study has further highlighted the potential for media-driven bias in syndromic surveillance, and the challenges in disentangling true increases in community infection from those driven by media reporting.},

note = {This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt thez material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{b778a7043eda457598f178ffc1192493,

title = {Recommendations for dealing with waste contaminated with Ebola virus: a hazard analysis of critical control points approach},

author = {Kelly Edmunds and Samira Abd Elrahman and Diana Bell and Julii Brainard and Samir Dervisevic and Tsimbiri P Fedha and Roger Few and Guy Howard and Iain Lake and Peter Maes and Joseph Matofari and Harvey Minnigh and Ahmed A. Mohamedani and Maggie Montgomery and Sarah Morter and Edward Muchiri and Lutendo S Mudau and Benedict M Mutua and Julius M Ndambuki and Katherine Pond and Mark D Sobsey and Mike Van der Es and Mark Zeitoun and Paul Hunter},

doi = {10.2471/BLT.15.163931},

year  = {2016},

date = {2016-06-01},

journal = {Bulletin WHO},

volume = {94},

number = {6},

pages = {424–432},

abstract = {Objective: To assess, within communities experiencing Ebola virus outbreaks, the risks associated with the disposal of human waste and to generate recommendations for mitigating such risks. Methods: A team with expertise in the Hazard Analysis of Critical Control Points framework identified waste products from the care of individuals with Ebola virus disease and constructed, tested and confirmed flow diagrams showing the creation of such products. After listing potential hazards associated with each step in each flow diagram, the team conducted a hazard analysis, determined critical control points and made recommendations to mitigate the transmission risks at each control point. Findings: The collection, transportation, cleaning and shared use of blood-soiled fomites and the shared use of latrines contaminated with blood or bloodied faeces appeared to be associated with particularly high levels of risk of Ebola virustransmission. More moderate levels of risk were associated with the collection and transportation of material contaminated with bodily fluids other than blood, shared use of latrines soiled with such fluids, the cleaning and shared use of fomites soiled with such fluids, and the contamination of the environment during the collection and transportation of blood-contaminated waste. Conclusion: The risk of the waste-related transmission of Ebola virus could be reduced by the use of full personal protective equipment, appropriate hand hygiene and an appropriate disinfectant after careful cleaning. Use of the Hazard Analysis of Critical Control Points framework could facilitate rapid responses to outbreaks of emerging infectious disease.},

note = {© 2016. The Authors; licensee the World Health Organization. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{712dc5a778794afcbfa2a68824ff034b,

title = {The effects of flooding on dioxin and PCB levels in food produced on industrial river catchments},

author = {Iain Lake and Christopher D. Foxall and Alwyn Fernandes and Mervyn Lewis and Martin Rose and Oliver White and Andrew Lovett and Shaun White and Alan Dowding and David Mortimer},

doi = {10.1016/j.envint.2015.01.006},

issn = {1873-6750},

year  = {2015},

date = {2015-04-01},

journal = {Environment International},

volume = {77},

pages = {106–115},

publisher = {Elsevier},

abstract = {This research examined the effect of flooding upon PCDD/F and PCB levels in milk, beef and lamb, produced on the floodplains of industrial river catchments. Our unique dataset included more than 200 samples analysed for PCDD/Fs and PCBs over two data collection phases (1998-1999 & 2008-2010) from working farms. A robust paired study design was adopted with samples taken from flood-prone farms and nearby control farms not subject to flooding. On industrial river catchments regular flooding is associated with higher PCDD/Fs and PCBs levels in soils and grass. This contamination may be transferred to food but the impact varied by food type. These contrasts may be due to physiological differences between animals, the ages at which they are sent to market and differences in animal husbandry. To minimise the risks of producing food on flood-prone land in catchments with a history of industrialisation, as well as on any land with elevated PCDD/F and PCB levels this research suggests a number of options. The choice of livestock may be important and as an example in our study beef cattle appeared to accumulate PCDD/Fs to a higher degree than sheep. Land management may also play a role and could include minimising the time that livestock spend on such land or feeding commercial feed, low in PCDD/Fs and PCBs, where appropriate.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{e2c01b957b4e4776a6088b077c0da42a,

title = {Climate change and the emergence of vector-borne diseases in Europe: Case study of dengue fever},

author = {Maha Bouzid and Felipe J Colón-González and Tobias Lung and Iain Lake and Paul Hunter},

doi = {10.1186/1471-2458-14-781},

issn = {1471-2458},

year  = {2014},

date = {2014-08-22},

journal = {BMC Public Health},

volume = {14},

publisher = {BioMed Central},

abstract = {Background: Dengue fever is the most prevalent mosquito-borne viral disease worldwide. Dengue transmission is critically dependent on climatic factors and there is much concern as to whether climate change would spread the disease to areas currently unaffected. The occurrence of autochthonous infections in Croatia and France in 2010 has raised concerns about a potential re-emergence of dengue in Europe. The objective of this study is to estimate dengue risk in Europe under climate change scenarios. Methods. We used a Generalized Additive Model (GAM) to estimate dengue fever risk as a function of climatic variables (maximum temperature, minimum temperature, precipitation, humidity) and socioeconomic factors (population density, urbanisation, GDP per capita and population size), under contemporary conditions (1985-2007) in Mexico. We then used our model estimates to project dengue incidence under baseline conditions (1961-1990) and three climate change scenarios: short-term 2011-2040, medium-term 2041-2070 and long-term 2071-2100 across Europe. The model was used to calculate average number of yearly dengue cases at a spatial resolution of 10 × 10 km grid covering all land surface of the currently 27 EU member states. To our knowledge, this is the first attempt to model dengue fever risk in Europe in terms of disease occurrence rather than mosquito presence. Results: The results were presented using Geographical Information System (GIS) and allowed identification of areas at high risk. Dengue fever hot spots were clustered around the coastal areas of the Mediterranean and Adriatic seas and the Po Valley in northern Italy. Conclusions: This risk assessment study is likely to be a valuable tool assisting effective and targeted adaptation responses to reduce the likely increased burden of dengue fever in a warmer world.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{bfe02f2b53474bdfabe5111c02265c9e,

title = {Experimental test of a conservation intervention for a highly threatened waterbird.},

author = {Hugh Wright and Nigel Collar and Net Norin and Rours Vann and Sok Ko and Sum Pherun and Iain Lake and Paul Dolman},

doi = {10.1002/jwmg.605},

issn = {0022-541X},

year  = {2013},

date = {2013-11-01},

journal = {Journal of Wildlife Management},

volume = {77},

number = {8},

pages = {1610–1617},

publisher = {Wiley},

abstract = {Human exploitation and disturbance often threaten nesting wildlife. Nest guarding, a technique that employs local people to prevent such interference, is being applied to an increasing number of species and sites, particularly in South-East Asia. Although research has begun to assess the costeffectivenessof nest guarding, case–control studies are rare and the circumstances in which the schemes are most useful remain unclear. We experimentally tested the effect of nest guarding for the critically endangered white-shouldered ibis (Pseudibis davisoni), a species exploited opportunistically for food and now largelyconfined to dry forests in Cambodia.We randomly applied guarded and unguarded (control) treatments to 24 and 25 nests, respectively, at a single site over 2 years. Nest guarding had no detectable effect on nest success, with an overall probability of nest success of 0.63–0.86 at guarded and 0.55–0.82 at unguarded nests. Nest monitoring across 4 study sites over 3 breeding seasons found a combination of natural predation, weather, and anthropogenic activities (robbery and vandalism) responsible for nest failure, although causes of failureremained unknown at 58% of nests. Nest guarding itself increased nest destruction at 1 site, indicating that this intervention needs cautious implementation if only a small proportion of the local community gains benefit. Comparison with other studies suggests that nest guarding effectiveness may be context-specific and differ between species that are exploited opportunistically, such as white-shouldered ibis, and those routinely targeted for trade.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{9320ae997b974c0d9db232d0248aeab3,

title = {Seasonality, disease and behavior: Using multiple methods to explore socio-environmental health risks in the Mekong Delta},

author = {Roger Few and Iain Lake and Paul R. Hunter and Pham Gia Tran},

doi = {10.1016/j.socscimed.2012.12.027},

issn = {0277-9536},

year  = {2013},

date = {2013-03-01},

journal = {Social Science & Medicine},

volume = {80},

pages = {1–9},

publisher = {Elsevier},

abstract = {Any analysis of how changing environmental hazards impact on public health is fundamentally constrained unless it recognizes the centrality of the social and behavioral dimensions of risk. This paper reports on a research project conducted among low-income peri-urban households in the Mekong Delta of Vietnam. The research was based on cross-disciplinary inputs to develop a multi-layered understanding of the implications of a dynamic seasonal environment for diarrheal disease risk. It is a widely held assumption that the major changes in the abundance of surface water between the flood and dry seasons in the Mekong Delta are likely to be reflected in the changing patterns of disease risk, especially for poorer households that tend to rely heavily on river water for domestic water use. Therefore, this study investigated seasonal patterns in the contamination of environmental water, incidences of diarrheal illnesses, water use and hygiene behavior, together with perceptions of health risks and seasonality. During the period of October 2007 to October 2008, the UK and Vietnamese research team worked with a total of 120 households in four low-income sites around the city of Long Xuyen to conduct water testing; administer questionnaires on self-reported health, risk perceptions and behavior; and conduct semi-structured interviews. The research team found no overall evidence of a systematic seasonal risk pattern. At the population level, marginal temporal variations in water quality in the environment failed to translate into health outcomes. A complex risk narrative emerged from the interweaving data elements, demonstrating major inter- and intra-household variations in risk perceptions, hygiene behavior, seasonal behavior and other risk factors. It is suggested that these complexities of human behavior and transmission routes challenge simplistic assumptions about change in health outcomes as a result of seasonal environmental changes. These findings demonstrate the key role social science can play in a holistic and critical analysis of environment and health interactions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{93a8dd8b1a7e447cb519dc68e9641031,

title = {The influence of hurricane risk on tourist destination choice in the Caribbean},

author = {Johanna Forster and Peter W. Schuhmann and Iain Lake and Andrew Watkinson and Jenny Gill},

doi = {10.1007/s10584-012-0433-5},

issn = {0165-0009},

year  = {2012},

date = {2012-01-01},

journal = {Climatic Change},

volume = {114},

number = {3-4},

pages = {745–768},

publisher = {Springer},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{310db075eaea4cf89798def7104530d7,

title = {Effects of distance to treatment centre and case load upon tuberculosis treatment completion},

author = {IR Lake and NR Jones and L Bradshaw and I Abubakar},

doi = {10.1183/09031936.00036211},

issn = {0903-1936},

year  = {2011},

date = {2011-11-01},

journal = {European Respiratory Journal},

volume = {38},

number = {5},

pages = {1223–1225},

publisher = {European Respiratory Society},

abstract = {To the Editors: The prompt identification and adequate treatment of tuberculosis (TB) cases are key components of the global control effort [1]. In many high-income countries, TB is relatively uncommon, implying that many clinicians do not have regular and continuing experience of managing TB. To address this, a policy response is a trend towards small numbers of centralised treatment facilities where individuals may receive better and more complete treatment [2, 3]. This centralising trend is the opposite to many low-income countries, where there is a move towards larger numbers of more decentralised TB services to facilitate patient access [4]. The difference is that such countries have sufficient cases to allow clinical staff to maintain their expertise, even in rural areas. If TB services become more centralised, then patients may experience greater difficulty in accessing TB services due to increasing the distance between the home and treatment centre. There is little research on how distance affects TB completion, but rural residence is a known risk factor associated with a delay in the diagnosis and treatment of TB [5] and may therefore affect treatment completion. However, most of this evidence comes from low-income countries. In contrast, in high-income countries, good transport links and reasonable social security systems imply that such barriers may not exist. This epidemiological study examined whether treatment centre case load (annual number of TB patients seen) and healthcare accessibility (proximity of patient residence to TB treatment centre) have an influence upon the completion of TB treatment in England and Wales, UK. The study was based upon a sample of 21,954 patients reported to the national enhanced TB surveillance system (ETS) from 2001 to 2006 in England and Wales.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{584b,

title = {Climate variability and dengue fever in warm and humid Mexico},

author = {FJ Colón-González and IR Lake and G Bentham},

isbn = {00029637},

year  = {2011},

date = {2011-01-01},

journal = {American Journal of Tropical Medicine and Hygiene},

volume = {84},

pages = {757-763},

chapter = {757},

abstract = {<p>Multiple linear regression models were fitted to look for associations between changes in the incidence rate of dengue fever and climate variability in the warm and humid region of Mexico. Data were collected for 12 Mexican provinces over a 23-year period (January 1985 to December 2007). Our results show that the incidence rate or risk of infection is higher during El Niño events and in the warm and wet season. We provide evidence to show that dengue fever incidence was positively associated with the strength of El Niño and the minimum temperature, especially during the cool and dry season. Our study complements the understanding of dengue fever dynamics in the region and may be useful for the development of early warning systems. Copyright © 2011 by The American Society of Tropical Medicine and Hygiene.</p>},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{7e5f41ad4f1d467c96781a2a6762cd61,

title = {Effect of water hardness on cardiovascular mortality: an ecological time series approach},

author = {Iain Lake and L. Swift and L. A. Catling and I. Abubakar and C. E. Sabel and P. Hunter},

doi = {10.1093/pubmed/fdp121},

issn = {1741-3842},

year  = {2010},

date = {2010-12-01},

journal = {Journal of Public Health},

volume = {32},

number = {4},

pages = {479–487},

publisher = {Oxford University Press},

abstract = {Background Numerous studies have suggested an inverse relationship between drinking water hardness and cardiovascular disease. However, the weight of evidence is insufficient for the WHO to implement a health-based guideline for water hardness. This study followed WHO recommendations to assess the feasibility of using ecological time series data from areas exposed to step changes in water hardness to investigate this issue. Method Monthly time series of cardiovascular mortality data, subdivided by age and sex, were systematically collected from areas reported to have undergone step changes in water hardness, calcium and magnesium in England and Wales between 1981 and 2005. Time series methods were used to investigate the effect of water hardness changes on mortality. Results No evidence was found of an association between step changes in drinking water hardness or drinking water calcium and cardiovascular mortality. The lack of areas with large populations and a reasonable change in magnesium levels precludes a definitive conclusion about the impact of this cation. We use our results on the variability of the series to consider the data requirements (size of population, time of water hardness change) for such a study to have sufficient power. Only data from areas with large populations (>500 000) are likely to be able to detect a change of the size suggested by previous studies (rate ratio of 1.06). Conclusion Ecological time series studies of populations exposed to changes in drinking water hardness may not be able to provide conclusive evidence on the links between water hardness and cardiovascular mortality unless very large populations are studied. Investigations of individuals may be more informative},

keywords = {},

pubstate = {published},

tppubtype = {article}

}