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    ABSTRACT: This paper considers estimation of disease prevalence for small areas (neighbourhoods) when the available observations on prevalence are for an alternative partition of a region, such as service areas. Interpolation to neighbourhoods uses a kernel method extended to take account of two types of collateral information. The first is morbidity and service use data, such as hospital admissions, observed for neighbourhoods. Variations in morbidity and service use are expected to reflect prevalence. The second type of collateral information is ecological risk factors (e.g., pollution indices) that are expected to explain variability in prevalence in service areas, but are typically observed only for neighbourhoods. An application involves estimating neighbourhood asthma prevalence in a London health region involving 562 neighbourhoods and 189 service (primary care) areas.
    International Journal of Environmental Research and Public Health 10/2013; 10(10):5011-5025. DOI:10.3390/ijerph10105011
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    ABSTRACT: It has been hypothesised that residents of deprived neighbourhoods have poorer economic access to physical activity resources, inhibiting physical activity. Here we explore whether the cost of accessing gyms and fitness centres varies by neighbourhood deprivation in Wales. The location of gyms and fitness suites were obtained, and a telephone survey of all facilities was conducted to collect entry price data. We tested associations between neighbourhood deprivation and mean entry prices for public and private facilities. The cost of accessing private facilities is lower in deprived versus affluent neighbourhoods, whereas costs are similar across all deprivation categories for public facilities.
    Health & Place 08/2013; 24C:16-19. DOI:10.1016/j.healthplace.2013.08.001
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    ABSTRACT: Drawing on evidence from the Framingham Heart Study, Christakis and Fowler in their 2007 article published in the New England Journal of Medicine make the claim that obesity spreads in social networks. Whether they are correct in this assertion is neither the concern nor focus of this article. Rather, what is of interest is the subsequent mobilisation of 'contagion' to describe this spread and to account for the emergence of an 'obesity epidemic' in contemporary society. Contrary to the argument that there is less stigma attached to obesity, the reporting of the Christakis and Fowler article suggests that being 'fat' remains a signifier of moral and physical decay; if we add to this the suggestion that obesity is spread within social networks, it is possible that the stigma associated with body size will begin to mirror that which is attached to other infectious bodies. In order to consider the potential implications of this, the article develops in three directions: it explores the application of contagion as a metaphor for understanding the spread of obesity; it sets this understanding within the context of scholarship on contagion and it draws on critical obesity studies literature to call for a more cautionary approach to be taken when deploying a term that when combined with pre-emptive public health discourse would add significantly to the pathologising of the corpulent, fat or obese body.
    Health 04/2013; 18(2). DOI:10.1177/1363459313480971
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    ABSTRACT: The risk of hospitalisation from bushfire exposure events in Darwin, Australia, is examined. Several local studies have found evidence for the effects of exposure to bushfire particulates on respiratory and cardiovascular hospital admissions. They have characterised the risk of admission from seasonal exposures to biomass air pollution. A new, unanalysed data set presented an additional chance to examine unique exposure effects, as there are no anthropogenic sources of particulates in the vicinity of the exposure monitor. The incidence of daily counts of hospital admissions for respiratory and cardiovascular diagnoses was calculated with respect to exposures of particulate matter (PM(10)), course particulate matter, fine particulate matter (FPM) and black carbon composition. A Poisson model was used to calculate unadjusted (crude) measures of effect and then adjusted for known risk factors and confounders. The final model adjusted for the effects of minimum temperature, relative humidity, a smoothed spline for seasonal effects, 'date' for a linear effect over time, day of the week and public and school holidays. A subset analysis adjusted for an influenza epidemic in a particular year. The main findings suggest that respiratory admissions were associated with exposure to PM(10) with a lag of 1 day when adjusted for flu and other confounders (RR = 1.025, 95 % CI 1.000-1.051, p < 0.05). This effect is strongest for exposure to FPM concentrations (RR = 1.091, 95 % CI 1.023-1.163, p < 0.01) when adjusted for flu. Respiratory admissions were also associated with black carbon concentrations recorded the previous day (RR = 1.0004, 95 % CI 1.000-1.0008, p < 0.05), which did not change strength when adjusted for flu. Cardiovascular admissions had the strongest association with exposure to same-day PM and highest RR for exposure to FPM when adjusted for confounders (RR = 1.044, 95 % CI 0.989-1.102). Consistent risks were also found with exposure to black carbon with lags of 0-3 days.
    Environmental Geochemistry and Health 10/2012; DOI:10.1007/s10653-012-9489-4
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    ABSTRACT: Although the term biosurveillance is employed with increasing frequency there remain variances in way in which the concept is both understood and practiced in the US and the UK, respectively. In this paper I begin by exploring the different epistemological and geographical approaches to biosurveillance that are employed in each locality, paying particular attention to the scales at which they, respectively, operate. I also consider how the subjects of these systems (a State's citizenry) are monitored in each jurisdiction and with what effects. I contend in this paper, and illustrate through a study of the techniques of surveillance employed during the recent H1N1 (swine flu) pandemic, that these different 'registers' of biosurveillance are now being bought into the same frame of reference to create new, ever more robust and finely calibrated systems of biological surveillance. In thinking through the political implications of the emergent collision, I outline here, employing work from Cooper, Katz, and Lyon how biosurveillance is becoming progressively domesticated and reflect on the potential this has for creating new, expansive, and very pervasive, forms of biological 'governmentality'.
    Health & Place 07/2012; 18(4):718-25. DOI:10.1016/j.healthplace.2011.10.010
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    ABSTRACT: Coastal saltmarsh ecosystems occupy only a small percentage of Earth's land surface, yet contribute a wide range of ecosystem services that have significant global economic and societal value. These environments currently face significant challenges associated with climate change, sea level rise, development and water quality deterioration and are consequently the focus of a range of management schemes. Increasingly, soft engineering techniques such as managed realignment (MR) are being employed to restore and recreate these environments, driven primarily by the need for habitat (re)creation and sustainable coastal flood defence. Such restoration schemes also have the potential to provide additional ecosystem services including climate regulation and waste processing. However, these sites have frequently been physically impacted by their previous land use and there is a lack of understanding of how this ‘disturbance’ impacts the delivery of ecosystem services or of the complex linkages between ecological, physical and biogeochemical processes in restored systems. Through the exploration of current data this paper determines that hydrological, geomorphological and hydrodynamic functioning of restored sites may be significantly impaired with respects to natural ‘undisturbed’ systems and that links between morphology, sediment structure, hydrology and solute transfer are poorly understood. This has consequences for the delivery of seeds, the provision of abiotic conditions suitable for plant growth, the development of microhabitats and the cycling of nutrients/contaminants and may impact the delivery of ecosystem services including biodiversity, climate regulation and waste processing. This calls for a change in our approach to research in these environments with a need for integrated, interdisciplinary studies over a range of spatial and temporal scales incorporating both intensive and extensive research design.
    Estuarine Coastal and Shelf Science 06/2012; 106:23–32. DOI:10.1016/j.ecss.2012.04.020
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    ABSTRACT: Health data may be collected across one spatial framework (e.g. health provider agencies), but contrasts in health over another spatial framework (neighbourhoods) may be of policy interest. In the UK, population prevalence totals for chronic diseases are provided for populations served by general practitioner practices, but not for neighbourhoods (small areas of circa 1500 people), raising the question whether data for one framework can be used to provide spatially interpolated estimates of disease prevalence for the other. A discrete process convolution is applied to this end and has advantages when there are a relatively large number of area units in one or other framework. Additionally, the interpolation is modified to take account of the observed neighbourhood indicators (e.g. hospitalisation rates) of neighbourhood disease prevalence. These are reflective indicators of neighbourhood prevalence viewed as a latent construct. An illustrative application is to prevalence of psychosis in northeast London, containing 190 general practitioner practices and 562 neighbourhoods, including an assessment of sensitivity to kernel choice (e.g. normal vs exponential). This application illustrates how a zero-inflated Poisson can be used as the likelihood model for a reflective indicator.
    Statistical Methods in Medical Research 05/2012; 23(2). DOI:10.1177/0962280212447150
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    ABSTRACT: In the first of this pair of papers we introduced the conceptual and hydrological basis of the peatland development model—DigiBog. Here we describe the submodels which simulate (i) the production of plant litter, (ii) peat decomposition, and (iii) changes in peat hydraulic conductivity due to decomposition. To illustrate how the model works, DigiBog was applied to three example situations: Bogs 1, 2, and 3. For each, the net rainfall was held constant at 30 cm year−1 and the oxic decomposition parameter kept at 0·015 year−1. The anoxic decomposition parameter varied from 5 × 10−6 (Bog 1) to 5 × 10−4 year−1 (Bog 3). Peatland development was simulated for 5000 years. For Bogs 1 and 2, plausible large peatland domes develop. Despite having a higher anoxic decomposition rate, Bog 2 grew thicker than Bog 1. This apparently counter-intuitive result is caused by the feedback between hydraulic conductivity and degree of peat decomposition. For both Bogs 1 and 2, DigiBog also simulates transitions from wet to dry states, demarked by sudden switches from poorly decomposed to well-decomposed peat moving upwards in the peat profile. These regime shifts result from internal peatland dynamics and not from allogenic influences, and challenge the view that peat properties are always a reflection of climate. In Bog 3, a ‘mini-bog’ developed and persisted near the margin of the peatland; this bog can also be explained in terms of the internal feedbacks within the model. Copyright © 2011 John Wiley & Sons, Ltd.
    Ecohydrology 05/2012; 5(3):256 - 268. DOI:10.1002/eco.229
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    ABSTRACT: Using a literature review, we argue that new models of peatland development are needed. Many existing models do not account for potentially important ecohydrological feedbacks, and/or ignore spatial structure and heterogeneity. Existing models, including those that simulate a near total loss of the northern peatland carbon store under a warming climate, may produce misleading results because they rely upon oversimplified representations of ecological and hydrological processes. In this, the first of a pair of papers, we present the conceptual framework for a model of peatland development, DigiBog, which considers peatlands as complex adaptive systems. DigiBog accounts for the interactions between the processes which govern litter production and peat decay, peat soil hydraulic properties, and peatland water-table behaviour, in a novel and genuinely ecohydrological manner. DigiBog consists of a number of interacting submodels, each representing a different aspect of peatland ecohydrology. Here we present in detail the mathematical and computational basis, as well as the implementation and testing, of the hydrological submodel. Remaining submodels are described and analysed in the accompanying paper. Tests of the hydrological submodel against analytical solutions for simple aquifers were highly successful: the greatest deviation between DigiBog and the analytical solutions was 2·83%. We also applied the hydrological submodel to irregularly shaped aquifers with heterogeneous hydraulic properties—situations for which no analytical solutions exist—and found the model's outputs to be plausible. Copyright © 2011 John Wiley & Sons, Ltd.
    Ecohydrology 05/2012; 5(3):242 - 255. DOI:10.1002/eco.230
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    ABSTRACT: The last two decades have seen a profound shift in how labour is spatially conceptualized and understood within economic geography, based on a recognition of workers’ abilities to fashion the geography of capitalism to suit their own needs. However, the bulk of work in labour geography fails to examine worker agency beyond a narrow focus on the trade union movement, largely divorces workers’ activities from the sphere of social reproduction, and rarely looks beyond the ‘core’ capitalist economies of the Global North. In response, this article presents findings from a regional labour mobility survey of 439 call centre workers in India’s National Capital Region (May 2007). Here, previous work has heavily criticized the ‘dead-end’ nature of call centre jobs offshored to India from the Global North, yet has done so based on an intra-firm focus of analysis. By taking an alternative cross-firm worker agency approach, our analysis documents for the first time some Indian call centre agents’ abilities to circumvent a lack of internal job ladders and achieve career progression through lateral ‘career staircases’, as they job hop between firms in pursuit of better pay, improved working conditions and more complex job roles. In the absence of widespread unionization within this sector, the article also discusses the productive and social reproductive factors that underpin these patterns of Indian call centre worker agency, and their mediation by a complex nexus of labour market intermediaries beyond the firm. In so doing, the article ‘theorizes back’ (Yeung, 2007) on ‘mainstream’ (Western) theories of the limits to call centre worker agency and career advancement.
    Journal of Economic Geography 04/2012; 12(4):841-875. DOI:10.1093/jeg/lbs008
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