Small Geographic Area Research Articles

Spatial patterns of biomass change across Finland in 2009–2015

Forest characteristics vary largely at the regional level and in smaller geographic areas in Finland. The amount of greenhouse gas emissions is related to changes in biomass and the soil type (e.g. upland soils vs. peatlands). In this paper, estimating and explaining spatial patterns of tree biomass change across Finland was the main interest. We analysed biomass changes on different soil and site types between the years 2009 and 2015 using the Finnish multi-source national forest inventory (MS-NFI) raster layers. MS-NFI method is based on combining information from satellite imagery, digital maps and national forest inventory (NFI) field data. Automatic segmentation was used to create silvicultural management and treatment units. An average biomass estimate of the segmented MS-NFI (MS–NFI–seg) map was 73.9 tons ha−1 compared to the national forest inventory estimate of 76.5 tons ha−1 in 2015. Forest soil type had a similar effect on average biomass in MS–NFI–seg and NFI data. Despite good regional and country-level results, segmentation narrowed the biomass distributions. Hence, biomass changes on segments can be considered only approximate values; also, those small differences in average biomass may accumulate when map layers from more than one time point are compared. A kappa of 0.44 was achieved for precision when comparing undisturbed and disturbed forest stands in the segmented Global Forest Change data (GFC-seg) and MS–NFI–seg map. Compared to NFI, 69% and 62% of disturbed areas were detected by GFC-seg and MS–NFI–seg, respectively. Spatially accurate map data of biomass changes on forest land improve the ability to suggest optimal management alternatives for any patch of land, e.g. in terms of climate change mitigation.

Adult asthma associated with roadway density and housing in rural Appalachia: the Mountain Air Project (MAP)

BackgroundAppalachian Kentucky is a rural area with a high prevalence of asthma among adults. The relative contribution of environmental exposures in the etiology of adult asthma in these populations has been understudied.ObjectiveThis manuscript describes the aims, study design, methods, and characteristics of participants for the Mountain Air Project (MAP), and focuses on associations between small area environmental exposures, including roadways and mining operations, and lifetime and current asthma in adults.MethodsA cohort of residents, aged 21 and older, in two Kentucky counties, was enrolled in a community-based, cross-sectional study. Stratified cluster sampling was used to select small geographic areas denoted as 14-digit USGS hydrologic units (HUCs). Households were enumerated within selected HUCs. Community health workers collected in-person interviews. The proximity of nearby active and inactive coal mining operations, density of oil and gas operations, and density of roadways were characterized for all HUCs. Poisson regression analyses were used to estimate adjusted prevalence ratios.ResultsFrom 1,459 eligible households contacted, 1,190 individuals were recruited, and 972 persons completed the interviews. The prevalence of lifetime asthma was 22.8%; current asthma was 16.3%. Adjusting for covariates, roadway density was positively associated with current asthma in the second (aPR = 1.61; 95% CI 1.04–2.48) and third tertiles (aPR = 2.00; 95% CI 1.32–3.03). Increased risk of current asthma was associated with residence in public, multi-unit housing (aPR = 2.01; 95% CI 1.27–3.18) compared to a residence in a single-family home. There were no notable associations between proximity to coal mining and oil and gas operations and asthma prevalence.ConclusionsThis study suggests that residents in rural areas with higher roadway density and those residing in public housing units may be at increased risk for current asthma after accounting for other known risk factors. Confirming the role of traffic-related particulates in producing high asthma risk among adults in this study contributes to the understanding of the multiple environmental exposures that influence respiratory health in the Appalachia region.

Mapping of cholera hotspots in Kenya using epidemiologic and water, sanitation, and hygiene (WASH) indicators as part of Kenya's new 2022-2030 cholera elimination plan.

Cholera is an issue of major public health importance. It was first reported in Kenya in 1971, with the country experiencing outbreaks through the years, most recently in 2021. Factors associated with the outbreaks in Kenya include open defecation, population growth with inadequate expansion of safe drinking water and sanitation infrastructure, population movement from neighboring countries, crowded settings such as refugee camps coupled with massive displacement of persons, mass gathering events, and changes in rainfall patterns. The Ministry of Health, together with other ministries and partners, revised the national cholera control plan to a multisectoral cholera elimination plan that is aligned with the Global Roadmap for Ending Cholera. One of the key features in the revised plan is the identification of hotspots. The hotspot identification exercise followed guidance and tools provided by the Global Task Force on Cholera Control (GTFCC). Two epidemiological indicators were used to identify the sub-counties with the highest cholera burden: incidence per population and persistence. Additionally, two indicators were used to identify sub-counties with poor WASH coverage due to low proportions of households accessing improved water sources and improved sanitation facilities. The country reported over 25,000 cholera cases between 2015 and 2019. Of 290 sub-counties, 25 (8.6%) sub-counties were identified as a high epidemiological priority; 78 (26.9%) sub-counties were identified as high WASH priority; and 30 (10.3%) sub-counties were considered high priority based on a combination of epidemiological and WASH indicators. About 10% of the Kenyan population (4.89 million) is living in these 30-combination high-priority sub-counties. The novel method used to identify cholera hotspots in Kenya provides useful information to better target interventions in smaller geographical areas given resource constraints. Kenya plans to deploy oral cholera vaccines in addition to WASH interventions to the populations living in cholera hotspots as it targets cholera elimination by 2030.

Household wealth, neighbourhood deprivation and frailty amongst middle-aged and older adults in England: a longitudinal analysis over 15years (2002-2017).

frailty is a condition of reduced function and health due to ageing processes and is associated with a higher risk of falls, hospitalisation, disability and mortality. to determine the relationship between household wealth and neighbourhood deprivation with frailty status, independently of demographic factors, educational attainment and health behaviours. population-based cohort study. communities in England. in total 17,438 adults aged 50+ from the English Longitudinal Study of Ageing. multilevel mixed-effects ordered logistic regression was used in this study. Frailty was measured using a frailty index. We defined small geographic areas (neighbourhoods) using English Lower layer Super Output Areas. Neighbourhood deprivation was measured by the English Index of Multiple Deprivation, grouped into quintiles. Health behaviours included in this study are smoking and frequency of alcohol consumption. the proportion of respondents who were prefrail and frail were 33.8% [95% confidence interval (CI) 33.0-34.6%] and 11.7 (11.1-12.2)%, respectively. Participants in the lowest wealth quintile and living in the most deprived neighbourhood quintile had 1.3 (95% CI = 1.2-1.3) and 2.2 (95% CI = 2.1-2.4) times higher odds of being prefrail and frail, respectively, than the wealthiest participants living in the least deprived neighbourhoods Living in more deprived neighbourhood and poorer wealth was associated with an increased risk of becoming frail. Those inequalities did not change over time. in this population-based sample, living in a deprived area or having low wealth was associated with frailty in middle-aged and older adults. This relationship was independent of the effects of individual demographic characteristics and health behaviours.

Using Slutsky equation to find the hotel growth model in the destination life cycle: an empirical study in Myrtle Beach

PurposeThe purpose of this paper is to examine the hotel growth model including hotel brand, culture and life cycle phases of the Myrtle Beach, South Carolina, the fastest growing tourism destination in the United States.Design/methodology/approachCulture reflecting consuming behaviour of low-context innovators and high-context imitators is measured by the price elasticity of demand (PED). Hotel brand reflecting guests’ hotel class is measured by the income elasticity of demand. Autoregressive distributed lag has been conducted on the Smith Travel Research data in 33 years (1989–2022) to determine the relationship among hotel brand, culture and life cycles.FindingsSkilled labour is the key to make hotels grow. Therefore, increase room rates when hotels possess skilled professionals and decrease room rates when hotels have no skilled professionals. During the rejuvenation in Myrtle Beach (1999–2003), hoteliers increased room rates for innovators due to skilled professionals to increase revenue. Otherwise, a decrease in room rates due to lack of skilled professionals would lead to increase revenue.Research limitations/implications(1) Although Myrtle Beach is one of the fastest growing tourism destinations in the US, it has a relatively small geographic area relative to the country. (2) Data cover over one tourist life cycle, so the time span is relatively short. Hoteliers can forecast the number of guests in different culture by changing room rates.Practical implicationsTo optimize revenue, hoteliers can select skilled labour in professional design hotel brands which could make an increase in demand for leisure transient guests no matter what room rates increase after COVID-19 pandemic.Social implicationsThe study has considered the applied ethical processes regarding revenue management that would maximize both revenue and customer satisfaction when it set up an increase in room rates to compensate for professional hotel room design or it decreases room rates for low-income imitators in exploration and development.Originality/valueThis research highlights that (1) skilled design in the luxury hotel brand is the key for the hotel growth and (2) there is a steady state of the growth model in the destination life cycle.

The magnetic signal from trunk bark of urban trees catches the variation in particulate matter exposure within and across six European cities.

Biomagnetic monitoring increasingly is applied to assess particulate matter (PM) concentrations, mainly using plant leaves sampled in small geographical area and from a limited number of species. Here, the potential of magnetic analysis of urban tree trunk bark to discriminate between PM exposure levels was evaluated and bark magnetic variation was investigated at different spatial scales. Trunk bark was sampled from 684 urban trees of 39 genera in 173 urban green areas across six European cities. Samples were analysed magnetically for the Saturation isothermal remanent magnetisation (SIRM). The bark SIRM reflected well the PM exposure level at city and local scale, as the bark SIRM (i) differed between the cities in accordance with the mean atmospheric PM concentrations and (ii) increased with the cover of roads and industrial area around the trees. Furthermore, with increasing tree circumferences, the SIRM values increased, as a reflection of a tree age effect related to PM accumulation over time. Moreover, bark SIRM was higher at the side of the trunk facing the prevailing wind direction. Significant relationships between SIRM of different genera validate the possibility to combine bark SIRM from different genera to improve sampling resolution and coverage in biomagnetic studies. Thus, the SIRM signal of trunk bark from urban trees is a reliable proxy for atmospheric coarse to fine PM exposure in areas dominated by one PM source, as long as variation caused by genus, circumference and trunk side is taken into account.

Molecular and morphological analyses disclose the existence of three species of Dolichopoda (Orthoptera: Rhaphidophoridae) in the Calabria region (Italy)

ABSTRACT For a long time, Dolichopoda palpata was the only species of this genus thought to live in the cave habitats of the Calabrian region. The results of our study, based on morphological and molecular data, highlight the existence of three species in the Calabria region. In particular, our data demonstrate the occurrence of two well-separated species, one in the northern Tyrrhenian area and one in the Calabrian Ionian area, attesting to the validity of D. calabra Galvagni 1968, and the discovery of a new species, D. apollinea sp. nov. Both species appear to be geographically very limited. Dolichopoda calabra occurs in the mountain region between Scalone Pass in the north and the Savuto Valley in the south (a district called ‘Catena Costiera’), whereas D. apollinea sp. nov. appears to be distributed on the eastern slope of Pollino Massif. On the other hand, D. palpata shows a vast distribution, occurring in caves from La Sila in the north to the Aspromonte Massif in the extreme south of Calabria. About 1/3 of the Italian Dolichopoda species are present in this relatively small geographical area, supporting the importance of Calabria as a geographical region characterised by a high level of biodiversity. It shows the maximum values of genetic diversity and species richness in comparison with the rest of the Italian peninsula. This fact could be related to the palaeogeological and palaeoclimatic history of the region, as it was affected by glaciation events and eustatic movements. The combination of these two conditions that occurred during the Pliocene and Pleistocene transformed the Calabria into a vast archipelago of little islands, favouring the isolation of populations and the consequent speciation processes. http://www.zoobank.org/urn:lsid:zoobank.org:pub:AB64936E-EAEF-4730-A517-4F0C11226A94

An Assessment of Uncertainties in Flood Frequency Estimation Using Bootstrapping and Monte Carlo Simulation

Reducing uncertainty in design flood estimates is an essential part of flood risk planning and management. This study presents results from flood frequency estimates and associated uncertainties for five commonly used probability distribution functions, extreme value type 1 (EV1), generalized extreme value (GEV), generalized pareto distribution (GPD), log normal (LN) and log Pearson type 3 (LP3). The study was conducted using Monte Carlo simulation (MCS) and bootstrapping (BS) methods for the 10 river catchments in eastern Australia. The parameters were estimated by applying the method of moments (for LP3, LN, and EV1) and L-moments (for GEV and GPD). Three-parameter distributions (e.g., LP3, GEV, and GPD) demonstrate a consistent estimation of confidence interval (CI), whereas two-parameter distributions show biased estimation. The results of this study also highlight the difficulty in flood frequency analysis, e.g., different probability distributions perform quite differently even in a smaller geographical area.

Riparian Spiders: Sentinels of Polychlorinated Dibenzo-p-dioxin and Dibenzofuran-Contaminated Sediment.

Polychlorinated dibenzo-p-dioxin and polychlorinated dibenzofuran (PCDD/F) are persistent, toxic, and bioaccumulative. Currently, PCDD/F monitoring programs primarily use fish and birds with potentially large home ranges to monitor temporal trends over broad spatial scales; sentinel organisms that provide targeted sediment contaminant information across small geographic areas have yet to be developed. Riparian orb-weaving spiders, which typically have small home ranges and consume primarily adult aquatic insects, are potential PCDD/F sentinels. Recent studies have demonstrated that spider tissue concentrations indicate the source and magnitude of dioxin-like chlorinated compounds in contaminated sediments, including polychlorinated biphenyls (PCBs). Our aim in the present study was to assess the utility of riparian spiders as sentinels for PCDD/F-contaminated sediments. We measured PCDD/F (total [Σ] and homologs) in surface sediments and spiders collected from three sites within the St. Louis River basin (Minnesota and Wisconsin, USA). We then compared (1) patterns in ΣPCDD/F concentrations between sediment and spiders, (2) the distribution of homologs within sediments and spiders when pooled across sites, and (3) the relationship between sediment and spider concentrations of PCDD/F homologs across 13 stations sampled across the three sites. The ΣPCDD/F concentrations in sediment (mean ± standard error 286 591 ± 97 614 pg/g) were significantly higher than those in riparian spiders (2463 ± 977 pg/g, p < 0.001), but the relative abundance of homologs in sediment and spiders were not significantly different. Spider homolog concentrations were significantly and positively correlated with sediment concentrations across a gradient of sediment PCDD/F contamination (R2 = 0.47, p < 0.001). Our results indicate that, as has been shown for other legacy organic chemicals like PCBs, riparian spiders are suitable sentinels of PCDD/F in contaminated sediment. Environ Toxicol Chem 2023;42:414-420. © 2022 SETAC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

The impact of public transport on the diffusion of COVID-19 pandemic in Lombardy during 2020

In 2020, the COVID-19 pandemic has impacted the world, affecting health, economy, education, and social behavior. Much concern was raised about the role of mobility in the diffusion of the disease, with particular attention to public transport. Indeed, understanding the relationship between mobility and the pandemic is key for developing effective public health interventions and policy decisions. In this work, we aim to understand how mobility, and more specifically mobility by public transport, has affected the diffusion of the pandemic at the regional scale. We focus our attention on Lombardy, the most populated Italian region severely hit by the pandemic in 2020. We explore static mobility data provided by Regione Lombardia, the regional service district, and dynamic mobility data provided by Trenord, a railway operator which serves Lombardy and neighboring areas. We develop an inventive pipeline for the dynamic estimation of Origin-Destination matrices obtained from tickets and passenger counts. This allows us to spot potential triggers in pandemic diffusion enhanced by the concept of proximity induced by mobility. We also develop a novel perspective for assessing the relationship between mobility and overall mortality based upon a functional approach combined with a spatial correlation analysis aimed at identifying the diversified effects on mortality in small geographical areas as a result of the restrictions on mobility introduced to contrast the pandemic.

Beyond visual-line-of-sight (BVLOS) drone operations for environmental and infrastructure monitoring: a case study in northwestern Canada

Aerial drones typically operate over small geographic areas (&lt;5 km2), yet environmental and infrastructure monitoring applications often require the collection of data over larger areas. Challenges to drone deployments in areas with people and frequent air traffic include aviation regulations that require missions to adhere to within-visual-line-of-sight (VLOS) conditions, thereby limiting mission extents. The performance and fuel consumption of longer drone missions could justify investment to advance future beyond-VLOS (BVLOS) data acquisitions. This work summarizes airspace deconfliction techniques that allowed testing of BVLOS capabilities in relatively busy airspace in northwestern Canada. Drone missions were conducted with a Griffon SeaHunter, capturing high-resolution imagery covering more than 550 km2 along 6200 km of flight lines, increasing conventional drone data coverage by two orders of magnitude. BVLOS hourly endurance was nearly double that of light aviation mapping aircraft, providing a suitable range for extended monitoring operations (1000–1200 km). Fuel consumption (L/100 km) also differed substantially; SeaHunter used 9%–16% of the fuel consumed by conventional mapping aircraft (84%–91% savings). Finally, we summarize lessons learned to further stimulate BVLOS adoption internationally. Opportunities will arise as BVLOS drones will increasingly be operated within a global context of transitions toward low-carbon emission economies.

Fighting the flames: site-specific effects determine species richness of Australian frogs after fire

Context Fire has played an integral role in regulating patterns of biodiversity for millions of years. However, anthropogenic disturbance and climate change has altered fire activity – driving increases in both fire severity and scale. The effect fire now has on the persistence of biodiversity is poorly known, especially for frogs. Studies examining frog responses to fire usually have small sample sizes, focus upon small geographic areas and are based on low-severity fires, which can mean results are not applicable to high-severity fires, such as those expected under future climate change. Aims Our aims were to examine (1) persistence of frog species, measured by species richness, up to 18 months post-fire, and (2) the effects of varying fire severity on frog species richness and recovery, where we expected higher fire severity to lead to lower species richness after fire. Methods Using large-scale citizen science data from the Australian Museum’s FrogID project, coupled with remotely sensed fire data, we present a spatially and taxonomically broad analysis examining post-fire recovery responses for Australian frog species after the 2019/2020 ‘Black Summer’ bushfires. Key results We reveal no overall decrease in the species richness of Australian frogs both in the short- and long-term post-fire. Furthermore, species richness did not decline with increasing fire severity. Instead, species richness and its response to fire was highly site-specific. Conclusions We provide evidence that widespread and common Australian frog species have persisted post-fire in most sites and concluded that this is potentially due to their ability to shelter from fire adequately and/or La Niña-driven high rainfall offering conditions conducive to breeding activity and persistence. Implications We show how citizen science provides critical data for conservation, especially in response to unprecedented disturbance events, such as the 2019/2020 megafires. Our research also highlights the need for ongoing and targeted scientific monitoring, especially for less common or threatened species.

Association of hormonal and reproductive risk factors with breast cancer in Indian women: A systematic review of case-control studies.

The incidence of breast cancer in India has seen a rapid increase in recent years. Hormonal and reproductive risk factors for breast cancer have been affected by socioeconomic development. Studies on breast cancer risk factors in India are limited by the small sample size and specific geographical area. The current systematic review was carried out to assess the association of hormonal and reproductive risk factors with breast cancer in Indian women. A systematic review of MEDLINE, Embase, Scopus, and Cochrane database of systematic reviews were done. Relevant case-control studies published in peer-reviewed indexed journals were analyzed for hormonal risk factors such as age at menarche, menopause, and first childbirth; breastfeeding; abortion; and oral contraceptive pills use. Younger age (<13 years) at menarche was associated with high risk (odds ratio 1.23-3.72). Other hormonal risk factors with strong association were age at first childbirth and menopause, parity, and duration of breastfeeding. Abortion and the use of contraceptive pills did not have a clear association with breast cancer. Hormonal risk factors have a higher association in premenopausal disease and estrogen receptor-positive tumors. There is a strong association between hormonal and reproductive risk factors and breast cancer in Indian women. The protective effect of breastfeeding is related to the cumulative duration of breastfeeding.

Flora vascular de alta montaña en la Patagonia argentina

Knowledge of the local biodiversity is extremely important to design conservation strategies. The goals of the present work are to provide a list of native species recorded in the high mountains of Argentine Patagonia, with comments about their distribution, habitat and habit, and to identify the most vulnerable species for inhabiting small geographical areas and/or have populations with few individuals, for inhabit specific habitats, for not being included in protected areas and/or inhabiting territories subject to human activities. This annotated list, resulting from the field survey of 111 mountains between 1992 and 2022, includes 550 native species belonging to 185 genera and 69 families. Of these, 124 species have restricted geographic distributions, 69 are exclusive to high mountains, and 13 species and 10 populations are in a vulnerable situation. The data in this contribution are important for future decisions when preparing management plans for existing protected areas, to evaluate the creation of new reserves, and as a database for future comparisons.

Overview: The value chain of Tra catfish in Mekong Delta Region, Vietnam

AbstractAquaculture of Tra catfish (Pangasius hypophthalmus) of Mekong Delta has a record production of 1,525 million tons in 2022. It is one of the largest single‐species based farming systems that is restricted to a small geographical area, in the world. The product (frozen fillets) that has been exported to over 138 countries with a value of about 1.6 billion USD is an acceptable alternative to white fish. Tra catfish is farmed in earthen ponds, up to 4 m in deep, in nine provinces in the Mekong Delta in South Vietnam. Over the years, the Tra catfish farming and processing industry in Vietnam has been constantly developed and become a spearhead economic sector of Vietnam which has become a leading part of international economic integration. However, due to the global impact of the Covid‐19 epidemic with increasing competition pressure and product quality requirements, the Tra catfish industry is facing both challenges and opportunities. Therefore, in this paper, the Tra catfish such as species, anatomical composition, and chemical composition is briefly reviewed. After that, the value chain of Tra catfish in the Mekong Delta as well as demand forecasting and development orientation in the future is further analyzed.

Response of a temperate coral to temperature stress: A comparison of populations across sites

The negative effects of warming temperatures on coral physiology are well-documented. However, research increasingly suggests that these effects are variable and that the degree to which corals are impacted by higher temperatures are dependent on a range of environmental and physiological variables. In tropical corals, which live near their upper thermal limits, these disparities have led to significant differences in bleaching and other negative health effects even over relatively small spatial scales. However, the response of temperate corals across small spatial scales is less well understood despite their occurrence in areas with larger temperature ranges than their tropical counterpart. To determine whether responses to thermal stress (27.4 versus 29 °C) differed in a common temperate coral species across a small geographic area, as has been documented in tropical corals, we evaluated coral growth and photosynthetic efficiency (Fv/Fm) of the coral Oculina arbuscula over the course of eight weeks when grown at differing temperatures. When measured as buoyant mass (calcification), growth of O. arbuscula did not differ as a function of temperature or site of collection. In contrast, when measured as change in tissue mass or total wet mass, elevated temperature suppressed growth. Change in total wet mass also varied significantly by collection site, corals from some sites experiencing little if any growth and those from other sites experiencing negative growth. Photosynthetic efficiency (Fv/Fm) was significantly lower at 29 °C than at 27.4 °C. Analyses of symbionts showed that sequence variants related to the genus Breviolum made up ∼98% of all Symbiondiniaceae across all sites and temperature treatments with one variant (100% sequence identity to Breviolum psygmophilum) being 91% of the total community. Only one Symbiodiniaceae, with a 99.28% sequence identity to Breviolum psygmophilum, differed significantly as a function of temperature. It also comprised only 1–3% of the community. Bacterial microbiome variance increased during our experiment, but there were no significant effects of temperature or collection site. For O. arbuscula from these collection sites, location did not impact the coral's ability to withstand the effects of temperature stress.

Geographical and spatial disparities in the incidence and survival of rare cancers in Australia.

Rare cancers collectively account for around a quarter of cancer diagnoses and deaths. However, epidemiological studies are sparse. We describe spatial and geographical patterns in incidence and survival of rare cancers across Australia using a population-based cancer registry cohort of rare cancer cases diagnosed among Australians aged at least 15 years, 2007 to 2016. Rare cancers were defined using site- and histology-based categories from the European RARECARE study, as individual cancer types having crude annual incidence rates of less than 6/100 000. Incidence and survival patterns were modelled with generalised linear and Bayesian spatial Leroux models. Spatial heterogeneity was tested using the maximised excess events test. Rare cancers (n=268 070) collectively comprised 22% of all invasive cancer diagnoses and accounted for 27% of all cancer-related deaths in Australia, 2007 to 2016 with an overall 5-year relative survival of around 53%. Males and those living in more remote or more disadvantaged areas had higher incidence but lower survival. There was substantial evidence for spatial variation in both incidence and survival for rare cancers between small geographical areas across Australia, with similar patterns so that those areas with higher incidence tended to have lower survival. Rare cancers are a substantial health burden in Australia. Our study has highlighted the need to better understand the higher burden of these cancers in rural and disadvantaged regions where the logistical challenges in their diagnosis, treatment and support are magnified.

Identifying Patterns of Clinical Interest in Clinicians' Treatment Preferences: Hypothesis-free Data Science Approach to Prioritizing Prescribing Outliers for Clinical Review.

Data analysis is used to identify signals suggestive of variation in treatment choice or clinical outcome. Analyses to date have generally focused on a hypothesis-driven approach. This study aimed to develop a hypothesis-free approach to identify unusual prescribing behavior in primary care data. We aimed to apply this methodology to a national data set in a cross-sectional study to identify chemicals with significant variation in use across Clinical Commissioning Groups (CCGs) for further clinical review, thereby demonstrating proof of concept for prioritization approaches. Here we report a new data-driven approach to identify unusual prescribing behaviour in primary care data. This approach first applies a set of filtering steps to identify chemicals with prescribing rate distributions likely to contain outliers, then applies two ranking approaches to identify the most extreme outliers amongst those candidates. This methodology has been applied to three months of national prescribing data (June-August 2017). Our methodology provides rankings for all chemicals by administrative region. We provide illustrative results for 2 antipsychotic drugs of particular clinical interest: promazine hydrochloride and pericyazine, which rank highly by outlier metrics. Specifically, our method identifies that, while promazine hydrochloride and pericyazine are barely used by most clinicians (with national prescribing rates of 11.1 and 6.2 per 1000 antipsychotic prescriptions, respectively), they make up a substantial proportion of antipsychotic prescribing in 2 small geographic regions in England during the study period (with maximum regional prescribing rates of 298.7 and 241.1 per 1000 antipsychotic prescriptions, respectively). Our hypothesis-free approach is able to identify candidates for audit and review in clinical practice. To illustrate this, we provide 2 examples of 2 very unusual antipsychotics used disproportionately in 2 small geographic areas of England.

International Humanitarian Award.

The International Humanitarian Award recognizes extraordinary humanitarian services and activism by psychologists, including professional and volunteer work conducted primarily in the field with underserved populations. Award recipients are psychologists who, by their extraordinary service at a difficult time, improve the lives and contribute to the well-being of people in a large or small geographic area anywhere in the world. The 2022 recipient of the APA International Humanitarian Award was selected by the Board of Directors as recommended by the 2021 Committee on International Relations in Psychology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Marriage on the Border: Love, Mutuality, and Divorce in the Upper South during the Civil War

In Marriage on the Border, Allison Dorothy Fredette explores how social values among white households and families in border Southern states did not fully adhere to norms common throughout the slave South. By tracing how these values manifested themselves in divorce records during the Civil War era, Fredette emphasizes that Southern gender norms were hardly monolithic. Her study of marriages and marital roles in white families in Kentucky, West Virginia, and Virginia reveals a world where “mutuality, love, and respect” shaped relationships (p. 9). Fredette's book is carefully framed and deeply researched. Instead of writing broadly about the entire region, she dives deeply into four counties to represent the border South—Ohio and Tazewell in western (later West) Virginia and Franklin and Warren in Kentucky. She examines Fauquier and Amelia Counties in Virginia as representative of the slaveholding South. By narrowing her focus on a relatively small geographic area, Fredette is able to mine the divorce records for each of the counties, augmenting them with a wide array of diaries, personal correspondence, speeches, and prescriptive literature.