Engaging stakeholders in an adaptation process: governance and institutional arrangements in heat-health policy development in Adelaide, Australia

Record breaking heat waves have been recorded in Adelaide, Australia in recent years and climate change would likely increase the frequency, duration and severity of heat waves. This paper describes the governance and institutional arrangements during the development of an adaptation strategy (herein referred to as heat-health policy) for heat waves in Adelaide, Australia. In-depth, semi-structured interviews were conducted between June and August 2011 among 18 stakeholders who were involved in the participatory process during the development of the heat-health policy. Informed consent was obtained and interviews were recorded, transcribed verbatim and the data analysed using framework analysis. Interview data were supplemented by data gathered through a review of documents associated with the process. The results found that the process of developing the heat-health policy was initiated by the state government and comprised of stakeholders from both the state and non-state sectors. There was a high level of leadership and political commitment demonstrated during the process, given that the different players wanted a policy to be in place before any future heat wave. A Steering Committee was established that provided coordination and oversight in addition to the Emergency Management Act within the state which provided the legislative framework during the heat-health policy development process. Although the decision-making authority was controlled by a controlled by a public institution, to a larger extent, there was collaborative decision-making by virtue of the context in which the heat-health policy was developed. An assurance mechanism established during the process was among the factors that ensured accountability during the participatory process. Overall, the development of the heat-health policy in Adelaide was largely successful, attributed to the extent of political commitment from the state government and the sound institutional and legislative framework that facilitated the process. Good governance and institutional arrangements provide the enabling environment, the structures, systems and resources that would facilitate the development of adaptation strategies such as heat-health policies.     

Disinfection By-Products in Drinking Water, Recycled Waterand Wastewater: Formation, Detection, Toxicity and HealthEffects: Preface

<正>The disinfection of drinking water was an outstanding(and perhaps the most important)public health achievement of the 20~(th) century.According to the United Nations World Health Organization,over 4 billion people have access to     

TIC-Tox: A preliminary discussion on identifying the forcing agents of DBP-mediated toxicity of disinfected water

The disinfection of drinking water is a major public health achievement; however, an unintended consequence of disinfection is the generation of disinfection by-products (DBPs). Many of the identified DBPs exhibit in vitro and in vivo toxicity, generate a diversity of adverse biological effects, and may be hazards to the public health and the environment. Only a few DBPs are regulated by several national and international agencies and it is not clear if these regulated DBPs are the forcing agents that drive the observed toxicity and their associated health effects. In this study, we combine analytical chemical and biological data to resolve the forcing agents associated with mammalian cell cytotoxicity of drinking water samples from three cities. These data suggest that the trihalomethanes (THMs) and haloacetic acids may be a small component of the overall cytotoxicity of the organic material isolated from disinfected drinking water. Chemical classes of nitrogen-containing DBPs, such as the haloacetonitriles and haloacetamides, appear to be the major forcing agents of toxicity in these samples. These findings may have important implications for the design of epidemiological studies that primarily rely on the levels of THMs to define DBP exposure among populations. The TIC-Tox approach constitutes a beginning step in the process of identifying the forcing agents of toxicity in disinfected water.     

The impact of iodinated X-ray contrast agents on formation and toxicity of disinfection by-products in drinking water

The presence of iodinated X-ray contrast media (ICM) in source waters is of high concern to public health because of their potential to generate highly toxic disinfection by-products (DBPs). The objective of this study was to determine the impact of ICM in source waters and the type of disinfectant on the overall toxicity of DBP mixtures and to determine which ICM and reaction conditions give rise to toxic by-products. Source waters collected from Akron, OH were treated with five different ICMs, including iopamidol, iopromide, iohexol, diatrizoate and iomeprol, with or without chlorine or chloramine disinfection. The reaction product mixtures were concentrated with XAD resins and the mammalian cell cytotoxicity and genotoxicity of the reaction mixture concentrates was measured. Water containing iopamidol generated an enhanced level of mammalian cell cytotoxicity and genotoxicity after disinfection. While chlorine disinfection with iopamidol resulted in the highest cytotoxicity overall, the relative iopamidol-mediated increase in toxicity was greater when chloramine was used as the disinfectant compared with chlorine. Four other ICMs (iopromide, iohexol, diatrizoate, and iomeprol) expressed some cytotoxicity over the control without any disinfection, and induced higher cytotoxicity when chlorinated. Only iohexol enhanced genotoxicity compared to the chlorinated source water.     

Total organic halogen (TOX) in human urine: A halogen-specific method for human exposure studies

Disinfection by-products(DBPs) are a complex mixture of compounds unintentionally formed as a result of disinfection processes used to treat drinking water. Effects of long-term exposure to DBPs are mostly unknown and were the subject of recent epidemiological studies. However,most bioanalytical methods focus on a select few DBPs. In this study, a new comprehensive bioanalytical method has been developed that can quantify mixtures of organic halogenated compounds, including DBPs, in human urine as total organic chlorine(TOCl), total organic bromine(TOBr), and total organic iodine(TOI). The optimized method consists of urine dilution, adsorption to activated carbon, pyrolysis of activated carbon, absorption of gases in an aqueous solution, and halide analysis with ion chromatography and inductively coupled plasma-mass spectrometry. Spike recoveries for TOCl, TOBr, and TOI measurements ranged between 78% and 99%. Average TOCl, TOBr, and TOI concentrations in five urine samples from volunteers who consumed tap water were 1850, 82, and 21.0 μg/L as X~-, respectively.Volunteers who consumed spring water(control) had TOCl, TOBr, and TOI average concentrations in urine of 1090, 88, and 10.3 μg/L as X~-, respectively. TOCl and TOI in the urine samples from tap water consumers were higher than the control. However, TOBr was slightly lower in tap water urine samples compared to mineral water urine samples, indicating other sources of environmental exposure other than drinking water. A larger sample population that consumes tap water from different cities and mineral water is needed to determine TOCl, TOBr, and TOI exposure from drinking water.     

First-trimester prenatal diagnosis of cystic fibrosis using fibroblasts from a deceased index child to establish haplotypes

First-trimester prenatal diagnosis of cystic fibrosis (CF) using linked DNA markers is usually only possible if there is an index affected child to establish the haplotype of the parental chromosomes. We describe a prenatal diagnosis where fibroblasts, cultured from the skin of a deceased affected child and then held in frozen storage for 3 years, were used as the starting point for tracking the CF gene. The fetus was diagnosed as a homozygous normal and the diagnosis confirmed by immunoreactive trypsin testing after birth. It was also possible to establish heterozygosity in the aunt of the affected child.     

A decision inventory approach for improving decision support for climate change impact assessment and adaptation

Assessing and adapting to the impacts of climate change requires balancing social, economic, and environmental factors in the context of an ever-expanding range of objectives, uncertainties, and management options. The term decision support describes a diverse class of resources designed to help manage this complexity and assist decision makers in understanding impacts and evaluating management options. Most climate-related decision support resources implicitly assume that decision making is primarily limited by the quantity and quality of available information. However, a wide variety of evidence suggests that institutional, political, and communication processes are also integral to organizational decision making. Decision support resources designed to address these processes are underrepresented in existing tools. These persistent biases in the design and delivery of decision support may undermine efforts to move decision support from research to practice. The development of new approaches to decision support that consider a wider range of relevant issues is limited by the lack of information about the characteristics, context, and alternatives associated with climate-related decisions. We propose a new approach called a decision assessment and decision inventory that will provide systematic information describing the relevant attributes of climate-related decisions. This information can be used to improve the design of decision support resources, as well as to prioritize research and development investments. Application of this approach will help provide more effective decision support based on a balanced foundation of analytical tools, environmental data, and relevant information about decisions and decision makers.     

The Climate for Joint Implementation: Case Studies from Russia,Ukraine, and Poland

Joint implementation (JI) can provide flexibility in meetingKyoto Protocol commitments, and 44 nations have already participated inthe U.N. Framework Convention on Climate Change – Activities Implemented Jointly (AIJ) pilot. Thispaper surveys JI policy and projects in three countries – Russia, Ukraine,and Poland – over the past five years and examines the effects of domesticinstitutions, foreign policy, and investment trends on JI in each country.The institutional and economic situation in the three nations differs greatly,and these distinctions have resulted in very different circumstances for AIJprojects, affecting both their number and scope. Poland has a well-definedset of rules and procedures for JI and its economy is quite strong. Ukrainehas not yet established criteria or clear procedures for AIJ project reviewsalthough it does have an Interagency Commission on Climate Change.Ukraine's economy declined by over 40% in the 1990s. Russia'seconomy has also declined, to a lesser extent. Russia does have aprocedure for reviewing AIJ projects, though it has temporarily halted thesereviews. Countries seeking JI investment can take several steps to improve thenumber and quality of AIJ projects that they receive. In the long term,governments can create macroeconomic stability and a solid legalinvestment basis to attract investment for JI and other areas. In the shortterm, however, governments can undertake several simple and inexpensivesteps to promote JI. Establishing clear rules and procedures for AIJprojects is an important step. So too are clearly delegating responsibilityfor AIJ project review and providing a single JI point of contact in thegovernment to which investors and project developers can turn. Gainingmore experience in implementing AIJ projects now is important preparationfor fully implementing the Kyoto Protocol beginning in 2008.     

Amniotic fluid calcium concentration in the prenatal diagnosis of cystic fibrosis

Calcium concentrations were measured in supernatant amniotic fluid in order to establish whether they may be used as a marker for cystic fibrosis. No difference in values were found, whether the sample was derived from a normal pregnancy or from a pregnancy which resulted in a baby affected with cystic fibrosis.