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Abstract Human respiratory syncytial virus (RSV) is a major cause of acute respiratory infection. In 2020, RSV was eliminated from New Zealand due to non-pharmaceutical interventions (NPI) used to control the spread of SARS-CoV-2. However, in 2021, following a brief quarantine-free travel agreement with Australia, there was a large-scale nationwide outbreak of RSV that led to reported cases more than five-times higher than typical seasonal patterns. We generated 1470 viral genomes of both RSV-A and RSV-B sampled between 2015–2022 from across New Zealand. Using a phylodynamics approach, we used these data to better understand RSV transmission patterns in New Zealand prior to 2020, and how RSV became re-established in the community following the relaxation of COVID-19 restrictions. We found that in 2021, there was a large epidemic of RSV due to an increase in importations, leading to several large genomic clusters of both RSV-A ON1 and RSV-B BA9 genotypes. However, while a number of viral importations were detected, there was also a major reduction in RSV genetic diversity compared to pre-pandemic years. These data reveal the impact of NPI used during the COVID-19 pandemic on other respiratory infections and highlight the important insights that can be gained from viral genomes.

Abstract By early 2022, the highly transmissible Omicron variant of SARS-CoV-2 had spread across most of the world. For the first time since the pandemic began, New Zealand was experiencing high levels of community transmission of SARS-CoV-2. We enroled a cohort of households to better understand differences in transmission dynamics among subvariants of Omicron. We enroled 71 households, comprising 289 participants, and aimed to use viral genomes to gain a clearer understanding of variant-specific differences in epidemiological parameters affecting transmission dynamics. Approximately 80% of the households enroled experienced transmission of BA.2, while most of the remaining households had infections with BA.1 or BA.5. Using a logistic regression generalised linear mixed model, we found no difference in household secondary infection rate between Omicron subvariants BA.1, BA.2 and BA.5. Of the households recruited, the vast majority (92%) experienced a single chain of transmission with one inferred introduction. Further, we found that in 48% of the households studied, all household participants became infected following an index case. Most household participants tested positive within a week following an introduction, supporting the seven-day isolation requirement for household contacts that was in place in New Zealand at the time. By integrating genomic and epidemiological data, we show that viral transmission dynamics can be investigated with a higher level of granularity than with epidemiological data alone. Overall, households are a high risk setting for viral transmission in New Zealand.

Abstract Background Teleaudiology can potentially improve access to hearing healthcare services. Remote hearing aid fittings offer a new mode of service delivery that removes barriers of geography and access to an audiologist. Real-ear measurements (REMs) are the gold standard for hearing aid output verification but require in-clinic appointments. This study will investigate whether remote hearing aid fittings can provide clinically equivalent outcomes when compared to current, in-clinic, best practice guidelines. Research design A repeated measure, double-blinded crossover design will be used. Participants will be randomly allocated to one of two groups to determine order of intervention, balanced for degree of hearing loss. Study sample Sixty adults with mild to moderate hearing loss and at least 1 year of experience with hearing aids will be recruited. Data collection and analysis Participants will complete two hearing aid fitting protocols, one using an in-clinic fitting process and the other using a remote (at-home) fitting process. In-clinic fittings will include REMs with adjustments to standard (NAL-NL2) prescription targets. The two fitting protocols will then be randomly assigned to participants in a crossover design, so participants and researchers will be blinded to the order of the two fitting protocols. Participants will then have a 4-week period with follow-up appointments for participant-directed gain adjustment. For each fitting protocol, participants will complete objective measurements of final hearing aid output with REMs, speech-in-noise testing, subjective measurements of hearing aid performance, and quality of life measurements. They will then begin an identical period of living with, adjusting, and objective assessment with the other fitting protocol. Data will be analysed as repeated measures with statistical control for potential confounding variables. Results Data will compare the four-frequency average real-ear aided response (4FREAR) for hearing aids programmed in-clinic and hearing aids programmed remotely, after participant-directed gain adjustments. Secondary measures will assess clinically significant differences in estimated speech intelligibility, hearing-related quality of life, hearing aid benefit, sound quality and preference, and speech-in-noise ability. Conclusions This study will inform the development of best practice guidelines for remote hearing aid fittings. If no clinically significant differences are found between in-clinic and remote fit hearing aids, it has the potential to expand teleaudiology initiatives. Trial registration Australian New Zealand Clinical Trial Registry, ACTRN12623000028606p . Date of registration: 12 January 2023.

Abstract An emerging intervention for control of airborne-mediated pandemics and epidemics is whole-room far-UVC (200–235 nm). Laboratory studies have shown that 222-nm light inactivates airborne pathogens, potentially without harm to exposed occupants. While encouraging results have been reported in benchtop studies and in room-sized bioaerosol chambers, there is a need for quantitative studies of airborne pathogen reduction in occupied rooms. We quantified far-UVC mediated reduction of aerosolized murine norovirus (MNV) in an occupied mouse-cage cleaning room within an animal-care facility. Benchtop studies suggest that MNV is a conservative surrogate for airborne viruses such as influenza and coronavirus. Using four 222-nm fixtures installed in the ceiling, and staying well within current recommended regulatory limits, far-UVC reduced airborne infectious MNV by 99.8% (95% CI: 98.2–99.9%). Similar to previous room-sized bioaerosol chamber studies on far-UVC efficacy, these results suggest that aerosolized virus susceptibility is significantly higher in room-scale tests than in bench-scale laboratory studies. That said, as opposed to controlled laboratory studies, uncertainties in this study related to airflow patterns, virus residence time, and dose to the collected virus introduce uncertainty into the inactivation estimates. This study is the first to directly demonstrate far-UVC anti-microbial efficacy against airborne pathogens in an occupied indoor location.

Listening to music can span a continuum from passive consumption to active exploration, relying on processes of coping with the sounds as well as higher-level processes of sense-making. Revolving around the major questions of “what” and “how” to explore, this paper takes a naturalistic stance toward music listening, providing tools to objectively describe the underlying mechanisms of musical sense-making by weakening the distinction between music and non-music. Starting from a non-exclusionary conception of “coping” with the sounds, it stresses the exploratory approach of treating music as a sound environment to be discovered by an attentive listener. Exploratory listening, in this view, is an open-minded and active process, not dependent on simply recalling pre-existing knowledge or information that reduces cognitive processing efforts but having a high cognitive load due to the need for highly focused attention and perceptual readiness. Music, explored in this way, is valued for its complexity, surprisingness, novelty, incongruity, puzzlingness, and patterns, relying on processes of selection, differentiation, discrimination, and identification.

In March 2022, Aotearoa New Zealand re-opened its border allowing quarantine-free travel for many travellers. Here, the authors describe circulating Omicron sub-variants before and after the reopening of the border and show that the rate of viral introductions grew roughly linearly with the increase in daily international travel.

Purpose: The mortality in patients with MYCN-amplified high-risk neuroblastoma remains greater than 50% despite advances in multimodal therapy. Novel therapies are urgently needed that requires preclinical evaluation in appropriate mice models. Combinatorial treatment with high-dose radiotherapy (HDRT) and immunotherapy has emerged as an effective treatment option in a variety of cancers. Current models of neuroblastoma do not recapitulate the anatomic and immune environment in which multimodal therapies can be effectively tested, and there is a need for an appropriate syngeneic neuroblastoma mice model to study interaction of immunotherapy with host immune cells. Here, we develop a novel syngeneic mouse model of MYCN-amplified neuroblastoma and report the relevance and opportunities of this model to study radiotherapy and immunotherapy. Materials and methods: A syngeneic allograft tumor model was developed using the murine neuroblastoma cell line 9464D derived a tumor from TH-MYCN transgenic mouse. Tumors were generated by transplanting 1 mm3 portions of 9464D flank tumors into the left kidney of C57Bl/6 mice. We investigated the effect of combining HDRT with anti-PD1 antibody on tumor growth and tumor microenvironment. HDRT (8 Gy x 3) was delivered by the small animal radiation research platform (SARRP). Tumor growth was monitored by ultrasound. To assess the effect on immune cells tumors sections were co-imuunostained for six biomarkers using the Vectra multispectral imaging platform. Results: Tumor growth was uniform and confined to the kidney in 100% of transplanted tumors. HDRT was largely restricted to the tumor region with minimal scattered out-of-field dose. Combinatorial treatment with HDRT and PD-1 blockade significantly inhibited tumor growth and prolonged mice survival. We observed augmented T-lymphocyte infiltration, especially CD3+CD8+ lymphocytes, in tumors of mice which received combination treatment. Conclusion: We have developed a novel syngeneic mouse model of MYCN amplified high-risk neuroblastoma. We have utilized this model to show that combining immunotherapy with HDRT inhibits tumor growth and prolongs mice survival.

Aotearoa New Zealand pursued a COVID-19 elimination strategy until October 2021 when it moved to a suppression strategy. In this genomic surveillance study, the authors describe spread of the virus during the transition between these strategies, with evidence of substantial undetected community transmission.

RESUMO Objetivo O objetivo do presente estudo foi traduzir, adaptar e validar transculturalmente a versão para língua portuguesa brasileira do questionário Hearing Protection Assessment Questionnaire (HPA). Método O instrumento original, desenvolvido na língua inglesa, buscou avaliar as barreiras e suportes relacionados ao uso dos dispositivos de proteção auditiva (DPA), assim como o conhecimento, hábitos e atitudes dos trabalhadores frente ao ruído ocupacional. A tradução, adaptação e validação transcultural do questionário foi composta de cinco etapas: Tradução do questionário do inglês para o português; 2) Processo inverso de tradução do português para o inglês; 3) Análise do instrumento por três especialistas na área; 4) Pré-teste do questionário com 10 trabalhadores; 5) Aplicação do instrumento em 509 trabalhadores de uma indústria frigorífica após o exame admissional. Resultados os resultados indicam a validade de construção e conteúdo da versão em Português Brasileiro para o seu uso com uma população trabalhadora e a consistência interna do mesmo. Conclusão Este estudo resultou na tradução, na adaptação cultural e validação do questionário Hearing Protection Assessment Questionnaire (HPA) com a finalidade de ser usado para avaliar o uso de proteção auditiva individual em âmbito ocupacional, denominado Questionário de Avaliação da Proteção Auditiva (APA).

Abstract The dental clinic air microbiome incorporates microbes from the oral cavity and upper respiratory tract (URT). This study aimed to establish a reliable methodology for air sampling in a dental clinic setting and quantify the abundance of culturable mesophilic aerobic bacteria present in these samples using regression modeling. Staphylococcus hominis, a potentially pathogenic bacterium typically found in the human oropharynx and URT, was consistently isolated. S. hominis was the most abundant species of aerobic bacteria (22%–24%) and comprised 60%–80% of all Staphylococcus spp. The study also assessed the susceptibility of S. hominis to 222 nm‐far‐UVC light in laboratory experiments, which showed an exponential surface inactivation constant of k = 0.475 cm2/mJ. This constant is a critical parameter for future on‐site use of far‐UVC light as a technique for reducing pathogenic bacterial load in dental clinics.

Abstract Many infectious diseases, including COVID-19, are transmitted by airborne pathogens. There is a need for effective environmental control measures which, ideally, are not reliant on human behaviour. One potential solution is Krypton Chloride (KrCl) excimer lamps (often referred to as Far-UVC), which can efficiently inactivate pathogens, such as coronaviruses and influenza, in air. Research demonstrates that when KrCl lamps are filtered to remove longer-wavelength ultraviolet emissions they do not induce acute reactions in the skin or eyes, nor delayed effects such as skin cancer. While there is laboratory evidence for Far-UVC efficacy, there is limited evidence in full-sized rooms. For the first time, we show that Far-UVC deployed in a room-sized chamber effectively inactivates aerosolised Staphylococcus aureus. At a room ventilation rate of 3 air-changes-per-hour (ACH), with 5 filtered-sources the steady-state pathogen load was reduced by 98.4% providing an additional 184 equivalent air changes (eACH). This reduction was achieved using Far-UVC irradiances consistent with current American Conference of Governmental Industrial Hygienists threshold limit values for skin for a continuous 8-h exposure. Our data indicate that Far-UVC is likely to be more effective against common airborne viruses, including SARS-CoV-2, than bacteria and should thus be an effective and “hands-off” technology to reduce airborne disease transmission. The findings provide room-scale data to support the design and development of effective Far-UVC systems.

Background: In New Zealand, as in many places, a significant proportion of the population lives outside the main urban centres. People living in regional areas have similar needs for audiological services as those living in urban centres; however, economic and geographical barriers can be a barrier to accessible services. The objective of this research was to explore factors that influence equitable audiological service provision and user uptake of services in regional areas of New Zealand. Methods: Fifteen participants who represented either audiological service users living in rural or non-urban areas (regional) or audiological service providers in these areas were recruited. Semi-structured interviews were conducted virtually and on average took forty minutes to complete. The interviews were transcribed and analysed using thematic analysis to identify themes and subthemes related to audiological service delivery and uptake. Results: Seven themes were identified. These are related to service provision, geographical barriers, and cultural appropriateness. Conclusions: This study provides a basis for understanding the challenges of delivering and accessing audiological services in non-urban areas in New Zealand, and in principle elsewhere. There is scope for future research to further understand policy directions needed to achieve equitable audiological service provision in regional areas.

Background: Noise sensitivity moderates the association between environmental noise exposure and annoyance and health outcomes. Methods: In normally hearing adults, we measured noise sensitivity in three ways: using the noise sensitivity questionnaire, a 3-point self-rating, and the loudness discomfort level (LDL; mean reported discomfort level for tone bursts). We then presented recordings of a 15-second 80 dBLAeq aeroplane overflight and participants rated the annoyance and loudness they experienced. Results: The three measures of noise sensitivity were not well correlated with each other, and only the overall LDL was associated with the ratings of loudness and annoyance in response to the aeroplane sounds. Conclusions: This implies that our current measures of noise sensitivity may only capture parts of the underlying construct, and therefore underestimate effects due to it on the association between environmental noise and annoyance and health outcomes. We developed a theoretical model to describe the set of factors that may influence a person’s sensitivity to noise and propose that interaction between the systems described is the basis for noise sensitivity. This paradigm alters the focus of noise research from the annoyance caused by the sound, to the sensitization to noise that may occur as a result of the interplay of many factors. We hope that our model will allow research to explore the sensitizing factors for noise more easily and systematically.

Abstract Transmission of SARS-CoV-2 by aerosols has played a significant role in the rapid spread of COVID-19 across the globe. Indoor environments with inadequate ventilation pose a serious infection risk. Whilst vaccines suppress transmission, they are not 100% effective and the risk from variants and new viruses always remains. Consequently, many efforts have focused on ways to disinfect air. One such method involves use of minimally hazardous 222 nm far-UVC light. Whilst a small number of controlled experimental studies have been conducted, determining the efficacy of this approach is difficult because chamber or room geometry, and the air flow within them, influences both far-UVC illumination and aerosol dwell times. Fortunately, computational multiphysics modelling allows the inadequacy of dose-averaged assessment of viral inactivation to be overcome in these complex situations. This article presents the first validation of the WYVERN radiation-CFD code for far-UVC air-disinfection against survival fraction measurements, and the first measurement-informed modelling approach to estimating far-UVC susceptibility of viruses in air. As well as demonstrating the reliability of the code, at circa 70% higher, our findings indicate that aerosolized human coronaviruses are significantly more susceptible to far-UVC than previously thought.

Since severe acute respiratory syndrome coronavirus 2 was first eliminated in New Zealand in May 2020, a total of 13 known coronavirus disease (COVID-19) community outbreaks have occurred, 2 of which led health officials to issue stay-at-home orders. These outbreaks originated at the border via isolating returnees, airline workers, and cargo vessels. Because a public health system was informed by real-time viral genomic sequencing and complete genomes typically were available within 12 hours of community-based positive COVID-19 test results, every outbreak was well-contained. A total of 225 community cases resulted in 3 deaths. Real-time genomics were essential for establishing links between cases when epidemiologic data could not do so and for identifying when concurrent outbreaks had different origins.

IntroductionNoise-induced hearing loss can be avoided by taking preventive measures.ObjectiveTo assess the effectiveness of the Brazilian version of the Dangerous Decibels® program for noise-exposed workers, using the ecological model as an educational intervention plan.MethodNon-randomized interventional study with a quantitative, experimental trial design, conducted at a meatpacking company. The participants were divided into two groups—the first one (n = 132, divided into 6 subgroups) received the Dangerous Decibels® Brazil educational intervention (DDBEI) adapted to workers while the second group (n = 138, divided into 5 subgroups) received a conventional educational intervention (CEI). The interventions lasted 50 min. The Hearing Protection Assessment Questionnaire (HPA-5) was administered before and after the interventions. The five dimensions (attitude, behavior, knowledge, supports, and barriers) were compared using the Student’s t-test for paired data (

Real-time genomic sequencing has played a major role in tracking the global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), contributing greatly to disease mitigation strategies. In August 2020, after having eliminated the virus, New Zealand experienced a second outbreak. During that outbreak, New Zealand used genomic sequencing in a primary role, leading to a second elimination of the virus. We generated genomes from 78% of the laboratory-confirmed samples of SARS-CoV-2 from the second outbreak and compared them with the available global genomic data. Genomic sequencing rapidly identified that virus causing the second outbreak in New Zealand belonged to a single cluster, thus resulting from a single introduction. However, successful identification of the origin of this outbreak was impeded by substantial biases and gaps in global sequencing data. Access to a broader and more heterogenous sample of global genomic data would strengthen efforts to locate the source of any new outbreaks.

Since the first wave of coronavirus disease in March 2020, citizens and permanent residents returning to New Zealand have been required to undergo managed isolation and quarantine (MIQ) for 14 days and mandatory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of October 20, 2020, of 62,698 arrivals, testing of persons in MIQ had identified 215 cases of SARS-CoV-2 infection. Among 86 passengers on a flight from Dubai, United Arab Emirates, that arrived in New Zealand on September 29, test results were positive for 7 persons in MIQ. These passengers originated from 5 different countries before a layover in Dubai; 5 had negative predeparture SARS-CoV-2 test results. To assess possible points of infection, we analyzed information about their journeys, disease progression, and virus genomic data. All 7 SARS-CoV-2 genomes were genetically identical, except for a single mutation in 1 sample. Despite predeparture testing, multiple instances of in-flight SARS-CoV-2 transmission are likely.

New Zealand implemented stringent COVID-19 control measures early after identification of its first case. Here, the authors perform whole genome sequencing of samples taken until 22 May 2020 and find high viral diversity indicative of multiple separate introductions and limited community transmission.

Abstract A direct approach to limit airborne viral transmissions is to inactivate them within a short time of their production. Germicidal ultraviolet light, typically at 254 nm, is effective in this context but, used directly, can be a health hazard to skin and eyes. By contrast, far-UVC light (207–222 nm) efficiently kills pathogens potentially without harm to exposed human tissues. We previously demonstrated that 222-nm far-UVC light efficiently kills airborne influenza virus and we extend those studies to explore far-UVC efficacy against airborne human coronaviruses alpha HCoV-229E and beta HCoV-OC43. Low doses of 1.7 and 1.2 mJ/cm2 inactivated 99.9% of aerosolized coronavirus 229E and OC43, respectively. As all human coronaviruses have similar genomic sizes, far-UVC light would be expected to show similar inactivation efficiency against other human coronaviruses including SARS-CoV-2. Based on the beta-HCoV-OC43 results, continuous far-UVC exposure in occupied public locations at the current regulatory exposure limit (~3 mJ/cm2/hour) would result in ~90% viral inactivation in ~8 minutes, 95% in ~11 minutes, 99% in ~16 minutes and 99.9% inactivation in ~25 minutes. Thus while staying within current regulatory dose limits, low-dose-rate far-UVC exposure can potentially safely provide a major reduction in the ambient level of airborne coronaviruses in occupied public locations.

Understanding global variation in democratic outcomes is critical to efforts to promote and sustain democracy today. Here, we use data on the democratic status of 221 modern and historical nations stretching back up to 200 years to show that, particularly over the last 50 years, nations with shared linguistic and, more recently, religious ancestry have more similar democratic outcomes. We also find evidence that for most of the last 50 years the democratic trajectory of a nation can be predicted by the democratic status of its linguistic and, less clearly, religious relatives, years and even decades earlier. These results are broadly consistent across three democracy indicators (Polity 5, Vanhanen's Index of Democracy, and Freedom in the World) and are not explained by geographical proximity or current shared language or religion. Our findings suggest that deep cultural ancestry remains an important force shaping the fortunes of modern nations, at least in part because democratic norms, institutions, and the factors that support them are more likely to diffuse between close cultural relatives.

Abstract Exploring the variability in gene expressions of rare cells at the single-cell level is critical for understanding mechanisms of differentiation in tissue function and development as well as for disease diagnostics and cancer treatment. Such studies, however, have been hindered by major difficulties in tracking the identity of individual cells. We present an approach that combines single-cell picking, lysing, reverse transcription and digital polymerase chain reaction to enable the isolation, tracking and gene expression analysis of rare cells. The approach utilizes a photocleavage bead-based microfluidic device to synthesize and deliver stable cDNA for downstream gene expression analysis, thereby allowing chip-based integration of multiple reactions and facilitating the minimization of sample loss or contamination. The utility of the approach was demonstrated with QuantStudio digital PCR by analyzing the radiation and bystander effect on individual IMR90 human lung fibroblasts. Expression levels of the Cyclin-dependent kinase inhibitor 1a (CDKN1A), Growth/differentiation factor 15 (GDF15), and Prostaglandin-endoperoxide synthase 2 (PTGS2) genes, previously shown to have different responses to direct and bystander irradiation, were measured across individual control, microbeam-irradiated or bystander IMR90 cells. In addition to the confirmation of accurate tracking of cell treatments through the system and efficient analysis of single-cell responses, the results enable comparison of activation levels of different genes and provide insight into signaling pathways within individual cells.

Summary: Background: COVID-19 elimination measures, including border closures have been applied in New Zealand. We have modelled the potential effect of vaccination programmes for opening borders.Methods: We used a deterministic age-stratified Susceptible, Exposed, Infectious, Recovered (SEIR) model. We minimised spread by varying the age-stratified vaccine allocation to find the minimum herd immunity requirements (the effective reproduction number Reff

Recent research using UV radiation with wavelengths in the 200–235 nm range, often referred to as far-UVC, suggests that the minimal health hazard associated with these wavelengths will allow direct use of far-UVC radiation within occupied indoor spaces to provide continuous disinfection. Earlier experimental studies estimated the susceptibility of airborne human coronavirus OC43 exposed to 222-nm radiation based on fitting an exponential dose–response curve to the data. The current study extends the results to a wider range of doses of 222 nm far-UVC radiation and uses a computational model coupling radiation transport and computational fluid dynamics to improve dosimetry estimates. The new results suggest that the inactivation of human coronavirus OC43 within our exposure system is better described using a bi-exponential dose–response relation, and the estimated susceptibility constant at low doses—the relevant parameter for realistic low dose rate exposures—was 12.4 ± 0.4 cm2/mJ, which described the behavior of 99.7% ± 0.05% of the virus population. This new estimate is more than double the earlier susceptibility constant estimates that were based on a single-exponential dose response. These new results offer further evidence as to the efficacy of far-UVC to inactivate airborne pathogens.

Abstract Airborne-mediated microbial diseases such as influenza and tuberculosis represent major public health challenges. A direct approach to prevent airborne transmission is inactivation of airborne pathogens, and the airborne antimicrobial potential of UVC ultraviolet light has long been established; however, its widespread use in public settings is limited because conventional UVC light sources are both carcinogenic and cataractogenic. By contrast, we have previously shown that far-UVC light (207–222 nm) efficiently inactivates bacteria without harm to exposed mammalian skin. This is because, due to its strong absorbance in biological materials, far-UVC light cannot penetrate even the outer (non living) layers of human skin or eye; however, because bacteria and viruses are of micrometer or smaller dimensions, far-UVC can penetrate and inactivate them. We show for the first time that far-UVC efficiently inactivates airborne aerosolized viruses, with a very low dose of 2 mJ/cm2 of 222-nm light inactivating >95% of aerosolized H1N1 influenza virus. Continuous very low dose-rate far-UVC light in indoor public locations is a promising, safe and inexpensive tool to reduce the spread of airborne-mediated microbial diseases.

We present the R package epinet, which provides tools for analyzing the spread of epidemics through populations. We assume that the relationships among individuals in a population are modeled by a contact network described by an exponential-family random graph model and that the disease being studied spreads across the edges of this network from infectious to susceptible individuals. We use a susceptible-exposed-infectiousremoved compartmental model to describe the progress of the disease within each host. We describe the functionality of the package, which consists of routines that perform simulation, plotting, and inference. The main inference routine utilizes a Bayesian approach and a Markov chain Monte Carlo algorithm. We demonstrate the use of the package through two examples, one involving simulated data and one using data from an actual measles outbreak.

Introduction: The aim of the study was to determine whether those who are noise sensitive are more adversely affected by airport noise than those who are not noise sensitive. Participants and Methods: One area was very close to Wellington International Airport and the other was distant from the airport and any other major sources of noise such as motorways and railways. Noise sensitivity was self-rated on a three-point scale as follows: non-noise sensitive, moderately noise sensitive, or highly noise sensitive. Statistical analysis consisted of analyses of variance using the domains of the WHOQOL score with the year, area (airport or the control), and noise sensitivity as covariates. Results: Noise-sensitive people were found to have a significantly poorer HRQOL than others when they lived near an airport, but not when they lived in the control area. The same effect was present at both of the time points investigated, suggesting that it is a general finding. Discussion: This finding is consistent with similar studies using the WHOQOL-BREF for investigating noise from road traffic, suggesting consistency in effect across transport noise sources.

Objectives Hearing loss is one of the most prevalent conditions affecting older people. In addition, there is little known about the factors influencing the uptake of hearing services among underserved communities. Our objective was to identify the barriers to accessing hearing care services among older Pacific Island people in New Zealand.Settings Eligible participants from Auckland City, New Zealand.Participants Individual face-to-face in-depth interviews were conducted with 36 older Pacific Island people who were experienced hearing difficulties.Methods A Pacific Island research methodology (Talanoa) and the ‘Health Care Access Barriers’ (HCAB) model, which identifies modifiable barriers to healthcare, was used as a theoretical framework for this research. The interviews were transcribed and analysed using a deductive approach to identify HCAB themes and subthemes experienced by older Pacific Island people.Results Identified themes aligned with HCAB’s themes of financial, structural and cognitive barriers and subthemes described Pacific Island perspectives related to hearing care access in New Zealand. The financial barriers related to the high cost of hearing care and the structural barriers included transportation difficulties, limited family support, preference for community-based services and the absence of hearing care delivered by family doctors. Community norms and attitudes, communication limitations and limited awareness of hearing care services formed cognitive barriers among older Pasifika people in this study.Conclusion We identified financial, structural and cognitive barriers that dissuaded older Pasifika people from accessing hearing care services. These modifiable barriers need to be eliminated or minimised to enable people to readily receive the hearing care assistance they need. It is essential to improve and develop culturally responsive models of hearing service delivery to ensure equitable access to hearing care, especially for underserved groups such as Pacific Island communities.

In this article, we consider music and noise in terms of vibrational and transferable energy as well as from the evolutionary significance of the hearing system of Homo sapiens. Music and sound impinge upon our body and our mind and we can react to both either positively or negatively. Much depends, in this regard, on the frequency spectrum and the level of the sound stimuli, which may sometimes make it possible to set music apart from noise. There are, however, two levels of description: the physical-acoustic description of the sound and the subjective-psychological reactions by the listeners. Starting from a vibrational approach to sound and music, we first investigate how sound may activate the sense of touch and the vestibular system of the inner ear besides the sense of hearing. We then touch upon distinct issues such as the relation between low-frequency sounds and annoyance, the harmful effect of loud sound and noise, the direct effects of overstimulation with sound, the indirect effects of unwanted sounds as related to auditory neurology, and the widespread phenomenon of liking loud sound and music, both from the point of view of behavioral and psychological aspects.

Exploring our understanding of soundscapes to understand why and how sound impacts people is important. The aim of this study was to develop a short quantitative questionnaire that would use terms generated by creative writers to assess people’s experiences of a soundscape. This process may provide different items for the questionnaire and thus, potentially, different dimensions or fuller definitions of dimensions that have already been identified. In the preliminary phase, a group of people identifying themselves as good writers listened to recordings of natural, traffic, and human sound environments and wrote about their impressions and responses to each. Qualitative analysis was used to extract themes from the writing. These themes were identified by key words, and scalar items were developed to form a short 17-item questionnaire. The questionnaire was administered to 228 people in Auckland City, New Zealand, with participants recruited from city streets and in a central-city park. Respondents were comfortable to use the questionnaire. Factor analysis revealed patterns of responding with five dimensions: Calming, Protecting, Hectic, Belonging, and Stability. There were correspondences between these and others previously reported in the literature, as well as differences. The use of items derived from creative writing provided interesting insights into the soundscape, including spirituality, the sense of time passing, and physical wellbeing. The park soundscape was measurably better than the street soundscapes on all dimensions, and streets with less vehicular traffic tended to be experienced as more Calming and Protecting, and less Hectic. This implies that there is validity in the scales generated. In future, it would be valuable to test the questionnaire in more varied environments, to add greater variability to the soundscapes.

Abstract Objective: The New Zealand Ministry of Health responded to community concern about dioxin exposure during on‐site remediation of a pesticide‐contaminated rural area by commissioning this exposed‐referent study of serum dioxins and health in local residents. Methods: All 200 residents were eligible, with age and sex matching to demographically comparable referents. Face‐to‐face interviews included questions on health status, health‐related quality of life (HRQOL) and perceptions about community consultation. Thirty serum samples were obtained, eligibility being based on likelihood of exposure and age. Both HRQOL and serum outcomes were analysed by the appropriate regression methods. Results: Of 200 eligible residents, 139 (69.5%) participated, with 139 matched referents. Mapua residents had lower physical and psychological HRQOL scores, but no difference in health status. 2,3,7,8 TCDD was below the limit of detection in the majority of all serum samples, with some congeners being higher in referents. Perceptions of the communication process were equivocal. Conclusions: Both dioxin levels and measures of health did not differ significantly between the exposed community and controls. Implications for public health: The results suggest neither significant dioxin exposure nor community health effects. Oversight by expert panel with health expertise, allied to sound communication, may have helped the community understand the risks.

Coping is a survival mechanism of living organisms. It is not merely reactive, but also involves making sense of the environment by rendering sensory information into percepts that have meaning in the context of an organism’s cognitions. Music listening, on the other hand, is a complex task that embraces sensory, physiological, behavioral, and cognitive levels of processing. Being both a dispositional process that relies on our evolutionary toolkit for coping with the world and a more elaborated skill for sense-making, it goes beyond primitive action–reaction couplings by the introduction of higher-order intermediary variables between sensory input and effector reactions. Consideration of music-listening from the perspective of coping treats music as a sound environment and listening as a process that involves exploration of this environment as well as interactions with the sounds. Several issues are considered in this regard such as the conception of music as a possible stressor, the role of adaptive listening, the relation between coping and reward, the importance of self-regulation strategies in the selection of music, and the instrumental meaning of music in the sense that it can be used to modify the internal and external environment of the listener.

We propose a framework based on evolutionary principles and the theory of enactive cognition (“being by doing”), that addresses the foundation of key results and central questions of soundscape research. We hypothesize that the two main descriptors (measures of how people perceive the acoustic environment) of soundscape appraisal (‘pleasantness’ and ‘eventfulness’), reflect evolutionarily old motivational and affective systems that promote survival through preferences for certain environments and avoidance of others. Survival is aimed at ending or avoiding existential threats and protecting viability in a deficient environment. On the other hand, flourishing occurs whenever survival is not an immediate concern and aims to improve the agent’s viability and by co-creating ever better conditions for existence. As such, survival is experienced as unpleasant, and deals with immediate problems to be ended or avoided, while flourishing is enjoyable, and therefore to be aimed for and maintained. Therefore, the simplest, safety-relevant meaning attributable to soundscapes (audible safety) should be key to understanding soundscape appraisal. To strengthen this, we show that the auditory nervous system is intimately connected to the parts of our brains associated with arousal and emotions. Furthermore, our theory demonstrates that ‘complexity’ and ‘affordance content’ of the perceived environment are important underlying soundscape indicators (measures used to predict the value of a soundscape descriptor). Consideration of these indicators allows the same soundscape to be viewed from a second perspective; one driven more by meaning attribution characteristics than merely emotional appraisal. The synthesis of both perspectives of the same person–environment interaction thus consolidates the affective, informational, and even the activity related perspectives on soundscape appraisal. Furthermore, we hypothesize that our current habitats are not well matched to our, evolutionarily old, auditory warning systems, and that we consequently have difficulty establishing audible safety. This leads to more negative and aroused moods and emotions, with stress-related symptoms as a result.

Prevention of superficial surgical wound infections from drug-resistant bacteria such as methicillin resistant Staphylococcus aureus (MRSA) currently present major health care challenges. The majority of surgical site infections (SSI) are believed to be caused by airborne transmission of bacteria alighting onto the wound during surgical procedures. We have previously shown that far-ultraviolet C light in the wavelength range of 207-222 nm is significantly harmful to bacteria, but without damaging mammalian cells and tissues. It is important that the lamp be fitted with a filter to remove light emitted at wavelengths longer than 230 nm which are harmful.Using a hairless mouse model of infection of superficial wounds, here we tested the hypothesis that 222-nm light kills MRSA alighting onto a superficial skin incisions as efficiently as typical germicidal light (254 nm), but without inducing skin damage.To simulate the scenario wherein incisions are infected during surgical procedures as pathogens in the room alight on a wound, MRSA was spread on a defined area of the mouse dorsal skin; the infected skin was then exposed to UVC light (222 nm or 254 nm) followed by a superficial incision within the defined area, which was immediately sutured. Two and seven days post procedure, bactericidal efficacy was measured as MRSA colony formation unit (CFU) per gram of harvested skin whereas fixed samples were used to assess skin damage measured in terms of epidermal thickness and DNA photodamage.In the circumstance of superficial incisions infected with bacteria alighting onto the wound, 222-nm light showed the same bactericidal properties of 254-nm light but without the associated skin damage.Being safe for patient and hospital staff, our results suggested that far-UVC light (222 nm) might be a convenient approach to prevent transmission of drug-resistant infectious agents in the clinical setting.

Drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) are a target for new antimicrobial technologies. Far-UVC technology is an emerging disinfection method that directly kills microorganisms using light. In contrast with conventional UV sterilization, far-UVC light has antimicrobial capabilities without apparent harm to mammalian cells. This study examines the application of 224 nm far-UVC light delivered from a laser using an optical diffuser towards the goal of protecting against bacterial invasion around skin penetrating devices. Delivery of far-UVC using a laser and optical fibers enables exposure to unique geometries that would otherwise be shielded when using a lamp. Testing of the bactericidal potential of diffusing the far-UVC laser output over a large area was tested and yielded qualitative area killing results. The killing of MRSA using this method was also examined using an in vitro survival assay. Results followed a classic log-linear disinfection model with a rate constant of k = 0.51 cm2/mJ, which corresponds to an inactivation cross section of D90 = 4.5 mJ/cm2. This study establishes far-UVC delivered from a laser through an optical diffuser as a viable solution for disinfection of susceptible regions such as around catheters, drivelines, or other skin penetrating medical devices.

Patterns of age and growth of a sedentary damsel fish Acanthochromis polyacanthus were tested over a latitudinal range of approximately 10 degrees (1200 km) on the Great Barrier Reef (GBR), Australia. Within latitudes, these patterns were also compared on reefs in distance strata (inner, mid, and outer) across a continental shelf that ranged in width from 52 to 128 km. Although variation in length-max (SLMAX), growth, age-max (AMAX), and the von Bertalanffy metrics of Linf and K were found within and among latitudes, the greatest variation in some demographic characteristics was found among distance strata across the shelf regardless of latitude. Fish were always relatively smaller at inner shelf reefs and grew more slowly when compared to mid and outer shelf reefs; this was true regardless of the color morph of fish. The oldest fish collected was 11 years old, and there was no consistent variation in age-max among distances from shore. On outer reefs, there was a negative linear relationship with age-max and latitude. This “tropical gradient” of age only explained 34% of the variation; furthermore, this was not found when only the oldest group of fish was considered (top 10%). Fish only reached an age-max of six years on the southernmost reefs. There was a trend for a smaller Linf with latitude but it was not significant and Linf did not vary predictably with water temperature. The sampling of marine protected areas (MPAs) and fished zones did not confound the resultant patterns in that fish were not consistently larger or older in MPAs or fished zones. Instantaneous mortality rates were 0.245–0.685; they were highest at inner reefs and also showed no consistent MPA-related patterns. Our study suggested that the mid and outer shelf waters of the GBR appeared best suited for growth of A. polyacanthus. In conclusion, the position on continental shelves dominated other geographical patterns and needs to be considered in spatial models of growth. We suggest that local environmental conditions such as turbidity and the quality and quantity of plankton likely have a strong influence on distance across the shelf-based demographic patterns of planktivores.

Evidence is emerging linking environmental noise to health problems. Noise can affect health directly and indirectly: For example, noise sensitivity moderates the effects of noise annoyance, which in turn mediates the effects of noise exposure. An alternative hypothesis is that noise sensitivity marks the presence of susceptibility to health problems in general, including annoyance from noise. Whether noise sensitivity causes poor health or whether it is a marker of susceptibility to health problems was addressed by comparing the results of a community-based survey of people with similar noise sensitivity profiles but different environmental noise exposures. A questionnaire was delivered to people living in two socio-economically-matched areas: One was within 50 m of a motorway and the other was away from any significant source of environmental noise. The questionnaire contained 58 questions comprised of the World Health Organization health-related quality of life questionnaire (WHOQOL), and questions about amenity, neighborhood issues, environmental annoyances, demographics, and noise sensitivity. Noise sensitivity did not vary with proximity to the motorway but annoyance with traffic noise and fumes was greater in those living close to the motorway than in those who were not. Scores on the four WHOQOL domains (physical, psychological, social, and environmental) were lower in those living close to the motorway, and the WHOQOL domain scores correlated negatively with noise sensitivity in those who lived near motorways but not in those who lived in the quieter areas. This suggests that noise sensitivity is related to poor health outcomes rather than being a trait marker of susceptibility to health problems in general.

Occupational noise is a significant contributor to disabling hearing loss worldwide. Noise-induced hearing loss (NIHL) has resulted in huge human and economic consequences costing New Zealand approximately $53M annually and rising. A high proportion of hearing loss claims are made by workers in the manufacturing sector. Hearing protection devices (HPDs) are used together with engineering and administrative controls to minimize noise exposure and to prevent hearing loss. Unfortunately, inconsistent and improper use of HPDs has hindered efforts to prevent NIHL. The purpose of this study was to understand the factors that influence the use of HPDs amongst a group of manufacturing workers in New Zealand. A purposive sample of twenty-five workers was recruited to take part in semi-structured interviews. The open-ended questions were aimed at exploring the participants′ knowledge, attitude, beliefs, and behavior towards noise and HPDs. The data were analyzed using conventional content analysis and key themes emerged in relation to HPD use. Themes that emerged from the interviews either supported good hearing protection behavior or acted as barriers against it. Five major themes, (perception of noise, hearing preservation, reluctance to use HPDs, workplace interaction, and value of hearing) and sub-themes described various factors that influence hearing protection use. Both personal and environmental factors influence the use of HPDs. Based on this study, personal and environmental factors need to be targeted for further research using ecological models to develop interventions that promote HPD use amongst workers.

Networks are often used to model the contact processes that allow pathogens to spread between hosts but it remains unclear which models best describe these networks. One question is whether clustering in networks, roughly defined as the propensity for triangles to form, affects the dynamics of disease spread. We perform a simulation study to see if there is a signal in epidemic transmission trees of clustering. We simulate susceptible-exposed-infectious-removed (SEIR) epidemics (with no re-infection) over networks with fixed degree sequences but different levels of clustering and compare trees from networks with the same degree sequence and different clustering levels. We find that the variation of such trees simulated on networks with different levels of clustering is barely greater than those simulated on networks with the same level of clustering, suggesting that clustering can not be detected in transmission data when re-infection does not occur.

We report a cross-sectional study comparing the health-related quality of life (HRQOL) of individuals residing in the proximity of a wind farm to those residing in a demographically matched area sufficiently displaced from wind turbines. The study employed a nonequivalent comparison group posttest-only design. Self-administered questionnaires, which included the brief version of the World Health Organization quality of life scale, were delivered to residents in two adjacent areas in semirural New Zealand. Participants were also asked to identify annoying noises, indicate their degree of noise sensitivity, and rate amenity. Statistically significant differences were noted in some HRQOL domain scores, with residents living within 2 km of a turbine installation reporting lower overall quality of life, physical quality of life, and environmental quality of life. Those exposed to turbine noise also reported significantly lower sleep quality, and rated their environment as less restful. Our data suggest that wind farm noise can negatively impact facets of HRQOL.

Overexploitation of living resources and climate change are among the most obvious global-scale impacts of human society on marine ecosystems. In an age of such large-scale anthropogenic impacts, marine scientists, resource managers, and policymakers must rethink their approaches to protecting and managing marine populations and ecosystems. Conservation oceanography is an emerging field of science that incorporates the latest advances in ocean science and technology to provide resource managers and policymakers with the information they need to ensure the sustainability of the marine environment and its living resources. Here, we discuss the historical context of conservation oceanography as it applies to marine fisheries management. We then describe two projects, one focused on Atlantic bluefin tuna and the other on Pacific salmon, that illustrate the potential of new tagging and tracking technologies for transforming the science underlying fisheries management.

Phylogenetic analyses which include fossils or molecular sequences that are sampled through time require models that allow one sample to be a direct ancestor of another sample. As previously available phylogenetic inference tools assume that all samples are tips, they do not allow for this possibility. We have developed and implemented a Bayesian Markov Chain Monte Carlo (MCMC) algorithm to infer what we call sampled ancestor trees, that is, trees in which sampled individuals can be direct ancestors of other sampled individuals. We use a family of birth-death models where individuals may remain in the tree process after sampling, in particular we extend the birth-death skyline model [Stadler et al., 2013] to sampled ancestor trees. This method allows the detection of sampled ancestors as well as estimation of the probability that an individual will be removed from the process when it is sampled. We show that even if sampled ancestors are not of specific interest in an analysis, failing to account for them leads to significant bias in parameter estimates. We also show that sampled ancestor birth-death models where every sample comes from a different time point are non-identifiable and thus require one parameter to be known in order to infer other parameters. We apply our phylogenetic inference accounting for sampled ancestors to epidemiological data, where the possibility of sampled ancestors enables us to identify individuals that infected other individuals after being sampled and to infer fundamental epidemiological parameters. We also apply the method to infer divergence times and diversification rates when fossils are included along with extant species samples, so that fossilisation events are modelled as a part of the tree branching process. Such modelling has many advantages as argued in the literature. The sampler is available as an open-source BEAST2 package (https://github.com/CompEvol/sampled-ancestors).

The Haw River, a high order river in the southeastern United States, is characterized by severe bank erosion and geomorphic change from historical conditions of clear waters and connected floodplains. In 2014 it was named one of the 10 most threatened rivers in the United States by American Rivers. Like many developed areas, the region has a history of disturbance including extensive upland soil loss from agriculture, dams, and upstream urbanization. The primary objective of this study was to identify the mechanisms controlling channel form and erosion of the Haw River. Field measurements including bank height, bankfull height, bank angle, root depth and density, riparian land cover and slope, surface protection, river width, and bank retreat were collected at 87 sites along 43.5 km of river. A Bank Erosion Hazard Index (BEHI) was calculated for each study site. Mean bank height was 11.8 m, mean width was 84.3 m, and bank retreat for 2005/2007-2011/2013 was 2.3 m. The greatest bank heights, BEHI values, and bank retreat were adjacent to riparian areas with low slope (

As the timing of spring productivity blooms in near-shore areas advances due to warming trends in global climate, the selection pressures on out-migrating salmon smolts are shifting. Species and stocks that leave natal streams earlier may be favoured over later-migrating fish. The low post-release survival of hatchery fish during recent years may be in part due to static release times that do not take the timing of plankton blooms into account. This study examined the effects of release time on the migratory behaviour and survival of wild and hatchery-reared coho salmon (Oncorhynchus kisutch) using acoustic and coded-wire telemetry. Plankton monitoring and near-shore seining were also conducted to determine which habitat and food sources were favoured. Acoustic tags (n = 140) and coded-wire tags (n = 266,692) were implanted into coho salmon smolts at the Seymour and Quinsam Rivers, in British Columbia, Canada. Differences between wild and hatchery fish, and early and late releases were examined during the entire lifecycle. Physiological sampling was also carried out on 30 fish from each release group. The smolt-to-adult survival of coho salmon released during periods of high marine productivity was 1.5- to 3-fold greater than those released both before and after, and the fish's degree of smoltification affected their downstream migration time and duration of stay in the estuary. Therefore, hatchery managers should consider having smolts fully developed and ready for release during the peak of the near-shore plankton blooms. Monitoring chlorophyll a levels and water temperature early in the spring could provide a forecast of the timing of these blooms, giving hatcheries time to adjust their release schedule.