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A survey of surface water was undertaken, in Jersey, in 1994, to measure the concentration of radon. Over most of the island the levels were found to be low. The highest levels correlated with the areas where granite was intruded into older rocks. The levels found could lead to elevated concentrations in some dwellings but it was felt that radon was not a major risk to the health of the public.
BACKGROUND: Recent UK government documents have stated that, within the National Health Service, consumers should be more involved in decision-making. This study considered the technique of discrete choice conjoint analysis (DCCA) for eliciting community views regarding the importance of reducing waiting times. More specifically, the study aimed to establish whether residents living on the Isle of Wight are prepared to travel to the mainland for elective surgery where waiting times are shorter but travel costs may be greater, and, further, if residents are willing to travel, what reduction in waiting time and increase in travel costs would be acceptable. METHODS: A DCCA questionnaire was sent to a random sample of 1,000 individuals living on the Isle of Wight. RESULTS: Seventy-eight per cent of respondents were willing to travel to the mainland for elective surgery. Of these, 48 per cent always chose the mainland and 30 per cent traded between island and mainland, depending on the levels of waiting time and travel costs. Whereas 'traders' preferred the Isle of Wight, they would forgo their preferred location if waiting times were reduced by at least 3.9 months, and they were willing to pay over 12 for a 1 month reduction in waiting time. Different combinations of waiting time reductions and travel cost increases that were acceptable to traders were estimated. CONCLUSIONS: Carrying out elective surgery on the mainland offers the potential to reduce waiting lists for island residents. The majority of respondents would be willing to travel to the mainland. However, one-fifth of respondents were not willing to travel to the mainland for elective surgery. The preferences of this group are important in policy decisions. More generally, the paper demonstrates the potential application of DCCA to public health issues.
The San Nicolas Island fox (Urocyon littoralis dickeyi) is genetically the most monomorphic sexually reproducing animal population yet reported and has no variation in hypervariable genetic markers. Such low levels of variation imply lower resistance to pathogens, reduced fitness, and problems in distinguishing kin from non-kin. In vertebrates, the MHC contains genes that influence disease resistance and kin recognition and may be under intense balancing selection in some populations. Hence, genetic variation at the MHC might persist despite the extreme monomorphism shown by neutral markers. We examine variation of five loci within the MHC of San Nicolas Island foxes and find remarkably high levels of variation. Further, we show by simulation that genetic monomorphism at neutral loci and high MHC variation could arise only through an extreme population bottleneck of <10 individuals, approximately 10-20 generations ago, accompanied by unprecedented selection coefficients of >0.5 on MHC loci. These results support the importance of balancing selection as a mechanism to maintain variation in natural populations and expose the difficulty of using neutral markers as surrogates for variation in fitness-related loci.
The island of Jersey is located 160 km south of Britain and 23 km from northwest France. The island has well-established primary and secondary mental health services, but tertiary services have to be purchased from UK mainland service providers. A pilot study of telepsychiatry was conducted, using videoconferencing to access tertiary mental health services from the UK. During a six-month study period, five patient consultations and six specialist presentations were carried out. The total cost of using videoconferencing to deliver tertiary mental health services not ordinarily available in Jersey was 3483.06 pounds. The costs of using the traditional model instead would have been 12,975.00 pounds. The threshold at which videoconferencing became cheaper than travel was between five and six telemedicine episodes per year; the actual workload during the pilot study was 22 episodes per year. The study suggests that telemedicine is cost-effective for providing tertiary mental health services not ordinarily available in Jersey.
In a prospective study conducted on the island of Guernsey a cohort of 5162 ostensibly healthy women was enrolled between 1967 and 1976. Blood samples were drawn from each participant, who also completed a questionnaire, which provided information on established risk indicators in human mammary carcinogenesis. Plasma selenium levels were measured in 46 breast cancer cases diagnosed a mean of 11 (S.D. 4) years after entry into the study cohort and in an age-stratified sample of 138 women drawn from the study base. Plasma selenium level in the cases was 109 (28) micrograms/l and in the base sample 103 (22) micrograms/l (95% confidence interval for the overall difference, -2 to 14 micrograms/l). The adjusted relative risk of developing breast cancer in the different quartiles of the selenium distribution was 0.80, 0.79, 0.72 and 1.00, respectively. Thus, in the present study selenium was not a strong indicator of human breast cancer risk.
The prolactin concentration has been determined in plasma from ostensibly healthy women living on the Island of Guernsey. There were 102, 42, and 41 women who had a mother, sister or maternal aunt, respectively, with breast cancer. The remaining 184 women in this study claimed to have no known family history of breast cancer and were used as a control group. The increased risk of breast cancer due to family history was not associated with a raised mean prolactin level compared to the control group. However, in the luteal phase of the menstrual cycle, daughters of breast cancer patients had significantly raised levels of prolactin at 19.00 h. There were no abnormalities in the mean plasma prolactin levels for the above groups associated with differences in age at first child, age at menarche, interval between age at menarche and first child, and body weight of post-menopausal women. (All these factors have been reported to influence breast cancer risk). It is concluded that prolactin has no obvious function in the aetiology of breast cancer. If it is involved, the mechanism by which it acts must be subtle and concerned with the homeostatic control governing nycthemeral prolactin rhythms.
BACKGROUND: A previous study has suggested an increased incidence rate of leukaemia from 1978 to 1992 in people aged 0 to 24 years and living in the vicinity of the La Hague nuclear waste reprocessing plant without considering age and cytological type. SETTING: The Nord Cotentin region (France) and the island of Alderney (United Kingdom). STUDY OBJECTIVE: To describe the occurrence of leukaemia for each age group and cytological type from 1978 to 1998 in the same area, using accurate reference incidence rates and adequate estimation of the at risk population. DESIGN: A geographical study of incidence using three zones defined according to their distance from the site (0 to 10 km: Beaumont-Hague electoral ward, 10 to 20 km and 20 to 35 km) has been conducted. The risk of leukaemia was estimated from the standardised incidence ratio (SIR) of the number of cases observed to the number expected. Exact 95% confidence intervals (CI) have been computed. PARTICIPANTS: All people under the age of 25 years living in the study region between 1978 and 1998. MAIN RESULTS: The observed number of cases of leukaemia in the study region as a whole was consistent with the expected value (SIR=1.03; 95%CI: 0.73, 1.41). No cases were observed on Alderney. The SIR in the Beaumont-Hague electoral ward was 2.17 (95%CI: 0.71, 5.07). The highest SIR was observed in the 5 to 9 years age group (SIR=6.38; 95%CI: 1.32, 18.65). This consists in acute lymphoblastic leukaemia cases. CONCLUSION: This study indicates an increased incidence of leukaemia in the area situated at less than 10 km from the plant. Monitoring and further investigations should be targeted at acute lymphoblastic leukaemia occurring during the childhood incidence peak (before 10 years) in children living near the La Hague site and may be other nuclear reprocessing plants.
The association with breast cancer of menstrual and reproductive events, family history of breast cancer, and body size have been studied on two cohorts of 6,706 volunteers on the island of Guernsey (United Kingdom), 168 of whom had breast cancer detected during follow-up. The median follow-up time of the non-cases was 21 years in the first study and 10 years in the second. A time-dependent Cox regression model was fitted to the data with age as the time-dependent variable in order to represent the effect of changing menopausal status. Other variables examined in the model were age at menarche, parity, age at first birth, family history of breast cancer, height, weight (both directly measured), relative weight (weight [kg]/height[m]), and Quetelet's body mass index (weight[kg]/height[m]2). Interactions between age and all other covariates also were examined. Family history was found to be the most important risk factor for women aged less than 51 years (relative risk [RR] = 3.5, 95 percent confidence interval [CI] = 2.0-6.0), and intervals between menarche and first birth longer than 14 years were found to increase significantly the risk of breast cancer in women older than 61 years (RR = 2.4, CI = 1.3-4.4). Height was the only indicator of body size which was associated significantly with risk of breast cancer, the estimated regression coefficient indicating an increase in risk of about 70 percent for women on the 90th centile of height relative to those on the 10th centile. A survey of the literature showed that the association between risk of breast cancer and height was found in those studies which used direct measurements of height but not in others which used self-reported values.
An extension of the logistic model (Cox, 1970) is applied to the prospective study of breast cancer in Guernsey (Bulbrook and Hayward, 1967). Four important risk factors, age at menarche, family history, age at first birth and etiocholanolone excretion, are identified and shown to have additive effects on a logistic scale for the probability of developing breast cancer. The feasibility of screening a high risk group of women is considered and shown unlikely to be of practical value.
Mean values of eight contaminants in Herring Gull (Larus argentatus) eggs were calculated for 15 Great Lakes sites for the 5 year period 1998-2002. The sites were ranked according to the concentrations of each of seven compounds relative to fish flesh criteria for the protection of piscivorous wildlife, and a single overall rank of contamination was calculated for each site. Based on this weighted ranking scheme, we found that sum PCBs, dioxin and DDE contributed the most (60.2, 30.5% and 8.5%, respectively) to the overall rankings. The weighted ranking scheme showed that eggs from Channel-Shelter Island (Saginaw Bay, Lake Huron), Strachan Island (St. Lawrence River) and Gull Island (northern Lake Michigan) ranked as the three most contaminated sites, while Agawa Rocks (eastern Lake Superior), Chantry Island (southern Lake Huron) and Port Colborne (eastern Lake Erie) ranked as the three least contaminated sites. Two of the three most contaminated sites are Areas of Concern; none of the three least contaminated sites are Areas of Concern.
The difficulties and injuries sustained during the emergency evacuation of 308 passengers and crew from the fast passenger catamaran M.V. St Malo are described. The vessel had hit a rock off Jersey and was listing severely. Fifty-three passengers were injured, 32 requiring hospital admission; one with a myocardial infarction and 31 with musculoskeletal injuries. Eighteen patients required operation for severe lower limb injuries. Increased numbers of emergency exits and the introduction of evacuation chutes to this type of twin-hulled vessel are recommended.
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Since 1971, the herring gull (Larus argentatus) has been used as a sentinel species for monitoring the levels of persistent contaminants in the Great Lakes ecosystem. In this study, 21 herring gull colonies in the Great Lakes and connecting channels were sampled during 1972-1976, 1981-1983, 1985 and 1992. For each year, 10 eggs (usually) were collected from each colony site and analyzed for total mercury (microg/g, wet wt). Results indicated that eggs from Lake Ontario displayed the highest lake-wide mercury levels (0.28-0.73 microg/g), followed by Lake Superior (0.21-0.50 microg/g). Lake Erie typically displayed the lowest mercury levels (0.18-0.24 microg/g). Overall, mercury levels ranged from 0.12 microg/g in 1985 to 0.88 microg/g in 1982 for Channel Shelter Island (Lake Huron) and Pigeon Island (Lake Ontario), respectively. Generally, all colony sites showed peak egg mercury levels in 1982. A significant decline in egg mercury levels was observed in five colony sites for the period 1972-1992 and in three different colony sites for the period 1981-1992. Mercury levels in the eggs of herring gulls for the period of this study were below levels associated with acute toxic effects in this species but were within a range, for certain years, which potentially reduces hatchability in other avian species.
With the centralisation and specialisation of cancer services, patients may have to travel considerable distances and stay away from their homes during treatment. This paper describes a comparative study that sought to identify the effects on patients of receiving chemotherapy and/or radiotherapy away from their homes, families and social support networks. Eighty four cancer patients treated in Southampton (42 from Guernsey and 42 from Southampton) agreed to participate in a structured interview and a standardised measure of social support. There were few differences in terms of satisfaction with services between Guernsey patients who stayed away from home during treatment and Southampton patients who lived at home. Counter-intuitively, Guernsey patients perceived themselves to have better social support.
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Environment Canada and the Québec Department of the Environment, partners in the St Lawrence Vision 2000 Action Plan, set out to prepare a compendium of knowledge of the flora and fauna of the St Lawrence and to identify potential conservation sites. The resulting Portrait is an Internet site that presents the current knowledge base of the river's ecological and biological diversity (http://lavoieverte.qc.ec.gc.ca/faune/biodiv/index.html). The Portrait provides information on over 5,000 species of flora and fauna. On the website, you will find a detailed ecological analysis of the richness, rarity and vulnerability of several broad groups of plant and animal species. Furthermore, you will find a list of species for each of the 700 survey units and a distribution map for 2,500 species recorded along the St Lawrence., in atlas form, along with a detailed conservation plan. The plan encompasses the most unique and heterogeneous landscapes of the St Lawrence, some of which have no protection at present. The Portrait provides an overview of the sites that are currently protected by public agencies and private-sector organisations and identifies new sites of interest for conserving biodiversity and protecting species at risk. This paper exposes the content of this extensive compendium on the biodiversity of the St. Lawrence. For conciseness, it presents some of the analyses conducted on birds to illustrate a few of the analytical approaches that were used. Then, the information on species richness and concentration areas for priority species of vascular plants, breeding birds and herpetofauna will serve to identify the terrestrial sites of significance for biodiversity. Finally, a similar approach having been applied to the aquatic environnement, we will conclude with a conservation plan that identifies the terrestrial and aquatic ecosystems, and the geographic sites where the most important elements of St. Lawrence biodiversity are concentrated. Our analysis of the biodiversity of the most thoroughly studied taxa of the St. Lawrence clearly shows the importance of wetlands, particularly those located at the mouths of rivers or within archipelagos or delta complexes, such as the groups of islands and channels found at both ends of the Montreal Archipelago. These aquatic landscapes are sites of intense biological production, combining in a small geographical area spawning, nursery and feeding grounds for a large number of fish species and breeding, rearing and foraging areas for aquatic birds. Variable flooding conditions, associated with seasonal flooding or daily tidal fluctuations, create a complex mosaic of wetland and aquatic habitats. Although wetlands occupy only a small area in comparison with terrestrial habitats, they support a large number of rare plant and animal species in relation to their size. At present, 10% of the vascular flora and 27% of the herpetofauna of the St. Lawrence are at risk. In the case of reptiles and amphibians, the situation is especially worrisome because nearly all of the most threatened species live in a narrow band along the river corridor. Not only is this the sector that is under the greatest pressure from human development, very little public land remains here, making it difficult to create protected areas. Increased participation by non-governmental organisations and individuals, through private stewardship arrangements, is an essential precondition for completing the network of conservation areas in this part of the St. Lawrence. Along the estuary and the Gulf, habitat integrity has not been affected as much by the expansion of Québec's human population. This is a vast territory, and sites have been identified with a view to making up for the deficiencies in the present network of protected sites in terms of representing biodiversity.
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