Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier...
Transcript of Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier...
![Page 1: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/1.jpg)
Oceans, Health and Wellbeing: the Next Frontier
IOC Bruun Memorial Lecture June 2015
Professor Lora E Fleming MD PhD MPH MSc European Centre for Environment and Human Health
University of Exeter Medical School
![Page 2: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/2.jpg)
Anton Frederick Bruun (1901-1961) The Anton Bruun Memorial Lecture Series is dedicated to the memory of the noted Danish oceanographer and first chairman of the Commission, Dr Anton Frederick Bruun. The “Anton Bruun Memorial Lectures” were established in accordance with Resolution 19 of the Sixth Session of the IOC Assembly in 1970, in which the Commission proposed that important intersession developments be summarized by speakers in the fields of solid earth studies, physical and chemical oceanography and meteorology, and marine biology.
Why Oceans and Human Health?
![Page 3: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/3.jpg)
• Oceans and Human Health
– Overview
• US
• Europe
• New Focus: Health and Wellbeing at the Coasts
– Beyond “Blue Gym”: the evidence base
• Future Challenges and Opportunities
Outline
![Page 4: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/4.jpg)
Oceans and Human Health Context and Principles
• Interconnections/Interdependence between Health of Humans and the Oceans/Seas
• Complexity of the science, challenges, contexts
• Multi/Inter Disciplinary, Institutional, Sector
• Benefits, Opportunities, and Risks
• Time is NOW
![Page 5: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/5.jpg)
Interconnections: Environment Human Health
Environment
Physical Environment,
Biodiversity, Natural Environment
Human
Health and
Wellbeing
Behaviour
![Page 6: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/6.jpg)
RISKS & REMEDIES from the OCEANS
National Need: • To Increase
Understanding of HumanHealth Risks & Remediesfrom the Seas
International Need:
• To Increase Understanding ofHuman and Ecosystem Interactions with the Seas and Oceans
• Both Risks AND Benefits/Opportunities
![Page 7: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/7.jpg)
Risks:
• Storms, Climate Events • Harmful Algal Blooms
(HABs) & Other Toxins • Infectious Diseases • Anthropogenic Chemicals • Fisheries Destruction
![Page 8: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/8.jpg)
May 2009
![Page 9: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/9.jpg)
Increased CO2 and Sea Surface Temperature (SST)
• Sea Level Rise & Increased Temperatures & Ocean Acidification
• Extreme Weather
• Human Health Impacts? – Drowning, trauma, migration
– Infectious & Vectorborne Diseases
– Threat to Fisheries & Agriculture, Food Security
– Marine Microbial
• Harmful Algal Blooms (HABs), Other Microbes
– ?Depression, Mental Illness
– ?”Distal” and Complex Effects
• ?Chemicals, Ocean Acidification, Mixtures
• Most Vulnerable are the Developing Nations!
Natural Events/Global Climate Change
![Page 10: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/10.jpg)
Harmful Algal Blooms (HABs)
![Page 11: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/11.jpg)
Florida Red Tide
One Health
Baden, Fleming et al
![Page 12: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/12.jpg)
Microbes & Infectious Diseases
![Page 13: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/13.jpg)
BEACHES Study
Randomization
$ 75 Fleisher, Fleming, Solo Gabriele et al
![Page 14: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/14.jpg)
Anthropogenic Pollution
Mixtures!!! Chemicals, HABs, Microbial Pollution, Climate Change,
Acidification, Ocean Currents, Demographic Change, etc
![Page 15: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/15.jpg)
“Seafood (fish and shellfish harvested from capture fisheries and aquaculture production in marine and freshwater environments) contributes at least 15% of average animal protein consumption to 2.9 billion people” (Smith 2010)
Seafood Depletion
![Page 16: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/16.jpg)
'NOT so FU . LisreNi .G To THe OCEAN, Hese DAYS .• ~
![Page 17: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/17.jpg)
Benefits & Opportunities:
• Modelling/Forecasting
• Pharmaceuticals & Other Bioactive Compounds & Biotechnology
• Marine Organisms as Biomedical Models
• Coastal Living/Blue Gym
![Page 18: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/18.jpg)
Florida
Florida Red Tide Improving Predictions
Carvalho 2010
![Page 19: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/19.jpg)
Remedies from the Seas Current successful examples:
– Bryostatin 1 (potent anticancer agent from marine invertebrate);
– Ecteinascidin 743 (potent anti cancer drug from the Caribbean sea squirt);
– Discodermolide (potential anti cancer drug from a marine sponge)
– Brevenal (possible cystic fibrosis agent from Florida Red Tide brevetoxin natural derivative)
Bourdelais, Baden, Abraham et al
![Page 20: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/20.jpg)
Aplysia (Sea Hare)
Simple Brains Enabled Nobel Award Winning Studies of Memory & Learning
Example: Aquatic Animal Model
![Page 21: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/21.jpg)
A relationship between environmental degradation and mental health in rural Western Australia (Speldewinde 2009)
• An association was detected between dryland salinity and depression, indicating that environmental processes may be driving the degree of psychological ill-health in these populations.
![Page 22: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/22.jpg)
Health and Wellbeing from the Environment
Rockpool rambles Sailing
Coastal walks
Swimming
Kayaking
Surfing Diving
Bluegym.org.uk Blue Gym = Campaign + Research
Rigorous scientific studies
(Secondary Data, Intervention & Mechanistic studies)
Mike Depledge PhD et al
![Page 23: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/23.jpg)
1999 United States
2005
2006
2012
2007
![Page 24: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/24.jpg)
2004
4 NSF NIEHS OHH Centers 3 NOAA OHH Centers
![Page 25: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/25.jpg)
Oceans & Human Health Centers: Inter-disciplinary Research, Training, Pilot
Projects, Facilities Cores, Shiptime
![Page 26: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/26.jpg)
2015
2 NSF NIEHS OHH Centers + 11 RO1s 3 NOAA OHH Centers + Training Grants
![Page 27: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/27.jpg)
OHH New Scientific Discipline
Gordon Conference in OCEANS & HUMAN HEALTH •June 2008 •June 2010 •June 2012 •June 2014
![Page 28: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/28.jpg)
Europe – a Maritime Continent • 4 seas & 2 oceans
• 91,000km coastline (EU + Norway)
• 50% EU population lives within 50km of coastline
• 50% EU territory underwater
• Trade: 90% external, 40% internal
• 40% World’s Merchant Fleet
• 5.4 M jobs
• GVA > €500 Billion/year
1 EU Blue Growth Strategy: COM(2012)494 final; N McDonough ESF Marine Board
![Page 29: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/29.jpg)
Integrated Maritime Policy
Marine Strategy Framework Directive
Common Fisheries Policy
Blue Growth
REACH Directive (chemicals)
Bathing Water Directive
Floods Directive
Shellfish Waters Directive
EU Climate and Energy Package
EU Biodiversity Strategy 2020
Water Framework Directive
Habitats & Birds Directives
Stockholm Convention (POPs)
EU Aquaculture Strategy
London Convention (Dumping at Sea)
Convention on Biological Diversity
EU Strategies, Policies and Directives
![Page 30: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/30.jpg)
EU Blue Growth Strategy
Blue energy
Aquaculture
Maritime tourism
Marine mineral resources
Marine biotechnology
Goal to reach 7 million jobs by 2020 with 5 Sectors
![Page 31: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/31.jpg)
36 Member Organizations from 19 European countries
Moore, McDonough et al 2014
![Page 32: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/32.jpg)
EMB Position Paper 19 (2014). Linking Oceans and Human Health: A Strategic
Research Priority for Europe.
“…many of our perceptions of the relationships between the marine environment and human health are limited and still relatively unexplored, leaving critical knowledge gaps for those seeking to develop effective policies for the sustainable use of marine resources and environmental and human health protection.”
![Page 33: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/33.jpg)
Recommendations
• Interdisciplinary collaboration
• Transmission processes
– Ocean Literacy
• Valuation methods
• Causal relationships
• Monitoring and surveillance
• Indicators
• Environmental modelling
![Page 34: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/34.jpg)
36 Member Organizations from 19 European countries
“….Unanimous call for a coordinated trans-national and interdisciplinary oceans and human health research programme in Europe..”
![Page 35: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/35.jpg)
6 Essential Areas to Build OHH Capacity
1. Community building
2. International cooperation
3. Strategic analyses
4. Human capacities
5. Policy assessment
6. Stakeholder engagement and knowledge transfer
Knowledge Gap: Interconnections
![Page 36: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/36.jpg)
Rome Declaration Goals Oct 2014
1. Valuing the ocean
2. Capitalizing on European leadership
3. Advancing ocean knowledge
4. Breaking barriers
![Page 37: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/37.jpg)
“A coordinated, cross-disciplinary and integrated programme on Oceans and Human Health, targeted at understanding and managing the risks and benefits to human physical and mental wellbeing from interactions with the seas.”
Rome Declaration Goals Oct 2014
![Page 38: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/38.jpg)
Dr Will Stahl-Timmins
Prof Michael Depledge
![Page 39: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/39.jpg)
RISKS
Microbial pollution Storms, Floods & Climate Change
Fisheries Destruction HABs & Other Toxins
Man-made Chemicals
![Page 40: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/40.jpg)
Linking Oceans and Human Health: A Strategic Research Priority for Europe. European Marine Board, www.marineboard.eu;
Oceans and Human Health (2014). Edited by R.E. Bowen, M.H. Depledge, C.P. Carlarne and L.E. Fleming. Wiley Blackwell, Oxford, UK.
Rich History of
Oceans & Human Health
Dr Richard Russell (1687– 1759)
Royal Sea Bathing Hospital (Est.1791)
Dr Fortescue Fox (1934 & 1938 Lancet)
Charlier & Chaineux (2009) Thalassotherapy
Dr Edouard Delcroix (1891-1973) Thalassotherapy
![Page 41: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/41.jpg)
Ian Alcock, Kat Ashbullby, Debbie Cracknell, Lewis Elliot, Bonny Hartley, Andrea Harvey, Ian Frampton, Sahran Higgins, Amanda Hignett, Julie Hollenbeck, Rebecca Jenkin, Rebecca Lovell, Cassie Phoenix, Karin Tanja-Dijkstra, Tim Taylor, Kayleigh Wyles.
www.ecehh.org.uk
The “Blue Gym” Team
Michael Depledge Ben Wheeler Sabine Pahl Lora Fleming
![Page 42: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/42.jpg)
< Stress
> Exercise
> Social
> Environ.
?
![Page 43: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/43.jpg)
Method Pros (inc.) Cons (inc.) Our studies
Qualitative interviews
In-depth understand of people’s motives & beliefs
Unrepresentative samples Demand characteristics
- Parent interviews - Child interviews
Visitor surveys Big numbers / Multiple environments (controls) Voluntary/chosen
Memory biases, selection effects
- MENE (N = 142,000) - Wembury surveys - Surfing / sailing studies
Where people live
Representative samples Some longitudinal data
Causality? Multiple confounders
- Census (N = 48 million) - BHPS (N =12,000 x 18 yrs)
Field experiments Realistic exposure conditions with some control
Hard to randomise/blind to condition
- Marine Aquarium - Dental surgeries - Volunteering studies
Lab experiments Reduced confounds & selection effects. Increased understanding of underlying processes (e.g. physiological, emotional, cognitive).
Small Ns (convenience samples); non-ecological e.g. may miss synergistic effects
- Videos/photos/sounds - Attention processes - Delay of gratification - Risk taking - Pain
Every methodology has its pros and cons!
![Page 44: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/44.jpg)
Health & Wellbeing in the Natural Environment Across the Life Course
Transitions into Retirement
Young Adults & Outdoor Physical Activity (ESRC/National Trust)
“Stories of the Sea” Exploring Embedment in Deprived Coastal Communities
Phoenix et al
![Page 45: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/45.jpg)
ACKNOWLEOGEMENTS Support for th1s pro1ect 1s prOVtded by thePemnsula College of Medicine and Oenbstry and the ERDF (European Reg1onal Development Fund) Convergence Programme. Support for th1s pro1ect was also prov1ded by the National Science Foundabon (NSF) and the NatJonal lnst1tute of Envuonmental Health Sciences (NIEHS) Oceans and Human Health Center at the UnMer"S1ty or M1am1 Rosensbel Sch~ fNSF OCE0432368/0911373] and (NIEHS PSO ES12736)
CKfVlt .. TYrw •LUll Ro:-;t:!'\~Tlt:J, Sl'ltOOLol MARl:-.OE a. ATI10SP11F.RH S<"IY.SCE
LJ
European Centre for Environment & Human Health
convergence for economic tronsformotion
![Page 46: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/46.jpg)
“Instead of the adults just sitting somewhere on a bench while the kids do activities, they get up and they play Frisbee or cricket and football and sometimes go swimming with them.” (Boy aged 11, Family 6).”
Ashbullby, Pahl, Webley & White (2013). Health & Place, 23,138-147
- The coast encourages families to play actively together
“There's no sunbathing sort of thing we don't have time for that…it's all kind of up and about and making up games and playing with
sandcastles and things” (Father, Family 2)
“If I lived closer to the beach I would probably do it more often but the whole packing up the car with all the kids’ stuff and the food and the picnic from here would be an absolute nightmare.” (Mother, f5).
![Page 47: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/47.jpg)
White, Hignett & Pahl (2012). Surf to Success Outcomes: Can Learning to Surf Promote Individual and Environmental Well-Being? Project Report for Ecominds.
*
* *
*
Vulnerable Communities
![Page 48: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/48.jpg)
A B C
All 3 rooms are identical (2-3 star, size, furniture, en-suite, price) except view from the balcony
£47.96 £72.85 £60.81
Choosing a hotel room…….
Mean Willingness to Pay (per night) White et al., 2010, J Environ Psych
![Page 49: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/49.jpg)
The effects are strongest in poorer communities a
aWheeler, White, Stahl-Timmins & Depledge (2012). Health & Place, 18, 1198-1201; bWhite, Alcock, Wheeler & Depledge (2013). Health & Place, 23, 97-103
Self-Reported Health Census Data (England, n = 48 million)
Error bars: 95% CI
0
0,2
0,4
0,6
0,8
1
1,2
1,4
<1km 1-6km 6-20km 20-50km >50km
Age
sta
nd
ard
ise
d %
of
po
pu
lati
on
w
ith
"go
od
he
alth
"
Home distance to coast
ref
<1km 3 million 1-6km 8 million
We see the same pattern when people move home b
Controlling for area: income, education, unemployment & crime
![Page 50: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/50.jpg)
Wheeler, B.W., Lovell, R., Higgins, S.L., White, M.P., Alcock, I., Osborne, N.J., Husk, K., Sabel, C.E., Depledge, M.H., 2015. Beyond greenspace: an ecological study of population general health and indicators of natural environment type and quality. Int J Health Geogr 14, 17.
2011 Census Data
![Page 51: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/51.jpg)
MENE Subset (n = 4,255) asked about experiences in a) Urban green space b) Rural green space c) Coast Stress reduction: To what extent did they feel ‘x’ after the visit: 1) Relaxed
2) Calm
3) Refreshed
4) Revitalised
![Page 52: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/52.jpg)
3,90
3,95
4,00
4,05
4,10
4,15
4,20
4,25
4,30
Urban parks Countryside Coast Urban parks Countryside Coast
Stre
ss re
duct
ion
All activities (n = 11,680) Walking (n = 5,592)
ref
* p < .05
*
*
ref
*
*
Monitor of Engagement with the Natural Environment [MENE] (Visits n = 11,680)
White, M.P., Pahl, S. Ashbullby, K., Herbert, S.& Depledge, M.H. (2013). Restoration from recent nature visits. Journal of Environmental Psychology, 35, 40-51.
Controlling for: Age, gender, SES, activity type, visit duration, companions, distance travelled & mode of transport
![Page 53: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/53.jpg)
0
5
10
15
20
25
30
35
40
45
50
% c
oas
tal v
isit
s
What do they do when they are there?
White, Bell, Elliot, Jenkins, Wheeler & Depledge (2014). Manuscript in prep
Water activities
Physical activities
Passive activities
UK MENE (n = 10,529) coastal visit activity details
![Page 54: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/54.jpg)
Do people who live near the coast exercise more?
White Wheeler, Herbert, Fleming Depledge (2014). Coastal proximity and physical activity in England
N = 183,755, controlling for area green space, & deprivation (IMD) + individual age, gender, SES, marital status, employment status, children, ethnicity, disability, car ownership, dog ownership, year and season.
0,94
0,99
1,04
1,09
1,14
<1km 1-5km 5-20km 20km+
Od
ds
of
rep
ort
ing
5 x
30
min
s w
ee
k p
hys
ical
ac
tivi
ty
Coastal proximity
ref
![Page 55: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/55.jpg)
a Papathanasopoulou, E., White, M., Hattam, C., Lannin, A., Harvey, A., Spencer, A. “Valuing the health benefits of physical activities in the marine environment and their importance for marine spatial planning” (submitted). [Health Survey for England)
Energy Expenditure, QALY gains, Health Service Savings from engaging with the marine environment
0 2 000 4 000 6 000 8 000
Sailing
Angling
Kayaking
Scuba diving
Surfing
Rowing
Wind surfing
Snorkelling
Water skiing
National QALY gains (per year)
0.2 Water skiing
0.9 Snorkelling
1.2 Wind surfing
3.6 Rowing
8.2 Surfing
14.6 Scuba diving
42.3 Kayaking
50.1 Angling
55.3 Sailing
Health Savings (£ million/year)
![Page 56: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/56.jpg)
Cherrie, M.P.C., Wheeler, B.W., White, M.P., Sarran, C.E., Osborne, N.J., 2015. Coastal climate is associated with elevated solar irradiance and higher 25(OH)D level. Environment International 77, 76-84.
• Higher Vitamin D levels among coastal dwellers*
*1958 Birth Cohort
Low Vitamin D associated with auto-immune, cardio-vascular diseases, cancer, possibly poor mental health UV Radiation exposure Vitamin D
• Higher UV near coast
![Page 57: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/57.jpg)
Basic Experimental
Paradigm
Stressor T1
Mood Physio.
T2 Mood
Physio.
Green Space
Blue Space
Grey Space
Lab work: Applied Settings & Different Populations Dental surgeries (+ VR) (Films, Sounds, +
During Exercise)
![Page 58: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/58.jpg)
Condition 1: Nothing! (“No fish”; n = 29) (water and tank decoration - no fish or invertebrates)
Condition 2: Small number of fish (“Low” biodiversity; n = 26) (2-10 fish species; 45-80 individuals)
Condition 3: Additional number of fish (“Medium” biodiversity; n = 29) (Total of 19 fish species; 138 individuals (9 additional species, 58 extra fish))
Thick-lipped grey mullet (Chelon labrosus)
Flounder (Platichthys flesus)
Thornback ray (Raja clavata)
Cracknell, White, Pahl, Nichols & Depledge (Under revision). Species diversity and psychological well-being: A preliminary examination of dose-response effects in an aquarium setting
![Page 59: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/59.jpg)
-8
-7
-6
-5
-4
-3
-2
-1
0
No bio Low bio Mod bio
HR
co
mp
ared
to
po
st s
tres
sor
bas
elin
e 5mins+
10mins+
Visitor observation data
• Participant heart rate – Significant drop in all
conditions: • Mod>Low>No
– No dose-response pattern for time spent
n = 40
![Page 60: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/60.jpg)
-1,5
-1,0
-0,5
0,0
0,5
1,0
1,5
-1,5 -1,0 -0,5 0,0 0,5 1,0 1,5
Excited/energised Tense/angry
Calm/content Sad/depressed No biodiversity
Low biodiversity
High biodiversity
High arousal
Low arousal
Negative feelings Positive feelings
![Page 61: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/61.jpg)
a Wyles, K. J., Pahl, S., Thomas, K., & Thompson, R. C. (in press). Environment & Behavior
Impacts on the Environment and Human Wellbeing?
C
A B
D
![Page 62: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/62.jpg)
Marine Litter Impacts
a Wyles, K. J., Pahl, S., Thomas, K., & Thompson, R. C. (in press). Environment & Behavior
Impacts on the Environment and Human Wellbeing
2
3
4
5
6
7
8
9
Clean
Seaweed
Fishing-litter
Public-litter
Ave
rage
Re
spo
nse
(o
n a
sca
le f
rom
1 t
o 1
0)
Preference Mood Arousal Perceived
Restoration
![Page 63: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/63.jpg)
Virtual Dental room
Virtual beach
Iced water/ Tooth Extraction
Tanja-Dijkstra, Pahl, White, Andrade & Moles (2014). .PLoS One, 9(3), e91276
- People feel (& recall) less pain when “at” the virtual beach
4
4,5
5
5,5
6
6,5
7
7,5
8
Experienced pain Recalled pain (+ 1 week)
Pai
n: 0
= N
on
e /
10
= U
nb
eara
ble
Dental Room Virtual Beach
*
![Page 64: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/64.jpg)
< Stress
> Exercise
> Social
> Environ.
Complex
Mixtures?
![Page 65: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/65.jpg)
Next steps • What is the optimal dose?
• How long do effects last?
• Comparisons to/Synergy with drugs (e.g. depression)?
• What about children, other vulnerable populations?
• Other countries?
• Pro-Environmental Behaviors?
• Environmental impacts?
![Page 66: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/66.jpg)
Dr Will Stahl-Timmins
Prof Michael Depledge
![Page 67: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/67.jpg)
EU Blue Growth Strategy
Blue energy
Aquaculture
Maritime tourism
Marine mineral resources
Marine biotechnology
Goal to reach 7 million jobs by 2020 with 5 Sectors Risks, Benefits and
Opportunities to
Ocean and Human Health?
![Page 68: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/68.jpg)
10,000 citizens from 10 EU countries (Clamer Survey) 1. How well informed? 2. Concern about 15 key marine environmental issues?
0 10 20 30 40 50 60 70 80 90
Pollution at the coast or in the sea
Overfishing
Destruction of habitats at the coast or in the sea
Melting sea ice
Coastal flooding
Sea-level rise
Changes in the frequency of extreme weather events
Coastal erosion
Sea temperature changes
Oceasn becoming more acidic
Ocean current changes
Changes in the distribution of marine wildlife
Effects of marine invasive species
Environmental impacts of aquaculture
Increased jellysish blooms.swarms
Informed %
Concerned %
www.clamer.eu; N McDonough ESF Marine Board
![Page 69: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/69.jpg)
Rome Declaration: “Policy Goal 1: Valuing the Ocean”
1) A coordinated interdisciplinary and integrated programme on Oceans and Human Health, understanding and managing the risks and benefits of our interactions with the seas 2) Advanced and agreed mechanisms for attaching monetary and non-monetary value systems to marine ecosystem services and benefits for use in management and decision-making 3) A major increase in the promotion of ocean education and literacy, using best practice in communication, training and social marketing
![Page 70: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/70.jpg)
Other Recommendations • Broad Definition of Oceans and Human Health
– Ocean Acidification
• Inclusivity, Diversity & Collaboration = Creativity – Oceanographic and Natural Sciences – Medical and Public Health Communities – Social Sciences – Governments, Businesses, NGOs, Communities, Citizens of All Ages – Equality & Access
• Across the Atlantic – Galloway Agreement
• Around the World – Hong Kong Example
![Page 71: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/71.jpg)
Anton Frederick Bruun (1901-1961) The Anton Bruun Memorial Lecture Series is dedicated to the memory of the noted Danish oceanographer and first chairman of the Commission, Dr Anton Frederick Bruun. The “Anton Bruun Memorial Lectures” were established in accordance with Resolution 19 of the Sixth Session of the IOC Assembly in 1970, in which the Commission proposed that important intersession developments be summarized by speakers in the fields of solid earth studies, physical and chemical oceanography and meteorology, and marine biology.
And Medical, Public Health, Social Sciences, Governments, Businesses, NGOs, Communities, Citizens of all ages……….
![Page 72: Oceans, Health and Wellbeing: the Next Frontier · Oceans, Health and Wellbeing: the Next Frontier IOC Bruun Memorial Lecture June 2015 Professor Lora E Fleming MD PhD MPH MSc . European](https://reader034.fdocuments.us/reader034/viewer/2022042222/5ec84216f75ebf6fea523ebe/html5/thumbnails/72.jpg)
With thanks to my current and future Oceans & Human Health Colleagues, including: T Appleby, G Armbrust, M Austen, L Backer, D Baden, R Barciela, J Benson, E Berdalet, B Bowen, A Boxhall, J Brandão, R Caldwell, C Carlarne, Y Cheng, D Cracknell, K Davidson, M Depledge, J Doyle, S Dupont, W Elliot, S Elmir, H Enevoldsen, E Faustman, M Friedman, R Gabriel, T Galloway, W Gaze, MB Gidley, A Goksøyr, M Gribble, C Hadjichristodoulou, A Harvey, C Hattam, P Hess, P Hoagland,J Hollenbeck, A Ianora, K Irvine, K Jakobsson, C Janssen, B Kirkpatrick, K Kohler, E Laws, E Lewis, J Lloret, L Madson, N McDonough, D McGillicuddy, J Mees, M Moore, S Moore, K Olden, A Ortiz, S Pahl, E Papathanasopoulou, B Reguera, A Reich, K Rein, D Rice, D Sarigiannis, SL Smith, G Nichols, F Regoli, C Sinigalliano, A Smalley, H Solo Gabriele, W Stephan, R Stumpf, N Taylor, T Taylor, R Thompson, M Thorndyke, V Trainer, F Tyson, S Vardoulakis, V Vasconcelos, P Walsh, S Warber, M White, K Wyles, N Young
Thank You