Neural Mechanisms of Young Adult Sexual Decision-Making and Risk Behavior

Sexual risk behavior among young adults is a serious public health concern; 50% will contract a sexually transmitted infection (STI) before the age of 25. The current study collected self-report personality and sexual history data, as well as neuroimaging, experimental behavioral (e.g., real-time hypothetical sexual decision making data), and self-report sexual arousal data from 120 heterosexual young adults ages 18-26. In addition, longitudinal changes in self-reported sexual behavior were collected from a subset (n = 70) of the participants. The primary aims of the study were (1) to predict differences in self-report sexual behavior and hypothetical sexual decision-making (in response to sexually explicit audio-visual cues) as a function of ventral striatum (VS) and amygdala activity, (2) test whether the association between sexual behavior/decision-making and brain function is moderated by gender, self-reported sexual arousal, and/or trait-level personality factors (i.e., self-control, impulsivity, and sensation seeking) and (3) to examine how the main effects of neural function and interaction effects predict sexual risk behavior over time. Our hypotheses were mostly supported across the sexual behavior and decision-making outcome variables, such that neural risk phenotypes (heightened reward-related ventral striatum activity coupled with decreased threat-related amygdala activity) were associated with greater lifetime sexual partners at baseline measured and over time (longitudinal analyses). Impulsivity moderated the relationship between neural function and self-reported number of sexual partners at baseline and follow up measures, as well as experimental condom use decision-making. Sexual arousal and sensation seeking moderated the relationship between neural function and baseline and follow up self-reports of number of sexual partners. Finally, unique gender differences were observed in the relationship between threat and reward-related neural reactivity and self-reported sexual risk behavior. The results of this study provide initial evidence for the potential role for neurobiological approaches to understanding sexual decision-making and risk behavior. With continued research, establishing biomarkers for sexual risk behavior could help inform the development of novel and more effective individually tailored sexual health prevention and intervention efforts.

'Lines of flight': digital musical instruments, inclusive music bands, meaningful engagement in music-making and learning

In this study I examine the development of three inclusive music bands in Cork city. Derived from Jellison’s research on inclusive music education, inclusive music bands involve students with disabilities coming together with typically developing peers to make and learn music that is meaningful (Jellison, 2012). As part of this study, I established three inclusive music bands to address the lack of inclusive music making and learning experiences in Cork city. Each of these bands evolved and adapted in order to be socio-culturally relevant within formal and informal settings: Circles (community education band), Till 4 (secondary school band) and Mish Mash (third level and community band). I integrated Digital Musical Instruments into the three bands, in order to ensure access to music making and learning for band members with profound physical disabilities. Digital Musical Instruments are electronic music devices that facilitate active music making with minimal movement. This is the first study in Ireland to examine the experiences of inclusive music making and learning using Digital Musical Instruments. I propose that the integration of Digital Musical Instruments into inclusive music bands has the potential to further the equality and social justice agenda in music education in Ireland. In this study, I employed qualitative research methodology, incorporating participatory action research methodology and case study design. In this thesis I reveal the experiences of being involved in an inclusive music band in Cork city. I particularly focus on examining whether the use of this technology enhances meaningful music making and learning experiences for members with disabilities within inclusive environments. To both inform and understand the person centered and adaptable nature of these inclusive bands, I draw theoretical insights from Sen’s Capabilities Approach and Deleuze and Guatarri’s Rhizome Theory. Supported by descriptive narrative from research participants and an indepth examination of literature, I discover the optimum conditions and associated challenges of inclusive music practice in Cork city.

Economic and trade relations between Latin America and Asia Pacific: The link with China

Includes bibliography

Changes in biodiversity and trade-offs among ecosystem services, stakeholders, and components of well-being: the contribution of the International Long-Term Ecological Research network (ILTER) to Programme on Ecosystem Change and Society (PECS)

The International Long-Term Ecological Research (ILTER) network comprises > 600 scientific groups conducting site-based research within 40 countries. Its mission includes improving the understanding of global ecosystems and informs solutions to current and future environmental problems at the global scales. The ILTER network covers a wide range of social-ecological conditions and is aligned with the Programme on Ecosystem Change and Society (PECS) goals and approach. Our aim is to examine and develop the conceptual basis for proposed collaboration between ILTER and PECS. We describe how a coordinated effort of several contrasting LTER site-based research groups contributes to the understanding of how policies and technologies drive either toward or away from the sustainable delivery of ecosystem services. This effort is based on three tenets: transdisciplinary research; cross-scale interactions and subsequent dynamics; and an ecological stewardship orientation. The overarching goal is to design management practices taking into account trade-offs between using and conserving ecosystems toward more sustainable solutions. To that end, we propose a conceptual approach linking ecosystem integrity, ecosystem services, and stakeholder well-being, and as a way to analyze trade-offs among ecosystem services inherent in diverse management options. We also outline our methodological approach that includes: (i) monitoring and synthesis activities following spatial and temporal trends and changes on each site and by documenting cross-scale interactions; (ii) developing analytical tools for integration; (iii) promoting trans-site comparison; and (iv) developing conceptual tools to design adequate policies and management interventions to deal with trade-offs. Finally, we highlight the heterogeneity in the social-ecological setting encountered in a subset of 15 ILTER sites. These study cases are diverse enough to provide a broad cross-section of contrasting ecosystems with different policy and management drivers of ecosystem conversion; distinct trends of biodiversity change; different stakeholders’ preferences for ecosystem services; and diverse components of well-being issues.

Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study

BACKGROUND: Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites. OBJECTIVE: To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites. METHODS: This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample. RESULTS: In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be demonstrated for female participants (P<.001), those who were widowed (P=.01), covered by statutory health insurance (P=.02), and with higher health care utilization (P<.001). Health care utilization was significantly associated with all dependent variables in our multivariate logistic regression models (P<.001). Furthermore, significantly higher scores could be shown for health insurance status in the unweighted and Internet use in the weighted models. CONCLUSIONS: Neither health policy makers nor physicians should underestimate the influence of physician-rating websites. They already play an important role in providing information to help patients decide on an appropriate physician. Assuming there will be a rising level of public awareness, the influence of their use will increase well into the future. Future studies should assess the impact of physician-rating websites under experimental conditions and investigate whether physician-rating websites have the potential to reflect the quality of care offered by health care providers.

The Search for the Operatic: Bridging the Gap Between the Spectatorial and Performer Positions Through Sketch-making and Embodiment Techniques

The exhibition was of sketches and a photograph from my PhD practice research. The practice-research was comprised of observing opera singers in rehearsal and sketching them as they moved. As well as records of body position, and to some degree dynamic flow, the exhibited sketches were regarded as kinaesthetic responses in and of themselves – responses to the environment of the rehearsal, in particular responding to the sounds of the orchestra. These sketches were, in part, generated through an embodiment of the music, which was occurring in the same moment as the singer was engaged in embodying the music. These sketches were then used as tools that therefore contained kinaesthetic information which could be unlocked through a process of Butoh derived embodiment techniques alongside reference to the sketched image. This ultimately allowed me to move from a spectatorial position to a performance maker position, bringing a sense of the operatic into the non-singing body, whether that was my own or the bodies of other performers. In this way, and combined with rigorous observation of the corporeal restrictions of singing operatically, choreographies were created that employed operatic ways of moving in non-singing bodies and the operatic was extracted from opera and employed in movement based practice. The aspect of the practice-research exhibited is the correspondence between sketched documentation of the singers in rehearsal and photographic documentation of the dancer (researcher) in performance.

Nationalist historiography, Nation-state making and Secondary School History: Curriculum Policy in Zimbabwe 1980-2010

This paper studies the curriculum policy trajectories that have characterized the teaching of secondary school History as a subject that is historically enmeshed in the politics of nation-state making in post-independence Zimbabwe. Through content analysis, the paper examines the ways in which the post-independence History syllabi, namely 2166 and 2167, have drawn from recent historiographies to frame both the aims and content of school History. The argument developed is that both syllabi have been deployed to serve the envisaged nation-state project; with Syllabus 2166 associated with the socialist nation-state project of the 1980s and 2167 with patriotic history since 2000. The paper concludes that such (mis)uses of school are not unique to Zimbabwe, but represent the political instrumentalization of school History that has become prevalent throughout the world.

Using an end-of-life care pathway in acute stroke: a mixed methods study of decision-making and care experiences

Background: The evidence base on end-of-life care in acute stroke is limited, particularly with regard to recognising dying and related decision-making. There is also limited evidence to support the use of end-of-life care pathways (standardised care plans) for patients who are dying after stroke. Aim: This study aimed to explore the clinical decision-making involved in placing patients on an end-of-life care pathway, evaluate predictors of care pathway use, and investigate the role of families in decision-making. The study also aimed to examine experiences of end-of-life care pathway use for stroke patients, their relatives and the multi-disciplinary health care team. Methods: A mixed methods design was adopted. Data were collected in four Scottish acute stroke units. Case-notes were identified prospectively from 100 consecutive stroke deaths and reviewed. Multivariate analysis was performed on case-note data. Semi-structured interviews were conducted with 17 relatives of stroke decedents and 23 healthcare professionals, using a modified grounded theory approach to collect and analyse data. The VOICES survey tool was also administered to the bereaved relatives and data were analysed using descriptive statistics and thematic analysis of free-text responses. Results: Relatives often played an important role in influencing aspects of end-of-life care, including decisions to use an end-of-life care pathway. Some relatives experienced enduring distress with their perceived responsibility for care decisions. Relatives felt unprepared for and were distressed by prolonged dying processes, which were often associated with severe dysphagia. Pro-active information-giving by staff was reported as supportive by relatives. Healthcare professionals generally avoided discussing place of care with families. Decisions to use an end-of-life care pathway were not predicted by patients’ demographic characteristics; decisions were generally made in consultation with families and the extended health care team, and were made within regular working hours. Conclusion: Distressing stroke-related issues were more prominent in participants’ accounts than concerns with the end-of-life care pathway used. Relatives sometimes perceived themselves as responsible for important clinical decisions. Witnessing prolonged dying processes was difficult for healthcare professionals and families, particularly in relation to the management of persistent major swallowing difficulties.

Auctioning versus grandfathering in cap-and-trade systems with market power and incomplete information

We compare auctioning and grandfathering as allocation mechanisms of emission permits when there is a secondary market with market power and firms have private information on their own abatement technologies. Based on real-life cases such as the EU ETS, we consider a multi-unit, multi-bid uniform auction. At the auction, each firm anticipates its role in the secondary market, either as a leader or a follower. This role affects each firms’ valuation of the permits (which are not common across firms) as well as their bidding strategies and it precludes the auction from generating a cost-effective allocation of permits, as it occurs in simpler auction models. Auctioning tends to be more cost-effective than grandfathering when the firms’ abatement cost functions are sufficiently different from one another, especially if the follower has lower abatement costs than the leader and the dispersion of the marginal costs is large enough.

Built heritage-making and socioeconomic renewal in declining rural areas : evidence from Portugal

This article focuses on the connections between built heritage-making and socioeconomic renewal in declining rural areas. Drawing on fieldwork in twelve rural villages in eastern Portugal, it sheds light on the outcomes of a State-led programme, the objectives of which were to renovate the historic built fabric and generate tourism revenue for a region with declining population levels. Overall, the programme was successful in terms of preservation / conservation of monuments and the built fabric, but failed to stimulate the anticipated social and economic development. The conclusion is that the making of heritage spaces is not the remedy for the economic and demographic ills of rural areas, notwithstanding the positive effect that such measures may have in certain cases.

The impacts of US agricultural and trade policy on trade liberalization and integration via a US- Central America free trade agreement

Resumen Este estudio analiza importantes acciones legislativas del 2002 que afectarán sustancialmente las negociaciones comerciales con Estados Unidos; examina, asimismo, la protección de importaciones de ese país con respecto a productos agrícolas que serán críticos en las negociaciones con los países centroamericanos. Las acciones legislativas mencionadas fueron la aprobación del Proyecto de ley Agrícola del 2002 y la aprobación de la Autorización de Promoción Legal, que provee tratamiento del ‘trámite rápido’ de los acuerdos comerciales…

Public capital, productivity and trade balances:some evidence for the Italian regions

This paper analyses the extent to which intensive investments in public capital may have had an unfavourable impact on the regional trade balances across the 20 Italian regions. Our working hypothesis is that investments in public capital, while stimulating the demand for tradables across the regions, may have a limited positive impact on the supply of tradables in regions characterised by relatively low productivity like the South of Italy (or Mezzogiorno). The empirical results are consistent with our expectations and suggest that programs of investments in public capital should be accompanied by additional policy measures that can remove the structural factors that hamper the total factor productivity growth in specific areas. © Springer-Verlag 2008.