Evaluating the Impact of the Positive Choices Intervention on Substance Use, Psychological, and Care Engagement Outcomes Relevant to Current National HIV Prevention Goals

The HIV epidemic in the United States continues to be a significant public health problem, with approximately 50,000 new infections occurring each year. National public health priorities have shifted in recent years towards targeted HIV prevention efforts among people living with HIV/AIDS (PLWHA) that include: increasing engagement in and retention in care, improving HIV treatment adherence, and increasing screening for and treatment of substance use and psychological difficulties. This study evaluated the efficacy of Positive Choices (PC), a brief, care-based, theory-driven, 3-session counseling intervention for newly HIV-diagnosed men who have sex with men (MSM), in the context of current national HIV prevention priorities. The study involved secondary analysis of data from a preliminary efficacy trial of the PC intervention (n=102). Descriptive statistics examined baseline substance use, psychological characteristics and strategies, and care engagement and HIV-related biological outcomes. Generalized Estimating Equations (GEE) examined longitudinal changes in these variables by study condition. Results indicated that PC improved adherence to HIV treatment, but increased use of illicit drugs, specifically amyl nitrates and other stimulant drugs; additionally, moderation analyses indicated differences in patterns of change over time in viral load by baseline depression status. Implications of the findings and suggestions for future research are discussed.

Characteristics of hospital-treated intentional drug overdose in Ireland and Northern Ireland

OBJECTIVES This study compared the profile of intentional drug overdoses (IDOs) presenting to emergency departments in Ireland and in the Western Trust Area of Northern Ireland between 2007 and 2012. Specifically the study aimed to compare characteristics of the patients involved, to explore the factors associated with repeated IDO and to report the prescription rates of common drug types in the population. METHODS We utilised data from two comparable registries which monitor the incidence of hospital-treated self-harm, recording data from deliberate self-harm presentations involving an IDO to all hospital emergency departments for the period 1 January 2007 to 31 December 2012. RESULTS Between 2007 and 2012 the registries recorded 56,494 self-harm presentations involving an IDO. The study showed that hospital-treated IDO was almost twice as common in Northern Ireland than in Ireland (278 vs 156/100,000, respectively). CONCLUSIONS Despite the overall difference in the rates of IDO, the profile of such presentations was remarkably similar in both countries. Minor tranquillisers were the drugs most commonly involved in IDOs. National campaigns are required to address the availability and misuse of minor tranquillisers, both prescribed and non-prescribed.

(Table XIV-1, Page 137-139) Physical characteristics of manganese nodules collected in the Pacific Ocean during cruise GH76-1 of R/V Hakurei Maru

Nodule samples obtained were described and studied on board for 1) observation of occurrence and morphology in and outside samplers, size classification, measurement of weight and calculation of population density (kg/m2); 2) photographing whole nodules on the plate marked with the frames of unit areas of both 0cean-70 (0.50 m2) and freefall grab (0.13 m2), and that of typical samples on the plate with a 5 cm grid scale: 3) observation of internal structures of the nodules on cut section; and 4) determination of mineral composition by X-ray diffractometer. The relation between nodule types and geological environment or chemical composition was examined by referring to other data of related studies, such as sedimentology. acoustic survey, and chemical analysis.

(Table XIII-2, Page 166) Physical characteristics of manganese nodules collected in the Pacific Ocean during cruise GH77-1 of R/V Hakurei Maru

In the GH77-1 cruise, manganese nodules were obtained from 31 stations among 37 total ones. Here are reported the preliminary results of the observation mainly done on-board. Special attention was paid to confirming the applicability of the nodule type classification tentatively established in the previous GH76-1 cruise and to delineating the pattern of the nodule distribution and clarifying its relation to the geological factors, such as topography, surface sediment types, and substrate stratigraphy. In addition, a short description of the obtained rock samples from a few stations is included in this chapter.

Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

Descriptions of Scottish Priority Marine Features (PMFs).

Background The seas around Scotland are rich and diverse – Scotland’s position at the edge of the continental shelf, the long coastline, large area of sea and the mixing of warm and coldwater currents combine to make its waters a special place for marine wildlife and habitats. Scotland has over 18,000 km of coastline and its inshore and offshore areas are among the largest of any EU country, representing 13% of all European seas. Scotland’s seas are of outstanding scenic, historical and cultural value and are part of the national identity at home and abroad. The Marine (Scotland) Act 2010 and the UK Marine and Coastal Access Act 2009 include new powers and duties to ensure that our seas are managed sustainably for future generations, integrating the economic growth of marine industries with the need to protect these assets. Measures to conserve Scotland’s marine natural heritage are based on a three pillar approach, with action at the wider seas level (e.g. marine planning or sectoral controls); specific species conservation measures (e.g. improved protection for seals); and through site protection measures - the identification of new Marine Protected Areas (MPAs). To help target action under each of the three pillars, Scottish Natural Heritage (SNH) and the Joint Nature Conservation Committee (JNCC) have generated a focused list of habitats and species of priority conservation importance - the Priority Marine Features (PMFs). The aim of the current study was to produce a descriptive catalogue of the Scottish PMFs (including component habitats and species where appropriate) to serve as a reference for future nature conservation action. Whilst derived from available existing accounts, the succinct 1-page descriptions are written from a Scottish perspective, refining, but clearly linking to more generic UK, EC or OSPAR (Oslo and Paris Commission) commentary. Available information on the geographic distribution of the features was collated as part of the project and a summary map is provided in each description. Main findings  This project has generated a descriptive catalogue of the 81 PMFs that have been identified in the seas around Scotland (out to the limit of the UK continental shelf). The list comprises 26 broad habitats (e.g. burrowed mud), seven low or limited mobility species (e.g. ocean quahog) and 48 mobile species, including fish (e.g. blue ling) and marine mammals (e.g. minke whale).  Information on the distribution of the PMFs was collated within a Geographic Information System (GIS). This is the first time that data about such a diverse range of Scottish marine nature conservation interests have been compiled within a single repository. These data have and will be used in conjunction with other contextual base-mapping to inform the development of nature conservation advice and commentary (e.g. in the production of the Scotland’s Marine Atlas - Baxter et al., 2011).  The feature distribution mapping used in the production of this report is being made available to view online via the National Marine Plan Interactive web portal (NMPi - http://www.gov.scot/Topics/marine/seamanagement/nmpihome). As new or refined data on Scottish PMFs become available, these will be fed into updates to the project geodatabase and NMPi.

Descriptions of Scottish Priority Marine Features (PMFs).

Background The seas around Scotland are rich and diverse – Scotland’s position at the edge of the continental shelf, the long coastline, large area of sea and the mixing of warm and coldwater currents combine to make its waters a special place for marine wildlife and habitats. Scotland has over 18,000 km of coastline and its inshore and offshore areas are among the largest of any EU country, representing 13% of all European seas. Scotland’s seas are of outstanding scenic, historical and cultural value and are part of the national identity at home and abroad. The Marine (Scotland) Act 2010 and the UK Marine and Coastal Access Act 2009 include new powers and duties to ensure that our seas are managed sustainably for future generations, integrating the economic growth of marine industries with the need to protect these assets. Measures to conserve Scotland’s marine natural heritage are based on a three pillar approach, with action at the wider seas level (e.g. marine planning or sectoral controls); specific species conservation measures (e.g. improved protection for seals); and through site protection measures - the identification of new Marine Protected Areas (MPAs). To help target action under each of the three pillars, Scottish Natural Heritage (SNH) and the Joint Nature Conservation Committee (JNCC) have generated a focused list of habitats and species of priority conservation importance - the Priority Marine Features (PMFs). The aim of the current study was to produce a descriptive catalogue of the Scottish PMFs (including component habitats and species where appropriate) to serve as a reference for future nature conservation action. Whilst derived from available existing accounts, the succinct 1-page descriptions are written from a Scottish perspective, refining, but clearly linking to more generic UK, EC or OSPAR (Oslo and Paris Commission) commentary. Available information on the geographic distribution of the features was collated as part of the project and a summary map is provided in each description. Main findings  This project has generated a descriptive catalogue of the 81 PMFs that have been identified in the seas around Scotland (out to the limit of the UK continental shelf). The list comprises 26 broad habitats (e.g. burrowed mud), seven low or limited mobility species (e.g. ocean quahog) and 48 mobile species, including fish (e.g. blue ling) and marine mammals (e.g. minke whale).  Information on the distribution of the PMFs was collated within a Geographic Information System (GIS). This is the first time that data about such a diverse range of Scottish marine nature conservation interests have been compiled within a single repository. These data have and will be used in conjunction with other contextual base-mapping to inform the development of nature conservation advice and commentary (e.g. in the production of the Scotland’s Marine Atlas - Baxter et al., 2011).  The feature distribution mapping used in the production of this report is being made available to view online via the National Marine Plan Interactive web portal (NMPi - http://www.gov.scot/Topics/marine/seamanagement/nmpihome). As new or refined data on Scottish PMFs become available, these will be fed into updates to the project geodatabase and NMPi.

Rainfall infiltration and soil hydrological characteristics below ancient forest, planted forest and grassland in a temperate northern climate

How rainfall infiltration rate and soil hydrological characteristics develop over time under forests of different ages in temperate regions is poorly understood. In this study, infiltration rate and soil hydrological characteristics were investigated under forests of different ages and under grassland. Soil hydraulic characteristics were measured at different scales under a 250-year-old grazed grassland (GL), 6-year-old (6yr) and 48-year-old (48yr) Scots pine (Pinus sylvestris) plantations, remnant 300-year-old individual Scots pine (OT) and a 4000-year-old Caledonian Forest (AF). In situ field-saturated hydraulic conductivity (Kfs) was measured, and visible root:soil area was estimated from soil pits. Macroporosity, pore structure and macropore connectivity were estimated from X-ray tomography of soil cores, and from water-release characteristics. At all scales, the median values for Kfs, root fraction, macroporosity and connectivity values tended to AF>OT>48yr>GL>6yr, indicating that infiltration rates and water storage increased with forest age. The remnant Caledonian Forest had a huge range of Kfs (12 to >4922mmh-1), with maximum Kfs values 7 to 15 times larger than those of 48-year-old Scots pine plantation, suggesting that undisturbed old forests, with high rainfall and minimal evapotranspiration in winter, may act as important areas for water storage and sinks for storm rainfall to infiltrate and transport to deeper soil layers via preferential flow. The importance of the development of soil hydrological characteristics under different aged forests is discussed.

School-Based Referrals to the Juvenile Courts: Prevalence and Characteristics in Several States

Effective school discipline practices are essential to keeping schools safe and creating an optimal learning environment. However, the overreliance of exclusionary discipline often removes students from the school setting and deprives them of the opportunity to learn. Previous research has suggested that students are being introduced to the juvenile justice system through the use of school-based juvenile court referrals. In 2011, approximately 1.2 million delinquency cases were referred to the juvenile courts in the United States. Preliminary evidence suggests that an increasing number of these referrals have originated in the schools. This study investigated school-based referrals to the juvenile courts as an element of the School-to-Prison Pipeline (StPP). The likelihood of school-based juvenile court referrals and rate of dismissal of these referrals was examined in several states using data from the National Juvenile Court Data Archives. In addition, the study examined race and special education status as predictors of school-based juvenile court referrals. Descriptive statistics, logistic regression and odds ratio, were used to analyze the data, make conclusions based on the findings and recommend appropriate school discipline practices.

‘Tenshillingland’: Community and Commerce, Myth and Madness in the Modern Scottish Novel.

While ‘community’ as a concept has come under increasing attack in a neoliberal era, it has remained in Scotland a mythic, though not unexamined, signifier of resistance to perceived threats to national identity. Community, central to the Scottish novel since the Kailyard, continues to be a prevalent theme in the many important novels of the twentieth and twenty-first centuries explored here. Yet, while often disturbingly oppressive in tenor, many of these representations of community actually attack the myth of Scottish communalism to critique, and often expose as forms of madness, the conventional values of social class, capitalism, patriarchy, and religion.

A national coastal erosion risk assessment for Scotland

The geography of Scotland, with a highly undulating hinterland, long and indented coastline, together with a large number of islands, means that much social and economic activity is largely located at the coast. The importance of the coast is further highlighted by the large number of ecosystem services derived from the coast. The threat posed by climate change, particularly current and future sea level rise, is of considerable concern and the associated coastal erosion and coastal flooding has the potential to have a substantial effect on the socioeconomic activity of the whole country. Currently, the knowledge base of coastal erosion is poor, which serves to hinder the current and future management of the coast. This research reported here aimed to establish four key aspects of coastal erosion within Scotland: the physical susceptibility of the coast to erosion; the assets exposed to coastal erosion; the vulnerability of communities to coastal erosion; and the coastal erosion risk to those communities. Coastal erosion susceptibility was modelled here within a GIS, using data for ground elevation, rockhead elevation, wave exposure and proximity to the open coast. Combining these data produced the Underlying Physical Susceptibility Model (UPSM), in the form of a 50 m2 raster of national coverage. The Coastal Erosion Susceptibility Model (CESM) was produced with the addition of sediment supply and coastal defence data, which then moderates the outputs of the UPSM. Asset data for dwellings, key assets, transport infrastructure, historic assets, and natural assets were used along with the UPSM and CESM to assess their degree of exposure to coastal erosion. A Coastal Erosion Vulnerability Model (CEVM) was produced using Experian Mosaic Scotland (a geodemographic classification which identifies 44 different social groups within Scotland) to classify populations based upon 11 vulnerability variables. Dwellings were assigned a CESM and CEVM score in order to establish their coastal erosion risk. This research demonstrated that the issue of coastal erosion will impact on a relatively low number of properties compared to those impacted by flooding (both coastal and fluvial) as many dwellings are already protected by coastal defences. There is therefore, a considerable future liability, and great pressure for coastal defences to be maintained and upgraded in their current form. The use of the CEVM is a novel inclusion within a coastal erosion assessment for Scotland. Use of the CEVM established that coastal erosion risk is not distributed equally amongst the Scottish coastal population and highlighted that risk can be reduced by either reducing exposure or reducing vulnerability. Thus far in Scotland, reducing exposure has been the primary management approach, which has a number of implications with regards social justice. This research identified the existing data gaps that should be addressed by future research in order to further improve coastal management in Scotland. Future research should focus on assessing historical coastal change rates on a national scale, improve modelling of national scale wave exposure, enhance the information held about current coastal defences and, determine the direct and indirect economic cost associated with the loss of different asset types. It is also necessary to clarify the social justice implications of using adaptation approaches to manage coastal erosion as well as establishing a method to communicate the susceptibility, exposure, vulnerability and risk aspects whilst minimising the potential negative impacts (e.g. property blight) of releasing such information.

Primary prevention of neural tube defects: data from the portuguese national registry of congenital anomalies (RENAC)

Background: In Portugal folic acid supplementation is recommended to start at least 2-3 months before conception for primary prevention of Neural Tube Defects. The aim of this study was to evaluate, within gestations with at least one congenital anomaly, possible association between maternal socio-demographic factors and the use of folic acid. Methods: Using data from the Portuguese national registry of congenital anomalies, for the 2004-2013 period, the association between folic acid use during pregnancy and maternal characteristics was studied using the chi-square test. Results: Considering all reported cases with congenital anomaly, the use of folic acid before conception was reported by 12.7% (n = 1233) of the women; 47.8% (n = 4623) started supplementation during the 1st trimester, 7% (n = 680) did not take folic acid and 32.5% (3143) of the records had no information on folic acid use. Women with professions that require higher academic differentiation started the use of supplements before pregnancy (p <0.001); women under 19 years old and with Arab ethnicity (p <0.001) did not take folic acid. Mothers with a previous pregnancy reported less use of folic acid (11.5% versus 14.7%) than mothers without a previous pregnancy (p <0.001). Conclusions: The results suggest some degree of association between maternal characteristics and use of folic acid. To increase the consumption of folic acid before pregnancy new measures are need to promote this primary prevention, among couples and health professionals. This study highlights some maternal characteristics and subgroups of mothers for who the measures should be reinforced.

Robert Edward’s Commonplace Book: the context and function of a seventeenth-century Scottish music manuscript (GB-En MS.9450), with an edition of the musical content

This study concerns the manuscript music book of Robert Edward (c. 1614–c. 1697), minister, author and musician. The manuscript, formerly part of the library at Panmure House, is now held in the National Library of Scotland and is commonly referred to as ‘Robert Edward’s Commonplace Book’ (GB-En MS.9450). The present study is in two parts and begins with an exploration of the physical book, including the structure, compilation, hands and ownership before a second chapter explores the biography of the eponymous owner, contextualising GB-En MS.9450 locally and nationally. The third chapter concerns the function of the manuscript which, it is argued, is closely related to pedagogy. The final three chapters discuss the content of the manuscript, taking in turn the vocal music, instrumental music and the selection of Italian three-part villanelle. The implications for dating and use arising from the first part of this

FAMILY CHARACTERISTICS, STATE PROGRAM EFFECTIVENESS, AND REPORT OF INADEQUATE CARE AMONG FAMILIES OF YOUNG CHILDREN WITH HEARING LOSS

Approximately 1.6 per 1,000 newborns in the U.S. are born with hearing loss. Congenital hearing loss poses a risk to their speech, language, cognitive, and social-emotional development. Early detection and intervention can improve outcomes. Every state has an Early Hearing Detection and Intervention program (EHDI) to promote and track screening, audiological assessments and linkage to early intervention. However, a large percentage of children are “lost to system (LTS),” meaning that they did not receive recommended care or that it was not reported. This study used data from the 2009-2010 National Survey of Children with Special Health Care Needs and data from the 2011 EHDI Hearing Screening and Follow-Up Survey to examine how 1) family characteristics; 2) EHDI program effectiveness, as determined by LTS percentages; and 3) the family conditions of education and poverty are related to parental report of inadequate care. The sample comprised 684 children between the ages of 0 and 5 years with hearing loss. The results indicated that living in states with less effective EHDI programs was associated with an increased likelihood of not receiving early intervention services (EIS) and of reporting poor family-centered communication. Sibling classification was associated with both receipt of EIS and report of unmet need. Single mothers were less likely to report increased difficulties accessing care. Poor and less educated families, assessed separately, who lived in states with less effective EHDI programs, were more likely to report non-receipt of EIS and less likely to report unmet need as compared to similar families living in states with more effective programs. Poor families living in states with less effective programs were more likely to report less coordinated care than were poor families living in states with more effective programs. This study supports the conclusion that both family characteristics and the effectiveness of state programs affect quality of care outcomes. It appears that less effective state programs affect disadvantaged families’ service receipt report more than that of advantaged families. These findings are important because they may provide insights into the development of targeted efforts to improve the system of care for children with hearing loss.