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.

Spectral sensitivity, spatial resolution and temporal resolution and their implications for conspecific signalling in cleaner shrimp.

Cleaner shrimp (Decapoda) regularly interact with conspecifics and client reef fish, both of which appear colourful and finely patterned to human observers. However, whether cleaner shrimp can perceive the colour patterns of conspecifics and clients is unknown, because cleaner shrimp visual capabilities are unstudied. We quantified spectral sensitivity and temporal resolution using electroretinography (ERG), and spatial resolution using both morphological (inter-ommatidial angle) and behavioural (optomotor) methods in three cleaner shrimp species: Lysmata amboinensis, Ancylomenes pedersoni and Urocaridella antonbruunii. In all three species, we found strong evidence for only a single spectral sensitivity peak of (mean ± s.e.m.) 518 ± 5, 518 ± 2 and 533 ± 3 nm, respectively. Temporal resolution in dark-adapted eyes was 39 ± 1.3, 36 ± 0.6 and 34 ± 1.3 Hz. Spatial resolution was 9.9 ± 0.3, 8.3 ± 0.1 and 11 ± 0.5 deg, respectively, which is low compared with other compound eyes of similar size. Assuming monochromacy, we present approximations of cleaner shrimp perception of both conspecifics and clients, and show that cleaner shrimp visual capabilities are sufficient to detect the outlines of large stimuli, but not to detect the colour patterns of conspecifics or clients, even over short distances. Thus, conspecific viewers have probably not played a role in the evolution of cleaner shrimp appearance; rather, further studies should investigate whether cleaner shrimp colour patterns have evolved to be viewed by client reef fish, many of which possess tri- and tetra-chromatic colour vision and relatively high spatial acuity.

"On our way": identities and representations of African women seeking asylum in Ireland

This thesis provides the first explicit Postcolonial study of asylum in the Irish context that integrates Black Feminist analyses of intersectional identity with Postcolonial Feminist theories of representation. African women seeking asylum in the Republic of Ireland were key political instruments used by the state to re-draw racial lines. The study examines how, for a group of African women “On their Way” through asylum, identity and representation work hand in hand to force identities, subaltern spaces and bodies to occupy them. Rich biographical data is gathered through mixed art and drama methods over two intensive participatory research projects conducted in a small Irish city. Data analysis critically examines the poetics (practices that signify) and politics (the powers that govern these practices) and affective economies of global and local NGO visual representations, exposing how they consume, fragment, and appropriate African women’s identities and bodies. Though hypervisible, the women themselves “cannot speak”. The women in the study reported feeling “tired” and “used”. Asking “What work are they doing as they do asylum?” the study finds that black female identities and bodies are forced to perform political, cultural, emotional and material labour on their way through this context of Irish asylum. The author argues that Postcolonial Asylum is a performative encounter that re-scripts colonial race/class/gender discourse through a humanitarian alibi to naturalize European/white supremacy, reinscribe patriarchal power and justify racialised incarceration of bodies seeking asylum in the North. This study takes an interdisciplinary approach that centralizes Black and Postcolonial Feminist theory and innovates Participatory Art-Based Action methodology. Black and Postcolonial feminisms can recognize, theorize and replenish black female political and intellectual agency. Participatory Action research, if grounded in Black feminist epistemology and ethics, can allow participants to “speak back” to what is already said about them in spaces of convivial self-representation.

Seawater carbonate chemistry and fish Amphiprion percula behaviour during experiments, 2012

Predicted future CO2 levels have been found to alter sensory responses and behaviour of marine fishes. Changes include increased boldness and activity, loss of behavioural lateralization, altered auditory preferences and impaired olfactory function. Impaired olfactory function makes larval fish attracted to odours they normally avoid, including ones from predators and unfavourable habitats. These behavioural alterations have significant effects on mortality that may have far-reaching implications for population replenishment, community structure and ecosystem function. However, the underlying mechanism linking high CO2 to these diverse responses has been unknown. Here we show that abnormal olfactory preferences and loss of behavioural lateralization exhibited by two species of larval coral reef fish exposed to high CO2 can be rapidly and effectively reversed by treatment with an antagonist of the GABA-A receptor. GABA-A is a major neurotransmitter receptor in the vertebrate brain. Thus, our results indicate that high CO2 interferes with neurotransmitter function, a hitherto unrecognized threat to marine populations and ecosystems. Given the ubiquity and conserved function of GABA-A receptors, we predict that rising CO2 levels could cause sensory and behavioural impairment in a wide range of marine species, especially those that tightly control their acid-base balance through regulatory changes in HCO3 and Cl levels.

The relationship between non-suicidal self-injury and suicidality

The overall purpose of this study was to explain the overlap and distinctiveness of non-suicidal self-injury (NSSI) and suicidality from a diathesis-stress perspective. The first part of this study evaluated the third variable theory as an explanation for the high rates of lifetime co-occurrence between NSSI and suicidality. Specifically, it was hypothesized that these forms of self-harm share a common vulnerability profile comprised of five affective, cognitive and behavioural diatheses. The second part of this study tested the hypothesis that NSSI and suicidality become distinguishable on the basis of immediate, proximal stressors, namely psychache and survival and coping beliefs (SCB). Participants (N = 262) were community individuals aged 16-24 years who reported either no history of self-harm (i.e., no history of NSSI, suicidality, or both), a history of NSSI, suicidality or both, or current NSSI-only or current NSSI+suicidality. They were recruited online to complete an online battery of questionnaires. Using a set of discriminant function analyses, it was found that the vulnerability profile was unable to distinguish between the three self-harm groups, but was able to differentiate the no self-harm group from a collated self-harm group. Result patterns were also analyzed for gender differences. It was also found that a current NSSI+suicidality group exhibited significantly higher psychache and lower SCB (for women only) than a current NSSI-only group. These results suggest that NSSI and suicidality may tend to co-occur because they have similar long-term diatheses, but that they may become more distinct with respect to immediate psychological stressors.

Understanding alexithymia in female adolescents: the role of attachment style

Adults with alexithymia retrospectively report emotional difficulties with caregivers during childhood. However, the association between attachment style and alexithymic traits may be evident at an earlier stage than adulthood, i.e. during adolescence. Sixty school-based healthy females aged 9–18 years (mean 14.08, SD 2.71 years) participated in an Attachment Style Interview (ASI) and completed the Toronto Alexithymia Scale (TAS-20). Greater levels of alexithymia were exhibited by both anxious and avoidant insecurely attached groups compared to securely attached participants. Fear of separation (characteristic of anxious attachment style) predicted both overall alexithymia scores and the specific alexithymic trait of ‘difficulty identifying feelings’ (DIF). Constraints on closeness (an avoidant attachment attitude) predicted ‘difficulty describing feelings’ (DDF). Low felt attachment to primary caregiver was a predictor of ‘externally oriented thinking’ (EOT). These findings indicate that features of anxious and avoidant insecure attachment styles are differentially related to the separate facets of alexithymia in female adolescents. Specifically, the findings concerning fear of separation may reflect the adolescent struggle for autonomy and the resulting effects on the affect regulation system. Our results also suggest that the normative differentiation of the emotional and cognitive aspects of alexithymia may occur on a developmental trajectory.

‘Learning to be Zen’: Women travellers and the imperative to happy

This paper follows the emotional management of lone, independent women travellers as they move through tourist spaces, based on my doctoral research Embodiment and Emotion in the experiences of independent women tourists (2012). Specifically, this paper will focus on ‘gendering happiness’ by arguing that women travellers are significantly compelled to feel and display characteristics of happiness, humour and ‘learning to be Zen’ in order to be successful travellers. The imperative to become, and remain, happy and humorous in the face of embodied, emotional and gendered constraints is a key feature of women’s reflections of their travelling experiences, mirroring the recent emergence of literature into happiness and positive thinking within feminist theory (Ehrenreich 2010, Ahmed 2010). Negotiating ‘bad’ emotions provides a powerful insight into the perceptions of women travellers; to remain happy can mask problematic power relations and other forms of resistance. This is not to say that emotional negotiation is not partly a form of effective resistance, rather, I wish to make room for the freedom to be unhappy and angry in travelling space without feeling failure for not achieving a successful travelling identity.

Perception of Filtered Speech by Children with Developmental Dyslexia and Children with Specific Language Impairments

Here we use two filtered speech tasks to investigate children’s processing of slow (<4 Hz) versus faster (∼33 Hz) temporal modulations in speech. We compare groups of children with either developmental dyslexia (Experiment 1) or speech and language impairments (SLIs, Experiment 2) to groups of typically-developing (TD) children age-matched to each disorder group. Ten nursery rhymes were filtered so that their modulation frequencies were either low-pass filtered (<4 Hz) or band-pass filtered (22 – 40 Hz). Recognition of the filtered nursery rhymes was tested in a picture recognition multiple choice paradigm. Children with dyslexia aged 10 years showed equivalent recognition overall to TD controls for both the low-pass and band-pass filtered stimuli, but showed significantly impaired acoustic learning during the experiment from low-pass filtered targets. Children with oral SLIs aged 9 years showed significantly poorer recognition of band pass filtered targets compared to their TD controls, and showed comparable acoustic learning effects to TD children during the experiment. The SLI samples were also divided into children with and without phonological difficulties. The children with both SLI and phonological difficulties were impaired in recognizing both kinds of filtered speech. These data are suggestive of impaired temporal sampling of the speech signal at different modulation rates by children with different kinds of developmental language disorder. Both SLI and dyslexic samples showed impaired discrimination of amplitude rise times. Implications of these findings for a temporal sampling framework for understanding developmental language disorders are discussed.

‘Poor prison flowers’: convict mothers and their children in Ireland, 1853-1900

Pregnant women and mothers were among the thousands of individuals who were sentenced to at least three years’ penal servitude and admitted to the nineteenth-century Irish female convict prison. While some babies were born behind bars, others were permitted to accompany their convicted mothers into the prison after the penal practice of transportation had ceased. Other dependent children were separated from their convicted mothers for years, cared for by family members or friends, or accommodated in Ireland’s growing web of institutions. Using individual case studies, this article focuses on convict mothers and their young offspring. It draws attention to the increasing restrictions on the admission of infants that were imposed as the nineteenth century progressed, the problems that children of various ages in the penal system seemed to pose for officials, and the difficulties faced by incarcerated mothers who wished to maintain communication with their offspring. This article argues that while there were benefits to parenting within the confines of the prison, sentences of penal servitude had a significant impact on the lives of dependent offspring by dislocating families, separating siblings, or initiating institutional or other care that broke familial bonds permanently. In so doing, the article reveals attitudes towards motherhood as well as female criminality and institutionalization generally during this period and sheds light on an aspect of convict life unique to the women’s prison.

Withdrawal of Antidementia Drugs in Older People: Who, When and How?

The evidence base to guide withdrawal of antidementia medications in older people with dementia is limited; while some randomised controlled studies have considered discontinuation of cholinesterase inhibitors, no such studies examining discontinuation of the N-Methyl-D-aspartate receptor antagonist memantine have been conducted to date. The purpose of this opinion article was to summarise the existing evidence on withdrawal of cholinesterase inhibitors and memantine, to highlight the key considerations for clinicians when making these prescribing decisions and to offer guidance as to when and how treatment might be discontinued. Until the evidence-base is enhanced by the findings of large scale randomised controlled discontinuation trials of ChEIs and memantine which use multiple, clinically relevant cognitive, functional and behavioural outcome measures, clinicians’ prescribing decisions involve balancing the risks of discontinuation with side-effects and costs of continued treatment. Such decisions must be highly individualised and patient-centred.

Comparing long-term placements for young children in care: Does type of placement really matter?

This paper presents findings from the third phase of a longitudinal study, entitled Care Pathways and Outcomes, which has been tracking the placements and measuring outcomes for a population of children (n = 374) who were under the age of five and in care in Northern Ireland on the 31st March 2000. It explores how a sub-sample of these children at age nine to 14 years old were getting on in the placements provided for them, in comparative terms across five placement types: adoption; foster care; kinship foster care (with relatives); on Residence Order; and living with birth parents. This specifically focused on the development of attachment and self-concept from the perspective of the children, and behavioural and emotional function, and parenting stress, from the perspective of parents and carers. Findings showed no significant placement effect from the perspective of children, and a statistically weak, but descriptively compelling, effect from the perspective of parents. The findings challenge the notion of adoption as the gold standard in long-term placements, specifically from the perspective of children in terms of their parent/carer attachments and self-concept, and highlight what appears to be the central importance of placement longevity for delivering positive longer-term outcomes for these children, irrespective of placement type.

Peptide Therapeutics and the Pharmaceutical Industry: Barriers Encountered Translating from the Laboratory to Patients

Peptides are receiving increasing interest as clinical therapeutics. These highly tunable molecules can be tailored to biocompatibility and biodegradability with simultaneously selective and potent therapeutic effects. Despite challenges regarding up-scaling and licensing of peptide products, their vast clinical potential is reflected in the 60 plus peptide-based therapeutics already on the market, and the further 500 derivatives currently in developmental stages. Peptides are proving effective for a multitude of disease states including: type 2 diabetes (controlled using the licensed glucagon-like peptide-1 receptor liraglutide); irritable bowel syndrome managed with linaclotide (currently at approval stages); acromegaly (treated with octapeptide somostatin analogues lanreotide and octreotide); selective or broad spectrum microbicidal agents such as the Gram-positive selective PTP-7 and antifungal heliomicin; anticancer agents including goserelin used as either adjuvant or for prostate and breast cancer,and the first marketed peptide derived vaccine against prostate cancer, sipuleucel-T. Research is also focusing on improving the biostability of peptides. This is achieved through a number of mechanisms ranging from replacement of naturally occurring L-amino acid enantiomers with D-amino acid forms, lipidation, peptidomimetics, N-methylation, cyclization and exploitation of carrier systems. The development of self-assembling peptides are paving the way for sustained release peptide formulations and already two such licensed examples exist, lanreotide and octreotide. The versatility and tunability of peptide-based products is resulting in increased translation of peptide therapies, however significant challenges remain with regard to their wider implementation. This review highlights some of the notable peptide therapeutics discovered to date and the difficulties encountered by the pharmaceutica lindustry in translating these molecules to the clinical setting for patient benefit, providing some possible solutions to the most challenging barriers. 

Fixed-boundary constituencies and the principle of equal representation in Ireland

The process of constituency boundary revision in Ireland, designed to satisfy what is perceived as a rigid requirement that a uniform deputy-population ratio be maintained across constituencies, has traditionally consumed a great deal of the time of politicians and officials. For almost two decades after a High Court ruling in 1961, the process was a political one, was highly contentious, and was marked by serious allegations of ministerial gerrymandering. The introduction in 1979 of constituency commissions made up of officials neutralised, for the most part, charges that the system had become too politicised, but it continued the process of micro-management of constituency boundaries. This article suggests that the continuing problems caused by this system – notably, the permanently changing nature of constituency boundaries and resulting difficulties of geographical identification – could be resolved by reversion to the procedure that is normal in proportional representation systems: periodic post-census allocation of seats to constituencies whose boundaries are based on those of recognised local government units and which are stable over time. This reform, replacing the principle of redistricting by the principle of reapportionment, would result in more recognisable constituencies, more predictable boundary trajectories over time, and a more efficient, fairer, and speedier process of revision.

What is health and what is important for its achievement? : A qualitative study on adolescent boys’ perceptions and experiences of health

Few qualitative studies have explored adolescent boys’ perceptions of health. Aim: The aim of this study was therefore to explore how adolescent boys understand the concept of health and what they find important for its achievement Methods: Grounded theory was used as a method to analyse interviews with 33 adolescent boys aged 16 to 17 years attending three upper secondary schools in a relatively small town in Sweden. Results: There was a complexity in how health was perceived, experienced, dealt with, and valued. Although health on a conceptual level was described as ‘holistic’, health was experienced and dealt with in a more dualistic manner, one in which the boys were prone to differentiate between mind and body. Health was experienced as mainly emotional and relational, whereas the body had a subordinate value. The presence of positive emotions, experiencing self-esteem, balance in life, trustful relationships, and having a sense of belonging were important factors for health while the body was experienced as a tool to achieve health, as energy, and as a condition. Conclusion: Our findings indicate that young, masculine health is largely experienced through emotions and relationships and thus support theories on health as a social construction of interconnected processes. 

Perceção das Competências Parentais por Pais e Filhos: fatores determinantes

O termo parentalidade tem evoluído com os estudos que foram sendo desenvolvidos na área, na sua maioria pretendem compreender como as crianças percecionam as competências parentais dos seus progenitores e qual o comportamento da criança em função do estilo educativo exercido. Para avaliar e analisar a parentalidade é necessário conhecer a comunidade onde se insere a família, sendo já amplamente discutida a influência do meio e contexto no comportamento e na perceção que temos de nós e do outro. O presente estudo propôs-se a entender quais os fatores sociodemográficos e comportamentais que podem condicionar o exercício das competências parentais. Constitui-se como um estudo descritivo-correlacional, com uma amostra não probabilística aleatória por conveniência, com 62 pais de crianças com idade compreendidas entre os 6 e os 11 anos e frequentam o 1º Ciclo do Ensino Básico no Distrito de Leiria. Para responder ao objetivo inicial foram utilizados os seguintes instrumentos: para a perceção das competências parentais recorreu-se às escalas EMBU-P e EMBU-C, para avaliar a ansiedade nos pais foi aplicado o Inventário de Ansiedade de Beck (IAB) e finalmente, o questionário sociodemográfico que pretendia identificar características da amostra (residência, idades, empregabilidade, escolaridade, frequência de ATL, rotinas familiares). Os resultados obtidos evidenciam que os pais percecionam fornecer um elevado suporte emocional aos filhos, que é coincidente com o sentido pelas crianças. Sendo de destacar que quando os pais exercem uma tentativa de controlo ou rejeição, o seu índice de ansiedade tendem a aumentar antevendo uma relação entre ambas as variáveis. Outro resultado com relevância estatística significativa é a relação entre a perceção da sua competência parental e o número de filhos que têm. Destaca-se, ainda, que existem dados sociodemográficos que apresenta uma relação estatisticamente significativa com o exercício da competência parental, como o rendimento mensal do agregado, a existência de irmãos e a subescala de tentativa de controlo. / The term parenting has evolved along with the studies in this field, and most of them aim to understand how children perceive their parents’ parenting skills as well as the child's behaviour depending on the style of education. To evaluate and analyse parenting it is also necessary to know the community, as we are aware of the influence of the environment on the behaviour and perception of ourselves and the people next to us. This study aims to understand which sociodemographic and behavioural factors might influence the performance of parenting skills. It is a descriptive-correlational study with a non-probabilistic sample, randomly chosen, with 62 parents, whose children are not only aged 6-11 years but also attending the primary school in the District of Leiria. In order to respond to the initial goal we used the following instruments: the scales EMBU-P and EMBU-C were used to perceive parenting skills, Beck’s Anxiety Inventory (BAI) was used to assess parents’ anxiety, and finally, the sociodemographic questionnaire was used to identify the characteristics of the sample (residence, ages, employment, education, ATL (after-school activities), family routines). The results show that parents believe they provide a high emotional support to their children, which is coincident with the children’s opinion. It is also important to mention that whenever parents attempt to control or reject, their level of anxiety tends to increase, foreseeing a relationship between both variables. Another result presenting significant statistic relevance is the correlation between parents’ perception of their parental competence and the number of children they have. Finally, it is worth mentioning that there are sociodemographic data that show a statistically significant correlation with parental competence, such as the monthly income of the household, the existence of siblings and the control subscale.