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Competing priorities and second chances - A qualitative exploration of prisoners’ journeys through the Hepatitis C continuum of care.
Get PDFHigh levels of undiagnosed and untreated HCV infection exist in prison populations globally. Prisons are a key location to identify, treat and prevent HCV infection among people who inject drugs (PWID). Understanding prisoners’ lived experiences of the HCV continuum of care informs how HCV care can be effectively delivered to this marginalised and high-risk population. This study aimed to explore Irish prisoners’ experience of prison and community-based HCV care. We conducted one-to-one interviews with 25 male prisoners with chronic HCV infection. Data collection and analysis was informed by grounded theory. The mean age of participants and first incarceration was 39.5 and 18.3 years respectively. The mean number of incarcerations was eight. The following themes were identified: medical and social factors influencing engagement (fear of treatment and lack of knowledge, HCV relevance and competing priorities), adverse impact of HCV on health and wellness, positive experience of prison life and health care and the transformative clinical and non-clinical changes associated with HCV treatment and cure. Findings suggest that prison release was associated with multiple stressors including homelessness and drug dependence which quickly eroded the health benefits gained during incarceration. The study generated a substantive theory of the need to increase the importance of HCV care among the routine competing priorities associated with the lives of PWID. HCV infected prisoners often lead complex lives and understanding their journeys through the HCV continuum can inform the development of meaningful HCV care pathways. Many challenges exist to optimising HCV treatment uptake in this group and incarceration is an opportunity to successfully engage HCV infected prisoners who underutilise and are underserved by community-based medical services. Support and linkage to care on release is essential to optimising HCV management
Getting off to a shaky start: specificity in planning and feedforward control during sensorimotor learning in autism spectrum disorder
Get PDFWhilst autistic individuals develop new internal action models during sensorimotor learning, the acquired movements are executed less accurately and with greater variability. Such movement profiles are related to differences in sensorimotor integration and/or altered feedforward/feedback sensorimotor control. We investigated the processes underlying sensorimotor learning in autism by quantifying accuracy and variability, relative timing, and feedforward and feedback control. Although autistic individuals demonstrated significant sensorimotor learning across trials, which was facilitated by processing knowledge-of-results feedback, motor execution was less accurate than non-autistic individuals. Kinematic analysis indicated that autistic individuals showed significantly greater spatial variability at peak acceleration, but comparable spatial variability at peak velocity. These kinematic markers suggest that autistic movement profiles are driven by specific differences in sensorimotor control processes (i.e., internal action models) associated with planning and regulating the forces required to execute the movement. The reduction of variability at peak velocity indicates intact early feedback-based sensorimotor control in autism. Understanding how feedforward and feedback-based control processes operate provides an opportunity to explore how these control processes influence the acquisition of socio-motor actions in autism
Local Authority provision of Environmental Planning Guidelines for Event Management in Ireland
Get PDFThis paper discusses the environmental impacts generated by hosting events. More specifically it focuses on the case study of assessing the provision of environmental planning guidelines by Local Authorities to manage the environmental impacts of events in Ireland. In order to determine which Local Authorities provided environmental planning guidelines, a quantitative methodology in the form of a content analysis approach was utilised to investigate every Local Authority in the Republic of Ireland. Analysis has revealed that few Local Authorities are providing planning guidelines for event management, which focus on environmental concerns. As such, the realization of the need to provide environmental planning guidelines to manage the environmental impacts of event management within Local Authorities has not been recognised nationwide. As a result the need for coherent guidelines and policies with sustainable indicators within Local Authorities is vital to further develop, grow and advance the event sector in Ireland. This paper concludes that while the low levels of environmental sustainability in Local Authorities for event management is worrying; it offers an opportunity to be improved by adopting and utilising best practice indicators in environmental policies and guidelines for event management
Palaeoenvironmental and palaeogeographic reconstruction of the Tequixquiac Basin, Central Eastern Mexico: Mid to late Pleistocene environments
Get PDFThis PhD research utilises, for the first time, sedimentary evidence for mid to late Quaternary environmental change in the Tequixquiac region of Central-eastern Mexico. This project has logged over 50 stratigraphic sections and geochemically analysed a 55 m lithostratigraphic sequence for multi-proxy palaeoenvironmental information. The main research objective was to develop a spatial and temporal Palaeogeographic and Palaeoenvironmental model for the study area the covered the late Pleistocene to early Holocene. The findings of the study, based on the analysis of sedimentology, micromorphology, stable isotopes δ18Ocarbonate and δ13CDIC as well as ICP-OES sediment and tephra geochemistry, LOI, AMS radiocarbon, 40Ar/39Ar and Uranium-series dating has allowed a chronologically constrained paleoenvironmental and palaeogeographic reconstruction of the study area. The results of the study suggest that the Tequixquiac Basin has undergone a significant hydrological change from perennial lacustrine to ephemeral fluvial conditions between MIS15 – MIS 1 controlled by a combination of; climatic fluctuations, expressed as depositional cyclicity driven by precessional fluctuations to insolation levels. On shorter time-scales, changes in the mean position of the ITCZ related to SST, latitudinal gradients, atmospheric surface pressure gradients, the extent of Northern Hemisphere land and sea ice cover, and oceanic circulation patterns. Fluctuations in the TOC content of sediments are thought to be related to El Niño-like (dry) and La Niña-like (wet) events. While climate is thought to have been critical to the development the Quaternary localised uplift, deformation and normal faulting have also influenced palaeohydrology and water-table elevation during the recorded depositional period (Figs 8.15 d & 8.16 d)
On a century of extragalactic novae and the rise of the rapid recurrent novae
Get PDFNovae are the observable outcome of a transient thermonuclear runaway on the surface of an accreting white dwarf in a close binary system. Their high peak luminosity renders them visible in galaxies out beyond the distance of the Virgo Cluster. Over the past century, surveys of extragalactic novae, particularly within the nearby Andromeda Galaxy, have yielded substantial insights regarding the properties of their populations and sub-populations. The recent decade has seen the first detailed panchromatic studies of individual extragalactic novae and the discovery of two probably related sub-groups: the 'faint-fast' and the 'rapid recurrent' novae. In this review we summarise the past 100 years of extragalactic efforts, introduce the rapid recurrent sub-group, and look in detail at the remarkable faint-fast, and rapid recurrent, nova M31N 2008-12a. We end with a brief look forward, not to the next 100 years, but the next few decades, and the study of novae in the upcoming era of wide-field and multi-messenger time-domain surveys
Circulating microRNAs as potential diagnostic biomarkers for osteoporosis
Get PDFOsteoporosis is the most common age-related bone disease worldwide and is usually clinically asymptomatic until the first fracture happens. MicroRNAs are critical molecular regulators in bone remodelling processes and are stabilised in the blood. The aim of this project was to identify circulatory microRNAs associated with osteoporosis using advanced PCR arrays initially and the identified differentially-expressed microRNAs were validated in clinical samples using RT-qPCR. A total of 161participants were recruited and 139 participants were included in this study with local ethical approvals prior to recruitment. RNAs were extracted, purified, quantified and analysed from all serum and plasma samples. Differentially-expressed miRNAs were identified using miRNA PCR arrays initially and validated in 139 serum and 134 plasma clinical samples using RT-qPCR. Following validation of identified miRNAs in individual clinical samples using RT-qPCR, circulating miRNAs, hsa-miR-122-5p and hsa-miR-4516 were statistically significantly differentially-expressed between non-osteoporotic controls, osteopaenia and osteoporosis patients. Further analysis showed that the levels of these microRNAs were associated with fragility fracture and correlated with the low bone mineral density in osteoporosis patients. The results show that circulating hsa-miR-122-5p and hsa-miR-4516 could be potential diagnostic biomarkers for osteoporosis in the future
Critical Review Report: DOC (4-Chloro-2,5-dimethoxyamfetamine)
Get PDFExecutive Summary Substance identification: DOC (4-chloro-2,5-dimethoxyamfetamine) (IUPAC name: 1-(4-chloro-2,5dimethoxyphenyl)propan-2-amine) is the chloro analogue of DOB (4-bromo-2,5dimethoxyamfetamine) and DOM (2,5-dimethoxy-4-methylamfetamine) which are both listed in Schedule I of the Convention on Psychotropic Substances of 1971. Information obtained from seizures and collections suggests that it has been encountered in powdered and liquid form but that it is predominantly found in the form of LSD-like blotter papers. WHO Review History: DOC has not been previously pre-reviewed or critically reviewed. Chemistry: There is no specific information available about the routes of synthesis employed for seized DOC products circulating on the drug market but straightforward methods for its preparation exist without requiring access to precursors that are controlled internationally. The presence of an asymmetric carbon atom gives rise to the (R)- and (S)-enantiomer and it seems likely for DOC to be most commonly available in the racemic form. Ease of convertibility into controlled substances: A conversion of DOC into another substance currently listed in any of the international drug conventions might be chemically feasible but specific information is not available. Similarity to known substances / Effects on the central nervous system: DOC can be considered a classical (serotonergic) hallucinogen and its effects and potency are comparable to the hallucinogenic amfetamines DOB, DOM and DOI (4-iodo-2,5dimethoxyamfetamine) and to some extent similar to LSD, psilocybin, mescaline and N,N-dimethyltryptamine. General pharmacology: DOC is a potent 5-HT2A receptor agonist with high affinity, a key element in mediating hallucinogenic effects in humans. The available data available so far also indicates that it also binds with high affinity to and activates 5-HT2B/2C receptors. Self-experiments suggested DOC to be active in the 1.5–3.0 mg range with duration of effects estimated to range between 12–24 h. A long duration of effects is also shared by the other hallucinogenic amfetamines DOI, DOB and DOM. DOC is most commonly administered orally and/or sublingually when encountered in the form of blotters. The discriminative stimulus effects of DOC in the drug discrimination paradigm were similar to those of other hallucinogens DOM and N,N-dimethyltryptamine but not methamfetamine. Data collected from in vitro metabolism studies showed that DOC is transformed into the two O-demethylated (2- and 5-position) metabolites. The parent molecule is the preferred analytical target in clinical casework. Toxicology: Information could not be identified. Adverse reactions in humans: The total number of cases reported in the scientific literature is very small and the detection of other drugs in published cases has also been reported. Clinical features associated with DOC intoxication included agitation, aggressive behaviour, hallucinations, tachycardia, rhabdomyolysis, seizures, and hyperthermia. In one case, some clinical features were observed to persist for up to 33 h. Dependence potential: Dependence potential in humans or animals has not been demonstrated. Abuse potential: Studies specifically linked to DOC could not be identified. Therapeutic applications / usefulness: DOC is not known to have any therapeutic uses. Listing on WHO Model List of Essential Medicines: DOC is not listed. Marketing authorizations: DOC is not known to have any marketing authorisations. Industrial use: DOC is not known to have any agricultural, industrial or cosmetic uses. Non-medical use: The mode of use may involve the combinational use (intentionally or unintentionally) of other drugs and users may be unaware of the exact dose or compound being ingested (by whatever route). Household or subpopulation surveys that specifically probe for prevalence of DOC could not be identified. Use of DOC is presumably limited to people who use hallucinogenic drugs in recreational settings (e.g. home environments, outdoors, discotheques/nightclubs and outdoor music festivals) rather than the general population. Nature and magnitude of public health problems: The information currently available suggests that DOC is most commonly found in the form of blotter papers and that it has also been misrepresented as LSD, which adds to health risks to people who use these substances where information about the identity and/or the dose are unavailable. Some Internet retailers also offer DOC for sale as a research chemical. Information from acute intoxications suggests that some people have obtained access to the powdered form which can increase the risk of overdose and untoward effects. Licit production, consumption, and international trade: DOC is available as standard reference material and produced for scientific research by commercial suppliers. Other uses could not be identified. Illicit manufacture and traffic: DOC has been formally notified in Europe in 2004 but its first published synthesis dates back to 1973. In Europe, DOC was encountered in seizures and collected specimens in several countries and notified between 2004–2016. The majority of notifications described the detection of DOC in blotters although powders and liquid samples were also reported. In the period between 2006 and 2009, a number of DOC identifications obtained from seizures (mostly blotters but also some powdered and liquid material) have been published in the forensic literature the United States of America. According to UNODC, a total number of 77 countries have so far reported the detection of DOC. Current international controls and their impact: DOC is not controlled under the 1961, 1971 or 1988 United Nations Conventions. Current and past national controls: DOC is controlled in some UN Member States
Exploring English speaking Muslim women's first-time maternity experiences: a qualitative longitudinal interview study
Get PDFBackground: Muslim women of child-bearing age make up a fair part of the UK society, however, literature addressing their health needs or experiences of health services have not been extensively researched. The term ‘Muslim’ is often combined with ethnic group identity, rather than used to refer to people distinguished by beliefs or affiliations. Muslim women commonly observe certain religious and cultural practices during their maternity journey. The little research there is in this area suggests that more could be done from a service provision perspective to support Muslim women through this significant life event. The aim of this study was to investigate Muslim women’s perceived needs and the factors that influence their health seeking decisions when engaging with maternity services located in North-West of England.
Methods: The study used longitudinal semi-structured interviews with seven English-speaking first-time pregnant Muslim women receiving maternity care in North-West of England. Total of 21 interview; each woman was interviewed during the antenatal (29 to 40 weeks of pregnancy), immediate postnatal (within the first 2 months after birth) and later postnatal (4 months after birth) period. Audio-recorded interviews were transcribed and thematically analysed using Braun & Clark (2006) as a guide to forming a systematic approach to handling raw data.
Results: Muslim women associated most aspects of the maternity journey with their religious beliefs. Religion was not the primary reason for them becoming pregnant, yet it was an aspiration for them becoming mothers. Emerging themes include: 1) a spiritual perspective; 2) expression of religious requirements; 3) perceptions of healthcare professionals. Religious values and practices provided a positive resource for women during their maternity journey. They described how healthcare professionals approached their needs, while highlighting their concerns of the negative presentation of Muslims in Western media.
Conclusion: Muslim women need to feel confident to express their needs within a maternity setting. Lack of awareness amongst healthcare professionals around religious values and how Muslim women may feel when expressing their needs can inhibit them getting optimal care that acknowledges their needs. The study concludes that educating healthcare professionals about Muslim women’s worldview would enhance the quality of maternity care for Muslim women
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