Assets and Financial Management Among Poor Households in Extreme Poverty Neighborhoods

Proposals supporting the accumulation of assets in poor households are hopeful of creating upward mobility. The experiences of poor families in managing assets and other elements of daily economic life were explored through interviews with low-income Hispanic and Anglo families. All families exhibited planning and management skills needed for assets accumulation, but were unable to escape the effects of unrewarding neighborhood environments. Assets did not provide clear avenues out of poverty. If assets-based programs are to raise the economic status of poor families in extreme poverty neighborhoods they must include mechanisms to protect value and reduce uncertainty

Pharmaceutical care for elderly patients shared between community pharmacists and general practitioners: A randomised evaluation. RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) [ISRCTN16932128]

Background: This trial aims to investigate the effectiveness and cost implications of 'pharmaceutical care' provided by community pharmacists to elderly patients in the community. As the UK government has proposed that by 2004 pharmaceutical care services should extend nationwide, this provides an opportunity to evaluate the effect of pharmaceutical care for the elderly. Design: The trial design is a randomised multiple interrupted time series. We aim to recruit 700 patients from about 20 general practices, each associated with about three community pharmacies, from each of the five Primary Care Trusts in North and East Yorkshire. We shall randomise the five resulting groups of practices, pharmacies and patients to begin pharmaceutical care in five successive phases. All five will act as controls until they receive the intervention in a random sequence. Until they receive training community pharmacists will provide their usual dispensing services and so act as controls. The community pharmacists and general practitioners will receive training in pharmaceutical care for the elderly. Once trained, community pharmacists will meet recruited patients, either in their pharmacies (in a consultation room or dispensary to preserve confidentiality) or at home. They will identify drug-related issues/problems, and design a pharmaceutical care plan in conjunction with both the GP and the patient. They will implement, monitor, and update this plan monthly. The primary outcome measure is the 'Medication Appropriateness Index'. Secondary measures include adverse events, quality of life, and patient knowledge and compliance. We shall also investigate the cost of pharmaceutical care to the NHS, to patients and to society as a whole.published_or_final_versio

Linked randomised controlled trials of face-to-face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14–17 years presenting to Emergency Departments (SIPS junior)

Background: Alcohol is a major global threat to public health. Although the main burden of chronic alcohol-related disease is in adults, its foundations often lie in adolescence. Alcohol consumption and related harm increase steeply from the age of 12 until 20 years. Several trials focusing upon young people have reported significant positive effects of brief interventions on a range of alcohol consumption outcomes. A recent review of reviews also suggests that electronic brief interventions (eBIs) using internet and smartphone technologies may markedly reduce alcohol consumption compared with minimal or no intervention controls. Interventions that target non-drinking youth are known to delay the onset of drinking behaviours. Web based alcohol interventions for adolescents also demonstrate significantly greater reductions in consumption and harm among ‘high-risk’ drinkers; however changes in risk status at follow-up for non-drinkers or low-risk drinkers have not been assessed in controlled trials of brief alcohol interventions

The Effectiveness of Alcohol Screening and Brief Intervention in Emergency Departments: A Multicentre Pragmatic Cluster Randomized Controlled Trial

BACKGROUND: Alcohol misuse is common in people attending emergency departments (EDs) and there is some evidence of efficacy of alcohol screening and brief interventions (SBI). This study investigated the effectiveness of SBI approaches of different intensities delivered by ED staff in nine typical EDs in England: the SIPS ED trial. METHODS AND FINDINGS: Pragmatic multicentre cluster randomized controlled trial of SBI for hazardous and harmful drinkers presenting to ED. Nine EDs were randomized to three conditions: a patient information leaflet (PIL), 5 minutes of brief advice (BA), and referral to an alcohol health worker who provided 20 minutes of brief lifestyle counseling (BLC). The primary outcome measure was the Alcohol Use Disorders Identification Test (AUDIT) status at 6 months. Of 5899 patients aged 18 or more presenting to EDs, 3737 (63·3%) were eligible to participate and 1497 (40·1%) screened positive for hazardous or harmful drinking, of whom 1204 (80·4%) gave consent to participate in the trial. Follow up rates were 72% (n?=?863) at six, and 67% (n?=?810) at 12 months. There was no evidence of any differences between intervention conditions for AUDIT status or any other outcome measures at months 6 or 12 in an intention to treat analysis. At month 6, compared to the PIL group, the odds ratio of being AUDIT negative for brief advice was 1·103 (95% CI 0·328 to 3·715). The odds ratio comparing BLC to PIL was 1·247 (95% CI 0·315 to 4·939). A per protocol analysis confirmed these findings. CONCLUSIONS: SBI is difficult to implement in typical EDs. The results do not support widespread implementation of alcohol SBI in ED beyond screening followed by simple clinical feedback and alcohol information, which is likely to be easier and less expensive to implement than more complex interventions

Apolipoprotein E O-glycosylation is associated with amyloid plaques and APOE genotype

Although the APOE ε4 allele is the strongest genetic risk factor for sporadic Alzheimer\u27s disease (AD), the relationship between apolipoprotein (apoE) and AD pathophysiology is not yet fully understood. Relatively little is known about the apoE protein species, including post-translational modifications, that exist in the human periphery and CNS. To better understand these apoE species, we developed a LC-MS/MS assay that simultaneously quantifies both unmodified and O-glycosylated apoE peptides. The study cohort included 47 older individuals (age 75.6 ± 5.7 years [mean ± standard deviation]), including 23 individuals (49%) with cognitive impairment. Paired plasma and cerebrospinal fluid samples underwent analysis. We quantified O-glycosylation of two apoE protein residues - one in the hinge region and one in the C-terminal region - and found that glycosylation occupancy of the hinge region in the plasma was significantly correlated with plasma total apoE levels, APOE genotype and amyloid status as determined by CSF Aβ42/Aβ40. A model with plasma glycosylation occupancy, plasma total apoE concentration, and APOE genotype distinguished amyloid status with an AUROC of 0.89. These results suggest that plasma apoE glycosylation levels could be a marker of brain amyloidosis, and that apoE glycosylation may play a role in the pathophysiology of AD

Social Workers' Attitudes Towards Public Accountability

The public demand for accountability of human services has been increasing in the United States. Despite the growing importance of public accountability as a special responsibility of social workers, little information is available in U.S. on how these pro fessionals react to the implementation of accountability programs. The survey reported in this paper was made to explore the attitudes of social workers in U.S. hospitals toward PSRO, a nationwide health care service review system. The paper presents a descriptive overview of significant aspects of American social workers' personal attitudes toward various issues of current concern about this accountability system.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67090/2/10.1177_002087288402700307.pd

'I probably would never move, but ideally like I’d love to move this week': class and residential experience, beyond elective belonging

This article critically engages with Savage et al.'s conceptualisation of 'elective belonging'. Drawing on research in a case-study site in central Salford, it argues that historical processes of deindustrialisation, slum clearance and social housing residualisation have been compounded by the subsequent strategies of gentrification and impact upon the forms of 'belonging' that can be constructed by marginal working-class populations. Correcting for the predominance of research on belonging from the perspective of middle-class incomers, findings are organised around the themes ‘the local/incomer distinction’, 'perceptions of and orientations to the neighbourhood', 'the power of economic capital', 'social others and social distance', and 'tectonic communities'. It is argued that the privileging of attracting inward investment into such locales necessarily entails that the elective belonging of the privileged is secured at the expense of the prescribed belonging of the marginal. Keywords : Belonging, Gentrification, Social Class, Social Distance, Tectonic Communitie

The Hyper Suprime-Cam Software Pipeline

In this paper, we describe the optical imaging data processing pipeline developed for the Subaru Telescope's Hyper Suprime-Cam (HSC) instrument. The HSC Pipeline builds on the prototype pipeline being developed by the Large Synoptic Survey Telescope's Data Management system, adding customizations for HSC, large-scale processing capabilities, and novel algorithms that have since been reincorporated into the LSST codebase. While designed primarily to reduce HSC Subaru Strategic Program (SSP) data, it is also the recommended pipeline for reducing general-observer HSC data. The HSC pipeline includes high level processing steps that generate coadded images and science-ready catalogs as well as low-level detrending and image characterizations.Comment: 39 pages, 21 figures, 2 tables. Submitted to Publications of the Astronomical Society of Japa

Mapping the beach beneath the street:digital cartography for the playable city

Maps are an important component within many of the playful and gameful experiences designed to turn cities into a playable infrastructures. They take advantage of the fact that the technology used for obtaining accurate spatial information, such as GPS receivers and magnetometers (digital compasses), are now so wide-spread that they are considered as ‘standard’ sensors on mobile phones, which are themselves ubiquitous. Interactive digital maps, therefore, are are widely used by the general public for a variety of purposes. However, despite the rich design history of cartography digital maps typically exhibit a dominant aesthetic that has been de-signed to serve the usability and utility requirements of turn-by-turn urban navigation, which is itself driven by the proliferation of in-car and personal navigation services. The navigation aesthetic is now widespread across almost all spatial applications, even where a be-spoke cartographic product would be better suited. In this chapter we seek to challenge this by exploring novel neo-cartographic ap-proaches to making maps for use within playful and gameful experi-ences designed for the cities. We will examine the potential of de-sign approaches that can producte not only more aesthetically pleasing maps, but also offer the potential for influencing user be-haviour, which can be used to promote emotional engagement and exploration in playable city experiences

Screening and brief interventions for hazardous and harmful alcohol use in primary care: a cluster randomised controlled trial protocol

A large number of randomised controlled trials in health settings have consistently reported positive effects of brief intervention in terms of reductions in alcohol use. However,although alcohol misuse is common amongst offenders, there is limited evidence of alcohol brief interventions in the criminal justice field. This factorial pragmatic cluster randomised controlledtrial with Offender Managers (OMs) as the unit of randomisation will evaluate the effectiveness and cost-effectiveness of different models of screening to identify hazardous and harmful drinkers in probation and different intensities of brief intervention to reduce excessive drinking in probation clients. Ninety-six OMs from 9 probation areas across 3 English regions (the NorthEast Region (n = 4) and London and the South East Regions (n = 5)) will be recruited. OMs will berandomly allocated to one of three intervention conditions: a client information leaflet control condition (n = 32 OMs); 5-minute simple structured advice (n = 32 OMs) and 20-minute brieflifestyle counselling delivered by an Alcohol Health Worker (n = 32 OMs). Randomisation will be stratified by probation area. To test the relative effectiveness of different screening methods all OMs will be randomised to either the Modified Single Item Screening Questionnaire (M-SASQ) orthe Fast Alcohol Screening Test (FAST). There will be a minimum of 480 clients recruited into the trial. There will be an intention to treat analysis of study outcomes at 6 and 12 months postintervention. Analysis will include client measures (screening result, weekly alcohol consumption,alcohol-related problems, re-offending, public service use and quality of life) and implementation measures from OMs (the extent of screening and brief intervention beyond the minimum recruitment threshold will provide data on acceptability and feasibility of different models of brief intervention). We will also examine the practitioner and organisational factors associated with successful implementation.The trial will evaluate the impact of screening and brief alcohol intervention in routine probation work and therefore its findings will be highly relevant to probation teams and thus the criminal justice system in the UK