Nutrient Trading in the Chesapeake Bay Region: An Analysis of Supply and Demand

This report provides an overview of nutrient trading programs as they currently exist in the Chesapeake Bay watershed and examines the potential for supply and demand of credits within those markets. In addition, the analysis considers the potential impacts of Bay-wide Total Maximum Daily Loads on nutrient trading - particularly those on the agricultural sector's ability to generate credits

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Understanding HIV care delays in the US South and the role of the social-level in HIV care engagement/retention: a qualitative study

Introduction: In a significant geographical shift in the distribution of HIV infection, the US South - comprising 17 states - now has the greatest number of adults and adolescents with HIV (PLHIV) in the nation. More than 60% of PLHIV are not in HIV care in Alabama and Mississippi, contrasted with a national figure of 25%. Poorer HIV outcomes raise concerns about HIV-related inequities for southern PLHIV, which warrant further study. This qualitative study sought to understand experiences of low-income PLHIV on the AIDS Drug Assistance Program in engagement and retention in continuous HIV care in two sites in Alabama. Methods: The study was designed using grounded theory. Semi-structured interviews with 25 PLHIV explored experiences with care linkage, reported factors and behaviors affecting engagement/retention in continuous HIV care, including socio-economic factors. To triangulate sources, 25 additional interviews were conducted with health and social service providers from the same clinics and AIDS Service Organizations where clients obtained services. Across the narratives, we used the HIV care continuum to map where care delays and drop out occurred. Using open coding, constant comparison and iterative data collection and analysis, we constructed a conceptual model illustrating how participants described their path to HIV care engagement and retention. Results: Most respondents reported delayed HIV care, describing concentric factors: psychological distress, fear, lack of information, substance use, incarceration, lack of food, transport and housing. Stark health system drop out occurred immediately after receipt of HIV test results, with ART initiation generally occurring when individuals became ill. Findings highlight these enablers to care: Alabama\u27s \u27social infrastructure\u27; \u27twinning\u27 medical with social services, \u27social enablers\u27 who actively link PLHIV to care; and \u27enabling spaces\u27 that break down PLHIV isolation, facilitating HIV care linkage/retention. Conclusions: Ryan White-funded programs, together with housing, food and psychological support were pre-conditions for participants\u27 entry and retention in HIV care. The path to achieving continuous HIV care for individuals at risk of lack of entry or delayed HIV care requires robust social-level responses, like in Alabama, that address physical and mental health of clients and directly engage the particular social and economic contexts and vulnerabilities of southern PLHIV

Social Actors Fight the Rising Tide of HIV in U.S. Southern Poor

The greatest number of persons living with HIV in the United States are now living in the South, and they face poorer health outcomes and increased AIDS-related deaths as compared to the rest of the country. The southern United States has a disproportionate share of low-income individuals, with many lacking access to health care and health insurance. Health facilities are also comparatively fewer and more difficult to reach than in other areas of the United States. The impacts of this already poor health infrastructure on low-income people living with HIV in the South can be life-threatening. This policy brief summarizes key findings and recommendations based on qualitative research carried out in 2012 by HIV researchers at the University of Massachusetts Boston

Three Men From Maine : Sir William Pepperrell, Sir William Phips, James Sullivan and A Bit of Old England in New England

Three Men From Maine : Sir William Pepperrell, Sir William Phips, James Sullivan (by John Francis Sprague); and A Bit of Old England in New England (by Bertram E. Packard) Sprague\u27s Journal of Maine History, Dover-Foxcroft, Maine (1924). Contents: Sir William Pepperrell (1696-1759) / Sir William Phips (1651-1695) / James Sullivan (1744-1808) / A Bit of Old England in New England (Gardiner family)https://digitalcommons.usm.maine.edu/me_collection/1096/thumbnail.jp