Significant Surface-Water Connectivity of Geographically Isolated Wetlands

We evaluated the current literature, coupled with our collective research expertise, on surface-water connectivity of wetlands considered to be geographically isolated (sensu Tiner Wetlands 23:494–516, 2003a) to critically assess the scientific foundation of grouping wetlands based on the singular condition of being surrounded by uplands. The most recent research on wetlands considered to be geographically isolated shows the difficulties in grouping an ecological resource that does not reliably indicate lack of surface water connectivity in order to meet legal, regulatory, or scientific needs. Additionally, the practice of identifying geographically isolated wetlands based on distance from a stream can result in gross overestimates of the number of wetlands lacking ecologically important surface-water connections. Our findings do not support use of the overly simplistic label of geographically isolated wetlands . Wetlands surrounded by uplands vary in function and surface water connections based on wetland landscape setting, context, climate, and geographic region and should be evaluated as such. We found that the geographically isolated grouping does not reflect our understanding of the hydrologic variability of these wetlands and hence does not benefit conservation of the Nation’s diverse wetland resources. Therefore, we strongly discourage use of categorizations that provide overly simplistic views of surface water connectivity of wetlands fully embedded in upland landscapes

Evaluating 'Prefer not to say' Around Sensitive Disclosures

As people's offline and online lives become increasingly entwined, the sensitivity of personal information disclosed online is increasing. Disclosures often occur through structured disclosure fields (e.g., drop-down lists). Prior research suggests these fields may limit privacy, with non-disclosing users being presumed to be hiding undesirable information. We investigated this around HIV status disclosure in online dating apps used by men who have sex with men. Our online study asked participants (N=183) to rate profiles where HIV status was either disclosed or undisclosed. We tested three designs for displaying undisclosed fields. Visibility of undisclosed fields had a significant effect on the way profiles were rated, and other profile information (e.g., ethnicity) could affect inferences that develop around undisclosed information. Our research highlights complexities around designing for non-disclosure and questions the voluntary nature of these fields. Further work is outlined to ensure disclosure control is appropriately implemented around online sensitive information disclosures

Geographically Isolated Wetlands: Rethinking a Misnomer

Abstract We explore the category Bgeographically isolated wetlands^(GIWs; i.e., wetlands completely surrounded by uplands at the local scale) as used in the wetland sciences. As currently used, the GIW category (1) hampers scientific efforts by obscuring important hydrological and ecological differences among multiple wetland functional types, (2) aggregates wetlands in a manner not reflective of regulatory and management information needs, (3) implies wetlands so described are in some way Bisolated,^an often incorrect implication, (4) is inconsistent with more broadly used and accepted concepts of Bgeographic isolation,^and (5) has injected unnecessary confusion into scientific investigations and discussions. Instead, we suggest other wetland classification systems offer more informative alternatives. For example, hydrogeomorphic (HGM) classes based on wellestablished scientific definitions account for wetland functional diversity thereby facilitating explorations into questions of connectivity without an a priori designation of Bisolation.^Additionally, an HGM-type approach could be used in combination with terms reflective of current regulatory or policymaking needs. For those rare cases in which the condition of being surrounded by uplands is the relevant distinguishing characteristic, use of terminology that does not unnecessarily imply isolation (e.g., Bupland embedded wetlands^) would help alleviate much confusion caused by the Bgeographically isolated wetlands^misnomer

Clinical and cost-effectiveness of contingency management for cannabis use in early psychosis: the CIRCLE randomised clinical trial

Background Cannabis is the most commonly used illicit substance among people with psychosis. Continued cannabis use following the onset of psychosis is associated with poorer functional and clinical outcomes. However, finding effective ways of intervening has been very challenging. We examined the clinical and cost-effectiveness of adjunctive contingency management (CM), which involves incentives for abstinence from cannabis use, in people with a recent diagnosis of psychosis. Methods CIRCLE was a pragmatic multi-centre randomised controlled trial. Participants were recruited via Early Intervention in Psychosis (EIP) services across the Midlands and South East of England. They had had at last one episode of clinically diagnosed psychosis (affective or non-affective); were aged 18 to 36; reported cannabis use in at least 12 out of the previous 24 weeks; and were not currently receiving treatment for cannabis misuse, or subject to a legal requirement for cannabis testing. Participants were randomised via a secure web-based service 1:1 to either an experimental arm, involving 12 weeks of CM plus a six-session psychoeducation package, or a control arm receiving the psychoeducation package only. The total potential voucher reward in the CM intervention was £240. The primary outcome was time to acute psychiatric care, operationalised as admission to an acute mental health service (including community alternatives to admission). Primary outcome data were collected from patient records at 18 months post-consent by assessors masked to allocation. The trial was registered with the ISRCTN registry, number ISRCTN33576045. Results: 551 participants were recruited between June 2012 and April 2016. Primary outcome data were obtained for 272 (98%) in the CM (experimental) group and 259 (95%) in the control group. There was no statistically significant difference in time to acute psychiatric care (the primary outcome) (HR 1.03, 95% CI 0.76, 1.40) between groups. By 18 months, 90 (33%) of participants in the CM group, and 85 (30%) of the control groups had been admitted at least once to an acute psychiatric service. Amongst those who had experienced an acute psychiatric admission, the median time to admission was 196 days (IQR 82, 364) in the CM group and 245 days (IQR 99,382) in the control group. Cost-effectiveness analyses suggest that there is an 81% likelihood that the intervention was cost-effective, mainly resulting from higher mean inpatient costs for the control group compared with the CM group, however the cost difference between groups was not statistically significant. There were 58 adverse events, 27 in the CM group and 31 in the control group. Conclusions Overall, these results suggest that CM is not an effective intervention for improving the time to acute psychiatric admission or reducing cannabis use in psychosis, at least at the level of voucher reward offered

Use of eHealth technologies to enable the implementation of musculoskeletal Models of Care: Evidence and practice

Musculoskeletal (MSK) conditions are the second leading cause of morbidity-related burden of disease globally. EHealth is a potentially critical factor that enables the implementation of accessible, sustainable and more integrated MSK models of care (MoCs). MoCs serve as a vehicle to drive evidence into policy and practice through changes at a health system, clinician and patient level. The use of eHealth to implement MoCs is intuitive, given the capacity to scale technologies to deliver system and economic efficiencies, to contribute to sustainability, to adapt to low-resource settings and to mitigate access and care disparities. We follow a practice-oriented approach to describing the ‘what’ and ‘how’ to harness eHealth in the implementation of MSK MoCs. We focus on the practical application of eHealth technologies across care settings to those MSK conditions contributing most substantially to the burden of disease, including osteoarthritis and inflammatory arthritis, skeletal fragility-associated conditions and persistent MSK pain

A randomised controlled trial of the clinical and cost-effectiveness of a contingency management intervention for reduction of cannabis use and of relapse in early psychosis (CIRCLE): a study protocol for a randomised controlled trial

Background: Around 35–45 % of people in contact with services for a first episode of psychosis are using cannabis. Cannabis use is associated with delays in remission, poorer clinical outcomes, significant increases in the risk of relapse, and lower engagement in work or education. While there is a clear need for effective interventions, so far only very limited benefits have been achieved from psychological interventions. Contingency management (CM) is a behavioural intervention in which specified desired behavioural change is reinforced through financial rewards. CM is now recognised to have a substantial evidence base in some contexts and its adoption in the UK is advocated by the National Institute for Health and Care Excellence (NICE) guidance as a treatment for substance or alcohol misuse. However, there is currently little published data testing its effectiveness for reducing cannabis use in early psychosis. Methods: CIRCLE is a two-arm, rater-blinded randomised controlled trial (RCT) investigating the clinical and cost-effectiveness of a CM intervention for reducing cannabis use among young people receiving treatment from UK Early Intervention in Psychosis (EIP) services. EIP service users (n = 544) with a recent history of cannabis use will be recruited. The experimental group will receive 12 once-weekly CM sessions, and a voucher reward if urinalysis shows that they have not used cannabis in the previous week. Both the experimental and the control groups will be offered an Optimised Treatment as Usual (OTAU) psychoeducational package targeting cannabis use. Assessment interviews will be performed at consent, at 3 months, and at 18 months. The primary outcome is time to relapse, defined as admission to an acute mental health service. Secondary outcomes include proportion of cannabis-free urine samples during the intervention period, severity of positive psychotic symptoms, quality-adjusted life years, and engagement in work or education. Discussion: CIRCLE is a RCT of CM for cannabis use in young people with a recent history of psychosis (EIP service users) and recent cannabis use. It is designed to investigate whether the intervention is a clinically and cost-effective treatment for cannabis use. It is intended to inform future treatment delivery, particularly in EIP settings

Mangrove and Mangrove-Fringe Wetlands in Ostional, Nicaragua: Current Conditions and Pathways Forward

Mangrove forests have traditionally protected the coastline of Ostional, a rural Nicaraguan fishing village, from degradation of fishery habitat and onshore effects of storm surge. Swaths of mangrove were converted to agricultural use before the ecological role of these mangroves was understood. We assessed the soils, hydrology, and vegetation of the intact mangrove and adjacent converted mangrove to inform a nonprofit conservation agency (Paso Pacifico) regarding the potential for ecosystem function restoration in this landscape

Mangrove and Mangrove-Fringe Wetlands in Ostional, Nicaragua: Current Conditions and Pathways Forward

Mangrove forests have traditionally protected the coastline of Ostional, a rural Nicaraguan fishing village, from degradation of fishery habitat and onshore effects of storm surge. Swaths of mangrove were converted to agricultural use before the ecological role of these mangroves was understood. We assessed the soils, hydrology, and vegetation of the intact mangrove and adjacent converted mangrove to inform a nonprofit conservation agency (Paso Pacifico) regarding the potential for ecosystem function restoration in this landscape

Water Sources and Hydrodynamics of Closed-Basin Depressions, Cook Inlet Region, Alaska

Among the most prevalent wetland and deep-water habitats in Alaska are ponds, many of which are subarctic ponds occurring as moraine, ice-scour, or dead-ice depressions. Many are closed-basin depressions, where surface-water inflows and outflows are negligible. The objective of this study was to quantify the water sources and hydrodynamics of these subarctic ponds, particularly with respect to the role they play in groundwater recharge. There are two types of ponds on the study site. Perched-precipitation ponds have inflows by melt water and direct precipitation, outflows by evapotranspiration and groundwater recharge, and are seasonally inundated because surface water is perched above the water table and infiltration through the low-permeability surficial deposits to the water table is slow. Flow-through ponds have inflows by melt water, direct precipitation, and groundwater discharge, outflows by evapotranspiration and groundwater recharge, and are perennially inundated because of groundwater throughflow. Both are groundwater recharge focal points. This is particularly true for perched-precipitation ponds, where net groundwater recharge rates were 215% larger than in flow-through ponds, and 332% larger than in the broader landscape. Most of the additional groundwater recharge occurs immediately following breakup, as aeolian-transported snow trapped in the depressions melts which results in enhanced groundwater recharge rates