Novel Psychoactive Substances in Custodial Settings: A Mixed Method Investigation on the Experiences of People in Prison and Professionals Working With Them

Introduction: Novel Psychoactive Substances (NPS), especially Synthetic Cannabinoid Receptor Agonists (SCRAs), pose a substantial challenge to health and the security of the prison environment. This study analyses the phenomenon from the perspective of people in prison and that of professionals working with them. Methods: A phenomenological qualitative approach was used to analyze self-reported experiences with ‘Spice’ (NPS) among users in prison. A semi-structured questionnaire was also disseminated among professionals working in these settings to better understand (a) the impact of NPS on their work; (b) perceived issues on safety in their working environment; (c) approaches used to tackle the phenomenon and best practices. Results: Psychotic events resulting from the collected Spice accounts (5) were marked by hallucinations, depression, self-harm, and suicidal ideations. Other emerging elements included fear, paranoia, inability to be with others, mistrust, breakdown and other risky behaviors. Overall, 186 responses from prison staff were collected across the country. 67% claimed NPS to have had a deep impact on their work as they commonly witnessed episodes involving outbursts of anger, slurred speech, hallucinations, psychosis, and significant mental deterioration among those in prison. Some 91% have witnessed aggression at least once, with 53% experiencing direct harm. Suggested interventions included enhanced training and education (84%), improved detection (92%) and treatment and support services (93%). Conclusions: Findings highlight the urgent need for joint multi-disciplinary efforts to tackle the exponential escalation of NPS in prisons as well as to facilitate the recovery and societal reintegration of those affected. Phenomenology can be recommended as a valuable methods to study drug induced experiences

Genome-Wide Association Studies of Cognitive and Motor Progression in Parkinson's Disease

BACKGROUND: There are currently no treatments that stop or slow the progression of Parkinson's disease (PD). Case-control genome-wide association studies have identified variants associated with disease risk, but not progression. The objective of the current study was to identify genetic variants associated with PD progression. METHODS: We analyzed 3 large longitudinal cohorts: Tracking Parkinson's, Oxford Discovery, and the Parkinson's Progression Markers Initiative. We included clinical data for 3364 patients with 12,144 observations (mean follow-up 4.2 years). We used a new method in PD, following a similar approach in Huntington's disease, in which we combined multiple assessments using a principal components analysis to derive scores for composite, motor, and cognitive progression. These scores were analyzed in linear regression in genome-wide association studies. We also performed a targeted analysis of the 90 PD risk loci from the latest case-control meta-analysis. RESULTS: There was no overlap between variants associated with PD risk, from case-control studies, and PD age at onset versus PD progression. The APOE ε4 tagging variant, rs429358, was significantly associated with composite and cognitive progression in PD. Conditional analysis revealed several independent signals in the APOE locus for cognitive progression. No single variants were associated with motor progression. However, in gene-based analysis, ATP8B2, a phospholipid transporter related to vesicle formation, was nominally associated with motor progression (P = 5.3 × 10-6 ). CONCLUSIONS: We provide early evidence that this new method in PD improves measurement of symptom progression. We show that the APOE ε4 allele drives progressive cognitive impairment in PD. Replication of this method and results in independent cohorts are needed. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC. on behalf of International Parkinson and Movement Disorder Society

Some cultural consequences in Spain of the Spanish Invasion of Morocco 1859-60

This article argues is a contribution to the study of interrelationships between colonialism, art, and literature in the nineteenth century. The article argues that the Spanish invasion of Morocco in 1859 led to contradictions and tensions within liberal nationalism, not least because of concerns about the tensions between the need for military reassertion of Spain and the respect for the independence of nations. This led to some reconfiguration of Spanish intellectuals' already complex relationship with North Africa and Islam. A major, perhaps surprising consequence of this reconfiguration, was some equation of Moroccan identity with a monotonous surface that was resistant to the gaze. In consequence, the Catalan painter Fortuny's crucial experience of Morocco led him to value near blank surfaces, and thus to make a major contribution to the origins of modern art

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Proceedings of the Sixth Caldwell Conference, St. Catherines Island, Georgia, May 20-22, 2011.

494 pages : illustrations (some color), maps (some color) ; 26 cm. Conference sponsored by the American Museum of Natural History and the St. Catherines Island Foundation.Although this volume covers a broad range of temporal and methodological topics, the chapters are unified by a geographic focus on the archaeology of the Georgia Bight. The various research projects span multiple time periods (including Archaic, Woodland, Mississippian, and contact periods) and many incorporate specialized analyses (such as petrographic point counting, shallow geophysics, and so forth). The 26 contributors conducting this cutting-edge work represent the full spectrum of the archaeological community, including museum, academic, student, and contract archaeologists. Despite the diversity in professional and theoretical backgrounds, temporal periods examined, and methodological approaches pursued, the volume is unified by four distinct, yet interrelated, themes. Contributions in Part I discuss a range of analytical approaches for understanding time, exchange, and site layout. Chapters in Part II model coastal landscapes from both environmental and social perspectives. The third section addresses site-specific studies of late prehistoric architecture and village layout throughout the Georgia Bight. Part IV presents new and ongoing research into the Spanish mission period of this area. These papers were initially presented and discussed at the Sixth Caldwell Conference, cosponsored by the American Museum of Natural History and the St. Catherines Island Foundation, held on St. Catherines Island, Georgia, May 20-22, 2011. TABLE OF CONTENTS: Revising the ¹⁴C reservoir correction for St. Catherines Island, Georgia / David Hurst Thomas, Matthew C. Sanger, and Royce H. Hayes -- An assessment of coastal faunal data from Georgia and northeast Florida / Alexandra L. Parsons and Rochelle A. Marrinan -- Archaeological geophysics on St. Catherines Island : beyond prospection / Ginessa J. Mahar -- Paste variability and clay resource utilization at the Fountain of Youth site, St. Augustine, 8SJ31 / Ann S. Cordell and Kathleen A. Deagan -- Petrographic analysis of pottery and clay samples from the Georgia Bight : evidence of regional social interactions / Neill J. Wallis and Ann S. Cordell -- Past shorelines of the Georgia coast / Chester B. DePratter and Victor D. Thompson -- Coastal landscapes and their relationship to human settlement on the Georgia coast / John A. Turck and Clark R. Alexander -- The role of small islands in foraging economies of St. Catherines Island / Matthew F. Napolitano -- Ever-shifting landscapes : tracking changing spatial usage along coastal Georgia / Matthew C. Sanger -- A paleoeconomic model of the Georgia coast (4500-300 B.P.) / Thomas G. Whitley -- A survey of Irene phase architecture on the Georgia coast / Deborah A. Keene and Ervan G. Garrison -- Life and death on the Ogeechee : a view from the Redbird Creek village / Ryan O. Sipe -- Mission San Joseph de Sapala : mission-period archaeological research on Sapelo Island / Richard W. Jefferies and Christopher R. Moore -- The Guale landscape of Mission Santa Catalina de Guale : 30 years of geophysics at a Spanish colonial mission / Elliot H. Blair -- Missions San Buenaventura and Santa Cruz de Guadalquini : retreat from the Georgia coast / Keith H. Ashley, Vicki L. Rolland, and Robert L. Thunen -- Entangling events : the Guale coastal landscape and the Spanish missions / Victor D. Thompson, John A. Turck, Amanda D. Roberts Thompson, and Chester B. DePratter -- Island and coastal archaeology on the Georgia Bight / Scott M. Fitzpatrick

A multicentre, randomised controlled trial to compare the clinical and cost-effectiveness of Lee Silverman Voice Treatment versus standard NHS Speech and Language Therapy versus control in Parkinson’s disease: a study protocol for a randomised controlled trial

Abstract: Background: Parkinson’s disease (PD) affects approximately 145,519 people in the UK. Speech impairments are common with a reported prevalence of 68%, which increase physical and mental demands during conversation, reliance on family and/or carers, and the likelihood of social withdrawal reducing quality of life. In the UK, two approaches to Speech and Language Therapy (SLT) intervention are commonly available: National Health Service (NHS) SLT or Lee Silverman Voice Treatment (LSVT LOUD®). NHS SLT is tailored to the individuals’ needs per local practice typically consisting of six to eight weekly sessions; LSVT LOUD® comprises 16 sessions of individual treatment with home-based practice over 4 weeks. The evidence-base for their effectiveness is inconclusive. Methods/design: PD COMM is a phase III, multicentre, three-arm, unblinded, randomised controlled trial. Five hundred and forty-six people with idiopathic PD, reporting speech or voice problems will be enrolled. We will exclude those with a diagnosis of dementia, laryngeal pathology or those who have received SLT for speech problems in the previous 2 years. Following informed consent and completion of baseline assessments, participants will be randomised in a 1:1:1 ratio to no-intervention control, NHS SLT or LSVT LOUD® via a central computer-generated programme, using a minimisation procedure with a random element, to ensure allocation concealment. Participants randomised to the intervention groups will start treatment within 4 (NHS SLT) or 7 (LSVT LOUD®) weeks of randomisation. Primary outcome: Voice Handicap Index (VHI) total score at 3 months. Secondary outcomes include: VHI subscales, Parkinson’s Disease Questionnaire-39; Questionnaire on Acquired Speech Disorders; EuroQol-5D-5 L; ICECAP-O; resource utilisation; adverse events and carer quality of life. Mixed-methods process and health economic evaluations will take place alongside the trial. Assessments will be completed before randomisation and at 3, 6 and 12 months after randomisation. The trial started in December 2015 and will run for 77 months. Recruitment will take place in approximately 42 sites around the UK. Discussion: The trial will test the hypothesis that SLT is effective for the treatment of speech or voice problems in people with PD compared to no SLT. It will further test whether NHS SLT or LSVT LOUD® provide greater benefit and determine the cost-effectiveness of both interventions. Trial registration: International Standard Randomised Controlled Trials Number (ISRCTN) Registry, ID: 12421382. Registered on 18 April 2016

A multicentre, randomised controlled trial to compare the clinical and cost-effectiveness of Lee Silverman Voice Treatment versus standard NHS Speech and Language Therapy versus control in Parkinson’s disease: a study protocol for a randomised controlled trial

Abstract: Background: Parkinson’s disease (PD) affects approximately 145,519 people in the UK. Speech impairments are common with a reported prevalence of 68%, which increase physical and mental demands during conversation, reliance on family and/or carers, and the likelihood of social withdrawal reducing quality of life. In the UK, two approaches to Speech and Language Therapy (SLT) intervention are commonly available: National Health Service (NHS) SLT or Lee Silverman Voice Treatment (LSVT LOUD®). NHS SLT is tailored to the individuals’ needs per local practice typically consisting of six to eight weekly sessions; LSVT LOUD® comprises 16 sessions of individual treatment with home-based practice over 4 weeks. The evidence-base for their effectiveness is inconclusive. Methods/design: PD COMM is a phase III, multicentre, three-arm, unblinded, randomised controlled trial. Five hundred and forty-six people with idiopathic PD, reporting speech or voice problems will be enrolled. We will exclude those with a diagnosis of dementia, laryngeal pathology or those who have received SLT for speech problems in the previous 2 years. Following informed consent and completion of baseline assessments, participants will be randomised in a 1:1:1 ratio to no-intervention control, NHS SLT or LSVT LOUD® via a central computer-generated programme, using a minimisation procedure with a random element, to ensure allocation concealment. Participants randomised to the intervention groups will start treatment within 4 (NHS SLT) or 7 (LSVT LOUD®) weeks of randomisation. Primary outcome: Voice Handicap Index (VHI) total score at 3 months. Secondary outcomes include: VHI subscales, Parkinson’s Disease Questionnaire-39; Questionnaire on Acquired Speech Disorders; EuroQol-5D-5 L; ICECAP-O; resource utilisation; adverse events and carer quality of life. Mixed-methods process and health economic evaluations will take place alongside the trial. Assessments will be completed before randomisation and at 3, 6 and 12 months after randomisation. The trial started in December 2015 and will run for 77 months. Recruitment will take place in approximately 42 sites around the UK. Discussion: The trial will test the hypothesis that SLT is effective for the treatment of speech or voice problems in people with PD compared to no SLT. It will further test whether NHS SLT or LSVT LOUD® provide greater benefit and determine the cost-effectiveness of both interventions. Trial registration: International Standard Randomised Controlled Trials Number (ISRCTN) Registry, ID: 12421382. Registered on 18 April 2016