Creating an Agency Coordination Plan for Care Compass Network

Care Compass Network (CCN) is a new non-profit organization that partners with local hospitals, community based organizations, and local government units whose aim is to transform the way Medicaid beneficiaries receive benefits from New York State. As a part of New York State’s Delivery System Reform Incentive Program (DSRIP), Care Compass Network collaborates with various agencies throughout a nine- county Performing Provider System (PPS) in the Southern Tier of New York. My capstone project is to develop an Agency Coordination Plan for CCN, which the organization must submit to New York State in order to meet requirements. This plan will guide their current and future partnerships with local government agencies.https://orb.binghamton.edu/mpa_capstone/1028/thumbnail.jp

Wandering womb: a real story of endometriosis

Endometriosis is a chronic disease found in at least ten percent of women worldwide-perhaps as many as 89 million women-making it more common than AIDS and cancer. While it was recognized as a disease as early as 1690, for years women have been battling doctors who insisted that there was nothing wrong, that monthly pain was normal, or that childbirth would solve the problem. Although endometriosis is finally becoming better understood, research still has not yielded a cure or even a reliable treatment. I have lived with the monthly pain of endometriosis since I first began menstruating at the age of twelve. It was a full nine years later that the official diagnosis confirmed by own unofficial one: I had endometriosis. This was not unexpected, as my mother, my aunt, and my sister also had the disease. The diagnosis, however, also placed me within a larger community of women connected by this odd wandering womb disease-a disease in which the lining of the uterus grows in places where it shouldn\u27t, causing such problems as severe monthly pain, pain during sex, infertility, and a host of immune-related diseases. This book examines the proposed causes of endometriosis, how it has been perceived and treated historically, problems with diagnosis, and its connection to infertility. The book examines studies specifically addressing the role of genetics in endometriosis, as well as the emerging evidence that endometriosis is closely tied to the immune system. The book chronicles my own experience with endometriosis in the larger context of the history, pathology, and etiology of the disease. It is a memoir, but also features a significant amount of scientific information, written for the layperson. Its ultimate message is one of admiration for both the disease and the women who have it, and of hope for an eventual cure

How do You Map a Von Karman Vortex Street and How do You Use One to Generate Electricity?

Swirling structures in calmly flowing water inspire a deep, primal sense of peace and well-being. At the same time, images of Poe’s maelstrom in turbulent oceans inspire a sense of terror.1 Throughout the duration of my PhD, modelling the flow through ocean channels full of tidal turbines, I experienced both of those feelings. The mathematical beauty in my work is involved in the equations that I use to describe the ocean flowing through a tidal channel full of turbines.  A von Karman vortex street is the repeating pattern in parallel rows of swirling eddies that form in the wake of an obstruction in flowing fluid. The beauty and terror that eddies inspire in humanity is mirrored by the blessing and curse that these cause for engineers designing tidal turbines. While the fast-flowing water provides the power to drive the turbine, the turbulent vortices in the wake of a turbine put stress on downstream turbines by bending and twisting the blade as a vortex moves past the turbine. Understanding the balance between the power in the flow that can be captured by turbines and the impact on the natural flow by building these turbines was a fundamental part of my research

Validation of the Ceredigion Youth Screening Tool

Risk assessment practices in Youth Justice in England and Wales have been predominantly conducted through the use of Asset (now Asset Plus), a tool that has shown good predictive capacity and case management properties (Baker, 2014; Wilson & Hinks, 2011). However, recent commentary on the use of such metrics with young people has questioned the longer-term benefits when issues such as the labelling/criminalisation of young people and more diversionary policies are brought to account (Bateman, 2011). Evidence suggests that the majority of young people will not continue to engage in challenging/ anti-social behaviour in the medium-term and only a small minority will actually offend in the longer-term, regardless of any interventions they may receive (Haines and Case, 2015). Hence, being able to ?screen out? this larger low-risk cohort could free up resources, whilst also having a longer-term positive impact upon the individual through a reduction in stigmatisation/ labelling effects. This paper outlines the development of the Ceredigion Youth Screening Tool (CYSTem), developed and tested to address the two facets of criminality and vulnerability and closely aligned to the eight key risk indicators identified in the R-N-R literature (Andrews and Bonta, 2010). Initial results with a cohort of 342 young people indicates good convergent and discriminative validity in screening out the lowest level referrals, whilst also identifying 90% of potential future offenders. More importantly, CYSTem is able to screen out approximately 35% of low risk offenders whom are unlikely to require formal evaluation and/or intervention. Suggestions for future scale refinement and the wider implications of screening out low risk referrals are also discussed.publishersversionPeer reviewe

Towards new indicators of disadvantage: deprivation and social exclusion

Studies of Australian poverty have concentrated on comparing people\u27s incomes with poverty lines. By focusing on income alone, poverty research has failed to connect with the actual living standards experienced by those in poverty. This paper addresses the broader issues of poverty and is the final report from stage 2 of a major project assisted by a Linkages grant from the Australian Research Council, and led by Professor Peter Saunders from the Social Policy Research Centre of the University of New South Wales, with Janet Taylor (Brotherhood of St Laurence) and Peter Davidson (ACOSS) as partner investigators. Mission Australia and Anglicare NSW are other industry partners

Heritage Lost:The cultural impact of wildlife crime in South Africa

Crimes against wildlife have come to the fore in South Africa in the past decade – largely due to the dramatic escalation of rhino poaching.  As a major custodian of iconic species such as the Big Five, South Africa is at the core of the illicit wildlife economy.  Since the country is reliant on wildlife tourism for economic development, poaching brings serious financial consequences.  These negative impacts, however, extend far beyond the economy and also protrude into the cultural sphere.  While some South Africans may be unmoved by the plight of the country’s wildlife as a result of a lack of exposure thereto, many feel socially linked to wildlife.  Concerned citizens often consider that future generations will not be able to experience wildlife due to extinction, and will thus be deprived of their rightful cultural inheritance.  The impact of wildlife crime may therefore be seen as a form of cultural victimisation

Examining 'window dressing' : the views of black police associations on recruitment and training

In a previous issue of this journal, Ellis Cashmore (2002 Cashmore, E. 2002. ‘Behind the window dressing: minority ethnic police perspectives on cultural diversity’. Journal of Ethnic and Migration Studies, 28(2): 327–41. [Taylor & Francis Online], [CSA], [Google Scholar] ) discussed two key issues currently confronting police constabularies in England and Wales: the recruitment of minority ethnic officers and civilian staff, and the impact of diversity training now in place for all police officers. Cashmore argued that not only are these policies ineffective in enhancing cultural diversity within constabularies, but that they are harmful, presenting a false outward image of effective action. This article examines Cashmore's arguments and develops them in light of findings from recent research on Black Police Associations (BPAs) in England and Wales. Our findings firstly suggest that, because of heavy involvement with these initiatives and the close relationship BPAs have developed with senior management (in comparison to non-BPA members), they must be considered in any discussion of minority ethnic recruitment and diversity training. In addition, the majority of the officers we interviewed were supportive of current recruitment and training programmes. Secondly, we argue that BPAs are helping to change the nature of the overall police culture to a certain extent. Many minority ethnic officers no longer feel they must downplay their ethnicity as members of constabularies

Towards a self-disseminating vaccine to control vampire bat rabies in its reservoir

Viruses that circulate in wildlife can have devastating health and economic consequences when they enter human and livestock populations. Efforts to mitigate the burden of these zoonotic pathogens currently tend to focus on the spillover hosts; however, since this approach does not address the reservoir of disease, it prolongs the risk of re-emergence as viruses continue to circulate unimpeded in wildlife. Vaccination of wildlife reservoirs has the potential to prevent spillover, but is hampered by the logistical challenge of delivering vaccine to and achieving sufficient coverage in large, reclusive animal populations. Whilst orally available vaccines held inside edible baits have seen success in combating disease in some wildlife reservoirs, unique dietary requirements or behaviours can preclude the use of this strategy. The obligate blood-feeding common vampire bat Desmodus rotundus, reservoir host of rabies virus and primary source of rabies cases throughout Latin America, is one species in which edible baits are unsuitable, and other management strategies have thus far failed. Virally vectored transmissible vaccines which utilise the replicative capabilities of live viral vectors to spread autonomously between hosts, offer a potential solution. However, progress towards real world use of such vaccines is hampered by the selection of vaccine vectors which will prove both safe and efficacious. A betaherpesvirus recently identified in vampire bats (Desmodus rotundus betaherpesvirus; DrBHV) presents a promising candidate vector. In this thesis, I aimed to identify the key characteristics of DrBHV, and evaluate its biological and epidemiological suitability to vector a transmissible vaccine targeting rabies virus. The results presented here are based on field-collected samples, subjected to a combination of PCR, deep sequencing, and computer modelling. In Chapter 2, I aimed to assess the prevalence and host specificity of DrBHV, and the similarity of its genome composition to other betaherpesviruses currently considered for use as vaccine vectors. I used PCR to amplify a conserved region of the herpesvirus genome in saliva samples from Peruvian bats, with 96.9% of vampire bats testing positive, regardless of demographic group. Sanger sequencing of these regions and those from other positive bats revealed specificity of DrBHV to the Phyllostomidae family. Thus, DrBHV is able to spread efficiently within vampire bats, with only rare infection of closely related and cohabitating bat species. Metagenomic sequencing was able to construct a full genome consensus sequence for DrBHV similar in length and composition to betaherpesviruses in other species. This sequencing also showed the presence of multiple strain infections, suggesting that DrBHV may have the capacity to superinfect individuals, evading the host immune response. I aimed to further explore superinfection and DrBHV diversity in Chapter 3, by the amplification and deep sequencing of the highly variable gene encoding glycoprotein B. I identified eleven strains of DrBHV which varied in prevalence and geographic distribution across Peru. The phylogeographic structure of these strains was predictable from both host genetics and landscape topology, informing long-term DrBHV-vectored vaccine deployment strategies. Multi-strain infections were observed in 79% of infected bats and resampling of marked individuals showed strain acquisitions by already infected individuals, implying that pre-existing immunity and strain competition are unlikely to inhibit vaccine spread. Finally, in Chapter 4, I used the strain-specific prevalence data to fit models of DrBHV transmission. I identified the most likely model to include lifelong, persistent infection with cycles of latency and re-activation, a mechanism which would allow vaccinated individuals to boost their own immunity, and continually transmit vaccines to other bats throughout their lifetime. Simulations of vaccine spread show that a DrBHV-vectored vaccine can reach a population equilibrium coverage of >80% after a single introduction of vaccine, resulting in a 95% decrease in the size of rabies outbreaks. Furthermore, ongoing vaccine transmission is able to maintain these levels of vaccine coverage long-term, even in the presence of realistic levels of reversion, negating the need for recurrent and costly vaccination campaigns. In summary, the work presented in this thesis supports DrBHV as a candidate to vector a transmissible vaccine targeting a major source of rabies in Latin America and shows how accessible genomic data can enlighten vector selection and deployment strategies for transmissible vaccines. This work constitutes a fundamental step towards what would be the first deployment of a transmissible vaccine to prevent spillover of a zoonotic virus, thus allowing the management of disease to shift from reactive damage control to proactive prevention

An ecological role for assortative mating under infection?

Wildlife diseases are emerging at a higher rate than ever before meaning that understanding their potential impacts is essential, especially for those species and populations that may already be of conservation concern. The link between population genetic structure and the resistance of populations to disease is well understood: high genetic diversity allows populations to better cope with environmental changes, including the outbreak of novel diseases. Perhaps following this common wisdom, numerous empirical and theoretical studies have investigated the link between disease and disassortative mating patterns, which can increase genetic diversity. Few however have looked at the possible link between disease and the establishment of assortative mating patterns. Given that assortative mating can reduce genetic variation within a population thus reducing the adaptive potential and long-term viability of populations, we suggest that this link deserves greater attention, particularly in those species already threatened by a lack of genetic diversity. Here, we summarise the potential broad scale genetic implications of assortative mating patterns and outline how infection by pathogens or parasites might bring them about. We include a review of the empirical literature pertaining to disease-induced assortative mating. We also suggest future directions and methodological improvements that could advance our understanding of how the link between disease and mating patterns influences genetic variation and long-term population viability.Funding was provided by Marie Curie Fellowship and NERC PhD Studentship