Ammunition stocks: Promoting safe and secure storage and disposal.

yes[Introduction]International commitments and measures to prevent, reduce and combat uncontrolled or illicit small arms and light weapons (SALW) holdings and flows are widely understood to encompass not only the weapons but also their ammunition. This is obviously necessary. Thus the UN Programme of Action to Prevent Combat and Eradicate the Illicit Trade in Small Arms and Light Weapons in All Its Aspects (PoA) includes many commitments that apply to ammunition as well as to small and light weapons. Progress in implementing the PoA includes many measures concerning ammunition, including: controls on transfers; preventing diversion to illicit trade; marking, record-keeping and tracing; weapons collection; secure storage; and destruction.1 Unfortunately, progress in implementing the PoA in relation to ammunition remains particularly patchy and inadequate. This is partly because it has too often been considered as a residual category. Negotiations and programmes to control SALW have tended in the first instance to focus on the weapons systems, and have then been deemed to apply, `as appropriate¿, also to ammunition. But control and reduction of ammunition raise their own distinct and challenging issues. Without focused attention, and clarification of what is meant by `appropriate¿, controls and measures on ammunition have often been neglected or mishandled.[Executive summary] The 2001 United Nations Programme of Action to Prevent, Combat and Eradicate the Illicit Trade in Small Arms and Light Weapons in All Its Aspects (PoA) and other associated Small Arms and Light Weapons (SALW) international commitments and measures are widely understood to encompass not only the weapons but also their ammunition. Unfortunately, progress in implementing the PoA in relation to ammunition remains particularly patchy and inadequate. This is partly because it has too often been considered as a residual category. But control and reduction of ammunition raise their own distinct and challenging issues. This relative neglect is resulting in large numbers of avoidable deaths and injuries

Recommendations for International gambling harm-minimisation guidelines: comparison with effective public health policy

Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of basing policy on empirical evidence, international conventions exist for policy on alcohol, tobacco, and illegal substances. This paper examines the evidence of best practice policies to provide recommendations for international guidelines for harm-minimisation policy for gambling, including specific consideration of the specific requirements for policies on Internet gambling. Evidence indicates that many of the public health policies implemented for addictive substances can be adapted to address gambling-related harms. Specifically, a minimum legal age of at least 18 for gambling participation, licensing of gambling venues and activities with responsible gambling and consumer protection strategies mandated, and brief interventions should be available for those at-risk for and experiencing gambling-related problems. However, there is mixed evidence on the effectiveness of limits on opening hours and gambling venue density and increased taxation to minimise harms. Given increases in trade globalisation and particularly the global nature of Internet gambling, it is recommended that jurisdictions take actions to harmonise gambling public health policies

Access to Emergency Contraception After Removal of Age Restrictions

BACKGROUND: Levonorgestrel emergency contraception (EC) is safe and effective for postcoital pregnancy prevention. Starting in 2013, the US Food and Drug Administration removed age restrictions, enabling EC to be sold over the counter to all consumers. We sought to compare the availability and access for female adolescents with the 2012 study, using the same study design. METHODS: Female mystery callers posing as 17-year-old adolescents in need of EC used standardized scripts to telephone 979 pharmacies in 5 US cities. Using 2015 estimated census data and the federal poverty level, we characterized income levels of pharmacy neighborhoods. RESULTS: Of 979 pharmacies, 827 (83%) indicated that EC was available. This proportion did not vary by pharmacy neighborhood income level, nor was significantly different from the 2012 study (P = .78). When examining access, 8.3% of the pharmacies reported it was impossible to obtain EC under any circumstances, which occurred more often in low-income neighborhoods (10.3% vs 6.3%, adjusted odds ratio 1.5; 95% confidence interval 1.20-1.94). This was not significantly different from 2012 (P = .66). Correct information regarding over-the-counter access was conveyed only 51.6% of the time; accuracy did not differ by pharmacy's neighborhood income (47.9% vs 55.3%, adjusted odds ratio 0.89; 95% confidence interval 0.71-1.11) and was not significantly different from 2012 (P = .37). CONCLUSIONS: A majority of pharmacies have EC available; however, barriers to and disparities in access for adolescents persist and have not changed since the previous study despite regulatory changes that were designed to improve access to EC

Older Teen Attitudes Towards Birth Control Access in Pharmacies: A Qualitative Study

Objectives To examine adolescent attitudes toward accessing contraception through a new pharmacist prescribing model in the State of California. Study design In-depth telephone interviews were conducted in summer 2015 with 30 females ages 18 to 19 in California. Participants were recruited using a social media advertisement. Semi-structured interviews utilized open-ended questions to understand teens' experiences with pharmacies, experiences obtaining contraception, and views on pharmacist prescribing of contraception. Responses were transcribed and qualitatively analyzed using an independent-coder method to identify salient themes. Results Participants were ethnically diverse and primarily living in suburban areas. All participants had completed high school and many had completed one year of college. Nearly all participants were supportive of California's new law allowing pharmacist prescribing of contraception. Thematic analyses revealed that while participants were satisfied with traditional service providers and valued those relationships, they appreciated the benefit of increased access and convenience of going directly to a pharmacy. Participants expected increased access to contraception in pharmacies would lead to both personal and societal benefits. They expressed concerns regarding parental involvement, as well as confidentiality in the pharmacy environment and with insurance disclosures. Conclusion Older teens in California are very supportive of pharmacies and pharmacists as direct access points for contraception, but confidentiality concerns were noted. Policy makers and pharmacies can incorporate study findings when designing policies, services, and physical pharmacy spaces to better serve teens. Further research is warranted after pharmacies implement this new service to assess teen utilization and satisfaction as well as outcomes. Implication statement Several states recently passed legislation enabling pharmacists to prescribe contraception and other states are considering similar legislation. Older teens are interested in this additional method of contraceptive access and understanding their perspectives can help guide implementation by states and in individual pharmacies

Pharmacist Outlooks on Prescribing Hormonal Contraception Following Statewide Scope of Practice Expansion

In an effort to increase access to contraception, the pharmacist scope of practice is being expanded to allow prescribing. While this is being accomplished in the United States by a variety of models, legislation that allows pharmacists to prescribe hormonal contraception under a statewide protocol is the most common. This study was designed to explore the outlooks of pharmacists regarding prescribing contraception in the period following the first state legislation and prior to statewide protocol development and availability. A qualitative study of community pharmacists in California using structured phone interviews explored their opinions regarding access to contraception in pharmacies and outlooks regarding prescribing. Data were analyzed using an inductive approach to identify themes. Among the thirty participants, the majority worked in a chain pharmacy. Themes were identified in five overarching domains: Pharmacist barriers, system barriers, patient issues, safety concerns, and pharmacist role. Most were unfamiliar with the new law, yet were interested in expanding access for patient benefit despite foreseeing challenges with implementing the service in community pharmacies. Barriers will need to be addressed and requisite training disseminated widely to facilitate successful implementation and thus improve access on a broad scale. Further research following protocol implementation is needed to understand service implementation, as well as patient utilization and satisfaction

Stabilising urea nitrogen enhances flowering, nitrogen use efficiency, and growth habit for stress tolerance in ornamental plants

Purpose: Supplying plants with nitrogen in ammonium nitrate- or urea-based fertiliser is wasteful: much is degraded before acquisition, releasing environmental pollutants. Preventing urea degradation can reduce pollution and improve crop nitrogen use efficiency. We investigate benefits to ureic stabilisation, on flowering and stress tolerance, as organic nitrogen sources favourably alter biomass partitioning in this regard. Research Method: We test effects of adding chemically stabilised urea to soil, on the physical form and flowering of containerised, greenhouse-grown pelargonium, petunia, pansy and marigold, when transplanting seedlings to larger pots. Efficacies of stabilised urea, non-stabilised urea and industry standard fertiliser are compared under identical total nitrogen supply. The significance of treatment differences is calculated using a one-tailed t-test. Findings: Development is favourably altered by ureic stabilisation. Earliest changes measured are increased root lengths, leaf growth rates and chlorophyll concentrations. Plants then develop more shoots and 25-130% more flowers. Improvements arise partially through increased nitrogen longevity in soil, and partially through positive effects of urea itself on biomass partitioning between organs, and on plant physiology; giving rise to improved commercial attributes (more branches and flowers) and tolerance to stress (more root, less apical dominance, more chlorophyll). Research Limitations: Further research could measure leachate nitrogen content, and compare different methods of ureic stabilisation in more crops. Originality/Value: Urea stabilisation can increase fruit and flower yields, whilst reducing vulnerability to erratic climates, and fertiliser-derived pollution. We propose that urea’s effectiveness arises because plants have evolved strategies to proliferate whilst competing with micro-organisms for organic nitrogen

Predicting dropout in adolescents receiving therapy for depression.

OBJECTIVE: Therapy dropout is a common occurrence, especially in adolescence. This study investigated whether dropout could be predicted from a range of child, family, and treatment factors in a sample of adolescents receiving therapy for depression. METHOD: This study draws on data from 406 participants of the IMPACT study, a randomized controlled trial, investigating three types of therapy in the treatment of adolescent depression. Logistic regression was used to estimate the effects of predictors on the odds of dropout. RESULTS: Few pre-treatment predictors of dropout were found, with the only significant predictors being older age, antisocial behaviour, and lower scores of verbal intelligence. Missed sessions and poorer therapeutic alliance early in treatment also predicted dropout. Most child and family factors investigated were not significantly associated with dropout. CONCLUSIONS: There may be little about depressed adolescents' presentation prior to therapy starting that indicates their risk of dropout. However, within-treatment factors indicated that warning signs of dropout may be identifiable during the initial phase of therapy. Identifying and targeting early treatment indicators of dropout may provide possibilities for improving engagement. Clinical and methodological significance of this article: In the literature, a great deal of attention has been paid to child and family factors that predict therapy dropout, yet in this study, few pre-treatment characteristics were predictive of dropout. However, findings revealed possible warning signs of dropout in the early part of treatment, as poor therapeutic alliance and missed sessions were both found to be predictive of dropout. These findings call for therapists to be aware of such warning signs and clinical guidelines for managing cases at risk of dropout are warranted

Use of mobile apps for teaching and research - implications for digital literacy

This paper reports on the results of an online survey about mobile application (app) use for academic purposes, i.e. teaching and research, by Higher Degree Research (HDR) students and academic staff at one of the eight New Zealand universities. Two thirds of the 138 respondents reported they used apps for academic purposes. In teaching, apps were reported to be used as a means to push information to students. In research, apps appeared to be used to self-organise, collaborate with colleagues, store information, and to stay current with research. This paper presents the survey results and discusses implications for personal information management in education context and opportunities for university library services

Who knows best? Older people’s contribution to understanding and preventing avoidable hospital admissions

A report outlining the findings from a research project into older people's experiences of emergency admission to hospital and the possibilities for prevention. The overall study was funded by the NIHR Research for Patient Benefit programme (PB–PG–0712–28045), albeit the conclusions drawn are those of the research team and do not necessarily reflect those of the NIHR, the Department of Health or the NHS/social care. This research was carried out at the University of Birmingham