Initial findings from a mixed-methods feasibility and effectiveness evaluation of the 'Breaking Free Health an Justice' treatment and recovery programme for substance misuse in prison settings

Reshaping substance misuse treatment in prisons is central to the UK Government’s drive to address substance dependence in the prison population and reduce substance-related offending and recidivism. Therefore, a through-care project to support prisoners released from custody to community, “Gateways”, is taking place across North-West England. Amongst support with housing, education, training and employment, Gateways incorporates the Breaking Free Online (BFO) substance misuse treatment programme. Aims: To explore BFO’s potential to provide support to prisoners’ substance misuse recovery and continuity of care post-release, and examine quantitative outcomes provided by prisoners who have used the programme. Methods: Qualitative interviews with prisoners and analyses of quantitative psychometric data collected pre- and post-intervention. Findings: Themes emerging from qualitative data around prisoners’ experiences of engaging with BFO illustrate its potential for use in prison settings and also upon release to the community. Significant quantitative improvements to quality of life, severity of substance dependence and aspects of recovery progression illustrate initial effectiveness of BFO. Conclusions: The BFO programme demonstrates potential in providing effective treatment for offenders with substance misuse difficulties, and specifically in delivering continuity of care following release to the community

Using the ‘recovery’ and ‘rehabilitation’ paradigms to support desistence of substance-involved offenders: Exploration of dual and multi-focus interventions (Invited Paper)

Purpose The links between substance use and offending are well evidenced in the literature, and increasingly, substance misuse recovery is being seen as a central component of the process of rehabilitation from offending, with substance use identified as a key criminogenic risk factor. In recent years, research has demonstrated the commonalities between recovery and rehabilitation, and the possible merits of providing interventions to substance-involved offenders that address both problematic sets of behaviours. The purpose of this paper is to provide an overview of the links between substance use and offending, and the burgeoning literature around the parallel processes of recovery and rehabilitation. Design/methodology/approach This is provided as a rationale for a new treatment approach for substance-involved offenders, Breaking Free Online (BFO), which has recently been provided as part of the “Gateways” throughcare pathfinder in a number of prisons in North-West England. The BFO programme contains specific behaviour change techniques that are generic enough to be applied to change a wide range of behaviours, and so is able to support substance-involved offenders to address their substance use and offending simultaneously. Findings This dual and multi-target intervention approach has the potential to address multiple, associated areas of need simultaneously, streamlining services and providing more holistic support for individuals, such as substance-involved offenders, who may have multiple and complex needs. Practical implications Given the links between substance use and offending, it may be beneficial to provide multi-focussed interventions that address both these behaviours simultaneously, in addition to other areas of multiple and complex needs. Specifically, digital technologies may provide an opportunity to widen access to such multi-focussed interventions, through computer-assisted therapy delivery modalities. Additionally, using digital technologies to deliver such interventions can provide opportunities for joined-up care by making interventions available across both prison and community settings, following offenders on their journey through the criminal justice system. Originality/value Recommendations are provided to other intervention developers who may wish to further contribute to widening access to such dual- and multi-focus programmes for substance-involved offenders, based on the experiences developing and evidencing the BFO programme

Inferred changes in El Niño–Southern Oscillation variance over the past six centuries

It is vital to understand how the El Niño–Southern Oscillation (ENSO) has responded to past changes in natural and anthropogenic forcings, in order to better understand and predict its response to future greenhouse warming. To date, however, the instrumental record is too brief to fully characterize natural ENSO variability, while large discrepancies exist amongst paleo-proxy reconstructions of ENSO. These paleo-proxy reconstructions have typically attempted to reconstruct ENSO's temporal evolution, rather than the variance of these temporal changes. Here a new approach is developed that synthesizes the variance changes from various proxy data sets to provide a unified and updated estimate of past ENSO variance. The method is tested using surrogate data from two coupled general circulation model (CGCM) simulations. It is shown that in the presence of dating uncertainties, synthesizing variance information provides a more robust estimate of ENSO variance than synthesizing the raw data and then identifying its running variance. We also examine whether good temporal correspondence between proxy data and instrumental ENSO records implies a good representation of ENSO variance. In the climate modeling framework we show that a significant improvement in reconstructing ENSO variance changes is found when combining information from diverse ENSO-teleconnected source regions, rather than by relying on a single well-correlated location. This suggests that ENSO variance estimates derived from a single site should be viewed with caution. Finally, synthesizing existing ENSO reconstructions to arrive at a better estimate of past ENSO variance changes, we find robust evidence that the ENSO variance for any 30 yr period during the interval 1590–1880 was considerably lower than that observed during 1979–2009

Polyacrylate grafted graphene oxide nanocomposites for biomedical applications

[[abstract]]Utilizing a reverse micelle process, we have grafted polyacrylate (P) on graphene oxide (GO) to realize polyacrylate grafted graphene oxide (P-GO) nanocomposites, upon whose subsequent reduction, polyacrylate grafted reduced graphene oxide (P-rGO) nanocomposites are achieved. Using techniques such as ultraviolet photoelectron spectroscopy (UPS), x-ray photoelectron spectroscopy, and x-ray absorption near edge structure (XANES) spectroscopy, in conjunction with high-resolution microscopy, Raman spectroscopy, and superconducting quantum interference device analysis, we have studied in depth the electronic, microstructural, electrical, and magnetic properties of these P-GO and P-rGO nanocomposites. While polyacrylate grafting ensures a high solubility of P-GO and P-rGO, the P-rGO nanocomposites additionally show a near doubling of the paramagnetic response (9.6 × 10−3 emu/g) as compared to the r-GO (5.6 × 10−3 emu/g) and P-GO (5.5 × 10−3 emu/g), respectively, at 2 K. The grafting of diamagnetic polyacrylate enhances the magnetic response for the P-GO and P-rGO owing to the increase in the defect states, sp3-type bonding, and enhanced magnetic coupling between the magnetic moments arising due to the presence of nitrogen functionalities. This behavior is further corroborated via the measurements of the electronic structure by XANES and UPS measurements. Thus, the possibility of manipulation of the magnetic behavior along with the abundance of surface functional groups makes both P-GO and P-rGO nanocomposites highly conducive for deriving water-soluble functionalized graphene by linking affinity molecules with polyacrylate backbone for biological and biomedical applications.[[notice]]補正完

Interplay of Cavity Thickness and Metal Absorption in Thin-film InGaN Photonic Crystal Light-emitting Diodes

Thin-film InGaN photonic crystal (PhC) light-emitting diodes (LEDs) with a total semiconductor thickness of either 800 nm or 3.45 μm were fabricated and characterized. Increased directional radiance relative to Lambertian emission was observed for both cases. The 800-nm-thick PhC LEDs yielded only a slight improvement in total light output over the 3.45-μm-thick PhC LEDs. Simulations indicate that, except for ultrathin devices well below 800 nm, the balance between PhC extraction and metal absorption at the backside mirror results in modal extraction efficiencies that are almost independent of device thickness, but highly dependent on mirror reflectivity.Engineering and Applied Science

Layanan Kebidanan Era Jaminan Kesehatan Nasional: Memperkuat Posisi Bidan Praktik Mandiri

Survei Demografi Kesehatan Indonesia (SDKI) 2007 menunjukkan Angka Kematian Ibu (AKI) di Indonesia mencapai 228 kematian per 100.000 kelahiran hidup dan pada 2012 menunjukkan peningkatan menjadi 359 kematian per 100.000 kelahiran hidup. Angka ini sangat jauh dari target Millennium Development Goals (MDGs) yaitu sebesar 102 kematian per 100.000 kelahiran hidup. Menjelang berakhirnya Millennium Development Goals 2015, Indonesia masih menyisakan rapor merah terhadap penurunan target tujuan kelima MDGs, yaitu Angka Kematian Ibu. Sebagai upaya mencapai target tersebut, sejak 1 Januari 2014 pemerintah mengimplementasikan jaminan pelayanan kesehatan kepada perempuan hamil, melahirkan, dan dalam masa nifas melalui Jaminan Ke sehatan Nasional (JKN) yang seharusnya sudah disiapkan sejak Undang-Undang Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial (BPJS) disahkan. Dalam konteks penurunan angka kematian ibu, bidan merupakan tenaga kesehatan yang menjadi ujung tombak dalam pelayanan kesehatan nasional. Bidan tidak hanya diharapkan mampu menghadapi tantangan dalam implementasi JKN, tetapi juga diberikan tanggungjawab dalam menurunkan angka kematian ibu dan mencapai akses universal terhadap pelayanan kesehatan reproduksi. Melalui penelitian Women Research Institute (WRI) mengenai JKN terkait Pelayanan Kebidanan di Jakarta dan Bandung, didapat berbagai temuan terkait tantangan yang dihadapi oleh bidan dan perempuan peserta JKN dalam mengakses pelayanan kebidanan

Pemenuhan Fasilitas Kesehatan Ibu Melahirkan Era Jaminan Kesehatan Nasional

Menjelang berakhirnya Millennium Development Goals (MDGs) 2015, Indonesia masih menyisakan rapor merah terhadap penurunan target kelima MDGs, yaitu Angka Kematian Ibu (AKI). Pemerintah Indonesia berupaya menekan AKI melalui program Jaminan Kesehatan Nasional (JKN). Hal ini dimulai ketika Undang Undang Nomor 24 Tahun 2011 tentang Badan Penyelenggara Jaminan Sosial (BPJS) disahkan, maka secara bertahap semua bentuk perlindungan sosial beralih menjadi Jaminan Kesehatan Nasional (JKN). Termasuk Jaminan Persalinan (Jampersal) yang sebelumnya memberikan pelayanan kebidanan menjadi lebur dalam sistem Jaminan Kesehatan Nasional dan menjadi bagian pelayanan kesehatan ibu dan anak. Antusiasme masyarakat untuk menggunakan layanan kesehatan JKN yang ditanggung BPJS Kesehatan tercermin melalui jumlah peserta yang melebihi target. Data BPJS Kesehatan per 30 Juni 2014 memperlihatkan bahwa jumlah peserta BPJS Kesehatan yang terdaftar telah mencapai 124.553.040 jiwa. Dari total jumlah peserta tersebut sudah memenuhi target kepesertaan dalam setahun, yaitu minimal menjaring sekitar 121 juta jiwa. Namun dalam pelaksanaannya terdapat permasalahan yang dirasakan oleh masyarakat peserta JKN, terutama perempuan yang ingin menggunakan layanan kebidanan. Women Research Institute (WRI) mengidentifikasi beberapa tantangan yang dihadapi oleh perempuan peserta Jaminan Kesehatan Nasional yang ingin memanfaatkan layanan kebidanan

Medicago truncatula and Glomus intraradices gene expression in cortical cells harboring arbuscules in the arbuscular mycorrhizal symbiosis

<p>Abstract</p> <p>Background</p> <p>Most vascular flowering plants have the capacity to form symbiotic associations with arbuscular mycorrhizal (AM) fungi. The symbiosis develops in the roots where AM fungi colonize the root cortex and form arbuscules within the cortical cells. Arbuscules are enveloped in a novel plant membrane and their establishment requires the coordinated cellular activities of both symbiotic partners. The arbuscule-cortical cell interface is the primary functional interface of the symbiosis and is of central importance in nutrient exchange. To determine the molecular events the underlie arbuscule development and function, it is first necessary to identify genes that may play a role in this process. Toward this goal we used the Affymetrix GeneChip^®Medicago Genome Array to document the <it>M. truncatula </it>transcript profiles associated with AM symbiosis, and then developed laser microdissection (LM) of <it>M. truncatula </it>root cortical cells to enable analyses of gene expression in individual cell types by RT-PCR.</p> <p>Results</p> <p>This approach led to the identification of novel <it>M. truncatula </it>and <it>G. intraradices </it>genes expressed in colonized cortical cells and in arbuscules. Within the arbuscule, expression of genes associated with the urea cycle, amino acid biosynthesis and cellular autophagy was detected. Analysis of gene expression in the colonized cortical cell revealed up-regulation of a lysine motif (LysM)-receptor like kinase, members of the GRAS transcription factor family and a symbiosis-specific ammonium transporter that is a likely candidate for mediating ammonium transport in the AM symbiosis.</p> <p>Conclusion</p> <p>Transcript profiling using the Affymetrix GeneChip^®Medicago Genome Array provided new insights into gene expression in <it>M. truncatula </it>roots during AM symbiosis and revealed the existence of several <it>G. intraradices </it>genes on the <it>M. truncatula </it>GeneChip^®. A laser microdissection protocol that incorporates low-melting temperature Steedman's wax, was developed to enable laser microdissection of <it>M. truncatula </it>root cortical cells. LM coupled with RT-PCR provided spatial gene expression information for both symbionts and expanded current information available for gene expression in cortical cells containing arbuscules.</p