Publications by authors named "Peter Miller"

346 Publications

Environmental heterogeneity promotes individual specialisation in habitat selection in a widely distributed seabird.

J Anim Ecol 2021 Sep 7. Epub 2021 Sep 7.

School of Environmental Sciences, University of Liverpool, Liverpool, UK.

Individual specialisations in behaviour are predicted to arise where divergence benefits fitness. Such specialisations are more likely in heterogeneous environments where there is both greater ecological opportunity and competition-driven frequency dependent selection. Such an effect could explain observed differences in rates of individual specialisation in habitat selection, as it offers individuals an opportunity to select for habitat types that maximise resource gain while minimising competition; however, this mechanism has not been tested before. Here, we use habitat selection functions to quantify individual specialisations while foraging by black-legged kittiwakes Rissa tridactyla, a marine top predator, at 15 colonies around the United Kingdom and Ireland, along a gradient of environmental heterogeneity. We find support for the hypothesis that individual specialisations in habitat selection while foraging are more prevalent in heterogeneous environments. This trend was significant across multiple dynamic habitat variables that change over short time-scales and did not arise through site fidelity, which highlights the importance of environmental processes in facilitating behavioural adaptation by predators. Individual differences may drive evolutionary processes, and therefore these results suggest that there is broad scope for the degree of environmental heterogeneity to determine current and future population, species and community dynamics.
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http://dx.doi.org/10.1111/1365-2656.13588DOI Listing
September 2021

Bright spots as climate-smart marine spatial planning tools for conservation and blue growth.

Glob Chang Biol 2021 Sep 6. Epub 2021 Sep 6.

Marine Institute, Oranmore, Ireland.

Marine spatial planning that addresses ocean climate-driven change ('climate-smart MSP') is a global aspiration to support economic growth, food security and ecosystem sustainability. Ocean climate change ('CC') modelling may become a key decision-support tool for MSP, but traditional modelling analysis and communication challenges prevent their broad uptake. We employed MSP-specific ocean climate modelling analyses to inform a real-life MSP process; addressing how nature conservation and fisheries could be adapted to CC. We found that the currently planned distribution of these activities may become unsustainable during the policy's implementation due to CC, leading to a shortfall in its sustainability and blue growth targets. Significant, climate-driven ecosystem-level shifts in ocean components underpinning designated sites and fishing activity were estimated, reflecting different magnitudes of shifts in benthic versus pelagic, and inshore versus offshore habitats. Supporting adaptation, we then identified: CC refugia (areas where the ecosystem remains within the boundaries of its present state); CC hotspots (where climate drives the ecosystem towards a new state, inconsistent with each sectors' present use distribution); and for the first time, identified bright spots (areas where oceanographic processes drive range expansion opportunities that may support sustainable growth in the medium term). We thus create the means to: identify where sector-relevant ecosystem change is attributable to CC; incorporate resilient delivery of conservation and sustainable ecosystem management aims into MSP; and to harness opportunities for blue growth where they exist. Capturing CC bright spots alongside refugia within protected areas may present important opportunities to meet sustainability targets while helping support the fishing sector in a changing climate. By capitalizing on the natural distribution of climate resilience within ocean ecosystems, such climate-adaptive spatial management strategies could be seen as nature-based solutions to limit the impact of CC on ocean ecosystems and dependent blue economy sectors, paving the way for climate-smart MSP.
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http://dx.doi.org/10.1111/gcb.15827DOI Listing
September 2021

Clonal hematopoiesis in patients receiving chimeric antigen receptor T-cell therapy.

Blood Adv 2021 08;5(15):2982-2986

Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.

Chimeric antigen receptor (CAR) T-cells have emerged as an efficacious modality in patients with non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). Clonal hematopoiesis of indeterminate potential (CHIP), a state in which mutations in hematopoietic cells give rise to a clonal population of cells, is more common in patients exposed to cytotoxic therapies, has been shown to influence inflammatory immune programs, and is associated with an adverse prognosis in patients with NHL and MM receiving autologous transplantation. We therefore hypothesized that CHIP could influence clinical outcomes in patients receiving CAR T-cell therapy. In a cohort of 154 patients with NHL or MM receiving CAR T-cells, we found that CHIP was present in 48% of patients and associated with increased rates of complete response and cytokine release syndrome severity, but only in patients younger than age 60 years. Despite these differences, CHIP was not associated with a difference in progression-free or overall survival, regardless of age. Our data suggest that CHIP can influence CAR T-cell biology and clinical outcomes, but, in contrast to autologous transplantation, CHIP was not associated with worse survival and should not be a reason to exclude individuals from receiving this potentially life-prolonging treatment.
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http://dx.doi.org/10.1182/bloodadvances.2021004554DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361461PMC
August 2021

Optimization of the Urea Linker of Triazolopyridazine MMV665917 Results in a New Anticryptosporidial Lead with Improved Potency and Predicted hERG Safety Margin.

J Med Chem 2021 Aug 3;64(15):11729-11745. Epub 2021 Aug 3.

Department of Chemistry, Saint Louis University, Saint Louis, Missouri 63103, United States.

Cryptosporidiosis is caused by infection of the small intestine by parasites, resulting in severe diarrhea, dehydration, malabsorption, and potentially death. The only FDA-approved therapeutic is only partially effective in young children and ineffective for immunocompromised patients. Triazolopyridazine MMV665917 is a previously reported anti- screening hit with efficacy but suffers from modest inhibition of the hERG ion channel, which could portend cardiotoxicity. Herein, we describe our initial development of structure-activity relationships of this novel lead series with a particular focus on optimization of the piperazine-urea linker. We have discovered that piperazine-acetamide is a superior linker resulting in identification of SLU-2633, which has an EC of 0.17 μM, an improved projected margin versus hERG, prolonged pharmacokinetic exposure in small intestine, and oral efficacy with minimal systemic exposure. SLU-2633 represents a significant advancement toward the identification of a new effective and safe treatment for cryptosporidiosis.
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http://dx.doi.org/10.1021/acs.jmedchem.1c01136DOI Listing
August 2021

Preventing Thrombohemorrhagic Complications of Heparinized COVID-19 Patients Using Adjunctive Thromboelastography: A Retrospective Study.

J Clin Med 2021 Jul 14;10(14). Epub 2021 Jul 14.

Department of Internal Medicine, Indiana University School of Medicine South Bend Campus, Notre Dame, IN 46617, USA.

Background: The treatment of COVID-19 patients with heparin is not always effective in preventing thrombotic complications, but can also be associated with bleeding complications, suggesting a balanced approach to anticoagulation is needed. A prior pilot study supported that thromboelastography and conventional coagulation tests could predict hemorrhage in COVID-19 in patients treated with unfractionated heparin or enoxaparin, but did not evaluate the risk of thrombosis.

Methods: This single-center, retrospective study included 79 severely ill COVID-19 patients anticoagulated with intermediate or therapeutic dose unfractionated heparin. Two stepwise logistic regression models were performed with bleeding or thrombosis as the dependent variable, and thromboelastography parameters and conventional coagulation tests as the independent variables.

Results: Among all 79 patients, 12 (15.2%) had bleeding events, and 20 (25.3%) had thrombosis. Multivariate logistic regression analysis identified a prediction model for bleeding (adjusted R = 0.787, < 0.001) comprised of increased reaction time ( = 0.016), decreased fibrinogen ( = 0.006), decreased D-dimer ( = 0.063), and increased activated partial thromboplastin time ( = 0.084). Multivariate analysis of thrombosis identified a weak prediction model (adjusted R = 0.348, < 0.001) comprised of increased D-dimer ( < 0.001), decreased reaction time ( = 0.002), increased maximum amplitude ( < 0.001), and decreased alpha angle ( = 0.014). Adjunctive thromboelastography decreased the use of packed red cells ( = 0.031) and fresh frozen plasma ( < 0.001).

Conclusions: Significantly, this study demonstrates the need for a precision-based titration strategy of anticoagulation for hospitalized COVID-19 patients. Since severely ill COVID-19 patients may switch between thrombotic or hemorrhagic phenotypes or express both simultaneously, institutions may reduce these complications by developing their own titration strategy using daily conventional coagulation tests with adjunctive thromboelastography.
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http://dx.doi.org/10.3390/jcm10143097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303660PMC
July 2021

Cancer and COVID-19: analysis of patient outcomes.

Future Oncol 2021 Sep 15;17(26):3499-3510. Epub 2021 Jul 15.

Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112 USA.

We sought to investigate the outcomes associated with COVID-19 disease in cancer patients. We conducted a retrospective cohort study of laboratory-confirmed COVID-19 patients. Of the 206 patients included, 57 had at least one preexisting malignancy. Cancer patients were older than noncancer patients. Of the 185 discharged cases, cancer patients had a significantly higher frequency of unplanned reintubation (7.1% vs 0.9%, p < 0.049), and required longer hospital stay (8.58 ± 6.50 days versus 12.83 ± 11.44 days, p < 0.002). Regression analysis revealed that obesity and active smoking were associated with an increased risk of mortality. Outcomes in COVID-19 appear to be driven by obesity as well as active smoking, with no difference in mortality between cancer and noncancer patients.
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http://dx.doi.org/10.2217/fon-2021-0121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284249PMC
September 2021

Male Barroom Aggression among Members of the Australian Construction Industry: Associations with Heavy Episodic Drinking, Trait Variables and Masculinity Factors.

Int J Environ Res Public Health 2021 06 24;18(13). Epub 2021 Jun 24.

Centre for Addiction and Mental Health, University of Toronto, London, ON N6G 4X8, Canada.

Past research indicates heavy episodic drinking (HED), trait aggression, male honour and conformity to masculine norms are risk factors for male barroom aggression (MBA) perpetration. However, little is known about the impact of these variables on experiences of MBA victimization. Further, data derived previously, particularly in relation to perpetration have come from relatively low-risk samples comprising university students, limiting the generalizability of findings to other, at-risk male groups. Thus, the present study assessed the impact of the aforementioned variables as well as personality constructs of impulsivity and narcissism on both the perpetration of and victimization from MBA among a high-risk sample sourced from male members of the Australian construction industry. A purposive sample of Australian male construction workers aged 18 to 69 years ( = 476, M = 25.90, SD = 9.44) completed individual interviews at their current place of employment or while training at various trade schools in Geelong and Melbourne, Victoria, Australia. Items related to past month HED, past year experiences of verbal and physical MBA (perpetration and victimization), trait aggression's four factors (physical, verbal, anger, hostility), impulsivity, narcissism, male honour and conformity to masculine norms. Participants reported high levels of verbal (24.2%) and physical (21%) MBA perpetration and verbal (33.6%) and physical (31.1%) MBA victimization. Hierarchical binary logistic regression analyses identified HED as the strongest predictor of aggression involvement, while trait physical aggression, trait anger, narcissism and conformity to norms endorsing violence and a need to win were significantly and positively associated with MBA perpetration. The present study reinforces the key relationships between heavy drinking and aspects of personality and MBA, while also highlighting narcissism as a risk factor for barroom aggression perpetration. Indeed, personality profiles and HED appear to exert stronger influences on MBA perpetration than socially constructed masculinity factors, most of which were unrelated to aggression involvement in bars, clubs or pubs.
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http://dx.doi.org/10.3390/ijerph18136769DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297199PMC
June 2021

Size does matter: An exploration of the relationship between licensed venue capacity and on-premise assaults.

Alcohol Clin Exp Res 2021 06 22;45(6):1298-1303. Epub 2021 Jun 22.

School of Psychology, Deakin University, Geelong, Vic., Australia.

Aims: Venue capacity has been proposed as a factor associated with increased number of violent incidents on-premises, though no specific research has demonstrated this association, and instead has tended to focus on the relationship between crowding and aggression. The aim of current paper is to investigate the association between venue capacity and the number of violent incidents on-premises.

Methods: Venue capacity data (the maximum capacity listed on the liquor license) were obtained for all venues in central Melbourne from 2010 until 2016. These data were then matched with police-recorded on-premises assaults that occurred within high-alcohol hours (Friday and Saturday 8 pm-6 am) inside the venue.

Results: Analyses were conducted on 5729 venue-years (yearly assault counts per venue, per year) across central Melbourne. Compared with venues that have a maximum capacity of between 0 and 100 patrons, venues with higher capacities have increasingly more recorded assaults. Venues with maximum capacities between 501 and 1000 are 6.1 times more likely to have an assault recorded compared with venues with a maximum capacity between 0 and 100. Further, each additional high-alcohol hour that a venue can be open for is associated with a 72% increase in the number of recorded assaults.

Conclusions: Greater venue capacity was found to be strongly associated with an increased risk of violent incidents for any given venue. This was further exacerbated by late-night trading which substantially adds to the risk of assaults inside the venue.
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http://dx.doi.org/10.1111/acer.14621DOI Listing
June 2021

A randomized controlled trial of the effectiveness of combinations of 'why to reduce' and 'how to reduce' alcohol harm-reduction communications.

Addict Behav 2021 10 3;121:107004. Epub 2021 Jun 3.

Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, Australia. Electronic address:

Introduction: Alcohol is a major source of harm worldwide. The aim of this study was to experimentally assess the effects of exposing Australian adult drinkers to combinations of 'why to reduce' and 'how to reduce' alcohol harm-reduction messages.

Methods: Three online surveys were administered over six weeks: Time 1 at baseline (n = 7,995), Time 2 at three weeks post-baseline (n = 4,588), and Time 3 at six weeks post-baseline (n = 2,687). Participants were randomly assigned to one of eight conditions: (1) a control condition; (2) a 'why to reduce' television advertisement; (3-5) one of three 'how to reduce' messages referring to the following protective behavioral strategies (PBSs): Keep count of your drinks, Decide how many drinks and stick to it, It's okay to say no; and (6-8) the television advertisement combined with each PBS message individually. Intention-to-treat analyses were conducted to determine effects of condition assignment on changes over time in attempts to reduce alcohol consumption and amount of alcohol consumed.

Results: Participants assigned to the 'TV ad' and 'TV ad + Keep count of your drinks PBS' conditions reported significant increases in attempts to reduce alcohol consumption. Only participants assigned to the 'TV ad + Keep count of your drinks PBS' condition exhibited a significant reduction in alcohol consumed (-0.87 drinks per person per week).

Conclusions: Well-executed 'why to reduce' alcohol harm-reduction advertisements can encourage drinkers to attempt to reduce their alcohol consumption. These ads may be effectively supplemented by specific 'how to reduce' messages designed to encourage drinkers to monitor their intake.
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http://dx.doi.org/10.1016/j.addbeh.2021.107004DOI Listing
October 2021

Public opinion of alcohol industry corporate political activities.

Aust N Z J Public Health 2021 Jun 24;45(3):283-289. Epub 2021 May 24.

Public Health Advocacy Institute, Curtin University, Western Australia.

Objectives: This study explores Australian public awareness and attitudes towards political donations from the alcohol industry and the 'revolving door' of politicians into industry or lobbyist positions.

Methods: Data were collected via a nationwide online panel.

Results: In total, n=1,044 participants completed the survey. More than half of the participants agreed that donations are made to influence government policy and to support the interests of the industry. More than half of the participants did not believe that it is appropriate for political parties to accept donations from the alcohol industry or for politicians to attend alcohol industry-hosted events. One-third of the participants agreed that public officials (including politicians) with a role in health policy should never be allowed to work or lobby for the alcohol industry (31.7%) and one-third endorsed a waiting time of 4-5 years.

Discussion: There were demographic differences in the views that participants held of the alcohol industry and the relationship between the government and the alcohol industry. The findings suggest that the laws and controls governing industry-government relationships should be reviewed to ensure they are in line with public expectations, accompanied by education programs including a focus on corporate political activity by the alcohol industry.
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http://dx.doi.org/10.1111/1753-6405.13121DOI Listing
June 2021

The impact of late-night alcohol restrictions on ambulance call-outs in entertainment precincts.

Drug Alcohol Rev 2021 Jul 20;40(5):708-716. Epub 2021 May 20.

Eastern Health Clinical School, Monash University, Melbourne, Australia.

Introduction: In July 2016, the Queensland Government introduced the Tackling Alcohol-Fuelled Violence (TAFV) policy to address alcohol-related harm in entertainment precincts [safe night precincts (SNP)]. Additional measures were introduced in February and July 2017. We aim to examine the impact of the policy on Queensland Ambulance Service call-outs in Fortitude Valley, Surfers Paradise, all 15 SNP suburbs combined and statewide.

Methods: Auto-regressive integrated moving average (ARIMA) models and seasonal ARIMA (SARIMA) models were developed to test the impact of TAFV policy stages on monthly number of ambulance call-outs during high alcohol hours (HAH; Friday and Saturday nights, 20:00-05:59) over an 8-year period (July 2011-June 2019).

Results: The average number of monthly call-outs in HAH reduced by 26.2% in Fortitude Valley, 21.1% in Surfers Paradise and 4.3% in all 15 SNP suburbs combined. In Fortitude Valley, there was a significant decline in the monthly number of call-outs between 00:00 and 02:59 and across all HAH combined when examining the cumulative effect of the policy stages; and significant declines between 03:00 and 05:59 after each stage and cumulatively. Across the 15 SNP suburbs combined, there was a significant decline in call-outs between 03:00 and 05:59 after the third policy stage (July 2017). There were no significant declines in Surfers Paradise or statewide.

Discussion And Conclusions: Overall, the introduction of the TAFV policy stages in Queensland had a limited effect on ambulance call-outs during HAH. However, there were some notable declines in HAH ambulance call-outs in some of the state's key nightlife suburbs.
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http://dx.doi.org/10.1111/dar.13308DOI Listing
July 2021

The impact of changes to alcohol policy on patron drinking behaviours in Queensland.

Drug Alcohol Rev 2021 Jul 20;40(5):728-737. Epub 2021 May 20.

School of Psychology, Deakin University, Geelong, Australia.

Introduction: On 1 July 2016, stage 1 of the Tackling Alcohol-Fuelled Violence (TAFV) policy was introduced in Queensland, Australia and included restricted alcohol service to 03:00 in dedicated entertainment precincts (safe night precincts or SNPs). During stage 2 (from 1 February 2017), the number of extended trading permits (i.e. trading until 05:00) per venue were reduced; and during stage 3 (from 1 July 2017), networked identification scanners were mandated for late-night venues. We aim to examine whether patron drinking behaviours in two key SNPs changed significantly following stages 2 and 3.

Methods: The study design was repeated cross-sectional, with three data collection (policy) stages. Patrons street surveys were conducted in Fortitude Valley (n = 2066) and Cairns (n = 1021) SNPs between July 2016 and November 2018. Linear or negative binomial regressions were conducted to examine changes in three key outcomes: blood alcohol concentration (BAC) reading, proportion of pre-drinkers and number of pre-drinks.

Results: We found no significant difference in BAC reading, proportion of pre-drinkers or number of pre-drinks at stages 2 and 3 of the policy compared to baseline in Fortitude Valley. In Cairns, we found significant reductions in patron BAC at stage 3 of the policy, and female BAC at stages 2 and 3 compared to baseline; while the proportion of females pre-drinking significantly reduced by half in stage 2.

Discussion And Conclusions: Despite evidence of some reductions in alcohol consumption, high levels of intoxication remain, suggesting harm reduction may be more difficult to achieve in these drinkers.
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http://dx.doi.org/10.1111/dar.13299DOI Listing
July 2021

The impact of liquor legislation changes on police-recorded serious assault in Queensland, Australia.

Drug Alcohol Rev 2021 Jul 20;40(5):717-727. Epub 2021 May 20.

School of Psychology, Deakin University, Geelong, Australia.

Introduction And Aims: In July 2016, the Queensland government introduced the Tackling Alcohol-Fuelled Violence policy, with some amendments over the subsequent 12 months. Key measures included restricting alcohol sales to 3 am in safe night precincts (SNPs), limiting the annual number of extended trading permits (i.e. trading until 5 am) and introducing mandatory networked identification scanners. We examined the policy impact on the number of serious assaults across all combined SNPs and in five major SNPs: Fortitude Valley, Cairns, Surfers Paradise, Toowoomba and Townsville.

Design And Methods: Using police data (July 2009-June 2019), we examined the impact of the policy on serious assaults during high-alcohol hours (high-alcohol hours; 8 pm-6 am, Friday and Saturday), employing time series methods.

Results: Across all SNPs there was no significant change in the number of serious assaults during overall high-alcohol hours, but a significant 49% decrease in the monthly number of serious assaults between 3 am and 6 am on Friday/Saturday. A significant decrease in the monthly count of serious assaults during high-alcohol hours and specifically 3 am-6 am on Friday/Saturday was evident in Fortitude Valley SNP (52%), and during high-alcohol hours in Toowoomba SNP (43%).

Discussion And Conclusions: Although results were mixed, there was evidence of some promising reductions in alcohol-related violence in SNPs. It is likely that factors such as extended trading permits (venues not closing at 3 am), continued drinking in some venues and 24-h trading in casinos have reduced the potential impacts seen elsewhere.
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http://dx.doi.org/10.1111/dar.13181DOI Listing
July 2021

The impact of Queensland's Tackling Alcohol-Fuelled Violence Policy on nightlife and business trade.

Drug Alcohol Rev 2021 Jul 20;40(5):746-754. Epub 2021 May 20.

School of Psychology, Deakin University, Geelong, Australia.

Introduction: Key elements of the Queensland Government's Tackling Alcohol Fuelled Violence (TAFV) policy included the introduction of mandatory identification (ID) scanners and reduced trading hours for licensed venues located within Safe Night Precincts (SNP). These measures raised concerns among licensed venue owners and other key stakeholders regarding the potential negative impact of the policy on business trade and nightlife. Using multiple data sources, this paper examines the impact of the TAFV policy on nightlife and trade in three Queensland SNPs: Fortitude Valley, Surfers Paradise and Cairns.

Methods: Data from ID scanners (2017-2019), foot traffic counters (2017-2019) and counts of liquor licences issued (2015-2019) were used to measure the policy's impact on the number of patrons and licensed venues within SNPs. Joinpoint regression and auto-regressive integrated moving average models were developed to examine changes in these measures over time.

Results: No significant changes were observed in the number of ID scans over time, although Surfers Paradise showed a 0.13% reduction during high alcohol hours. Foot traffic counts from Fortitude Valley showed no significant impact of the policy on the number of patrons in the area during high-alcohol hours. The number of commercial hotel licenses increased in all three regions, and commercial other-bar licenses increased in all regions except Surfers Paradise SNP where numbers remained stable.

Discussion And Conclusions: Patterns in trading and the number of patrons within SNPs were mostly stable or increasing following the implementation of the TAFV policy beyond normal fluctuations.
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http://dx.doi.org/10.1111/dar.13271DOI Listing
July 2021

The impact of the Queensland Government's Tackling Alcohol-Fuelled Violence Policy on live music performances in Fortitude Valley, Brisbane, Australia.

Drug Alcohol Rev 2021 Jul 20;40(5):738-745. Epub 2021 May 20.

Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

Introduction: The Queensland Government's Tackling Alcohol-Fuelled Violence (TAFV) Policy was met with concern from live music venue owners who feared decreased patronage and associated revenue. This study investigates the impact of the TAFV Policy on live music venues and performances in Fortitude Valley, an inner-city suburb of Brisbane, Australia recognised as a hub of live music performances.

Methods: Data relating to live music venues and performances in Fortitude Valley for the 2000-2018 financial years were obtained from the Australasian Performing Right Association (APRA AMCOS), who maintains an online data portal allowing artists to enter performance details to collect royalty payments. These data were supplemented with six precinct mapping audits of live music venues operating in the Fortitude Valley Safe Night Precinct between July 2016 and September 2019.

Results: APRA AMCOS data show increases in the number of reported live music performances and venues in Fortitude Valley between 2000 and 2019. Precinct mapping audits show minimal changes in the operation of live music venues in Fortitude Valley between 2016 and 2019.

Discussion And Conclusions: As the first study to independently document the impact of licenced venue trading hour changes on live music, this study shows the number of live performances reported to APRA AMCOS and original live music venues trading in the Fortitude Valley Safe Night Precinct were unchanged by the introduction of the TAFV. The study highlights the value of using performance returns and venue audits to track live music in a contested policy space.
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http://dx.doi.org/10.1111/dar.13274DOI Listing
July 2021

Summarising the impacts of the Queensland Alcohol-related violence and Night-Time Economy (QUANTEM) project.

Drug Alcohol Rev 2021 Jul 19;40(5):755-760. Epub 2021 May 19.

Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

This closing commentary to the special section presents an overview of the Queensland Alcohol-related violence and Night-Time Economy Monitoring evaluation findings in comparison to those from other jurisdictions where similar interventions have been implemented (such as Sydney and Newcastle), and especially with previous studies that have used similar evaluation methodologies, such as the Dealing with Alcohol and the Night-Time Economy study. Overall, the articles documented promising reductions in alcohol-related harm, building on the existing evidence base for multi-pronged interventions in entertainment districts. Importantly, this is the first comprehensive investigation to also look at impacts on nightlife-related business and findings demonstrated, that there were improvements for many businesses. There are substantial policy implications for Queensland and other jurisdictions (nationally and globally) wanting to reduce late night alcohol-related harm in entertainment districts.
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http://dx.doi.org/10.1111/dar.13272DOI Listing
July 2021

Assessing the impact of Queensland's late-night alcohol restrictions using health system data.

Drug Alcohol Rev 2021 Jul 19;40(5):698-707. Epub 2021 May 19.

School of Psychology, Deakin University, Geelong, Australia.

Introduction And Aims: In an attempt to reduce alcohol-related harm in night-time entertainment precincts, the Queensland state government (Australia) introduced the Tackling Alcohol-Fuelled Violence strategy in July 2016, including restrictions on late-night service of alcohol and-later-compulsory ID scanners at venues. In this article, we examined the impact of these changes on emergency department (ED) presentations and hospital admissions for alcohol-related harm.

Design And Methods: We used data on ED presentations (July 2009-June 2019) and hospital admissions (July 2009-December 2018). Interrupted time series models using seasonal auto-regressive integrated moving average methods were developed to test the impact of the policy change on presentations for alcohol intoxication, any injury or maxillofacial fractures, and admissions for rates of assault-related injuries or maxillofacial fractures. Analyses were conducted using state-wide Queensland data with a sub-analysis focussing on major Brisbane hospitals.

Results: The introduction of 3 am last drinks and mandatory ID scanners had no significant impact on most outcome measures, either across the state or within Brisbane. State-wide, there was a significant decline in ED injury presentations following the introduction of mandatory ID scanners.

Discussion And Conclusions: The introduction of the Tackling Alcohol-Fuelled Violence strategy in Queensland Safe Night Precincts was potentially associated with a small reduction in injury presentations to EDs. The lack of other impacts may relate to the relative lack of specificity in health system data, which challenges in the implementation of the Tackling Alcohol-Fuelled Violence policies or other local factors.
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http://dx.doi.org/10.1111/dar.13182DOI Listing
July 2021

Queensland Alcohol-related violence and Night-time Economy Monitoring (QUANTEM): Rationale and overview.

Drug Alcohol Rev 2021 Jul 18;40(5):693-697. Epub 2021 May 18.

Centre for Health Services Research, The University of Queensland, Brisbane, Australia.

This commentary introduces the special section on the outcomes of the Queensland Alcohol-related violence and Night-time Economy Monitoring project and outlines the political and policy context of the interventions put in place under the Queensland government's Tackling Alcohol-Fuelled Violence strategy. The development of the strategy was informed by alcohol policy initiatives trialled in other major Australian cities over the past two decades. The articles in this special section examine the impact of the Tackling Alcohol-Fuelled Violence policy stages on alcohol-related harms and local economies across selected entertainment precincts (Safe Night Precincts). A rich array of data were utilised, including administrative health and justice data, data reflective of nightlife trading (i.e. foot traffic data, ID scanner data and live music performances) and street surveys. Findings have implications for research, policy and practice and demonstrate the need for comprehensive evaluations that can accommodate the complexities of modern alcohol policy in Australia.
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http://dx.doi.org/10.1111/dar.13270DOI Listing
July 2021

Current Trends and Challenges for Rapid SMART Diagnostics at Point-of-Site Testing for Marine Toxins.

Sensors (Basel) 2021 Apr 3;21(7). Epub 2021 Apr 3.

Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, 19 Chlorine Gardens, Belfast BT9 5DL, UK.

In the past twenty years marine biotoxin analysis in routine regulatory monitoring has advanced significantly in Europe (EU) and other regions from the use of the mouse bioassay (MBA) towards the high-end analytical techniques such as high-performance liquid chromatography (HPLC) with tandem mass spectrometry (MS). Previously, acceptance of these advanced methods, in progressing away from the MBA, was hindered by a lack of commercial certified analytical standards for method development and validation. This has now been addressed whereby the availability of a wide range of analytical standards from several companies in the EU, North America and Asia has enhanced the development and validation of methods to the required regulatory standards. However, the cost of the high-end analytical equipment, lengthy procedures and the need for qualified personnel to perform analysis can still be a challenge for routine monitoring laboratories. In developing regions, aquaculture production is increasing and alternative inexpensive Sensitive, Measurable, Accurate and Real-Time (SMART) rapid point-of-site testing (POST) methods suitable for novice end users that can be validated and internationally accepted remain an objective for both regulators and the industry. The range of commercial testing kits on the market for marine toxin analysis remains limited and even more so those meeting the requirements for use in regulatory control. Individual assays include enzyme-linked immunosorbent assays (ELISA) and lateral flow membrane-based immunoassays (LFIA) for EU-regulated toxins, such as okadaic acid (OA) and dinophysistoxins (DTXs), saxitoxin (STX) and its analogues and domoic acid (DA) in the form of three separate tests offering varying costs and benefits for the industry. It can be observed from the literature that not only are developments and improvements ongoing for these assays, but there are also novel assays being developed using upcoming state-of-the-art biosensor technology. This review focuses on both currently available methods and recent advances in innovative methods for marine biotoxin testing and the end-user practicalities that need to be observed. Furthermore, it highlights trends that are influencing assay developments such as multiplexing capabilities and rapid POST, indicating potential detection methods that will shape the future market.
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http://dx.doi.org/10.3390/s21072499DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038394PMC
April 2021

The combined impact of higher-risk on-license venue outlet density and trading hours on serious assaults in night-time entertainment precincts.

Drug Alcohol Depend 2021 06 12;223:108720. Epub 2021 Apr 12.

School of Psychology, Deakin University, Geelong Waterfront Campus, Vic, 3220, Australia.

Background: Night-time entertainment precincts (NEPs) are clusters of higher-risk on-licence venues, that pose a significant burden on health and social order services. Outlet density and trading hours are two of the most well researched contributors to alcohol availability within NEPs; increases in outlet density and late-night trading hours within NEPs have been independently associated with increased assaults. This is the first study to examine both factors across cities to predict alcohol-related assaults.

Methods: Licensing data were used to investigate the effect of outlet density and trading hours on police recorded serious assaults in nine NEPs (9 cross-sectional units) across Queensland from January 2010 to July 2018 at monthly intervals (102 longitudinal units). Multi-level models were used to determine i) whether precinct-level trading hours moderated the relationship between outlet density and serious assaults; and ii) the impact of outlets closing before 12am, 3am, and 5am on serious assaults.

Findings: The positive relationship between outlet density and assaults was stronger in precincts with trading hours ending at 5am compared to 3am (IRR = 1.01, p = 0.03). The amount of venues closing before 12am was associated with reduced numbers of assaults (IRR = 0.97, p = 0.04), while venues closing between 12:01am-3am and 3:01am-5am were associated with increased assaults (IRR = 1.02, p<0.01; IRR = 1.01, p = 0.02).

Conclusions: Late night service of alcohol creates more harm in areas of high outlet density, whereas early closing venues in areas where outlet density is low is associated with reduced number of assaults. This relationship should be taken into account in the development of future alcohol policies.
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http://dx.doi.org/10.1016/j.drugalcdep.2021.108720DOI Listing
June 2021

Spontaneous Selection of Drug Resistance in a Calf Model of Infection.

Antimicrob Agents Chemother 2021 05 18;65(6). Epub 2021 May 18.

Cellular, Molecular and Biomedical Sciences Graduate Program, University of Vermont, Burlington, Vermont, USA

The intestinal protozoan is a leading cause of diarrheal disease and mortality in young children. There is currently no fully effective treatment for cryptosporidiosis, which has stimulated interest in anticryptosporidial development over the last ∼10 years, with numerous lead compounds identified, including several tRNA synthetase inhibitors. Here, we report the results of a dairy calf efficacy trial of the methionyl-tRNA ( MetRS [MetRS]) synthetase inhibitor 2093 and the spontaneous emergence of drug resistance. Dairy calves experimentally infected with initially improved with 2093 treatment, but parasite shedding resumed in two of three calves on treatment day 5. Parasites shed by each recrudescent calf had different amino acid-altering mutations in the gene encoding MetRS (), yielding either an aspartate 243-to-glutamate (D243E) or a threonine 246-to-isoleucine (T246I) mutation. Transgenic parasites engineered to have either the D243E or T246I MetRS mutation using CRISPR/Cas9 grew normally but were highly 2093 resistant; the D243E and T246I mutant-expressing parasites, respectively, had 2093 half-maximal effective concentrations (ECs) that were 613- and 128-fold that of transgenic parasites with wild-type MetRS. In studies using recombinant enzymes, the D243E and T246I mutations shifted the 2093 IC >170-fold. Structural modeling of MetRS based on an inhibitor-bound MetRS crystal structure suggested that the resistance mutations reposition nearby hydrophobic residues, interfering with compound binding while minimally impacting substrate binding. This is the first report of naturally emerging drug resistance, highlighting the need to address the potential for anticryptosporidial resistance and establish strategies to limit its occurrence.
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http://dx.doi.org/10.1128/AAC.00023-21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8316126PMC
May 2021

New-onset atrial arrhythmias associated with mortality in black and white patients hospitalized with COVID-19.

Pacing Clin Electrophysiol 2021 05 16;44(5):856-864. Epub 2021 Apr 16.

Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, Louisiana, USA.

Background: Specific details about cardiovascular complications, especially arrhythmias, related to the coronavirus disease of 2019 (COVID-19) are not well described.

Objective: We sought to evaluate the incidence and predictive factors of cardiovascular complications and new-onset arrhythmias in Black and White hospitalized COVID-19 patients and determine the impact of new-onset arrhythmia on outcomes.

Methods: We collected and analyzed baseline demographic and clinical data from COVID-19 patients hospitalized at the Tulane Medical Center in New Orleans, Louisiana, between March 1 and May 1, 2020.

Results: Among 310 hospitalized COVID-19 patients, the mean age was 61.4 ± 16.5 years, with 58,7% females, and 67% Black patients. Black patients were more likely to be younger, have diabetes and obesity. The incidence of cardiac complications was 20%, with 9% of patients having new-onset arrhythmia. There was no significant difference in cardiovascular outcomes between Black and White patients. A multivariate analysis determined age ≥60 years to be a predictor of new-onset arrhythmia (OR = 7.36, 95% CI [1.95;27.76], p = .003). D-dimer levels positively correlated with cardiac and new-onset arrhythmic event. New onset atrial arrhythmias predicted in-hospital mortality (OR = 2.99 95% CI [1.35;6.63], p = .007), a longer intensive care unit length of stay (mean of 6.14 days, 95% CI [2.51;9.77], p = .001) and mechanical ventilation duration(mean of 9.08 days, 95% CI [3.75;14.40], p = .001).

Conclusion: Our results indicate that new onset atrial arrhythmias are commonly encountered in COVID-19 patients and can predict in-hospital mortality. Early elevation in D-dimer in COVID-19 patients is a significant predictor of new onset arrhythmias. Our finding suggest continuous rhythm monitoring should be adopted in this patient population during hospitalization to better risk stratify hospitalized patients and prompt earlier intervention.
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http://dx.doi.org/10.1111/pace.14226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251330PMC
May 2021

Attitudinal factors associated with drink counting.

Drug Alcohol Rev 2021 Sep 14;40(6):1056-1060. Epub 2021 Mar 14.

Food Policy Division, The George Institute for Global Health, Sydney, Australia.

Introduction: 'Count your drinks' is a protective behavioural strategy (PBS) that has been found to be effective in reducing alcohol consumption. Previous research has shown that females, older people and low-risk drinkers are more likely to use this strategy, but little is known about the attitudinal factors associated with engaging in drink counting. This information is important for developing effective interventions to encourage use of this PBS. The aim of this paper was to assess whether the following attitudinal factors are associated with frequency of enactment of the 'Count your drinks' PBS: (i) perceived ease of use; (ii) perceived effectiveness; (iii) personal relevance; and (iv) believability.

Methods: A total of 683 Australian drinkers completed an online survey assessing demographic variables, alcohol consumption, frequency of drink counting and attitudes to the 'Count your drinks' PBS. A hierarchical regression analysis was used to determine whether the attitudinal factors were associated with frequency of enactment after controlling for demographic and alcohol-related factors.

Results: Attitudes to the 'Count your drinks' PBS accounted for 28% of the variance in reported frequency of drink counting. Perceptions of personal relevance, ease of use and effectiveness were found to be significantly associated with frequency of enactment.

Discussion And Conclusions: Interventions designed to encourage drinkers to count their drinks should aim to increase the perceived personal relevance, ease of use and effectiveness of this strategy.
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http://dx.doi.org/10.1111/dar.13277DOI Listing
September 2021

Otoacoustic Emissions Evoked by the Time-Varying Harmonic Structure of Speech.

eNeuro 2021 Mar-Apr;8(2). Epub 2021 Apr 13.

Department of Bioengineering and Centre for Neurotechnology, Imperial College London, London SW7 2AZ, United Kingdom

The human auditory system is exceptional at comprehending an individual speaker even in complex acoustic environments. Because the inner ear, or cochlea, possesses an active mechanism that can be controlled by subsequent neural processing centers through descending nerve fibers, it may already contribute to speech processing. The cochlear activity can be assessed by recording otoacoustic emissions (OAEs), but employing these emissions to assess speech processing in the cochlea is obstructed by the complexity of natural speech. Here, we develop a novel methodology to measure OAEs that are related to the time-varying harmonic structure of speech [speech-distortion-product OAEs (DPOAEs)]. We then employ the method to investigate the effect of selective attention on the speech-DPOAEs. We provide tentative evidence that the speech-DPOAEs are larger when the corresponding speech signal is attended than when it is ignored. Our development of speech-DPOAEs opens up a path to further investigations of the contribution of the cochlea to the processing of complex real-world signals.
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http://dx.doi.org/10.1523/ENEURO.0428-20.2021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046024PMC
July 2021

The impact of a minimum unit price on wholesale alcohol supply trends in the Northern Territory, Australia.

Aust N Z J Public Health 2021 Feb;45(1):26-33

National Drug Research Institute, Curtin University, Western Australia.

Objective: The Northern Territory (NT) Government introduced a minimum unit price (MUP) of $1.30 per standard drink (10g pure alcohol) explicitly aimed at reducing the consumption of cheap wine products from October 2018. We aimed to assess the impact of the NT MUP on estimates of beverage-specific population-adjusted alcohol consumption using wholesale alcohol supply data.

Methods: Interrupted time series analyses were conducted to examine MUP effects on trends in estimated per capita alcohol consumption (PCAC) for cask wine, total wine and total alcohol, across the NT and in the Darwin/Palmerston region.

Results: Significant step decreases were found for cask wine and total wine PCAC in Darwin/Palmerston and across the Northern Territory. PCAC of cask wine decreased by 50.6% in the NT, and by 48.8% in Darwin/Palmerston compared to the prior year. PCAC for other beverages (e.g. beer) were largely unaffected by MUP. Overall, PCAC across the Territory declined, but not in Darwin/Palmerston.

Conclusion: With minimal implementation costs, the Northern Territory Government's MUP policy successfully targeted and reduced cask wine and total wine consumption. Cask wine, in particular, almost halved in Darwin/Palmerston where the impact of the MUP was able to be determined and considering other interventions. Implications for public health: Implementation of a minimum unit price for retail alcohol sales is a cost-effective way to reduce the consumption of high alcohol content and high-risk products, such as cheap cask wine.
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http://dx.doi.org/10.1111/1753-6405.13055DOI Listing
February 2021

Reversible cerebral vasoconstriction syndrome (RCVS) caused by over-the-counter calcium supplement ingestion.

BMJ Case Rep 2021 Jan 28;14(1). Epub 2021 Jan 28.

Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunological Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA

A 59-year-old woman was found unresponsive at home. Initial neurologic examination revealed aphasia and right-sided weakness. Laboratory results demonstrated a serum calcium level of 17.3 mg/dL (corrected serum calcium for albumin concentration was 16.8 mg/dL). Extensive workup for intrinsic aetiology of hypercalcemia was unrevealing. Further discussion with family members and investigation of the patient's home for over-the-counter medications and herbal supplements revealed chronic ingestion of calcium carbonate tablets. CT angiogram of the brain revealed multifocal intracranial vascular segmental narrowing, which resolved on a follow-up cerebral angiogram done 2 days later. These findings were consistent with reversible cerebral vasoconstriction syndrome.Appropriate blood pressure control with parenteral agents, calcium channel blockade with nimodipine and supportive care therapies resulted in significant improvement in neurologic status. By discharge, patient had near-complete resolution of neurologic symptoms.
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http://dx.doi.org/10.1136/bcr-2019-233877DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845714PMC
January 2021

Coercive Controlling Behaviors and Reporting Physical Intimate Partner Violence in Australian Women: An Exploration.

Violence Against Women 2021 Jan 28:1077801220985932. Epub 2021 Jan 28.

Deakin University, Geelong, Victoria, Australia.

This study explores two approaches to measuring coercive controlling behaviors (CCBs)-counting how many different CCB types and examining the frequency of each CCB experienced-to examine their utility in explaining the relationship between CCBs and physical intimate partner violence (IPV). Australian women aged 18-68 years ( = 739; = 31.58, = 11.76) completed an online survey. Count and frequency CCB approaches yielded similar significant associations with increased physical IPV. Both approaches suggest that frightening behaviors in particular are significantly indicative of also experiencing physical IPV; however, when you count CCB types, public name-calling becomes important, whereas when you examine the frequency of each CCB type, jealousy/possessiveness becomes important. These findings suggest differential utility between measures of CCBs, which examine the frequency of specific CCB types and which count CCB types, and that both approaches are useful in understanding how coercion and control relate to physical violence within intimate relationships.
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http://dx.doi.org/10.1177/1077801220985932DOI Listing
January 2021

Alcohol Accessibility and Family Violence-related Ambulance Attendances.

J Interpers Violence 2021 Jan 18:886260520986262. Epub 2021 Jan 18.

Monash University, Box Hill, Australia.

There is substantial evidence supporting the association between alcohol license density and violent crime. However, the impact of different types of alcohol licenses on intimate partner and family violence is sparse. We explored the associations between access to alcohol outlets, and family and intimate partner violence using paramedic clinical records, given this service is often the first to respond to acute crises. Coded ambulance attendance data from 694 postcodes in Victoria, Australia, from July 1, 2016 to June 30, 2018 where alcohol or another drug, mental health or self-harm associated with family or intimate partner violence was indicated were examined. A hybrid model of spatial autoregressive and negative binomial zero-inflated Poisson-based count regression models was used to examine associations with alcohol outlet density and socioeconomic factors. We found that access to a liquor license outlet was significantly associated with family violence-related attendances across all types of outlets, including on-premise (late night) licenses ( = 1.73, SE: 0.18), restaurant licenses ( = 0.83, SE: 0.28), and packaged liquor licenses ( = 0.62, SE: 0.06). Our results demonstrate a significant relationship between alcohol-related harms in the context of family violence and provides evidence of the relationship between alcohol-related family violence in both victims and perpetrators. The findings of this study highlight the need for public health interventions such as licensing policy and town planning changes to reduce these harms by restricting alcohol availability.
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http://dx.doi.org/10.1177/0886260520986262DOI Listing
January 2021

Cardiac MRI to Manage Atrial Fibrillation.

Arrhythm Electrophysiol Rev 2020 Dec;9(4):189-194

Tulane Research Innovation for Arrhythmia Discoveries (TRIAD), Heart and Vascular Institute, Tulane University School of Medicine, LA, US.

AF is the most common arrhythmia in clinical practice. In addition to the severe effect on quality of life, patients with AF are at higher risk of stroke and mortality. Recent studies have suggested that atrial and ventricular substrate play a major role in the development and maintenance of AF. Cardiac MRI has emerged as a viable tool for interrogating the underlying substrate in AF patients. Its advantage includes localisation and quantification of structural remodelling. Cardiac MRI of the atrial substrate is not only a tool for management and treatment of arrhythmia, but also to individualise the prevention of stroke and major cardiovascular events. This article provides an overview of atrial imaging using cardiac MRI and its clinical implications in the AF population.
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http://dx.doi.org/10.15420/aer.2020.21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7788396PMC
December 2020

A systematic mapping review of interventions to improve adolescent mental health literacy, attitudes and behaviours.

Early Interv Psychiatry 2021 Jan 3. Epub 2021 Jan 3.

School of Psychology, Faculty of Health, Deakin University Geelong, Waterfront Campus, Geelong, Victoria, Australia.

Aim: The onset of mental illness is most common in adolescence, therefore mental health promotion efforts frequently target this age group. Evaluation literature in this area is largely segmented into specific domains in terms of settings, countries, and/or groups of young people, but an overall understanding and comparison across these areas is lacking. The current review aims to provide such an overview of interventions/programs which attempt to improve adolescents' mental health literacy, attitudes/stigma and behaviours.

Methods: A systematic mapping review synthesized the strengths and weaknesses of published interventions/programs to improve mental health outcomes in youth. Ten databases and grey literature sources were searched, and results were categorized according to sample, location/setting, type of information presented, delivery and testing procedures, mental health outcome/s evaluated, and limitations.

Results: One hundred and forty articles met the inclusion criteria; 126 were original records and 14 were reviews. Mental health literacy and attitudes/stigma were examined most frequently, and studies were predominantly conducted in school-based environments and high income economies. Intervention/program effectiveness varied across outcome/s measured, setting, and control group usage, with mental health literacy exhibiting the most positive changes overall. Common limitations included no long-term follow up or control group inclusion.

Conclusions: Despite generally positive changes seen throughout studies in this area, effectiveness differed across a range of methodological domains. Most research is conducted in schools and higher income economies, but the lack of investigation in other contexts (i.e., internet or community) or lower income countries suggests our understanding in this area is constrained.
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http://dx.doi.org/10.1111/eip.13109DOI Listing
January 2021
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