Clinical trial: a primary-care-based model for the delivery of anti-viral treatment to injecting drug users infected with hepatitis C.

BACKGROUND: Injecting drug use is the main risk factor for hepatitis C virus (HCV) infection. Secondary-care-based strategies for the management of HCV do not effectively target this vulnerable population. AIMS: To evaluate the feasibility, safety and efficacy of a primary-care-based model for the delivery of HCV services including anti-viral therapy to injecting drug users. METHODS: A partnership between a clinical nurse specialist employed by, and working under the supervision of, a secondary-care-based hepatitis service and drug workers and general practitioners. Three hundred and fifty-three clients attending opiate substitution clinics in primary care were evaluated. Outcomes were: number of new diagnoses of HCV infection, number of clients assessed as suitable for anti-viral treatment, and number of patients treated. RESULTS: 174 HCV antibody positive clients were identified. Of these, 124 were chronically infected with HCV of whom only six had been previously identified. Of 118 new chronically-infected individuals, 86 entered the care pathway, 43 were assessed as suitable for anti-viral treatment and 30 have so far been treated. Outcomes of anti-viral treatment are comparable with those obtained in secondary care settings. CONCLUSION: A primary-care-based model offers a new paradigm for the treatment of HCV in injecting drug users.

Foraging, food selection and worker size in the seed harvesting ant Messor bouvieri.

Interactions among granivores and seeds depend on the foraging behaviour and morphology of the granivores and on the attributes and availability of seeds. We investigated seed selection by the seed harvesting ant Messor bouvieri in three adjacent plant communities in Spain by relating the harvested seeds to those in the seed rain. Preference was positively correlated with seed size and abundance which accounted for 43% and 20% of the variance respectively. Contrary to predictions of central place foraging theory, the size of seeds harvested did not increase with distance from the nest. Inclusion of a less-preferred item in the diet was more strongly related to the abundance of more-preferred items (60% of the variance) than the abundance of the less-preferred item (14% of the variance). Worker size accounted for 20-30% of the variance in the size of harvested seeds, although small workers did not appear to be constrained by load size for the range of seeds available. The body size of ants was significantly larger in the community with the greatest proportion of large seeds, although this was not due to their ability to carry larger loads or due to the greater force required to crush these seeds. The strong preference of M. bouvieri for large seeds may have important consequences for the plant communities in which they forage.

The effects of selective logging on the distribution of moths in a Bornean rainforest.

The effects of selective logging on the diversity and species composition of moths were investigated by sampling from multiple sites in primary forest, both understorey and canopy, and logged forest at Danum Valley, Sabah, Malaysia. The diversity of individual sites was similar, although rarefied species richness of logged forest was 17% lower than for primary forest (understorey and canopy combined). There was significant heterogeneity in faunal composition and measures of similarity (NESS index) among primary forest understorey sites which may be as great as those between primary understorey and logged forest. The lowest similarity values were between primary forest understorey and canopy, indicating a distinct canopy fauna. A number of species encountered in the logged forest were confined to, or more abundant in, the canopy of primary forest. Approximately 10% of species were confined to primary forest across a range of species' abundances, suggesting this is a minimum estimate for the number of species lost following logging. The importance of accounting for heterogeneity within primary forest and sampling in the canopy when measuring the effects of disturbance on tropical forest communities are emphasized.

Building your own lifeboat: working-class male offenders talk about economic crime.

This study examines the ways in which a group of working-class men serving custodial sentences and probation orders for money-related crimes talk about criminal activity and the implications of this talk for their gender identity. Using a critical social-psychological approach, we carried out nine semi-structured group discussions in probation centres and one open prison and then analyzed the transcripts using a combination of grounded theory and discourse analytic methods. The men critiqued dominant constructions of crime and argued that their criminal activity was justified in two related ways. First, they drew on a discourse of male breadwinning to argue that they were expected to provide for their families. Second, they argued that those now suffering under the broken promises made by the State should not be expected to conform to its rules. For the majority of men, earning through crime was talked about as a last resort and the parameters of 'what they did to whom' were informed by a Robin Hood-type cultural narrative. Finally, the study contextualizes and critically explores these patterns of discourse and their rhetorical use from a historical and structural perspective.