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Background The objective of this study was to investigate the neutralizing response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VoC) during coronavirus disease 2019 (COVID-19) convalescence and after vaccination. Methods COVID-19-convalescent and -naïve individuals were tested for neutralizing activity against SARS-CoV-2 VoC Alpha, Beta, Gamma, and Delta at 1 and 7 months postinfection and 4–6 weeks after BNT162b2 vaccination. Results Vaccination induced a high neutralizing response in naïve individuals. Interestingly, vaccination of convalescent patients induced a boosted response that was able to neutralize all VoC at high titers. Conclusions Vaccination with BNT162b2 induced high levels of neutralization against SARS-CoV-2 VoC in most patients; this is especially beneficial in COVID-19-convalescent individuals.

The humid highlands of the Galapagos are the islands’ most biologically productive regions and a key habitat for endemic animal and plant species. These areas are crucial for the region’s food security and for the control of invasive plants, but little is known about the spatial distribution of its land cover. We generated a baseline high-resolution land cover map of the agricultural zones and their surrounding protected areas. We combined the high spatial resolution of PlanetScope images with the high spectral resolution of Sentinel-2 images in an object-based classification using a RandomForest algorithm. We used images collected with an unmanned aerial vehicle (UAV) to verify and validate our classified map. Despite the astounding diversity and heterogeneity of the highland landscape, our classification yielded useful results (overall Kappa: 0.7, R2: 0.69) and revealed that across all four inhabited islands, invasive plants cover the largest fraction (28.5%) of the agricultural area, followed by pastures (22.3%), native vegetation (18.6%), food crops (18.3%), and mixed forest and pioneer plants (11.6%). Our results are consistent with historical trajectories of colonization and abandonment of the highlands. The produced dataset is designed to suit the needs of practitioners of both conservation and agriculture and aims to foster collaboration between the two areas.

Introduction and Aims The Australian Treatment Outcomes Profile (ATOP) is a brief instrument that assesses a range of substance use, health and well-being measures over the past 28 days. Previously, it has been validated in general adult Australian alcohol and other drug (AOD) treatment populations. However, the increasing number of older-aged clients attending AOD treatment warrants the instrument to be validated for this population. The aim of this study was to validate the ATOP for use in older AOD populations, by comparing it with validated ‘gold standard’ measures used in older populations. Design and Methods A convenience sample of 99 participants aged ≥50 attending specialist AOD services in Sydney, Australia were administered the ATOP by a researcher, along with alcohol use (AUDIT) and health questionnaires [Physical Health Questionnaire-15, 12-item short-form Health Survey (SF-12) and Geriatric Depression Scale]. Results The ATOP items had strong agreement with the comparison instruments. The highest correlation was between the 28 days alcohol use and the AUDIT. ATOP psychological health scores highly correlated with the SF-12 mental health subscale and the Geriatric Depression Scale, and ATOP physical health scores significantly correlated with the SF-12 physical health subscale and the Physical Health Questionnaire-15. The ATOP Quality of Life score significantly correlated with all health measures. Discussion and Conclusions The ATOP has good concurrent validity with other validated substance use and health measures in an older population. Comparison with general older populations demonstrated the poorer health of this group of older AOD clients in particular.[Lintzeris N, Monds L A, Rivas G, Leung S, Withall A, Draper B. The Australian Treatment Outcomes Profile instrument as a clinical tool for older alcohol and other drug clients: A validation study. Drug Alcohol Rev 2016;35:673-677]

Productive development policies (PDPs) are notoriously hard. They involve a daunting level of technical detail, require public-private collaboration, are in constant danger of capture, and demand time consistency hard to achieve in a politically volatile region. Nevertheless, the potential of PDPs to revitalize the region’s economic performance and spur productivity growth cannot be ignored. This book takes an in-depth look at 17 cases involving productive development agencies from Argentina, Brazil, Costa Rica and Uruguay, identifying key features of institutional design and agency-level practices that make success more likely in this difficult policy arena. Careful study of these experiences might help successful productive development policies gain currency across the region. The cases in this book should not be seen as the exceptions that prove the rule of lackluster PDP performance, but rather as examples that demonstrate the rule can be broken.

The increasing movement of people and resources around the planet has allowed numerous organisms to avoid natural dispersal barriers and become introduced to new sites. In some cases, introduced species become invasive, rapidly expanding their populations and becoming extremely noxious, causing significant ecological impacts and economic harm. Despite the many examples of negative ecological, social, and economic impacts from invasive species, their management may not be beneficial for all affected stakeholders. Perceived benefits for some stakeholders can complicate invasive species control and management and frustrate policy interventions if diverse stakeholders have opposing views about their positive or negative impacts.

Cannabis causes lower mortality and morbidity than alcohol and tobacco so it is clinically important if quitting cannabis is associated with substitution with these substances. This study tests if cannabis is substituted with alcohol and/or tobacco during cannabis abstinence, and factors predicting such substitution.A secondary analysis of a prospective community based study quantified cannabis, alcohol and tobacco use with Timeline Follow-back during a two-week voluntary cannabis abstinence and at one-month follow-up in non-treatment seeking cannabis users (n=45). Cannabis use was verified by urine THC-COOH levels.Alcohol use increased by 8 standard units (SU; d=0.48)/week and cigarette use by 14 cigarettes/week (d=0.29) during cannabis abstinence. Those using less of each substance at baseline had greater increases during cannabis abstinence (alcohol P0.0001, tobacco P=0.01). There was a decrease in alcohol (-4.8 SU, d=-0.29) and tobacco (-13 cigarettes/week, d=-0.26) use at follow-up, when most participants (87%, n=39) had resumed cannabis use. Increased cigarette use was predicted by cannabis withdrawal related sleep difficulty (insomnia) (P=0.05), restlessness (P=0.03) and physical symptoms (P=0.02). Neither alcohol nor cigarette use increased significantly in those (13.3%, n=6) who remained abstinent from cannabis through to follow-up.Abstaining from cannabis was associated with increases in alcohol and tobacco use that decreased with resumption of cannabis use; however there were no increases in individuals who remained abstinent from cannabis at one-month follow-up. Tobacco use did not increase in those experiencing milder cannabis withdrawal symptoms. Research on substitution in treatment seekers during outpatient cannabis abstinence is needed.

Introduction and Aims The measurement of clinical outcomes is an important, but lacking, component of drug and alcohol treatment in Australia. This study aimed to psychometrically validate the Treatment Outcomes Profile under Australian conditions, examining implementation and feasibility issues in three public opioid treatment program clinics in NSW. Design and Methods The Treatment Outcomes Profile was modified to reflect Australian conditions and re-named the Australian Treatment Outcomes Profile (ATOP). The ATOP was introduced into the participating clinics and administered by clinic staff at 3-month intervals as part of routine clinical practice. Participants completed a research interview, consisting of the ATOP and a suite of ‘gold standard’ instruments assessing substance use and related health and welfare domains, in the 72 h following completion of a routine clinical ATOP. The researcher- and clinician-administered ATOPs were compared to assess interrater reliability, and the researcher-administered ATOP and ‘gold standard’ instruments were compared to assess concurrent validity. Implementation and feasibility issues were assessed using questionnaires and focus groups with clinician and clients. Results The ATOP demonstrated acceptable concurrent validity and interrater reliability. It was well received by clients and clinicians, particularly for its ease of use, applicability and brevity. Conclusions The ATOP is a psychometrically valid instrument for the measurement of treatment outcomes in Australian opioid treatment populations and can feasibly be implemented as part of routine clinical practice in specialist opioid treatment program clinics. The role of the ATOP to measure outcomes in other drug and alcohol treatment modalities requires exploration. [Ryan A, Holmes J, Hunt V, Dunlop A, Mammen K, Holland R, Sutton Y, Sindhusake D, Rivas G & Lintzeris N. Validation and implementation of the Australian Treatment Outcomes Profile in specialist drug and alcohol settings. Drug Alcohol Rev 2014;33:33–42]

Background Alprazolam, has been associated with disproportionate harms compared to other benzodiazepines, especially among people in opioid substitution treatment (OST). We examine the effect of the rescheduling of alprazolam in Australia, from Schedule 4 to Schedule 8 in February 2014 amongst a high-risk population of clients in OST. Methods OST participants who reported recent (last month) alprazolam use were recruited from three Sydney clinics. Participants ( n =57) were interviewed immediately prior to rescheduling and again three months and 12 months after rescheduling. We examined self-reported patterns of drug use, drug availability, mental and physical health. A linear mixed models approach was used to analyse changes in alprazolam and other benzodiazepine use. Results Mean days of alprazolam use in the past 28 days decreased from 13.7 to 7.1 days, and mean weekly alprazolam dose decreased from 15.1mg to 6.1mg at 12 months follow-up ( p =0.001). Total weekly benzodiazepine use also reduced from a mean of 222mg diazepam equivalent to 157mg ( p =0.044). Other substance use did not change significantly. Reported mode of cost price of street alprazolam doubled from $5 to $10 over the 12-month period. Conclusion Alprazolam rescheduling resulted in an overall reduction in alprazolam and total benzodiazepine use, without substitution with other drugs, in the short term. Unintended harms were not observed. Rescheduling appears to have been effective in reducing alprazolam use in this high-risk population.

Fundamentos: La acumulación de patologías crónicas en un mismo paciente es cada vez más frecuente, por lo que se está convirtiendo en un problema de salud pública. Los objetivos de este estudio son describir la prevalencia de pluripatología en la población, sus características epidemiológicas y su influencia en la utilización de servicios sanitarios a partir de la Encuesta Regional de Salud de Madrid (ERSM2007) y comparar dos indicadores de pluripatología. Métodos: Estudio descriptivo transversal. Se analizó la ERSM2007 (n=12.190 mayores de 15 años). Se elaboraron dos indicadores: la presencia de 2 o más Problemas Crónicos (PC) y la existencia de 2 o más categorías clínicas afectadas según una definición de Paciente Pluripatológico (PP). Otras variables analizadas fueron: sexo, edad, clase social, nivel de estudios, índice de masa corporal, actividad física, consumos de alcohol y de tabaco, y la utilización de servicios sanitarios. Se realizó un análisis descriptivo, bivariado y multivariado mediante regresión logística con el cálculo de odds ratios (OR) e intervalos de confianza del 95%. Resultados: La prevalencia de pluripatología medida con PC fue 23,7% en hombres y 37,3% en mujeres y con PP fue 5,4% y 8,0% respectivamente. La pluripatología aumentó con la edad, con el bajo nivel educativo (OR=2,0; 1,4-2,8, en mujeres sin estudios o primarios respecto a universitarios), con la obesidad (OR=2,6; 1,9-3,3, en obesas respecto a mujeres de peso normal), y con el consumo previo de alcohol y de tabaco. La mayor asociación se observó con PP y el ingreso hospitalario (OR=4,1 ; 3,0-5,5 en hombres y OR=3,3 ; 2,6-4,3 en mujeres). Conclusiones: La prevalencia de pluripatología fue mayor en mujeres, en personas de mayor edad, con menor nivel de estudios o en clases sociales más desfavorecidas. Se asoció con la obesidad, con consumos previos de tabaco o alcohol. La utilización de los servicios sanitarios aumentó con la pluripatología. Estos indicadores pueden ser complementarios, por su diferente asociación con cada nivel asistencial.

Aims: Cocaine abuse remains an important public health issue. This study was designed to test how the short-acting KOP-r antagonist tetrapeptide [D-Trp]CJ-15,208 (cyclo[Phe-d-Pro-Phe-d-Trp]) affects cocaine self-administration (SA), cocaine-induced locomotor activity and food intake. Methods: (1) Male C57/BL6 mice acquired cocaine SA (0.5mg/kg/infusion, FR1) for 7 consecutive days. Half of the mice were injected with [D-Trp]CJ-15,208 (20mg/kg, s.c.) and half were injected with vehicle before cocaine SA daily for 7 days. (2) To determine the effect of [D-Trp]CJ-15,208 on cocaineinduced locomotor activity, mice were injected with either compound or vehicle before cocaine injection (15mg/kg, i.p.) and locomotor activities were recorded. (3) To assess the effect of [DTrp]CJ-15,208 on food intake, mice were injected with compound or vehicle and the amount of food consumed over a 2-h period was measured. Results: (1) Mice injected with [D-Trp]CJ-15,208 had attenuated cocaine SA compared to controls. (2) Mice pre-treated with [D-Trp]CJ-15,208 did not differ in their locomotor activity either before or after cocaine injection compared to controls. (3) Mice injected with [D-Trp]CJ-15,208 before food exposure did not differ in their food intake from controls. Conclusions: These studies show that [D-Trp]CJ-15,208 produced a decrease in daily cocaine SA in mice. This effect of [D-Trp]CJ-15,208was neither due to a decrease in cocaine-induced locomotor activity nor accompanied by decreases in food intake. These data support future studies of short-acting compounds with KOP-r antagonist effects as potential pharmacotherapeutic approaches against cocaine addiction. Financial support: NIH-NIDA 1R01DA029147-01A1 (YZ), NIHNIDA 1R01DA032928-01 (JA) and NIH-NIDA P60 DA05130 (MJK).