Search results

Currently, people leaving prisons face concurrent risks from the COVID-19 pandemic and the overdose public health emergency. The closure or reduction of community services people rely on after release such as treatment centres and shelters has exacerbated the risks of poor health outcomes and harms. This paper aims to learn from peer health mentors (PHM) about changes to their work during overlapping health emergencies, as well as barriers and opportunities to support people leaving prison in this context.

The Unlocking the Gates (UTG) Peer Health Mentoring Program supports people leaving prison in British Columbia during the first three days after release. The authors conducted two focus groups with PHM over video conference in May 2020. Focus groups were recorded and transcribed, and themes were iteratively developed using narrative thematic analysis.

The findings highlighted the importance of peer health mentorship for people leaving prisons. PHM discussed increased opportunities for collaboration, ways the pandemic has changed how they are able to provide support, and how PHM are able to remain responsive and flexible to meet client needs. Additionally, PHM illuminated ways that COVID-19 has exacerbated existing barriers and identified specific actions needed to support client health, including increased housing and recovery beds, and tools for social and emotional well-being.

This study contributes to our understanding of peer health mentorship during the COVID-19 pandemic from the perspective of mentors. PHM expertise can support release planning, improved health and well-being of people leaving prison and facilitate policy-supported pandemic responses.

People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic.

The authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, “changes in illicit opioid consumption,” was measured using the question “Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?” The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated.

A total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14–8 vs 18–39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9–55 vs living alone) and 9% (95% CI 0–18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively.

The authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.

The purpose of this paper is to evaluate the relative importance of attributes for patient selection of a medical institution and to quantitatively evaluate the impact of different types of organizational forms upon the patient ' s selection of a medical institution.

By using a conjoint analysis, evaluation criteria in patient selection of a medical institution were examined. The paper assumed the selection of a medical institution under the situation of “being given a diagnosis of suspected diabetes with a physical examination and then visiting a medical institution”. The attributes included in the questionnaire were: quality of the medical institution, distance to the hospital, amount paid at the initial visit, amount paid at hospitalization for examinations, and organizational form of the hospital. Relative importance of the attributes and relative importance of organizational form were assessed. A total of 140 people were requested to respond to the questionnaire by way of researchers who have a connection with the authors. Completed responses were obtained from 111 subjects (79 per cent).

The results of the conjoint analysis revealed that the most important attribute was quality of the medical institution. Organizational form was the attribute with the lowest importance. The utility value of being a public hospital was the highest within the organizational form attribute for all respondents and being a private hospital was the lowest. The quality of the medical institution was considered the most important factor in selecting a medical institution and the type of organizational form was considered least important. Regarding organizational form, being a public hospital was most preferred and being a hospital managed by a company and a private hospital were least preferred respectively among healthcare professionals and other occupations.

The paper provides a relative evaluation of the factors thought to be important for patients in Japan when selecting a medical institution.

Most research on the work conditions and family responsibilities associated with work-family conflict and other measures of mental health uses the individual employee as the unit of analysis. We argue that work conditions are both individual psychosocial assessments and objective characteristics of the proximal work environment, necessitating multilevel analyses of both individual- and team-level work conditions on mental health.

This study uses multilevel data on 748 high-tech professionals in 120 teams to investigate relationships between team- and individual-level job conditions, work-family conflict, and four mental health outcomes (job satisfaction, emotional exhaustion, perceived stress, and psychological distress).

We find that work-to-family conflict is socially patterned across teams, as are job satisfaction and emotional exhaustion. Team-level job conditions predict team-level outcomes, while individuals’ perceptions of their job conditions are better predictors of individuals’ work-to-family conflict and mental health. Work-to-family conflict operates as a partial mediator between job demands and mental health outcomes.

Our findings suggest that organizational leaders concerned about presenteeism, sickness absences, and productivity would do well to focus on changing job conditions in ways that reduce job demands and work-to-family conflict in order to promote employees’ mental health.

We show that both work-to-family conflict and job conditions can be fruitfully framed as team characteristics, shared appraisals held in common by team members. This challenges the framing of work-to-family conflict as a “private trouble” and provides support for work-to-family conflict as a structural mismatch grounded in the social and temporal organization of work.

The purpose of this paper is to report and comment on the Court of Appeal, Poole and Others v. HM Treasury.

The paper outlines the facts surrounding the case and comments on the ruling.

Lord Justice Buxton gave the only judgment in this appeal, with which his fellow judges concurred, and he confirmed that the lower Court was right to dismiss the appellants' claim based on their interpretation of the 1973 insurance directive and the effect of the European Court of Justice decision in Francovich.

The Court of Appeal, in this decision, confirms that the principles of European law surrounding state liability are unlikely to be of much help to those who suffer such losses and see them partly as a result of state or regulatory failure.

This study aims to describe knowledge of Canada’s Good Samaritan Drug Overdose Act (GSDOA) and take home naloxone (THN) training and kit possession among people being released from provincial correctional facilities in British Columbia.

The authors conducted surveys with clients of the Unlocking the Gates Peer Health Mentoring program on their release. The authors compared the characteristics of people who had and had not heard of the GSDOA and who were in possession of a THN kit.

In this study, 71% people had heard of the GSDOA, and 55.6% were in possession of a THN kit. This study found that 99% of people who had heard of the GSDOA indicated that they would call 911 if they saw an overdose. Among people who perceived themselves to be at risk of overdose, 28.3% did not have a THN kit. Only half (52%) of participants had a mobile phone, but 100% of those with a phone said they would call 911 if they witnessed an overdose.

The authors found that people with knowledge of the GSDOA were likely to report that they would call 911 for help with an overdose. Education about the GSDOA should be a standard component of naloxone training in correctional facilities. More than one in four people at risk of overdose were released without a naloxone kit, highlighting opportunities for training and distribution. Access to a cellphone is important in enabling calls to 911 and should be included in discharge planning.

Within-prison drug injection (WPDI) is a particularly high HIV risk behavior, yet has not been examined in Central Asia. A unique opportunity in Kyrgyzstan where both methadone maintenance treatment (MMT) and needle-syringe programs (NSP) exist allowed further inquiry into this high risk environment. The paper aims to discuss these issues.

A randomly selected, nationally representative sample of prisoners within six months of release in Kyrgyzstan completed biobehavioral surveys. Inquiry about drug injection focused on three time periods (lifetime, 30 days before incarceration and during incarceration). The authors performed bivariate and multivariable generalized linear modeling with quasi-binomial distribution and logit link to determine the independent correlates of current WPDI.

Of 368 prisoners (13 percent women), 109 (35 percent) had ever injected drugs, with most (86 percent) reporting WPDI. Among those reporting WPDI, 34.8 percent had initiated drug injection within prison. Despite nearly all (95 percent) drug injectors having initiated MMT previously, current MMT use was low with coverage only reaching 11 percent of drug injectors. Two factors were independently correlated with WPDI: drug injection in the 30 days before the current incarceration (AOR=12.6; 95%CI=3.3-48.9) and having hepatitis C infection (AOR: 10.1; 95%CI=2.5-41.0).

This study is the only examination of WPDI from a nationally representative survey of prisoners where both MMT and NSP are available in prisons and in a region where HIV incidence and mortality are increasing. WPDI levels were extraordinarily high in the presence of low uptake of prison-based MMT. Interventions that effectively scale-up MMT are urgently required as well as an investigation of the environmental factors that contribute to the interplay between MMT and WPDI.

At the invitation of Miss Olga Nethersole, founder and honorary organiser of the People's League of Health, a number of medical and science councillors and official members of the League met at luncheon at Claridge's Hotel, London, on October 18th, to welcome the members of the newly appointed Veterinary Council. The speeches which followed dealt with the campaign of the League for a safe milk supply, and the part which veterinary science, in conjunction with the other interested professions, might play in attaining the desired end.—Prof. T. J. Mackie, D.P.H., of the Department of Bacteriology, Edinburgh University, said that the formation of the new Veterinary Council was a significant event in the history of the League. It emphasised the absolute necessity of enlisting the co‐operation of the veterinary profession in the campaign for human health. If we were to guard our own health we must pay due respect to the health of our domestic animals, and particularly those from which we received our essential foods, such as milk. It was common knowledge to both the medical and the veterinary profession that our milk supplies, collectively speaking, were not safe, and that, in fact, they might carry a constant menace to the public health. Milk‐borne tuberculosis dominated the whole question of our milk supplies. It must be remembered, however, that tuberculosis was only one of the milk‐borne infections. There were others such as diphtheria, enteric fever, scarlet fever, and undulant fever. Yet there was distinct apathy, and sometimes antipathy, to the simple measures that would regulate this state of affairs. The League were to be congratulated on having performed a valuable public service in their critical survey of the question of bovine tuberculosis, and bringing out in fair relief the essential facts in regard to tuberculosis of animal origin in human beings. Some of the facts in the report could not be too often and strongly repeated. In England and Wales, for instance, it had been shown that every year the bovine type of tuberculosis bacillus caused at least 4,000 new cases of human tuberculosis and at least 2,000 deaths. And seven per cent. of the ordinary samples of vended milk contained this organism. He could speak feelingly, for in Scotland they had rather more than their share of tuberculosis of the bovine type in the human subject. When one reflected on all that had been done in various ways for the improvement of public health, it seemed almost incredible that food was being sold daily with a seven per cent. and sometimes a 14 per cent. chance of it containing a germ capable of producing a crippling or even fatal disease without any warning to the public. If tuberculosis were not an insidious disease, but an explosive epidemic, even if its incidence were not so high, these conditions would not have been tolerated so long as they had been. The veterinary profession recommended the eradication of disease from herds as the fundamental remedy. It was the fundamental remedy, but even the highest grade tubercle‐free milk might carry a very dangerous infection, and, in any case, he did not think the objects which the veterinary profession had at heart, and with which he sympathised, and compulsory or universal pasteurisation on the other hand, were mutually exclusive. He did not see that pasteurisation would set back the clock of progress against the eradication of tuberculosis in the herds. The problem was an urgent one. The eradication of the disease from dairy cattle must proceed slowly and against difficult obstacles, and they could not wait. It was estimated that, if the eradication of tuberculosis were continued at the present rate in this country, it would be 400 years before we reached the stage that had been reached in America. Even if it were expedited, it must remain a relatively slow process. He could not understand those individuals who were content to tolerate the continuance of bovine tuberculosis in the human being in the hope that some day a raw tubercle‐free milk might be universal. Our agricultural and public health organisations were doing the people an injustice in their tacit sanction of the ordinary raw market milk. If they were not prepared to countenance compulsory pasteurisation, at least in the large communities, the only alternative was an official designation of that milk, which would make it clear to the public that it was not free from potential danger. He sometimes wondered what would be the effect of such an official designation if there were displayed in the retail milk shops an official notice stating to the public that such milk was not free from diseases dangerous to human subjects, and that they were warned not to use it without previous sterilisation. He was sure that if that were done the problem would very soon solve itself. Some Local Authorities were pressing hard for powers of compulsory pasteurisation. He thought the League might very well carry on the campaign by educating public opinion and influencing Parliament to that end. If the Government Departments were not willing to move in the matter and take action, then the public must be informed in the clearest possible terms what the position was. The League, in tackling the milk problem by its own methods, had a magnificent opportunity of making a great contribution to the important cause for which it stood.—Professor J. Basil Buxton, of the Institute of Animal Pathology at Cambridge University, said that pasteurisation could not by any means dispense with the necessity for clean milk. They must produce clean milk, however much or however little they might cook it or otherwise treat it afterwards.—Professor Gaiger, President of the Royal College of Veterinary Surgeons, said that they had an enormous job in front of them if they were going to make our milk free from the germ of bovine tuberculosis.—Sir Leonard Hill said that if we could get the people on the right diet we should enormously diminish the amount of disease. Of all the foods milk was one of the most important, and we ought to make the supply safe. Pasteurisation should be made compulsory at once.—Major D. S. Rabagliati, Chief Veterinary Inspector to the County Council of the West Riding of Yorkshire, told the gathering of the important work carried out by his Local Authority, who were the pioneers in the veterinary inspection of cows. He maintained that even if there were compulsory pasteurisation that was no reason why they should not have a clean supply of milk.