Concomitant Mycobacterium tuberculosis infection and type 2 diabetes: A descriptive model with global health implications

The type 2 diabetes (diabetes) pandemic is recognized as a threat to tuberculosis (TB) control worldwide. This secondary data analysis project estimated the contribution of diabetes to TB in a binational community on the Texas-Mexico border where both diseases occur. Newly-diagnosed TB patients > 20 years of age were prospectively enrolled at Texas-Mexico border clinics between January 2006 and November 2008. Upon enrollment, information regarding social, demographic, and medical risks for TB was collected at interview, including self-reported diabetes. In addition, self-reported diabetes was supported by blood-confirmation according to guidelines published by the American Diabetes Association (ADA). For this project, data was compared to existing statistics for TB incidence and diabetes prevalence from the corresponding general populations of each study site to estimate the relative and attributable risks of diabetes to TB. In concordance with historical sociodemographic data provided for TB patients with self-reported diabetes, our TB patients with diabetes also lacked the risk factors traditionally associated with TB (alcohol abuse, drug abuse, history of incarceration, and HIV infection); instead, the majority of our TB patients with diabetes were characterized by overweight/obesity, chronic hyperglycemia, and older median age. In addition, diabetes prevalence among our TB patients was significantly higher than in the corresponding general populations. Findings of this study will help accurately characterize TB patients with diabetes, thus aiding in the timely recognition and diagnosis of TB in a population not traditionally viewed as at-risk. We provide epidemiological and biological evidence that diabetes continues to be an increasingly important risk factor for TB.^

The Open Door Mission: Measuring and predicting outcomes of one community-based substance abuse treatment program

The objectives of this study were to identify and measure the average outcomes of the Open Door Mission's nine-month community-based substance abuse treatment program, identify predictors of successful outcomes, and make recommendations to the Open Door Mission for improving its treatment program.^ The Mission's program is exclusive to adult men who have limited financial resources: most of which were homeless or dependent on parents or other family members for basic living needs. Many, but not all, of these men are either chemically dependent or have a history of substance abuse.^ This study tracked a cohort of the Mission's graduates throughout this one-year study and identified various indicators of success at short-term intervals, which may be predictive of longer-term outcomes. We tracked various levels of 12-step program involvement, as well as other social and spiritual activities, such as church affiliation and recovery support.^ Twenty-four of the 66 subjects, or 36% met the Mission's requirements for success. Specific to this success criteria; Fifty-four, or 82% reported affiliation with a home church; Twenty-six, or 39% reported full-time employment; Sixty-one, or 92% did not report or were not identified as having any post-treatment arrests or incarceration, and; Forty, or 61% reported continuous abstinence from both drugs and alcohol.^ Five research-based hypotheses were developed and tested. The primary analysis tool was the web-based non-parametric dependency modeling tool, B-Course, which revealed some strong associations with certain variables, and helped the researchers generate and test several data-driven hypotheses. Full-time employment is the greatest predictor of abstinence: 95% of those who reported full time employment also reported continuous post-treatment abstinence, while 50% of those working part-time were abstinent and 29% of those with no employment were abstinent. Working with a 12-step sponsor, attending aftercare, and service with others were identified as predictors of abstinence.^ This study demonstrates that associations with abstinence and the ODM success criteria are not simply based on one social or behavioral factor. Rather, these relationships are interdependent, and show that abstinence is achieved and maintained through a combination of several 12-step recovery activities. This study used a simple assessment methodology, which demonstrated strong associations across variables and outcomes, which have practical applicability to the Open Door Mission for improving its treatment program. By leveraging the predictive capability of the various success determination methodologies discussed and developed throughout this study, we can identify accurate outcomes with both validity and reliability. This assessment instrument can also be used as an intervention that, if operationalized to the Mission’s clients during the primary treatment program, may measurably improve the effectiveness and outcomes of the Open Door Mission.^

Tuberculosis in Texas correctional facilities between 2005--2009

It has been well documented that inmates incarcerated in prisons and correctional facilities exhibit higher incidence and prevalence of mycobacterium tuberculosis (TB) disease than the general population. This has public health implications because correctional systems may serve as reservoirs for TB disease that can lead to TB outbreaks in the facilities or can be spread to the general public once inmates are released. Although Texas has one of the largest correctional systems in both the US and the world, little is known about TB prevalence and incidence among Texas inmates. The purpose of this study was to elucidate the relationship between TB incidence and incarceration in Texas correctional facilities and investigate differences in various demographic factors. ^ The study used the national TB database from the US Centers for Disease Control and Prevention (CDC) to calculate and compare the overall incidences of TB disease among correctional facility inmates and similar non-inmates in Texas during 2005–2009. Data were also stratified by age, gender, race/ethnicity, birth status, and HIV status and compared between inmates and non-inmates using chi-squared analysis and relative risks with 95% confidence intervals to assess any significant differences. ^ Results suggest that the overall TB incidence among Texas correctional facility inmates per year (88.6 per 100,000) was significantly higher than that of Texas non-inmates (6.3 per 100,000); a 14 fold difference. Relative risk analyses by gender, race/ethnicity, and those with HIV infection found that the TB incidences for all these demographics were significantly and consistently higher in inmates compared to non-inmates. In particular, Hispanic inmates were more likely to develop TB than their non-inmate counterparts by a relative risk of 23.9 (95% CI 19.4–29.4). Likewise, both male and female inmates were more likely to develop TB than non-inmates (RR = 10.2, 95% CI 8.5–12.2; RR = 20.8, 95% CI 12.2–25.3, respectively), although female inmates unconventionally exhibited a higher TB incidence and relative risk than males inmates, which has not been shown. Among those with HIV infections, correctional facility inmates were 2.6 times were likely to develop TB disease than non-inmates (95% CI 1.5–4.4). ^ Inmates in Texas correctional facilities have a higher incidence of TB than non-inmates. Part of this higher risk may be because a large proportion of inmates come from populations already at high risks for TB, such as foreign born immigrants, those infected with HIV, and low SES groups such as many racial/ethnic minorities. Thus, these results may be used as a basis for more controlled and detailed research in the area, and to further characterize incarceration as a risk factor for TB incidence. They may also bring much needed attention about this health disparity to public health officials, legislators, and health administrators to expand and improve TB control in Texas correctional facilities, particularly among inmates released to the community, and reduce the risk of TB transmission to the general population.^

A individualização da medida cautelar pessoal no processo penal brasileiro

O sistema de medidas cautelares pessoais no processo penal brasileiro não mais gravita em torno da prisão preventiva, uma vez que o legislador instituiu um rol de medidas cautelares menos gravosas, a ela alternativas. Nesse contexto, como deve orientar-se a escolha judicial da medida a ser aplicada ao caso concreto? A constitucional idade de qualquer intervenção no direito fundamental de liberdade depende, essencialmente, de sua fundamentação constitucional, que é controlada a partir da proporcionalidade. A proporcional idade, portanto, é a pedra angular do sistema de medidas cautelares pessoais. A decisão que impõe uma medida cautelar pessoal jamais pode resultar de uma intuição individual misteriosa, senão de um procedimento cognoscitivo estruturado e comprovável de maneira intersubjetiva. Daí a importância da investigação da existência de um direito fundamental do imputado à individualização da medida cautelar pessoal, para afastar qualquer discricionariedade judicial na sua escolha. O objetivo do presente trabalho, portanto, é propor um método racional, baseado no exame da proporcionalidade, para controle intersubjetivo da justificação da decisão judicial que, no processo penal, imponha uma medida cautelar pessoal.

Trauma Treatment in Forensic Settings: Clinicians' Perspectives, Barriers to Effective Treatment, and Suggestions for Clinical Practice

Between 30% and 90% of the prison population is estimated to have survived traumatic experiences such as sexual, emotional, and physical abuse prior to incarceration (Anonymous, 1999; Fondacaro, Holt, & Powell, 1999; Messina & Grella, 2006; Pollard & Baker, 2000; Veysey, De Cou, & Prescott, 1998). Similarly, information from the Bureau of Justice Statistics (as reported in Warren, 2001) estimated that more than half of the women in state prisons have experienced past physical and sexual abuse. Thus, given the astonishing number of inmates who appear to be victims of some kind of trauma, it seems likely that those who work with these inmates (e.g., prison staff, guards, and treatment providers) will in some way encounter challenges related to the inmates' trauma history. These difficulties may appear in any number of forms including inmates' behavioral outbursts, increased emotionality, sensitivity to triggering situations, and chronic physical or mental health needs (Veysey, et al., 1998). It is also likely that these individuals with trauma histories would benefit greatly from treatment while incarcerated. This treatment could be utilized to minimize symptoms of posttraumatic stress, decrease behavioral problems, and help the inmate function more effectively in society when released from incarceration (Kokorowski & Freng, 2001; Tucker, Cosio, Meshreki, 2003). Few studies have explored the types of trauma treatment that are effective with inmate populations or made specific suggestions for clinicians working in forensic settings (Kokorowski & Freng, 2001). Essentially, there appears to be a large gap in terms of the need for trauma treatment for inmates and the lack of literature addressing what to do about it. However, clinicians across the country seem to be quietly attempting to fulfill this need for trauma treatment with incarcerated populations. They are providing this greatly needed treatment every day. in the face of enormous challenges and often without recognition or the opportunity to share their valuable work with the larger community.

Psychological Perspectives on the Civil Liberties of Transgendered Inmates in a Prison Setting

As society becomes increasingly less binary, and moves towards a more spectrum based approach to mental illness, medical illness, and personality, it becomes necessary to address this shift within formerly rigid institutions. This paper explores this shift as it is occurring within correctional settings around the United States concerning the medical care, housing, and safety of transgendered inmates. As there is no legal standard for the housing or access to gender-affirming medical care (i.e., hormone therapy, sexual reassignment surgery), these issues are addressed on an institutional level, with very little consistency throughout the country. Currently, most institutions follow a genitalia-based system of classification. Within the system, core beliefs are held, some adaptive and some no longer adaptive, that drive the system's behavior and outcomes. With regard to transgendered inmates, several underlying beliefs within the system serve to maintain the status quo; however, the most basic underpinning is the system's reliance on a binary gender system. As views of humane treatment of the incarcerated expand and modernize, the role of mental health within corrections has also expanded. Psychologists, social workers, counselors, and psychiatrists are found in almost all correctional facilities, and have become a voice of advocacy for an often underserved population.

Naturalizing Immigration Imprisonment

Only recently has imprisonment become a central feature of both t across every level of government and involving civil and criminal law enforcement tools. Examining the population as a whole provides crucial insights as to how we arrived at this state of mass immigration imprisonment. While political motivations — parallel to those that fueled the rapid expansion of criminal mass incarceration — may have started the trend, this Article demonstrates that key legal and policy choices explain how imprisonment has become an entrenched feature of immigration law enforcement. In fact, legislators and immigration officials have locked themselves into this choice, as there are now literally billions of dollars, tens of thousands of prison beds, and innumerable third parties invested in maintaining and expanding the use of immigration imprisonment. Using the literature on path dependence and legal legitimacy, this Article explains the phenomenon of immigration imprisonment as a single category that spans all levels of government. Rather than continue further along this path, the Article concludes by suggesting that policymakers should seek a future reflective of immigration law enforcement’s past when imprisonment was the exception rather than the norm.

La conduite avec facultés affaiblies : les contrevenants et les services offerts dans les établissements de détention du Québec

Rapport de stage présenté à la Faculté des études supérieures en vue de l’obtention du grade de Maître ès science (M. Sc.) en criminologie Option stage en analyse criminologique

La conduite avec facultés affaiblies : les contrevenants et les services offerts dans les établissements de détention du Québec

Rapport de stage présenté à la Faculté des études supérieures en vue de l’obtention du grade de Maître ès science (M. Sc.) en criminologie Option stage en analyse criminologique

Commodification of Black Bodies: Convict Leasing and Prison Privatization in the United States of America

The United States is home to a private prison industry, which allows for the detention of human beings to be transformed into a multi-billion dollar industry. This paper traces the parallels between the post-civil war convict leasing system and the current system of prison privatization, which encourages the commodification of black bodies in order to maintain a racial hierarchy. It analyzes the incompatibility of prison privatization with the US Constitution. Private prisons, which hold African American men at a higher rate that state-run prisons, take cost-cutting measures in order to increase profit, which expose prisoners to higher rates of abuse and increased recidivism rates. Private prisons have significant political power to determine crime control legislation, which has led to harsh laws which increase the number of men of color behind bars. This paper provides a three-phase plan for abolishing private prisons and reducing overall incarceration rates in the United States.

Maximum security: 'Being in the belly of the beast'

Very little information or research is available about the operation of Maximum Security Units (MSUs) in Queensland prisons. These units were developed within existing prisons in the early 1980s to deal with the incarceration of prisoners considered to be the worst and highest risk. Drawing on a number of interviews with prison visitors and on published documents and cases, this article examines the purpose and possible shortcomings of MSUs in Queensland in light of the Standard Guidelines for Corrections in Australia (1996).

COMPREENSÃO DA VULNERABILIDADE CRIMINAL FEMININA A PARTIR DA ANÁLISE DO CARÁTER

O presente estudo teve por objetivos a) identificar aspectos da história de vida pessoal, das etapas de desenvolvimento evolutivo e das relações familiares e afetivas de mulheres que cumprem pena em regime fechado, com o intuito de colher elementos significativos e contributivos para a compreensão da vulnerabilidade criminal feminina; b) realizar uma análise sistematizada do caráter, segundo abordagem de Wilhelm Reich, a partir do conteúdo do discurso clínico dessas mulheres. Para tal foram estudados três casos de mulheres reclusas em regime fechado no Centro de Ressocialização Feminino, na cidade de São José do Rio Preto, que respondem pelos artigos 33 e 35 da Lei 11343/06, que refere-se ao tráfico de drogas ilícitas e a associação para o crime, e artigo 157 do Código Penal Brasileiro, que refere-se a roubo. O conteúdo das entrevistas realizadas indicou graves dificuldades no crescimento e desenvolvimento por ambiente desfavorável e por relações psico-afetivas empobrecidas ou insatisfatórias. Encontrou-se em comum nos casos estudados, segundo uma análise reichiana, indicativos de fixação na oralidade, ou seja, traços orais insatisfatórios relacionados à primeira infância, indicando pouca referência identificatória que lhes oferecesse base para defenderem-se da realidade. Entendeu-se que tais falhas desenvolvimentais podem indicar vulnerabilidade para ações criminais como forma de defesa contra angústia, fazendo com que atuem de forma mais imediata ou impulsiva na busca de satisfação.

Effect of the Supplemental Nutrition Assistance Program (SNAP) and nutrition education on nutrition and health outcomes of HIV+ individuals

Factors associated with and barriers to participation in Supplemental Nutrition Assistance Program (SNAP) and the effect participation has on food security, nutrition status, disease status and quality of life was investigated in a cross-sectional study including 175 HIV infected individuals. In addition, the effect of a targeted nutrition education on nutrition knowledge, readiness to dietary behavior change, nutrition status, disease status and quality of life was also investigated among a subset of the population (N = 45) in a randomized clinical control trial. ^ SNAP participation rate was 70.3%, similar to the State of Florida and national participation rates. SNAP participation was positively and independently associated with being born in the US (P < 0.001), having monthly income less than $1000 (P = 0.006), and receiving antiretroviral treatment (P < 0.001). Participation barriers include denial of participation by program, recent incarceration, living in a shelter where participation is not allowed and unawareness of eligibility status. In regression analyses, SNAP participation was not significantly associated with improved food security, nutrition status, disease status and health related quality of life (HRQOL). Over half (56%) of the population experienced food insecurity and had inadequate intakes of half of the nutrients assessed. Illicit drug, alcohol and cigarette use were high in this population (31%, 55% and 63% respectively), and affected food security, nutrients intake, disease status and HRQOL. The nutrition education intervention resulted in a trend towards improvements nutrition knowledge, self-efficacy, and readiness to change without impacting nutrition status, disease state and quality of life. ^ Food insecurity and other nutrition related issues, with implications for treatment, management and cost of HIV disease, continue to plague infected individuals living in poverty. More resources, including food and nutrition programs, specifically targeted towards this population are needed to address these issues.^

A "Transforming the School-to-Prison Pipeline" Initiative: Mentoring Model Pilot Project Symposium

Abstract: This informative and interactive teaching symposium posits the Positive Peer Leadership Mentoring Program (PPLM) as an evidence-based wrap-around service for youth and families in Miami-Dade who are involved in the school-to-prison pipeline. Presenters first provide information to initiate the dialogic process of discerning and interpreting the school-to-prison pipeline, impacted by costs of incarceration for Black youth and families and the move toward effective mental health services in the juvenile justice system. Then, participants experience an interactive pedagogical mentoring format set forth in PPLM as the first step toward transforming the school-to-prison pipeline in their own classroom or other educational setting.

Prisons, Profits, and Hard Labor: A Brief History of Convict Labor In Florida

The purpose of this research is to develop a broader understanding of the system in Florida. Specifically, I am looking at the privatization of convict labor programs by the Prison Rehabilitative Industries and Diversified Enterprises Corporation (PRIDE) in the 1980s and 1990s in state correctional institutions. This research will contribute to historiography of prisons in Florida in the context of the developing research about the Prison-Industrial Complex. Many scholars studying the Prison-Industrial Complex have drawn comparisons to today’s prison industries and the convict lease system of the late 19th and early 20th centuries, seeing the prison system go full circle drawing attention to the exploitative and institutionally racist nature of the modern prison system. This researched showed that the trend other scholars have studied also exist in Florida and Florida was actually a pioneer in the Prison-Industrial Complex. It was the first state to privatize its convict labor programs, becoming a model for other states. This research also shows that political and economic motivations were the primary forces governing prison policies, rather than education, rehabilitation, and safety. To complete this project, I analyzed articles from South Florida newspapers, such as the Sun-Sentinel and the Miami Herald, published during this period as well as literature published by the Department of Corrections. The United States has the highest rate of incarceration in the world and spends more money on prisons than education. Being such a large part of country, prisons warrant more critical study. This research will shed light on the nature of prisons, specifically here in Florida, in the hopes of seeking alternatives.