Missed Opportunities for Compassion: A Call to Action for Incarcerated Individuals Denied Compassionate Release

Abstract In 2016, a total of 4,117 state and federal prisoners died in publicly or privately operated prisons. Each year from 2001 to 2016, an average of 88% of deaths in state prisons were due to natural causes, with more than half of those due to cancer, heart disease or liver disease, conditions for which non-incarcerated citizens often benefit from palliative care and hospice. Prisoners age 55 and older are the fastest-growing segment of the population residing in prisons, as well as those with the highest mortality rate. Compassionate release of seriously ill prisoners became a matter of federal statute in 1984 and has currently been adopted by the majority of U.S. prison jurisdictions. The spirit of the mandate is based on the idea that catastrophic health conditions ie terminal illness affect the four principles of incarceration: retribution, rehabilitation, deterrence, and incapacitation. Concerned about an aging prison population, overcrowded facilities, and soaring costs, many policy makers are calling for a wider use of compassionate release for persons with terminal illness as well as broader prison reform. The prognosticating criteria of compassionate release guidelines are clinically flawed, and the application and procedural barriers are prohibitive. In this paper we review cases of patients who qualified for compassionate release but had their applications denied. We will discuss the urgent need for access to quality palliative medicine for incarcerated persons with advanced illness and call healthcare providers to action with the aim of reducing suffering and promoting social justice for those in need.

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The Unusual Cruelty of Nursing Homes Behind Bars

Federal Sentencing Reporter ◽

10.1525/fsr.2020.32.5.264 ◽

2020 ◽

Vol 32 (5) ◽

pp. 264-271

Author(s):

Rachel E. López

Keyword(s):

Nursing Homes ◽

Human Dignity ◽

Prison Population ◽

Financial Burden ◽

The Elderly ◽

The United States ◽

Term Care ◽

Trained Staff ◽

State Prisons ◽

The Cost

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

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Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry

Pediatric Nephrology ◽

10.1007/s00467-021-04928-w ◽

2021 ◽

Author(s):

Marjolein Bonthuis ◽

Enrico Vidal ◽

Anna Bjerre ◽

Özlem Aydoğ ◽

Sergey Baiko ◽

...

Keyword(s):

Replacement Therapy ◽

Cox Regression ◽

Patient Survival ◽

Healthcare Providers ◽

Resource Planning ◽

Policy Makers ◽

Age Related ◽

Kidney Replacement Therapy ◽

Over Time ◽

Related Population

Abstract Background For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods We included all children aged <15 years starting KRT 2007–2016 in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.

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Stethoscope hygiene: A call to action. Recommendations to update the CDC guidelines

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.115 ◽

2021 ◽

pp. 1-3

Author(s):

Sarathi Kalra ◽

Alpesh Amin ◽

Nancy Albert ◽

Cindy Cadwell ◽

Cole Edmonson ◽

...

Keyword(s):

Healthcare Providers ◽

Acoustic Properties ◽

Patient Encounter ◽

Call To Action ◽

The Us ◽

Cdc Guidelines ◽

Control And Prevention ◽

Healthcare Acquired Infections ◽

Current Guidance ◽

Tremendous Challenge

Abstract Healthcare-acquired infections are a tremendous challenge to the US medical system. Stethoscopes touch many patients, but current guidance from the Centers for Disease Control and Prevention does not support disinfection between each patient. Stethoscopes are rarely disinfected between patients by healthcare providers. When cultured, even after disinfection, stethoscopes have high rates of pathogen contamination, identical to that of unwashed hands. The consequence of these practices may bode poorly in the coronavirus 2019 disease (COVID-19) pandemic. Alternatively, the CDC recommends the use of disposable stethoscopes. However, these instruments have poor acoustic properties, and misdiagnoses have been documented. They may also serve as pathogen vectors among staff sharing them. Disposable aseptic stethoscope diaphragm barriers can provide increased safety without sacrificing stethoscope function. We recommend that the CDC consider the research regarding stethoscope hygiene and effective solutions to contemporize this guidance and elevate stethoscope hygiene to that of the hands, by requiring stethoscope disinfection or change of disposable barrier between every patient encounter.

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Predictors of poor health and functional recovery following road trauma: protocol of a British Columbian inception cohort study

BMJ Open ◽

10.1136/bmjopen-2021-049623 ◽

2021 ◽

Vol 11 (4) ◽

pp. e049623

Author(s):

Leona K Shum ◽

Herbert Chan ◽

Shannon Erdelyi ◽

Lulu X Pei ◽

Jeffrey R Brubacher

Keyword(s):

Resource Use ◽

Healthcare Resource ◽

Healthcare Providers ◽

Healthcare Resource Use ◽

Physical And Mental Health ◽

Inception Cohort ◽

Policy Makers ◽

Productivity Costs ◽

Poor Outcome ◽

Lost Productivity

IntroductionRoad trauma (RT) is a major public health problem affecting physical and mental health, and may result in prolonged absenteeism from work or study. It is important for healthcare providers to know which RT survivors are at risk of a poor outcome, and policy-makers should know the associated costs. Unfortunately, outcome after RT is poorly understood, especially for RT survivors who are treated and released from an emergency department (ED) without the need for hospital admission. Currently, there is almost no research on risk factors for a poor outcome among RT survivors. This study will use current Canadian data to address these knowledge gaps.Methods and analysisWe will follow an inception cohort of 1500 RT survivors (16 years and older) who visited a participating ED within 24 hours of the accident. Baseline interviews determine pre-existing health and functional status, and other potential risk factors for a poor outcome. Follow-up interviews at 2, 4, 6, and 12 months (key stages of recovery) use standardised health-related quality of life tools to determine physical and mental health outcome, functional recovery, and healthcare resource use and lost productivity costs.Ethics and disseminationThe Road Trauma Outcome Study is approved by our institutional Research Ethics Board. This study aims to provide healthcare providers with knowledge on how quickly RT survivors recover from their injuries and who may be more likely to have a poor outcome. We anticipate that this information will be used to improve management of all road users following RT. Healthcare resource use and lost productivity costs will be collected to provide a better cost estimate of the effects of RT. This information can be used by policy-makers to make informed decisions on RT prevention programmes.

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The downside of downsizing: Persistence of racial disparities following state prison reform

Punishment & Society ◽

10.1177/14624745211006039 ◽

2021 ◽

pp. 146247452110060

Author(s):

Amy E Lerman ◽

Alyssa C Mooney

Keyword(s):

Racial Disparities ◽

Prison Population ◽

Mass Incarceration ◽

Prison Reform ◽

State Prison ◽

Probation And Parole ◽

Substantial Progress ◽

Prison Populations ◽

Racial Ethnic ◽

Double Digit

Nationwide, prison populations have declined nearly 5% from their peak, and 16 states have seen double-digit declines. It is unclear, though, how decarceration has affected racial disparities. Using national data, we find substantial variation in state prison populations from 2005–2018, with increases in some states and declines in others. However, although declines in the overall state prison population were associated with declines for all groups, states with rising prison populations experienced slight upticks in prison rates among the white population, while rates among Black and Latinx populations declined. As a result, greater progress in overall decarceration within states did not translate to larger reductions in racial disparities. At the same time, we do not find evidence that a decline in prison populations is associated with a rise in jail incarceration for any racial/ethnic group. In additional exploratory analyses, we suggest that recent incarceration trends may be driven by changes in returns to prison for probation and parole violations, rather than commitments for new crimes. Our results make clear that while efforts to reverse mass incarceration have reduced the size of prison populations in some states, they have not yet made substantial progress in resolving the crisis of race in American criminal justice.

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Good Data, Good Law

Federal Sentencing Reporter ◽

10.1525/fsr.2021.33.4.262 ◽

2021 ◽

Vol 33 (4) ◽

pp. 262-264

Author(s):

John Tilley ◽

Serena Chang ◽

Richard J. Peay

Keyword(s):

Real Time ◽

Racial Disparity ◽

Prison Population ◽

Time Data ◽

Policy Makers ◽

Non Profit ◽

Life Years ◽

Mandatory Minimums ◽

Visualization Tools ◽

Data Driven Decisions

Real-time data is crucial in delivering actionable information, yet sparse in the criminal justice space. Often, practitioners and policy makers (“System Actors”), are forced to rely on information that is missing, incorrect, and/or outdated. Recidiviz, a nonpartisan tech non-profit, enables System Actors to make data-driven decisions as part of their regular workflows. This article describes Recidiviz’s work modeling the projected influence of eliminating mandatory minimums in Virginia, including state costs avoided, impact on the prison population, and number of life-years individuals would regain by avoiding incarceration. Recidiviz calculated that if Virginia eliminated mandatory minimums for drug sales offenses only, over the next five years, it could avoid a cumulative $11.6 million in incarceration costs, give 360 years of life back to people, and decrease the prison population’s racial disparity. If Virginia eliminated all mandatory minimums, as SB 5046 proposes, it could help the Commonwealth avoid $80.2 million in costs and give back 2,496 years of life over five years. In addition to policy impact modeling, Recidiviz’s core work is in partnering with state corrections and supervision departments to provide real-time feedback and data visualization tools.

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The conceptualisation of patient-centred care: A case study of diabetes management in public facilities in southern Malawi

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v13i1.2755 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Martha Makwero ◽

Adamson Muula ◽

Felix C. Anyawu ◽

Jude Igumbor

Keyword(s):

Diabetes Management ◽

Healthcare Providers ◽

Major Elements ◽

Relationship Building ◽

Exploratory Research ◽

Framework Analysis ◽

Policy Makers ◽

Patient Centred Care ◽

Group Interviews ◽

Relational Framework

Background: Patient-centred care (PCC) is one of the pillars of Malawi’s quality of care policy initiatives. The role of PCC in facilitating quality service delivery is well documented, and its importance may heighten in chronic disease management. Yet, PCC conceptualisation is known to be context specific.Aim: The study aimed to understand the conceptualisation of PCC amongst patients, healthcare providers (HCP) and policy makers in Diabetes Mellitus (DM) management.Setting: This study was conducted in DM clinics in Southern Malawi.Methods: Our qualitative exploratory research study design used in-depth and focus group interviews. We interviewed patients with DM, HCPs and policy makers. The study used framework analysis guided by Mead and Bower’s work.Results: Patient-centred care conceptualisations from groups of participants showed convergence. However, they differed in emphasis in some elements. The prominent themes emerging from the participants’ conceptualisation of PCC included the following: meeting individual needs, goals and expectations, accessing medication, supporting relationship building, patient involvement, information sharing, holistic care, timeliness and being realistic.Conclusion: Patient-centred care conceptualisation in Malawi goes beyond the patient–HCP relational framework to include the technical aspects of care. Contrary to the global view, accessing medication and timeliness are major elements in PCC conceptualisation in Malawi. Whilst PCC conceptualisation is contextual, meeting expectations and needs of patients is fundamental.

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Health Communication and Inter-professional Care in Context of Multimorbidity Management: Assessment of Health Professional Curricular Focus in India

Frontiers in Communication ◽

10.3389/fcomm.2021.661930 ◽

2021 ◽

Vol 6 ◽

Author(s):

Sanghamitra Pati ◽

Rajeshwari Sinha ◽

Pranab Mahapatra

Keyword(s):

Health Communication ◽

Health Professional ◽

Healthcare Providers ◽

Multidisciplinary Care ◽

Term Care ◽

Policy Makers ◽

Competency Based ◽

Professional Care ◽

Care Demands

To meet the long term care demands of chronic diseases as well as multimorbidity, healthcare providers from different disciplines need to work collaboratively in practice. This requires healthcare providers to be appropriately trained on delivery of inter-professional care (IPC) and health communication aspects during formative professional years. In this study, we have looked at the prevailing undergraduate and postgraduate healthcare professional curricula to understand the focus on health communication and on IPC for the delivery of multidisciplinary care for multimorbidity management. We observe that while there are exclusive courses on health communication being delivered at different levels, the focus on IPC is still in stages of infancy. The IPC component is just beginning to be woven into the health professional curricula through elements like competency-based curriculum, rotational posting, inter-departmental engagements. At the same time, the need to put curricular attention on multimorbidity is also highlighted here. There remains wider scope for strengthening learning on health communication and IPC among different disciplines within the curricula in the context of multimorbidity. We expect our findings to provide key inputs to academic planners and policy makers towards the introduction of adequate curricular components for addressing multimorbidity along with necessary prescriptions for health communication and IPC in India.

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To live and age as who we really are

HRB Open Research ◽

10.12688/hrbopenres.12990.1 ◽

2020 ◽

Vol 3 ◽

pp. 6

Author(s):

Lorna Roe ◽

Miriam Galvin ◽

Laura Booi ◽

Lenisa Brandao ◽

Jorge Leon Salas ◽

...

Keyword(s):

Lived Experience ◽

Trinity College ◽

Healthcare Providers ◽

Open Letter ◽

Brain Health ◽

Policy Makers ◽

Trinity College Dublin ◽

Multidisciplinary Group ◽

Lgbt People ◽

Global Brain

This Open Letter discusses the theme of ‘diversity in brain health’ in research, practice and policy for older LGBT+ people. It is written by a multidisciplinary group of Atlantic Fellows for Equity in Brain Health at the Global Brain Health Institute in Trinity College Dublin (TCD), from a variety of disciplines (health economics, human geography, anthropology, psychology, gerontology) and professions (researcher, clinicians, writers, practicing artists). The group developed a workshop to explore the theme of ‘Diversity and Brain Health’ through the lens of non-normative gender identities and sexualities. Guided by two advisors (Prof Agnes Higgins, TCD; Mr Ciaran McKinney, Age and Opportunity), we invited older LGBT+ people and those interested in the topic of LGBT+ and ageing, healthcare providers, policy makers and interested members of the research community. We partnered with colleagues in the School of Law to include socio-legal perspectives. Following the workshop, Roe and Walrath wrote an opinion editorial, published in the Irish Times during the 2019 PRIDE festival, and were subsequently invited by HRB Open Access to provide a more detailed expansion of that work. In this Open Letter we describe the theme of ‘diversity and brain health’ and some of the lessons we learned from listening to the lived experience of older LGBT+ people in Ireland today. We illustrate why it’s important to understand the lived experience of older LGBT+ people and highlight the failure of the State to evaluate the experience of LGBT+ people in policy implementation. We call on researchers, clinicians, service planners and policy makers, to recognize and address diversity as an important way to address health inequities in Ireland.

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Barriers to the early detection and intervention of children with autism spectrum disorders: A literature review

Journal of Nursing Education and Practice ◽

10.5430/jnep.v11n11p72 ◽

2021 ◽

Vol 11 (11) ◽

pp. 72

Author(s):

Fatema Ali Bivarchi ◽

Vahe Kehyayan ◽

Sadriya Mohd Al-Kohji

Keyword(s):

Early Detection ◽

Literature Review ◽

Social Stigma ◽

Data Extraction ◽

Healthcare Providers ◽

Autism Spectrum ◽

Long Term Outcomes ◽

Missed Opportunities ◽

Early Intervention Services

Background and objective: Autism spectrum disorder (ASD) is a lifelong developmental disability that affects how individuals communicate and interact with others. A reliable diagnosis of ASD can be made within the first 24 months of a child’s life, but ASD is usually diagnosed late. Late diagnosis contributes to missed opportunities to provide early intervention services and improve long-term outcomes. The purpose of this project was to identify barriers to early detection and intervention of ASD faced by parents, other caregivers, and health care professionals.Methods: A literature review was conducted. CINAHL, Medline, and PsychINFO databases were used to search for relevant articles. Ten articles that met the inclusion criteria were selected and data from these articles were summarized in a data extraction table and themes were identified.Results: Five main barriers that prevent early diagnosis and intervention of children with ASD were identified. These barriers were lack of knowledge, social stigma, dismissal of parents’ first concerns by healthcare providers, barriers to ASD screening, and access to ASD services.Conclusions: The results of this literature review will inform the development of an educational guide for parents and other caregivers to promote their knowledge and awareness about ASD in children.

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