Clinical and legal implications of gangs

Author(s):  
Annette L. Hanson

Gangs are a fact of life in jails and prisons. The extent and impact of gang activity on a facility will depend upon the size and geographic location of the facility. Smaller jails and prisons, or facilities in rural areas, are more likely to be involved with local or regional groups, also known as street gangs, while large facilities in urban areas will be affected more by nationally known or connected gangs. One survey of Florida prisoners found that inmates who were suspected or confirmed gang members were 35% more likely to commit violent acts than non-members. In a study of 2,158 male inmates in the Arizona Department of Corrections, gang-affiliated inmates were more than twice as likely as nonaffiliated inmates to commit an assault during the first three years of confinement Since institutional management often involves restriction of privileges, placement on long-term segregation, or transfer to a control unit prison, advocacy groups and individual inmates have filed suit against these policies based on First and Eighth Amendment, religious freedom, and anti-discrimination claims. Gang validation procedures themselves have been challenged as arbitrary and inaccurate, leading to inappropriate segregation or restrictions on prisoners who have exhibited no institutional violence. Psychiatrists need to be aware of the dynamics of gang leadership, membership or involvement when working with any gang member, as that will affect their ability and interest in collaborative treatment. These issues and best practices for intervention will be presented in this chapter.

2007 ◽  
Vol 35 (69_suppl) ◽  
pp. 35-44 ◽  
Author(s):  
Samuel J. Clark ◽  
Mark A. Collinson ◽  
Kathleen Kahn ◽  
Kyle Drullinger ◽  
Stephen M. Tollman

Aim: To examine the hypothesis that circular labour migrants who become seriously ill while living away from home return to their rural homes to convalesce and possibly to die. Methods: Drawing on longitudinal data collected by the Agincourt health and demographic surveillance system in rural northeastern South Africa between 1995 and 2004, discrete time event history analysis is used to estimate the likelihood of dying for residents, short-term returning migrants, and long-term returning migrants controlling for sex, age, and historical period. Results: The annual odds of dying for short-term returning migrants are generally 1.1 to 1.9 times (depending on period, sex, and age) higher than those of residents and long-term returning migrants, and these differences are generally highly statistically significant. Further supporting the hypothesis is the fact that the proportion of HIV/TB deaths among short-term returning migrants increases dramatically as time progresses, and short-term returning migrants account for an increasing proportion of all HIV/TB deaths. Conclusions: This evidence strongly suggests that increasing numbers of circular labour migrants of prime working age are becoming ill in the urban areas where they work and coming home to be cared for and eventually to die in the rural areas where their families live. This shifts the burden of caring for them in their terminal illness to their families and the rural healthcare system with significant consequences for the distribution and allocation of health care resources.


Water ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 298 ◽  
Author(s):  
Sayed Mohammad Nazim Uddin ◽  
Jean Lapegue ◽  
Jutta Gutberlet ◽  
Jan Franklin Adamowski ◽  
Caetano C. Dorea ◽  
...  

The use of closed-loop sanitation systems (CLSS), or reuse-oriented sanitation systems, has increased in recent years, and such systems have been successfully implemented in many parts of the world. However, no research has explored Traditional CLSS (T-CLSS) for a long-term humanitarian situation. This study explores the strengths, weaknesses, opportunities and threats (SWOT) of T-CLSS in peri-urban and rural contexts in three different provinces in Afghanistan (the first study of its kind in Afghanistan). Participatory research tools, such as transect walks, focus group discussions, smart community gatherings and interactive workshops, were applied to assess the SWOT associated with T-CLSS. The results indicate that T-CLSS has been practiced historically in both peri-urban and rural areas using local and traditional knowledge, skills and technologies. The socio-cultural acceptance of the system in both rural and peri-urban areas is an important strength of this established system. However, due to chronic development challenges in the study regions, T-CLSS may possibly lead to exposure to microbial contaminants. It is recommended that the feasibility of an improved CLSS be assessed and implemented in light of the issues that are inherent in the use of T-CLSS in Afghanistan.


Author(s):  
Herbert Weinblatt ◽  
Erik Minge ◽  
Scott Petersen

Vehicle classification data are an important component of traffic-monitoring programs. Although most vehicle classification conducted in the United States is axle based, some applications could be supplemented or replaced by length-based data. The typically higher deployment cost and reliability issues associated with collecting axle-based data as compared with length-based data present a challenge. This paper reports on analyses of alternative length-based vehicle classification schemes and appropriate length bin boundaries. The primary analyses use data from a set of 13 Long-Term Pavement Performance weigh-in-motion sites, all in rural areas; additional analyses are conducted with data from 11 Michigan Department of Transportation weigh-in-motion sites located in rural and small urban areas and one site located in an urbanized area. For most states, the recommended length-based vehicle classification scheme is a four-bin scheme (motorcycles, short, medium, and long) with an optional very long bin recommended for use by states in which significant numbers of longer combination vehicles operate.


2021 ◽  
Vol 18 (2) ◽  
pp. 55-72
Author(s):  
Ryota Nakamura ◽  
◽  
Takumi Kondo ◽  

This study analyzed the effects of access to safe drinking water on the nutritional status of children under the age of 59 months in urban and rural areas in Indonesia using the Indonesian Family Life Survey 5. Both piped water and packaged water were considered safe to drink. The descriptive statistics show that children in rural areas typically had insufficient access to safe drinking water and children who consumed safe drinking water had higher short- and long-term nutrition levels. To mitigate selection bias due to the non-random distribution of access to safe drinking water, a matching estimation was used to quantitatively determine the effects of access to safe drinking water on child nutrition. The provision of safe drinking water improved the short- and long-term nutritional status of children in rural areas but had no significant effect to that of children in urban areas. A simulation of this effect on child nutrition shows that in rural areas, improved access to safe drinking water decreases the stunting ratio by 13 percentage points and the wasting ratio by 6.1 percentage points. Additionally, both household income levels and community drinking water prices are important determinants of access to safe drinking water. Therefore, access to safe drinking water is necessary to improve the nutritional status of children in rural Indonesia, and community characteristics contribute to access.


2020 ◽  
Vol 12 (8) ◽  
pp. 3144 ◽  
Author(s):  
Liangwen Zhang ◽  
Sijia Fu ◽  
Ya Fang

There are a large number of disabled elderly people in China, which results in huge care and financial burdens to their families and society. However, China has not yet launched a unified long-term care insurance (LTCI) system. This study aims to predict the contribution rate of LTCI in China from 2020 to 2050 based on the long-term care (LTC) cost of the disabled elderly, aged 65 and over, in order to provide strong evidence for the establishment of a unified and sustainable national LTCI system in China. The simulations are based on data from the population census data, the Chinese statistical yearbook, and the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database. Based on the International Labor Organization (ILO) financing model from the perspective of fund balance, an overall simulation model and a Monte Carlo simulation are used to estimate the contribution rate of LTCI for disabled elderly from 2020 to 2050 in China. The total financial demands will increase sharply from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050. Of that total, 80.2% will be required in urban areas. In addition, the per capita financial demands of care in urban and rural areas in 2050 will be approximately six times and 11 times higher than in 2020, respectively. The predicted results show that the overall contribution rate of LTCI in China will increase sharply from 1.46% in 2020 to 5.14% in 2050, an increase of about 3.5 times. By comparison, the contribution rate in 2020 will be close to 1.33% in Japan in 2015 and 1.40% in Germany in 2010. According to the 1:1 payment proportion between employer and employee, each side bears 0.68% of the insurance premium. From 2020 to 2050, the financial demands of long-term care for disabled elderly in China will increase, especially in urban areas, and the burden of per capita financial demands in rural areas will increase significantly. The overall contribution rate of LTCI will increase linearly and the payment burden of policyholders will increase year by year. This study provides evidence of the need for the establishment of a sustainable financing mechanism for multiple financial supplies.


Oryx ◽  
2017 ◽  
Vol 53 (1) ◽  
pp. 145-150 ◽  
Author(s):  
Emmanuel M. Hema ◽  
Valy Ouattara ◽  
Gnoumou Parfait ◽  
Massimiliano Di Vittorio ◽  
Djidama Sirima ◽  
...  

AbstractTo explore the patterns of bushmeat trade in the Sahel we carried out a multidisciplinary study, focusing on Burkina Faso. We conducted baseline interview surveys to examine the variation in people's perceptions of bushmeat in relation to their place of residence (urban vs rural), sex and age. We also analysed the long-term (1985–2010) population dynamics of two ungulate species, the oribi Ourebia ourebi and the common duiker Sylvicapra grimmia, known to be among the main targets of the bushmeat trade locally. For the antelopes we chose as our study area a protected area (Nazinga Game Ranch) where poaching activities occur and are likely to represent a threat to the local wildlife. The results of the interviews underlined significant differences in bushmeat consumption between rural and urban areas. In particular, the probability of finding people who did not consume bushmeat increased in the urban area, where bushmeat is less available than in the rural areas. Sex and age did not have any effect on people's perceptions of bushmeat. In Burkina Faso bushmeat is still widely consumed, and this could be because the bushmeat trade is poorly controlled, with a lack of enforcement of the legislation. Long-term field surveys revealed that the oribi and the common duiker have declined significantly in Nazinga Game Ranch, suggesting that the bushmeat trade in Burkina Faso may have negative consequences in terms of the conservation outlook for these species.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mukhammadfoik Bakhadirov ◽  
Zakir Pashayev ◽  
Omar Farooq

PurposeThe paper answers the following questions: (1) Do firms located in rural areas experience greater problems in accessing financial services? (2) If this is the case, what can these firms do to improve their access to finance?Design/methodology/approachThis paper uses the pooled logistic regression and the data collected by the World Bank's Enterprise Surveys during the period between 2008 and 2018 to answer the aforementioned questions.FindingsThe results of this paper show that firms headquartered in rural (urban) areas experience greater (lower) problems in accessing finance than other firms. This paper attributes these findings to higher (lower) levels of information asymmetry and lower (higher) levels of density of banking operations in rural (urban) areas. The results of this paper also show that firms headquartered in rural areas can improve their access to finance by increasing the skill levels of their employees.Originality/valueThis paper highlights the actions that rural firms can undertake to overcome the adverse impact of their geographic location.


2020 ◽  
Vol 32 (2) ◽  
pp. 448-458 ◽  
Author(s):  
Guoxing Li ◽  
Jing Huang ◽  
Jinwei Wang ◽  
Minghui Zhao ◽  
Yang Liu ◽  
...  

BackgroundFine particulate matter (PM2.5) is an important environmental risk factor for cardiopulmonary diseases. However, the association between PM2.5 and risk of CKD remains under-recognized, especially in regions with high levels of PM2.5, such as China.MethodsTo explore the association between long-term exposure to ambient PM2.5 and CKD prevalence in China, we used data from the China National Survey of CKD, which included a representative sample of 47,204 adults. We estimated annual exposure to PM2.5 before the survey date at each participant’s address, using a validated, satellite-based, spatiotemporal model with a 10 km×10 km resolution. Participants with eGFR <60 ml/min per 1.73 m2 or albuminuria were defined as having CKD. We used a logistic regression model to estimate the association and analyzed the influence of potential modifiers.ResultsThe 2-year mean PM2.5 concentration was 57.4 μg/m3, with a range from 31.3 to 87.5 μg/m3. An increase of 10 μg/m3 in PM2.5 was positively associated with CKD prevalence (odds ratio [OR], 1.28; 95% confidence interval [CI], 1.22 to 1.35) and albuminuria (OR, 1.39; 95% CI, 1.32 to 1.47). Effect modification indicated these associations were significantly stronger in urban areas compared with rural areas, in males compared with females, in participants aged <65 years compared with participants aged ≥65 years, and in participants without comorbid diseases compared with those with comorbidities.ConclusionsThese findings regarding the relationship between long-term exposure to high ambient PM2.5 levels and CKD in the general Chinese population provide important evidence for policy makers and public health practices to reduce the CKD risk posed by this pollutant.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Pattaraporn Khongboon ◽  
Sathirakorn Pongpanich

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 532-532
Author(s):  
Linda Edelman ◽  
Kara Dassel

Abstract The purpose of our Geriatric Workforce Enhancement Program is to provide geriatric and primary care education and training to long-term care (LTC) providers and staff, health professions students and community members. Our LTC partners and the communities we serve are often very rural and travel to urban areas for training can be difficult. Therefore, we have developed four online training that are offered free to our partners and rural communities statewide. These programs are designed to integrate the aims of the Age-Friendly 4M’s model (i.e., What Matters, Mobility, Medication, Mentation). The LTC nurse residency program provides gerontological nursing and inter-professional leadership training (all 4M’s), in a synchronous online environment. The asynchronous Alzheimer’s Disease and Related Dementias training modules educate LTC staff and family caregivers about types, diagnosis and care of older adults with dementia (Mentation and Medication). The asynchronous Opioid Use in LTC modules were developed with partners to deliver live at LTC staff trainings about opioid stewardship (Medication). The LTC Learning Communities are monthly tele-health sessions for inter-professional LTC teams to discuss current issues and propose solutions (all 4M’s). We have successfully leveraged different synchronous and asynchronous online modalities to increase educational opportunities for formal and informal caregivers, including those in rural areas whose educational opportunities are geographically limited. To date our programs have reached over 500 individuals across our state, increasing knowledge about geriatric concepts, communication and team leadership. Moving forward, we will continue to develop and refine educational programs that promote the Age-Friendly geriatric-focused health care.


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