The problems of offenders with mental disorders: A plurality of perspectives within a single mental health care organisation

Managers, doctors, nurses, occupational therapists, social workers, psychologists, unqualified staff and service users were interviewed for a qualitative study of risk management and rehabilitation in an inner city medium secure forensic mental health care unit. Different professional orientations to service user problems were identified. Doctors focused primarily on the diagnosis of mental disorder, which they managed mainly through pharmaceutical interventions. Psychologists were principally concerned with personal factors, for example service user insight into their biographical history. Occupational therapists concentrated mainly on daily living skills, and social workers on post-discharge living arrangements. Some front line nurses, held accountable for security lapses, adopted a criminogenic approach. Service users were more likely than professionals to understand their needs in terms of their wider life circumstances. These differences are explored qualitatively in relation to four models of crossdisciplinary relationships: monoprofessional self-organisation combined with restricted communication; hermeneutic reaching out to other perspectives; the establishment of interdisciplinary sub-systems; and transdisciplinary merger. Relationships between professions working in this unit, as portrayed in qualitative interviews, corresponded mainly to the first model of monoprofessional self-organisation. Reasons for restricted crossdisciplinary understanding, particularly the wide power/status differences between the medical and other professions, and between staff and patients, are discussed

The problems of offenders with mental disorders: A plurality of perspectives within a single mental health care organisation

Managers, doctors, nurses, occupational therapists, social workers, psychologists, unqualified staff and service users were interviewed for a qualitative study of risk management and rehabilitation in an inner city medium secure forensic mental health care unit. Different professional orientations to service user problems were identified. Doctors focused primarily on the diagnosis of mental disorder, which they managed mainly through pharmaceutical interventions. Psychologists were principally concerned with personal factors, for example service user insight into their biographical history. Occupational therapists concentrated mainly on daily living skills, and social workers on post-discharge living arrangements. Some front line nurses, held accountable for security lapses, adopted a criminogenic approach. Service users were more likely than professionals to understand their needs in terms of their wider life circumstances. These differences are explored qualitatively in relation to four models of crossdisciplinary relationships: monoprofessional self-organisation combined with restricted communication; hermeneutic reaching out to other perspectives; the establishment of interdisciplinary sub-systems; and transdisciplinary merger. Relationships between professions working in this unit, as portrayed in qualitative interviews, corresponded mainly to the first model of monoprofessional self-organisation. Reasons for restricted crossdisciplinary understanding, particularly the wide power/status differences between the medical and other professions, and between staff and patients, are discussed

Border Security: A Comprehensive Review of the United States’ Approach to Southwest Border Policy

This paper addresses the effect that the presence of a physical border wall on the southern United States-Mexico border has on deterring unauthorized immigration, illegal drug-trafficking, and countering narco-terrorism. While current techniques and legislation have intended to secure major crossing locations, they have resulted in a redistribution of border route traffic putting more immigrants in fatal danger and increasing demand for coyotes, or human trafficking guides. Not only have the government and media created a public perception of fear in its efforts to protect the homeland through national security, but there have also been negative effects on people on both sides of the border in the process. The impact of political-economic factors of border security and its ties to foreign policy will be considered as well as the relevance of drug violence and immigration perspectives in creating legislation. This paper will seek to describe a more comprehensive and contemporary border policy that utilizes technology and more inclusive policy while still upholding prevention of danger on America’s homeland

Correctional Practitioners on Reentry: A Missed Perspective

Much of the literature on reentry of formerly incarcerated individuals revolves around discussions of failures they incur during reintegration or the identification of needs and challenges that they have during reentry from the perspective of community corrections officers. The present research fills a gap in the reentry literature by examining the needs and challenges of formerly incarcerated individuals and what makes for reentry success from the perspective of correctional practitioners (i.e., wardens and non-wardens). The views of correctional practitioners are important to understand the level of organizational commitment to reentry and the ways in which social distance between correctional professionals and their clients may impact reentry success. This research reports on the results from an email survey distributed to a national sample of correctional officials listed in the American Correctional Association, 2012 Directory. Specifically, correctional officials were asked to report on needs and challenges facing formerly incarcerated individuals, define success, identify factors related to successful reentry, recount success stories, and report what could be done to assist them in successful outcomes. Housing and employment were raised by wardens and corrections officials as important needs for successful reentry. Corrections officials adopted organizational and systems perspectives in their responses and had differing opinions about social distance. Policy implications are presented

AI for the Common Good?! Pitfalls, challenges, and Ethics Pen-Testing

Recently, many AI researchers and practitioners have embarked on research visions that involve doing AI for "Good". This is part of a general drive towards infusing AI research and practice with ethical thinking. One frequent theme in current ethical guidelines is the requirement that AI be good for all, or: contribute to the Common Good. But what is the Common Good, and is it enough to want to be good? Via four lead questions, I will illustrate challenges and pitfalls when determining, from an AI point of view, what the Common Good is and how it can be enhanced by AI. The questions are: What is the problem / What is a problem?, Who defines the problem?, What is the role of knowledge?, and What are important side effects and dynamics? The illustration will use an example from the domain of "AI for Social Good", more specifically "Data Science for Social Good". Even if the importance of these questions may be known at an abstract level, they do not get asked sufficiently in practice, as shown by an exploratory study of 99 contributions to recent conferences in the field. Turning these challenges and pitfalls into a positive recommendation, as a conclusion I will draw on another characteristic of computer-science thinking and practice to make these impediments visible and attenuate them: "attacks" as a method for improving design. This results in the proposal of ethics pen-testing as a method for helping AI designs to better contribute to the Common Good.Comment: to appear in Paladyn. Journal of Behavioral Robotics; accepted on 27-10-201

Consumer-Directed Health Care: Can Consumers Look After Themselves?

In health care systems today, including those of Switzerland and the United States, participants do not necessarily see the big picture of lifetime health costs and quality of life, and in many systems consumers and providers lack the incentives to manage preventative and chronic care to minimize lifetime private and social health costs. Resource allocation problems induced by asymmetric information and misaligned incentives are exacerbated if consumers fail to have the acuity or perspective needed to make choices consistent with their self-interest when faced with complex health care choices with ambiguous future consequences. This paper examines rationality of consumers’ health perceptions and choices using as a natural experiment the recent introduction in the United States of a highly subsidized market for prescription drug insurance, and draws lessons from this experiment on the practicality of “Consumer Directed Health Care” as an approach to achieving efficient allocation of health care resources by confronting consumers with the full marginal costs of the services they use

Biopiracy <i>versus </i>one-world medicine – from colonial relicts to global collaborative concepts

Background: Practices of biopiracy to use genetic resources and indigenous knowledge by Western companies without benefit-sharing of those, who generated the traditional knowledge, can be understood as form of neocolonialism.Hypothesis: : The One-World Medicine concept attempts to merge the best of traditional medicine from developing countries and conventional Western medicine for the sake of patients around the globe.Study design: Based on literature searches in several databases, a concept paper has been written. Legislative initiatives of the United Nations culminated in the Nagoya protocol aim to protect traditional knowledge and regulate benefit-sharing with indigenous communities. The European community adopted the Nagoya protocol, and the corresponding regulations will be implemented into national legislation among the member states. Despite pleasing progress, infrastructural problems of the health care systems in developing countries still remain. Current approaches to secure primary health care offer only fragmentary solutions at best. Conventional medicine from industrialized countries cannot be afforded by the impoverished population in the Third World. Confronted with exploding costs, even health systems in Western countries are endangered to burst. Complementary and alternative medicine (CAM) is popular among the general public in industrialized countries, although the efficacy is not sufficiently proven according to the standards of evidence-based medicine. CAM is often available without prescription as over-the-counter products with non-calculated risks concerning erroneous self-medication and safety/toxicity issues. The concept of integrative medicine attempts to combine holistic CAM approaches with evidence-based principles of conventional medicine.Conclusion: To realize the concept of One-World Medicine, a number of standards have to be set to assure safety, efficacy and applicability of traditional medicine, e.g. sustainable production and quality control of herbal products, performance of placebo-controlled, double-blind, randomized clinical trials, phytovigilance, as well as education of health professionals and patients

BioCloud Search EnGene: Surfing Biological Data on the Cloud

The massive production and spread of biomedical data around the web introduces new challenges related to identify computational approaches for providing quality search and browsing of web resources. This papers presents BioCloud Search EnGene (BSE), a cloud application that facilitates searching and integration of the many layers of biological information offered by public large-scale genomic repositories. Grounding on the concept of dataspace, BSE is built on top of a cloud platform that severely curtails issues associated with scalability and performance. Like popular online gene portals, BSE adopts a gene-centric approach: researchers can find their information of interest by means of a simple “Google-like” query interface that accepts standard gene identification as keywords. We present BSE architecture and functionality and discuss how our strategies contribute to successfully tackle big data problems in querying gene-based web resources. BSE is publically available at: http://biocloud-unica.appspot.com/

Social and environmental factors influencing in-prison drug use

Purpose – There is a strong political imperative to regard the prison as a key social setting for health promotion, but evidence indicates that drug misuse continues to be a significant issue for many prisoners. This paper aims to examine the social and environmental factors within the setting that influence individuals' drug taking. Design/methodology/approach – Focus groups and interviews were conducted with prisoners and staff in three male training prisons in England. The sampling approach endeavoured to gain “maximum variation” so that a broad based understanding of the prison setting could be gathered. The data were analysed in accordance with Attride-Stirling's thematic network approach. Findings – The findings suggest a myriad of social and environmental factors influencing drug use. While staff recognised the scale of the drugs problem, they struggled to cope with creative inmates who were not perturbed by taking risks to gain their supplies. Fellow prisoners played a major role in individuals' decision making, as did the boredom of institutional life and Mandatory Drug Testing (MDT) policies within the institutions. Practical implications – Drug treatment is an essential component of prison healthcare, but it only forms a small part of creating a health-promoting setting. If the health-promoting prison is to be fully realised, a more radical, upstream and holistic outlook is required. Originality/value – The settings approach is an important theoretical and practical approach in health promotion. In comparison to other settings (such as schools), however, there has been limited research on the prison as a health-promoting environment