Doing research in immigration removal centres: ethics, emotions and impact

Immigration Removal Centres (IRCs) are deeply contested institutions that rarely open their doors to independent research. In this article we discuss some of the complications we faced in conducting the first national study of everyday life in them. As we will set out, research relationships were difficult to forge due to low levels of trust, and unfamiliarity with academic research. At the same time, many participants had unrealistic expectations about our capacity to assist while most exhibited high levels of distress. We were not immune from the emotional burden of the field sites. Such matters were compounded by the limited amount of published information about life in IRCs and a lack of ethical guidelines addressing such places. Drawing on related literature from prison sociology, we use our experiences in IRCs to set out a methodological account of understanding, ethics, and impact within these complex sites

Determining the labour force status of Aboriginal people using a multinomial logit model

It is well documented that Aboriginal people are less likely to be in employment and more likely to be unemployed or not in the labour force than are other Australians. The aim of this paper is to consider some of the reasons for these differences in the statistical framework of a multinomial regression equation. Using 1986 Census data, results are presented for males and females on the effect of Aboriginality, education, age, family characteristics and location of residence on the probability of being in full-time employment, part-time employment, unemployment or not in the labour force. Major results include the negative effect of Aboriginality on the probability of being in full-time employment and the positive effect of more education on the probability of being in full-time employment. This latter result was particularly strong for Aboriginal women. These results will provide an important benchmark for comparing results from a similar exercise using 1991 Census data

Study protocol: The Adherence and Intensification of Medications (AIM) study - a cluster randomized controlled effectiveness study

Abstract Background Many patients with diabetes have poor blood pressure (BP) control. Pharmacological therapy is the cornerstone of effective BP treatment, yet there are high rates both of poor medication adherence and failure to intensify medications. Successful medication management requires an effective partnership between providers who initiate and increase doses of effective medications and patients who adhere to the regimen. Methods In this cluster-randomized controlled effectiveness study, primary care teams within sites were randomized to a program led by a clinical pharmacist trained in motivational interviewing-based behavioral counseling approaches and authorized to make BP medication changes or to usual care. This study involved the collection of data during a 14-month intervention period in three Department of Veterans Affairs facilities and two Kaiser Permanente Northern California facilities. The clinical pharmacist was supported by clinical information systems that enabled proactive identification of, and outreach to, eligible patients identified on the basis of poor BP control and either medication refill gaps or lack of recent medication intensification. The primary outcome is the relative change in systolic blood pressure (SBP) measurements over time. Secondary outcomes are changes in Hemoglobin A1c, low-density lipoprotein cholesterol (LDL), medication adherence determined from pharmacy refill data, and medication intensification rates. Discussion Integration of the three intervention elements - proactive identification, adherence counseling and medication intensification - is essential to achieve optimal levels of control for high-risk patients. Testing the effectiveness of this intervention at the team level allows us to study the program as it would typically be implemented within a clinic setting, including how it integrates with other elements of care. Trial Registration The ClinicalTrials.gov registration number is NCT00495794.http://deepblue.lib.umich.edu/bitstream/2027.42/78258/1/1745-6215-11-95.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78258/2/1745-6215-11-95.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78258/3/1745-6215-11-95-S1.DOCPeer Reviewe

Virtual harm reduction efforts for Internet gambling: effects of deposit limits on actual Internet sports gambling behavior

Background: In an attempt to reduce harm related to gambling problems, an Internet sports betting service provider, bwin Interactive Entertainment, AG (bwin), imposes limits on the amount of money that users can deposit into their online gambling accounts. We examined the effects of these limits on gambling behavior. Methods: We compared (1) gambling behavior of those who exceeded deposit limits with those who did not, and (2) gambling behavior before and after exceeding deposit limits. We analyzed 2 years of the actual sports gambling behavior records of 47000 subscribers to bwin. Results: Only 160 (0.3%) exceeded deposit limits at least once. Gamblers who exceeded deposit limits evidenced higher average number of bets per active betting day and higher average size of bets than gamblers who did not exceed deposit limits. Comparing the gambling behavior before and after exceeding deposit limits revealed slightly more unfavorable gambling behavior after exceeding deposit limits. Conclusion: Our findings indicate that Internet gamblers who exceed deposit limits constitute a group of bettors willing to take high risks; yet, surprisingly, they appear to do this rather successfully because their percentage of losses is lower than others in the sample. However, some of these gamblers exhibit some poor outcomes. Deposit limits might be necessary harm reduction measures to prevent the loss of extremely large amounts of money and cases of bankruptcy. We discuss how these limits might be modified based on our findings

Narratives of self and identity in women's prisons: stigma and the struggle for self-definition in penal regimes

A concern with questions of selfhood and identity has been central to penal practices in women's prisons, and to the sociology of women's imprisonment. Studies of women's prisons have remained preoccupied with women prisoners’ social identities, and their apparent tendency to adapt to imprisonment through relationships. This article explores the narratives of women in two English prisons to demonstrate the importance of the self as a site of meaning for prisoners and the central place of identity in micro-level power negotiations in prisons

Exploring the character of rural businesses: performing change and continuity

The purpose of this paper is to use a series of business interviews in the UK and Denmark as a means of interrogating the categorisation of rural businesses presented in an earlier publication which sought to understand the rural character of different businesses (Bosworth 2012). Rather than defining a rural business purely on its geographical location, the engagement of a business within a rural economy and its relations with both rural and urban environments are more complex issues. A wider conceptualisation how rural social relations, cultural influences and landscape values, forms the basis for analysing how these assets can create value for rural businesses. Understanding these issues can better inform organisations that are seeking to support the rural economy and rural communities. It can also guide business owners themselves as to how they might benefit from being a part of, or associated with, the rural economy in capturing the possibilities linked to a growing urban population. The findings reveal how landscape assets are intertwined in the business concepts as positive drivers despite many voices within rural and economic research pointing at disadvantages relating to distance, sparseness of infrastructure or service provision. The research analysis draws on Actor-network theory and this tool reveals promising prospects for future place-based studies in how landscape assets can be enacted in the development of the rural economy

Exploring the character of rural businesses: performing change and continuity

The purpose of this paper is to use a series of business interviews in the UK and Denmark as a means of interrogating the categorisation of rural businesses presented in an earlier publication which sought to understand the rural character of different businesses (Bosworth 2012). Rather than defining a rural business purely on its geographical location, the engagement of a business within a rural economy and its relations with both rural and urban environments are more complex issues. A wider conceptualisation how rural social relations, cultural influences and landscape values, forms the basis for analysing how these assets can create value for rural businesses. Understanding these issues can better inform organisations that are seeking to support the rural economy and rural communities. It can also guide business owners themselves as to how they might benefit from being a part of, or associated with, the rural economy in capturing the possibilities linked to a growing urban population. The findings reveal how landscape assets are intertwined in the business concepts as positive drivers despite many voices within rural and economic research pointing at disadvantages relating to distance, sparseness of infrastructure or service provision. The research analysis draws on Actor-network theory and this tool reveals promising prospects for future place-based studies in how landscape assets can be enacted in the development of the rural economy

Improving Care Coordination for Veterans Within VA and Across Healthcare Systems

The VA faces a plethora of care coordination challenges. Many Veterans have multiple conditions and providers, and many get a portion of their care in the community, a number that will only grow as recent legislation expands options for private care. These challenges have spawned new VA initiatives for redesigning care to meet them, described in this supplement in an editorial by Hosenfeld and colleagues. The VA Health Services Research and Development (HSR&D) service, in partnership with VA’s Office of Primary Care, and Office of Community Care, sponsored a State of the Art (SOTA) conference with the goals of (a) summarizing what is known about care coordination relevant to Veterans’ care; (b) identifying care coordination approaches ready for wider dissemination and implementation within VA; and (c) identifying a research agenda and recommendations, as appropriate, for increasing VA’s knowledge and use of evidence-based approaches for coordinating care. Held in March 2018, the SOTA was jointly planned by VA HSR&D and Offices of Primary Care, Community Care, Nursing Services, and Care Management and Social Work, and convened VA and non-VA health services researchers, clinicians, and policy makers. This supplement presents recommendations from the SOTA as well as original research papers on care coordination strategies within VA and between VA and non-VA providers