Citizenship and belonging in a women's immigration detention centre

This chapter draws on six months of fieldwork in IRC Yarl’s Wood, Britain’s primary immigration removal centre for women, to explore the racialised logic of citizenship and nationality that underpin border control. Using women’s testimonies, it seeks to ‘give voice’ to an otherwise ilenced custodial population. In doing so, it seeks to enrich the predominantly theoretical literature on border control and challenge its pessimistic view of such places merely as ‘zones of exclusion.’ A second and related goal is to demonstrate the salience of detention centres – and migration - for criminological research on race/ethnicity. Detention centres are complex and nuanced sites where issues of race and nationality are under constant debate. While the government restricts migration, such places play an increasingly important role both in determining and managing populations who are unwelcome and in setting out a British national identity

Mental health services inside immigration removal centres (access, perceived quality of health care and the ACDT process in IRC Morton Hall)

Drawing on targeted, exploratory interviews with a small number of staff and detainees conducted in February 2017, this report sets out a series of common practices and issues relating to services access and quality of mental health service provision, including ACDT plans in Morton Hall IRC. While many of the findings are negative, including high levels of distress among detainees, and uncertainty among staff of how to manage mental health problems among the detained community, the report also identifies some areas of good practice and support. It offers suggestions for improved sign-posting to available services, while identifying additional areas of possible development

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

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

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

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