Finally Fit for Purpose: The Evolution of Australian Prison Architecture

This article argues that Australian prisons have uncritically emulated American penitentiaries in their architecture and structure. We suggest that simply transporting physical design models from one geographic and politicocultural setting to another, with little commitment to understanding the context-bound philosophies and conditions that underpin such models, has been highly problematic. The result has been an Australian penal estate that for decades was incompatible with its aims and purpose. Finally, we discuss the eventual introduction of unique, innovative styles of penal architecture in Australia, which are not only appropriate to their culture and context, but represent world-class developments in penal design.Elizabeth Grant, and Yvonne Jewke

Risk factors for teenage pregnancy among sexually active black adolescents in Cape Town. A case control study.

MOTIVATION: Teenage pregnancy is an important health and social problem in South Africa. So far research on adolescent sexual activity has been almost exclusively descriptive; as a result there is considerable knowledge about practices of adolescents in general and outcomes of their pregnancies, but very limited understanding of factors that place particular adolescents at increased risk of teenage pregnancy. Without this understanding, our ability to intervene effectively to reduce teenage pregnancy rates is limited. OBJECTIVE: To undertake an exploratory study to investigate risk factors for teenage pregnancy among sexually active adolescents in an urban and peri-urban context. METHODS: The study used a matched case-control design, with 191 cases and 353 age-matched controls from the same school or neighbourhood. Subjects were under 19 years of age and were recruited from township areas of Cape Town. A structured questionnaire was used to obtain information on socio-economic factors, contraceptive knowledge and use, and sexual behaviour. Conditional logistical regression was used to analyse the relationship between teenage pregnancy and the factors investigated. RESULTS: Teenage pregnancy was found to be most strongly associated with having frequent sex (risk ratio (RR) 30.81) without reliable contraceptive protection (RR 24.35), forced sexual initiation (RR 14.42), not owning a television set (RR 10.33), larger household size (RR 2.44), not living in a brick house (RR 5.09), not living with the biological father (RR 3.26), talking openly about sex with a boyfriend (RR 4.72), and perceiving most friends to be pregnant (RR 4.38). CONCLUSIONS: The findings suggest associations between the promotion of sexual health among adolescents and broader social development and promotion of gender equality. Although further research is needed, it is likely that important foci for short-term strategies should include developing assertiveness, enhancing decision-making competence, and promoting contraception and condoms as part of comprehensive sexual and reproductive health educational interventions

Where to for Sexual Health Education for Adolescents in Sub-Saharan Africa?

Rachel Jewkes discusses disappointing results from a school-based sexual health intervention study in Tanzania and their implications for future health education programs

Medico-Legal Findings, Legal Case Progression, and Outcomes in South African Rape Cases: Retrospective Review

Rachel Jewkes and colleagues examine the processing of rape cases by South African police and courts and show an association between documentation of ano-genital injuries, trials commencing, and convictions in rape cases

Towards Additive Manufacture of Functional, Spline-Based Morphometric Models of Healthy and Diseased Coronary Arteries:In Vitro Proof-of-Concept Using a Porcine Template

The aim of this study is to assess the additive manufacture of morphometric models of healthy and diseased coronary arteries. Using a dissected porcine coronary artery, a model was developed with the use of computer aided engineering, with splines used to design arteries in health and disease. The model was altered to demonstrate four cases of stenosis displaying varying severity, based on published morphometric data available. Both an Objet Eden 250 printer and a Solidscape 3Z Pro printer were used in this analysis. A wax printed model was set into a flexible thermoplastic and was valuable for experimental testing with helical flow patterns observed in healthy models, dominating the distal LAD (left anterior descending) and left circumflex arteries. Recirculation zones were detected in all models, but were visibly larger in the stenosed cases. Resin models provide useful analytical tools for understanding the spatial relationships of blood vessels, and could be applied to preoperative planning techniques, but were not suitable for physical testing. In conclusion, it is feasible to develop blood vessel models enabling experimental work; further, through additive manufacture of bio-compatible materials, there is the possibility of manufacturing customized replacement arteries

More important than guns or grog: The role of television for the health and wellbeing of Australian Aboriginal prisoners

Published online: 30 Nov 2018This article examines the provision of television in the South Australian prison system and its importance to the identity, health, wellbeing and ontological security of Aboriginal prisoners. Existing research has explored the use of broadcast and print media by prisoners in the United Kingdom, United States and Europe and has established that television has an impact on incarcerated audiences far beyond its role as an ‘electronic babysitter’ or a means of filling time. It is also recognised that television plays a significant role in the lives of Aboriginal people (Michaels 1986). However, little is known about television in relation to incarcerated Aboriginal and Torres Strait Islander Australians. This article draws on data concerning in-cell television (‘TV’) among Aboriginal men in prison,1 which found that, when asked to identify the most important factors in the prison environment, 87 per cent of participants identified access to in-cell television as the single most important factor contributing to their congruency with prison accommodation. The article further indicates that access to in-cell television has the potential to reduce incidents of suicide and self-harm and should be adopted as a ‘best-practice’ principle for Aboriginal prisoners in Australian correctional environments.Elizabeth Grant and Yvonne Jewkeshttp://heinonline.org/HOL/Index?index=journals/cicj&collection=journal

Sexual Power and HIV Risk, South Africa1

Among a sample of young women, limited sexual power was associated with inconsistent condom use but not directly with HIV

Exploring the effectiveness of the output-based aid voucher program to increase uptake of gender-based violence recovery services in Kenya: a qualitative evaluation

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Few studies in Africa have explored in detail the ability of output-based aid (OBA) voucher programs to increase access to gender-based violence recovery (GBVR) services. Methods: A qualitative study was conducted in 2010 and involved: (i) in-depth interviews (IDIs) with health managers, service providers, voucher management agency (VMA) managers and (ii) focus group discussions (FGDs) with voucher users, voucher non-users, voucher distributors and opinion leaders drawn from five program sites in Kenya. Results: The findings showed promising prospects for the uptake of OBA GBVR services among target population. However, a number of factors affect the uptake of the services. These include lack of general awareness of the GBVR services vouchers, lack of understanding of the benefit package, immediate financial needs of survivors, as well as stigma and cultural beliefs that undermine reporting of cases or seeking essential medical services. Moreover, accreditation of only hospitals to offer GBVR services undermines access to the services in rural areas. Poor responsiveness from law enforcement agencies and fear of reprisal from perpetrators also undermine treatment options and access to medical services. Low provider knowledge on GBVR services and lack of supplies also affect effective provision and management of GBVR services. Conclusions: The above findings suggest that there is a need to build the capacity of health care providers and police officers, strengthen the community strategy component of the OBA program to promote the GBVR services voucher, and conduct widespread community education programs aimed at prevention, ensuring survivors know how and where to access services and addressing stigma and cultural barriers.The Bill and Melinda Gates Foundatio

Delays in seeking an abortion until the second trimester: a qualitative study in South Africa

<p>Abstract</p> <p>Background</p> <p>Despite changes to the South African abortion legislation in 1996, barriers to women accessing abortions still exist. Second trimester abortions, an inherently more risky procedure, continue to be 20% of all abortions. Understanding the reasons why women delay seeking an abortion until the second trimester is important for informing interventions to reduce the proportion of second trimester abortions in South Africa.</p> <p>Methods</p> <p>Qualitative research methods were used to collect data. Twenty-seven in-depth interviews were conducted in 2006 with women seeking a second trimester abortion at one public sector tertiary hospital and two NGO health care facilities in the greater Cape Town area, South Africa. Data were analysed using a grounded theory approach.</p> <p>Results</p> <p>Almost all women described multiple and interrelated factors that influenced the timing of seeking an abortion. Reasons why women delayed seeking an abortion were complex and were linked to changes in personal circumstances often leading to indecision, delays in detecting a pregnancy and health service related barriers that hindered access to abortion services.</p> <p>Conclusion</p> <p>Understanding the complex reasons why women delay seeking an abortion until the second trimester can inform health care interventions aimed at reducing the proportion of second trimester abortions in South Africa.</p