Relationships Among Stress Measures, Risk Factors, and Inflammatory Biomarkers in Law Enforcement Officers

Law enforcement officers suffer higher morbidity and mortality rates from all causes than the general population. Cardiovascular disease (CVD) accounts for a significant portion of the excess illness, with a reported prevalence as high as 1.7 times that of the general population. To determine which occupational hazards cause this increased risk and morbidity, it is imperative to study law enforcement officers before they retire. The long-range goal of our research is to reduce the incidence of CVD-related illness and death among aging law enforcement officers. The purpose of the present study was to measure pro- and anti-atherogenic inflammatory markers in blood samples from law enforcement officers (n = 71) and determine what types of occupation-related stress correlate with differences in these markers. For each outcome variable of interest, we developed separate regression models. Two groups of potential predictors were examined for inclusion in the models. Selected measures of stress were examined for inclusion in the models, in addition to general covariates, such as gender, ethnicity, years in law enforcement, and body mass index. Our results revealed statistically significant relationships between several physiologic variables and measures of stress

Of House and Home: The meanings of housing for women engaged in criminalised street-based sex work

Despite emerging as a core concern for street-based sex workers participating in prostitution diversion programmes (PDPs), housing has received limited empirical attention. In this article, we explore the meanings of housing in the context of court-affiliated PDPs in the US cities of Baltimore and Philadelphia based on interviews and focus groups with 31 PDP participants and 32 criminal legal system professionals. Three themes emerged: (a) housing precarity and crisis mode, (b) housing as a foundation, and (c) housing as an idea(l). PDPs prioritise therapeutic interventions targeting individual behaviours and attitudes over meeting basic needs, often placing programme participants in substandard housing and removing them from existing networks of support. Such prioritisation, which often conflicts with participants’ expressed preferences, does not always leave them better off in the short or long term. PDPs’ neglect of the quality, type, and meaning of housing reveals and reinforces a fundamental disregard for people in street-based sex trade as multifaceted, agentic human beings. We conclude that programmes must prioritise home as a ‘comfort zone’ that must be afforded to all people

Reflections on the Arts, Environment, and Culture After Ten Years of The Goose

To mark the tenth anniversary of The Goose, we asked prominent ecologically-minded scholars, writers, artists, and educators from across Canada to reflect on the relationship between the arts, culture, and the environment. Their comments illuminate a wide range of triumphs and tensions, from the politics and practices of environmentalist writing and art, to the connections between the environment and matters of diversity and justice, to the past and future of ALECC (Association for Literature, Environment, and Culture in Canada), to the world of a single poem

Testimony on Pennsylvania SB1306: No Additional Protections for Religious Freedom

On behalf of the Public Rights/Private Conscience Project (PRPCP) at Columbia Law School I offer the following legal analysis of Senate Bill 1306. Overall, the current version of the bill promises to modernize Pennsylvania’s Human Relations Act by expanding antidiscrimination protections in employment to include sexual orientation and gender identity-based discrimination. Were the Pennsylvania legislature to pass SB 1306, the Commonwealth would join twenty-two states that include sexual orientation and nineteen states that include gender identity in their laws assuring equal employment opportunities for their citizens

Evaluating process and clinical outcomes of a primary care mental health integration project in rural Rwanda: a prospective mixed-methods protocol

Introduction: Integrating mental healthcare into primary care can reduce the global burden of mental disorders. Yet data on the effective implementation of real-world task-shared mental health programmes are limited. In 2012, the Rwandan Ministry of Health and the international healthcare organisation Partners in Health collaboratively adapted the Mentoring and Enhanced Supervision at Health Centers (MESH) programme, a successful programme of supported supervision based on task-sharing for HIV/AIDS care, to include care of neuropsychiatric disorders within primary care settings (MESH Mental Health). We propose 1 of the first studies in a rural low-income country to assess the implementation and clinical outcomes of a programme integrating neuropsychiatric care into a public primary care system. Methods and analysis A mixed-methods evaluation will be conducted. First, we will conduct a quantitative outcomes evaluation using a pretest and post-test design at 4 purposively selected MESH MH participating health centres. At least 112 consecutive adults with schizophrenia, bipolar disorder, depression or epilepsy will be enrolled. Primary outcomes are symptoms and functioning measured at baseline, 8 weeks and 6 months using clinician-administered scales: the General Health Questionnaire and the brief WHO Disability Assessment Scale. We hypothesise that service users will experience at least a 25% improvement in symptoms and functioning from baseline after MESH MH programme participation. To understand any outcome improvements under the intervention, we will evaluate programme processes using (1) quantitative analyses of routine service utilisation data and supervision checklist data and (2) qualitative semistructured interviews with primary care nurses, service users and family members. Ethics and dissemination This evaluation was approved by the Rwanda National Ethics Committee (Protocol #736/RNEC/2016) and deemed exempt by the Harvard University Institutional Review Board. Results will be submitted for peer-reviewed journal publication, presented at conferences and disseminated to communities served by the programme