Carceral citizenship in Puerto Rico: Self-help and punishment

The predominant criminological view of ‘carceral citizenship’ takes citizenship as a purely juridical matter, overlooking key social dimensions of citizenship as a human practice. To understand how the carceral turn is reconfiguring citizenship in Puerto Rico, I explore how formerly incarcerated people carve out a place for themselves in Puerto Rican society under the shadow of the prison. Focusing on one couple and their efforts to operate a therapeutic community, I show how self-help supplies a subset of former prisoners with a publicly recognized form of social belonging. Though more stable and encompassing than the stigmatized exile that awaits many people returning from prison, this carceral citizenship invites formerly incarcerated people to assume critical roles in the confinement, punishment, and care of people convicted of drug offences. Overall, this article highlights how self-help and punishment have emerged as intertwined mediums through which formerly incarcerated people assert their citizenship. Resumen: Ciudadanía carcelaria en Puerto Rico: Autoayuda y castigo La visión criminológica predominante de la “ciudadanía carcelaria” considera la ciudadanía como una cuestión puramente jurídica, obviando dimensiones sociales clave de la ciudadanía como la práctica humana. Para entender cómo el giro carcelario está reconfigurando la ciudadanía en Puerto Rico, exploro cómo las personas excarceladas se hacen un hueco en la sociedad puertorriqueña bajo la sombra de la prisión. Centrándome en una pareja y sus esfuerzos por gestionar una comunidad terapéutica, muestro cómo la autoayuda proporciona una forma de pertenencia social públicamente reconocida a un subconjunto de ex reclusos. Aunque más estable y abarcadora que el exilio estigmatizado que espera a muchas personas que regresan de la cárcel, esta ciudadanía carcelaria invita a personas anteriormente encarceladas a asumir funciones críticas en el confinamiento, castigo y cuidado de personas condenadas por delitos de drogas. En general, este artículo destaca cómo la autoayuda y el castigo han surgido como medios entrelazados a través de los cuales las personas excarceladas afirman su ciudadanía

Labors of Recovery: Superfluity and Livelihood in Puerto Rican Addiction Shelters

This dissertation examines Puerto Rican therapeutic communities – resource-poor mutual-aid collectives that have flourished over the past five decades, despite being heavily criticized by human rights groups for using unwaged labor as a method to treat addiction. The persistence of these communities, which are spreading rapidly across Latin America, is widely ascribed in international media to state neglect. I conducted a year of ethnographic research in Puerto Rico to understand why labor therapies thrive, and what these approaches are intended to achieve among those who practice them. Challenging the argument that labor therapies are the simple result of the state failing to provide alternatives, my research shows that during the last half century therapeutic communities have been successively recruited to serve a variety of distinct and sometimes competing interests. My examination of the multiple, contested, and sometimes-converging projects that inhere within this therapeutic regime shows that these organizations have variously served as entrepreneurial projects of informal enterprise, existential projects of redemption, state projects of containment, and shunt-valves for relieving burdens of dependency from straining kinship systems. Their endurance, therefore, not only reflects their capacity to patch the cracks of multiple faltering systems (including employment, corrections, family), but it also reflects their protean vulnerability to appropriation: that is, the ease with which they are co-opted by other actors for alternative utilities. Based on eight months of intensive participant observation in one therapeutic community, La Casita, where I explored the cultural logics and meanings of labor therapies, I argue that “drug treatment” here is not centrally geared towards “treating addiction.” Instead, La Casita’s therapeutic practices of labor therapy, time-discipline, prayer, and internal work are more instructively read as social technologies through which men who are excluded from the labor market and estranged from kinship ties seek to cultivate an alternative masculinity that restores their sense of worth. The “socially useful” masculinity under construction here, based on a performance of work, responsibility, and duty, offers unemployed men an alternative way to claim the dignity and social membership of work

Tea, talk and technology: patient and public involvement to improve connected health ‘wearables’ research in dementia

Plain English summary There are a growing number of mobile phones, watches and electronic devices which can be worn on the body to track aspects of health and well-being, such as daily steps, sleep and exercise. Dementia researchers think that these devices could potentially be used as part of future research projects, for example to help spot changes in daily activity that may signal the early symptoms of dementia. We asked a range of older people, including people living with dementia and their carers, to participate in interactive discussions about how future participants might find using these devices as part of research projects. We also invited volunteers to borrow a range of devices to test at home, giving them further insights. Discussions revealed that people were generally supportive of this type of research, provided they gave informed consent and that devices were discreet, comfortable and easy to use. They also valued technical support and regular feedback on study progress to encourage ongoing participation. These findings were used to develop a pool of devices for researchers, with computer software and written guidance to help plan, design and support studies. Our work shows that when given the right opportunities, people who are affected by dementia can provide valuable insights that can enhance the design, delivery and quality of future research. Abstract Background Increasingly, researchers are recognising the potential for connected health devices, including smartphones and smartwatches, to generate high resolution data about patterns of daily activity and health outcomes. One aim of the Dementias Platform UK (DPUK) project is to provide researchers with a secure means to collect, collate and link data generated by such devices, thereby accelerating this type of research in the field of dementia. We aimed to involve members of the public in discussions about the acceptability and feasibility of different devices and research designs to inform the development of a device pool, software platform and written guidance to support future studies. Methods Over 30 people attended a series of interactive workshops, drop-in sessions and meetings in Greater Manchester. This included people living with dementia and cognitive impairments, carers and people without memory problems. Discussions were tailored to suit different audiences and focused on the feasibility and acceptability of a range of different wearable devices and research designs. We also invited volunteers to borrow a device to test at home, enabling further insights from hands-on interactions with devices. Results Discussions revealed that people were supportive of connected health dementia research in principle, provided they gave informed consent and that devices were discreet, comfortable and easy to use. Moreover, they recommended technical support and regular feedback on study progress to encourage ongoing participation. Conclusion By using a range of discussion-based and practical activities, we found it was feasible to involve people affected by dementia and use their insights to shape the development of a software platform and device pool to support future connected health dementia research. We recommend that researchers planning such studies in future pay adequate attention to designing suitable participant information, technical support and mechanisms of providing study progress updates to support sustained engagement from participants

“You're Really Gonna Kick Us All Out?” Sustaining Safe Spaces for Community-Based HIV Prevention and Control among Black Men Who Have Sex with Men

Black men who have sex with men (BMSM) experience among the highest rates of HIV infection in the United States. We conducted a community-based ethnography in New York City to identify the structural and environmental factors that influence BMSMs vulnerability to HIV and their engagement with HIV prevention services. Methods included participant observation at community-based organizations (CBOs) in New York City, in-depth interviews with 31 BMSM, and 17 key informant interviews. Our conceptual framework shows how creating and sustaining safe spaces could be a critical environmental approach to reduce vulnerability to HIV among BMSM. Participant observation, in-depth and key informant interviews revealed that fear and mistrust characterized men’s relation to social and public institutions, such as churches, schools, and the police. This fear and mistrust created HIV vulnerability among the BMSM in our sample by challenging engagement with services. Our findings suggest that to be successful, HIV prevention efforts must address these structural and environmental vulnerabilities. Among the CBOs that we studied, “safe spaces” emerged as an important tool for addressing these environmental vulnerabilities. CBOs used safe spaces to provide social support, to address stigma, to prepare men for the workforce, and to foster a sense of community among BMSM. In addition, safe spaces were used for HIV and STI testing and treatment campaigns. Our ethnographic findings suggest that safe spaces represent a promising but so far under-utilized part of HIV prevention infrastructure. Safe spaces seem integral to high impact comprehensive HIV prevention efforts, and may be considered more appropriately as part of HIV capacity-building rather than being nested within program-specific funding structures

Household finances of Carer's Allowance recipients

This report presents findings from qualitative research into the experiences of people claiming or with an underlying entitlement to Carer's Allowance (CA). The findings are based on in-depth interviews with 44 people who claimed CA or had an underlying entitlement to it, in three areas of the UK in summer 2013. The aim of the research was to better understand the following research questions: • How is CA viewed in terms of the household budget, and does this vary by type of household? • How do recipients use CA and what would be the impact of non-receipt? • How does the use of CA vary depending on who is being cared for and where? • What led to the decision to claim CA? • Has receipt of CA had different impacts at different times of the caring career? • What impact has caring had on labour market participation

Priorities for HIV and chronic pain research results from a survey of individuals with lived experience

The Global Task Force on Chronic Pain in HIV published seven research priorities in the field of HIV-associated chronic pain in 2019: (1) causes; (2) management; (3) treatment individualization and integration with addiction treatment; (4) mental and social health factors; (5) prevalence; (6) treatment cost effectiveness; and (7) prevention. The current study used a web-based survey to determine whether the research topics were aligned with the priorities of adults with lived experiences of HIV and chronic pain. We also collected information about respondents' own pain and treatment experiences. We received 311 survey responses from mostly US-based respondents. Most respondents reported longstanding, moderate to severe, multisite pain, commonly accompanied by symptoms of anxiety and/or depression. The median number of pain treatments tried was 10 (IQR = 8, 13), with medications and exercise being the most common modalities, and opioids being viewed as the most helpful. Over 80% of respondents considered all research topics either "extremely important" or "very important". Research topic #2, which focused on optimizing management of pain in people with HIV, was accorded the greatest importance by respondents. These findings suggest good alignment between the priorities of researchers and US-based people with lived experience of HIV-associated chronic pain.</p

A Brief, Daily, Online Mental Health and Well-being Intervention for University Staff During the COVID-19 Pandemic: Program Description and Outcomes Using a Mixed Methods Design

BACKGROUND: The unprecedented changes and isolation measures to contain COVID-19 have had multiple psychological and social impacts, with implications for professional and personal functioning. Evidence-informed interventions that can be rapidly implemented under pandemic conditions to support mental health during such times are urgently needed. OBJECTIVE: The aim of this study was to determine the acceptability and preliminary outcomes of a daily online mental health promotion program for tertiary education staff during the COVID-19 pandemic. METHODS: The “Victoria University (VU) Elevenses” program was delivered as an uncontrolled intervention at Victoria University (VU) in the western metropolitan region of Melbourne, Australia. In April 2020, an email invitation was sent to all academic and professional staff inviting them to: (1) participate in the program and (2) opt-in to the research component. The “VU Elevenses” program provided 10-15–minute microinterventions comprising lifestyle and well-being strategies to promote mental health via an online meeting platform at 11 AM each weekday. A mixed methods approach was used to evaluate the program, combining structured questionnaires with semistructured interviews to investigate the experiences of staff who participated in the program. RESULTS: Between 16 and 90 participants provided weekly program feedback. A total of 106 university staff opted into the longitudinal research component and 10 staff participated in the interviews. Participants reported high levels of satisfaction with sessions and perceived benefits for mental health. Approximately one quarter of participants reported moderate to severe symptoms of depression, anxiety, and stress at baseline, with significant reductions in these symptoms in the first 7 weeks of the program, corresponding with easing in mandatory isolation (“lockdown”) restrictions. Symptoms of depression, anxiety, and stress all increased when lockdown measures were reintroduced, but not to the same levels as found during the initial lockdown period. Overall changes in depression and anxiety from baseline to the end of the program were explained by changes in COVID-19–related distress, whereas changes in self-compassion explained changes in stress. CONCLUSIONS: We show that it is feasible and acceptable to develop and deliver a program of brief interventions in a timely manner, using a simple and accessible online platform. Although participation in the program was initially associated with reduced symptoms of depression, anxiety, and stress, participants’ mental health worsened with the reintroduction of a “lockdown” period. However, as symptoms of depression, anxiety, and stress did not return to levels observed at the start of the VU Elevenses program, participation in the uncontrolled intervention may have offered a protective benefit against the impact of the second significant lockdown period

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Hundreds of variants clustered in genomic loci and biological pathways affect human height

Most common human traits and diseases have a polygenic pattern of inheritance: DNA sequence variants at many genetic loci influence the phenotype. Genome-wide association (GWA) studies have identified more than 600 variants associated with human traits, but these typically explain small fractions of phenotypic variation, raising questions about the use of further studies. Here, using 183,727 individuals, we show that hundreds of genetic variants, in at least 180 loci, influence adult height, a highly heritable and classic polygenic trait. The large number of loci reveals patterns with important implications for genetic studies of common human diseases and traits. First, the 180 loci are not random, but instead are enriched for genes that are connected in biological pathways (P = 0.016) and that underlie skeletal growth defects (P < 0.001). Second, the likely causal gene is often located near the most strongly associated variant: in 13 of 21 loci containing a known skeletal growth gene, that gene was closest to the associated variant. Third, at least 19 loci have multiple independently associated variants, suggesting that allelic heterogeneity is a frequent feature of polygenic traits, that comprehensive explorations of already-discovered loci should discover additional variants and that an appreciable fraction of associated loci may have been identified. Fourth, associated variants are enriched for likely functional effects on genes, being over-represented among variants that alter amino-acid structure of proteins and expression levels of nearby genes. Our data explain approximately 10% of the phenotypic variation in height, and we estimate that unidentified common variants of similar effect sizes would increase this figure to approximately 16% of phenotypic variation (approximately 20% of heritable variation). Although additional approaches are needed to dissect the genetic architecture of polygenic human traits fully, our findings indicate that GWA studies can identify large numbers of loci that implicate biologically relevant genes and pathways.

Impact of early disease factors on metabolic syndrome in systemic lupus erythematosus: data from an international inception cohort.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.The metabolic syndrome (MetS) may contribute to the increased cardiovascular risk in systemic lupus erythematosus (SLE). We examined the association between MetS and disease activity, disease phenotype and corticosteroid exposure over time in patients with SLE.Recently diagnosed (1, higher disease activity, increasing age and Hispanic or Black African race/ethnicity were independently associated with MetS over the first 2 years of follow-up in the cohort.MetS is a persistent phenotype in a significant proportion of patients with SLE. Renal lupus, active inflammatory disease and damage are SLE-related factors that drive MetS development while antimalarial agents appear to be protective from early in the disease course.Canadian Institutes of Health Research 93695 86526 Arthritis Research UK (Arthritis Research UK Epidemiology Unit Core Support Programme Grant) National Institute for Health Research (NIHR) Biomedical Research Unit Funding Scheme NIHR Manchester Biomedical Research Centre Arthritis Research UK Manchester Academic Health Science Centre NIHR Biomedical Research Unit Funding Scheme NIHR Manchester Wellcome Trust Clinical Research Facility Arthritis Research Clinical Research Fellowship 18845 Ministry for Health and Welfare, Republic of Korea A120404 Lupus UK NIHR/Wellcome Trust Clinical Research Facility at University Hospital Birmingham NHS Foundation Trust and City Hospital Sandwell and West Birmingham Hospitals NHS Trust, UK NIH UL1 RR025741 P60AR 30692 K24 AR 002138 RR00046 Hopkins Lupus Cohort NIH RD-1 43727 Department of Education, Universities and Research, Basque Government Singer Family Fund for Lupus Research tier 1 Canada Research Chair on Systemic Autoimmune Rheumatic Diseases, Universite Lava