Environmental Response Management Application

The Coastal Response Research Center (CRRC), a partnership between the University of New Hampshire (UNH) and NOAA\u27s Office of Response and Restoration (ORR), is leading an effort to develop a data platform capable of interfacing both static and real-time data sets accessible simultaneously to a command post and assets in the field with an open source internet mapping server. The Environmental Response Management Application (ERMA™) is designed to give responders and decision makers ready access to geographically specific data useful during spill planning/drills, incident response, damage assessment and site restoration. In addition to oil spill and chemical release response, this website can be relevant to other environmental incidents and natural disasters, responses and regional planning efforts. The platform is easy to operate, without the assistance of Information Technology or Geographic Information Systems (GIS) specialists. It allows users to access individual data layer values, overlay relevant data sets, and zoom into segments of interest. The platform prototype is being developed specifically for Portsmouth Harbor and the Great Bay Estuary, NH. The prototype demonstrates the capabilities of an integrated data management platform and serves as the pilot for web-based GIS platforms in other regions

Gender Differences in the Relationships between Alcohol, Tobacco and Mental Health in Patients attending an Emergency Department

Aims: There is evidence of a non-linear relationship between alcohol consumption and mental health status, and of an association between tobacco use and poor mental health. This paper examines the nature of the association between usual alcohol consumption, tobacco use and symptoms of anxiety and depression in Emergency Department patients in Queensland, Australia. Methods: A cross sectional survey of patients aged 16-84 presenting for treatment over a 14 day period to Gold Coast Hospital Emergency Department using socio-demographic items, the Alcohol Use Disorders Identification Test (AUDIT) to measure moderate, hazardous and harmful alcohol consumption, and the Hospital Anxiety and Depression Scale (HADS) to measure state anxiety and depression. Results: 812 patients were interviewed. Gender differences in results were evident. For men, there was a U-shaped relationship between alcohol consumption and anxiety/depression, and a linear association between smoking and anxiety. For women, alcohol consumption and anxiety/depression showed a more linear relationship, but there was no significant relationship between tobacco use and anxiety/depression. Conclusions: There may be important gender differences in the relationships between alcohol consumption, tobacco use and mental health status. This study supports previous evidence that mental health status of non-drinkers is worse than that of moderate drinkers, but only among males (First published on August 2, 2004, doi:10.1093/alcalc/agh080

Early primary care physician contact and health service utilisation in a large sample of recently released ex-prisoners in Australia: Prospective cohort study

Objective: To describe the association between ex-prisoner primary care physician contact within 1 month of prison release and health service utilisation in the 6 months following release. Design: A cohort from the Passports study with a mean follow-up of 219 (±44) days postrelease. Associations were assessed using a multivariate Andersen-Gill model, controlling for a range of other factors. Setting: Face-to-face, baseline interviews were conducted in a sample of prisoners within 6 weeks of expected release from seven prisons in Queensland, Australia, from 2008 to 2010, with telephone follow-up interviews 1, 3 and 6 months postrelease. Participants: From an original population-based sample of 1325 sentenced adult (≥18 years) prisoners, 478 participants were excluded due to not being released from prison during follow-up (n=7, 0.5%), loss to follow-up (n=257, 19.4%), or lacking exposure data (n=214, 16.2%). A total of 847 (63.9%) participants were included in the analyses. Exposure: Primary care physician contact within 1 month of follow-up as a dichotomous measure. Main outcome measures: Adjusted time-to-event hazard rates for hospital, mental health, alcohol and other drug and subsequent primary care physician service utilisations assessed as multiple failure time-interval data. Results: Primary care physician contact prevalence within 1 month of follow-up was 46.5%. One-month primary care physician contact was positively associated with hospital (adjusted HR (AHR)=2.07; 95% CI 1.39 to 3.09), mental health (AHR=1.65; 95% CI 1.24 to 2.19), alcohol and other drug (AHR=1.48; 95% CI 1.15 to 1.90) and subsequent primary care physician service utilisation (AHR=1.47; 95% CI 1.26 to 1.72) over 6 months of follow-up. Conclusions: Engagement with primary care physician services soon after prison release increases health service utilisation during the critical community transition period for ex-prisoners

Sensitivity of a national coronial database for monitoring unnatural deaths among ex-prisoners in Australia

<p>Abstract</p> <p>Background</p> <p>The period immediately after release from custody is a time of marked vulnerability and increased risk of death for ex-prisoners. Despite this, there is currently no routine, national system for monitoring ex-prisoner mortality in Australia. This study subsequently aimed to evaluate the sensitivity of Australia's National Coroners Information System (NCIS) for identifying reportable deaths among prisoners and ex-prisoners.</p> <p>Findings</p> <p>Prisoner and ex-prisoner deaths identified through an independent search of the NCIS were compared with 'gold standard' records of prisoner and ex-prisoner deaths, generated from a national monitoring system and a state-based record linkage study, respectively. Of 294 known deaths in custody from 2001-2007, an independent search of the NCIS identified 229, giving a sensitivity of 77.9% (72.8%-82.3%). Of 677 known deaths among ex-prisoners from 2001-2007, an independent search of the NCIS identified 37, giving a sensitivity of 5.5% (4.0-7.4%). Ex-prisoner deaths that were detected were disproportionately drug-related, occurring within the first four weeks post-release, among younger prisoners and among those with more than two prior prison admissions.</p> <p>Conclusions</p> <p>Although a search of the NCIS detected the majority of reportable deaths among prisoners, it was only able to detect a small minority of reportable deaths among ex-prisoners. This suggests that the NCIS is not effective for monitoring mortality among ex-prisoners in Australia. Given the elevated rates of mortality among ex-prisoners in Australia and elsewhere, there remains an urgent need to establish a process for routine monitoring of ex-prisoner mortality, preferably through record linkage.</p

Acceptability of prison-based take-home naloxone programmes among a cohort of incarcerated men with a history of regular injecting drug use

Background: Take-home naloxone (THN) programmes are an evidence-based opioid overdose prevention initiative. Elevated opioid overdose risk following prison release means release from custody provides an ideal opportunity for THN initiatives. However, whether Australian prisoners would utilise such programmes is unknown. We examined the acceptability of THN in a cohort of male prisoners with histories of regular injecting drug use (IDU) in Victoria, Australia. Methods: The sample comprised 380 men from the Prison and Transition Health (PATH) Cohort Study; all of whom reported regular IDU in the 6 months prior to incarceration. We asked four questions regarding THN during the pre-release baseline interview, including whether participants would be willing to participate in prison-based THN. We describe responses to these questions along with relationships between before- and during-incarceration factors and willingness to participate in THN training prior to release from prison. Results: Most participants (81%) reported willingness to undertake THN training prior to release. Most were willing to resuscitate a friend using THN if they were trained (94%) and to be revived by a trained peer (91%) using THN. More than 10 years since first injection (adjusted odds ratio [AOR] 2.22, 95%CI 1.03-4.77), having witnessed an opioid overdose in the last 5 years (AOR 2.53, 95%CI 1.32-4.82), having ever received alcohol or other drug treatment in prison (AOR 2.41, 95%CI 1.14-5.07) and injecting drugs during the current prison sentence (AOR 4.45, 95%CI 1.73-11.43) were significantly associated with increased odds of willingness to participate in a prison THN programme. Not specifying whether they had injected during their prison sentence (AOR 0.37, 95%CI 0.18-0.77) was associated with decreased odds of willingness to participate in a prison THN training. Conclusion: Our findings suggest that male prisoners in Victoria with a history of regular IDU are overwhelmingly willing to participate in THN training prior to release. Factors associated with willingness to participate in prison THN programmes offer insights to help support the implementation and uptake of THN programmes to reduce opioid-overdose deaths in the post-release period

The health of adolescents in detention : a global scoping review

Adolescents detained within the criminal justice system are affected by complex health problems, health-risk behaviours, and high rates of premature death. We did a global synthesis of the evidence regarding the health of this population. We searched Embase, PsycINFO, Education Resources Information Center, PubMed, Web of Science, CINCH, Global Health, the Cochrane Database of Systematic Reviews, the Campbell Library, the National Criminal Justice Reference System Abstract Database, and Google Scholar for peer-reviewed journal articles, including reviews, that reported the prevalence of at least one health outcome (physical, mental, sexual, infectious, and neurocognitive) in adolescents (aged <20 years) in detention, and were published between Jan 1, 1980, and June 30, 2018. The reference lists of published review articles were scrutinised for additional relevant publications. Two reviewers independently screened titles and abstracts, and three reviewed full texts of relevant articles. The protocol for this Review was registered with PROSPERO (CRD42016041392). 245 articles (204 primary research articles and 41 reviews) were included, with most primary research (183 [90%]) done in high-income countries. A high lifetime prevalence of health problems, risks, and conditions was reported in detained adolescents, including mental disorders (0–95%), substance use disorders (22–96%), self-harm (12–65%), neurodevelopmental disabilities (2–47%), infectious diseases (0–34%), and sexual and reproductive conditions (pregnant by age 19 years 20–37%; abnormal cervical screening test result 16%). Various physical and mental health problems and health-risk behaviours are more common among adolescents in detention than among their peers who have not been detained. As the social and structural drivers of poor health overlap somewhat with factors associated with exposure to the criminal justice system, strategies to address these factors could help to reduce both rates of adolescent detention and adolescent health inequalities. Improving the detection of mental and physical disorders, providing appropriate interventions during detention, and optimising transitional health care after release from detention could improve the health outcomes of these vulnerable young people

Age-related differences in patterns of criminal activity among a large sample of polydrug injectors in Australia

Background: The relationship between age and criminal activity among drug-using populations is poorly understood. Methods: Data from 10 years of repeat cross-sectional surveys of sentinel samples of regular people who inject drugs (PWID) across Australia (n=5844) were used to explore the relationship between age and past-month drug dealing, property crime and violent crime, and past-year arrest. Descriptive statistics were used to explore the prevalence and frequency of each outcome. The relationship between age and each outcome was measured using multivariable Poisson regression with robust error variance. Results: After adjusting for confounding factors, each 5-year increase in age was associated with significant reductions in drug dealing (adjusted incidence rate ratio [AIRR]: 0.90, 95% confidence interval [CI]: 0.87–0.94), property crime (AIRR: 0.85, 95% CI: 0.82–0.89) and violent crime (AIRR: 0.77, 95% CI: 0.70–0.85). Older participants were also significantly less likely to report being arrested in the past 12 months (AIRR: 0.91, 95% CI: 0.88–0.93). Conclusions: Younger PWID are more heavily involved in criminal activity compared with their older counterparts. This study highlights the need for early intervention programmes to prevent offending behaviour becoming entrenched, as well as continued efforts to redirect young PWID away from the criminal justice system and into treatment and education programmes