198 research outputs found

    Watched over or over-watched? Open street CCTV in Australia

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    Most developed countries, Australia included, are witnessing increased government and public concerns about crime and security. Amid these anxieties, closed circuit television (CCTV) systems to monitor public spaces are increasingly being touted as a solution to problems of crime and disorder. The city of Perth established Australia’s first open street closed circuit television system in July 1991. Subsequently, there has been significant expansion. At the end of 2002 Australia had 33 “open street” CCTV schemes. Based on site inspections, extensive reviews of documentation and interviews with 22 Australian administrators, this article discusses issues relating to system implementation, management and accountability.We also suggest ways relevant authorities might ensure that current and future schemes are appropriately audited and evaluated. We argue that rigorous independent assessment of both the intended and unintended consequences of open street CCTV is essential to ensure this measure is not deployed inappropriately. Finally, this article suggests any potential crime prevention benefits must be carefully weighed against the potential of CCTV to exacerbate social division and exclusion

    The terrain of urbanisation process and policy frameworks: A critical analysis of the Kampala experience

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    Kampala is urbanising in an unplanned manner, but without a clear picture of the underlying dynamics. The city is characterised by lack of proper zoning of economic activities and construction of physical infrastructure without regard to subsequent spatial quality and environmental conservation. Consequently, there are sharp differences in residential standards where expensive housing and luxury flats co-exist with shanty towns and informal settlements, with about 60% of the city’s population living in unplanned informal settlements and often faced with challenges of unemployment. The unprecedented increase in the urban population in Kampala and the prospects for further increases in the near future have economic and social implications concerning employment, housing, education and health, among others. Understanding the nature of the dynamics of the growth or decline of cities like Kampala helps planners to support the processes that lead to harmonious urban development and to deal with the negative consequences of urban growth. This paper reflects the urbanisation dynamics explaining Kampala’s urbanisation process with the view to analysing the implications for an alternative urban policy framework. It argues that the conditions that have allowed the situation to exist have serious policy implications which require the need for an integrated policy framework that can be used to effectively prevent or halt Kampala’s unplanned urbanisation while promoting planned urbanisation. Induced by the migration and lack of information, understanding urban dynamics is crucial to the development of urban policies that can effectively ensure that further urban changes occur in a systematic and satisfactory manner. The current urban process in developing countries like Uganda is associated with poverty, environmental degradation and population demands that outstrip service capacity

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Social determinants of male health: a case study of Leeds, UK.

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    BACKGROUND: The social determinants of health have a disproportionate impact on mortality in men. A study into the state of health of the male population in Leeds was undertaken to guide public health commissioning decisions. This paper reports on the data relating to the social lives of men. METHODS: A cross-sectional study was undertaken, comprising descriptive analysis of data relating to educational attainment, housing, employment (including benefit claimants), marital status and relationships. Data was considered for the whole city and localised at the Middle Super Output Area (MSOA) level and mapped against the Index of Deprivation. RESULTS: Boys' educational attainment was found to be lagging behind girls' from their earliest assessments (Early Years Foundation Stage Profile, 46% vs. 60%, P = 0.00) to GCSEs (53% vs. 63%, P = 0.00), leaving many men with no qualifications. There were 68% more men than women identified as being unemployed, with more men claiming benefits. Men living in social housing are more likely to be housed in high-rise flats. Almost 50% of men aged 16-64 are single, with 2254 lone fathers. CONCLUSIONS: There appears to be a lack of sex/gender analysis of current cross city data. In areas of deprivation a complex picture of multiple social problems emerges, with marked gender differences in the social determinants of health, with males seeming to be more negatively affected. There is a need for more focused planning for reaching out and targeting boys and men in the most deprived inner city areas, so that greater efficiency in service delivery can be obtained
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