Can a suitable model of community development be developed for the sustainable support of older people in Wales?

Community development is a crucial tool for the achievement of public health objectives, and the support of older people in the community is a key objective of public health This study examines the evolution of thinking on that subject. The history of community development, from its beginnings to the present, is studied in detail, particularly the development of divergent approaches to the method between the U.K. and the U.S.A. The development of community-based policies toward the revitalisation of communities in the U.K is examined There is a focus on Wales, and how the Welsh Government has strived for consistency in delivering its public health agenda in line with the World Health Organization's policies for health and well-being. In Wales, the economic and social realities of recession have retarded government's efforts to achieve this. Wales has produced innovative and progressive policies in the social regeneration field, especially for older people. The economic crisis will impact on future generations of older people with increasing severity unless an alternative source of support, outside the State, can be found. This study is the search for a viable solution for this problem - can the community be a sustainable resource for the support for older people? The salient issues arising from community development values, modelling, and practice in the U.K. and the U.S.A. have been combined with systems theory. This has produced a new model for the strategic planning of community development at the social planning level and for the co-ordination of local community resources. The work of Jack Rothman, Saul Alinsky, and the Tavistock Institute has been the baseline for this study, but the Welsh experience has been incorporated to ground this approach in context. The Welsh Government's Strategy for Older People has provided a model for policy formation and also for a vehicle for direct intervention for social change using community development models

Control room concept for remote maintenance in high radiation areas

This paper summarizes the design of a control room concept for an operator interface with remote maintenance equipment consisting of force-reflecting manipulators, tools, hoists, cranes, cameras, and lights. The design development involved two major activities. First, detailed requirements were defined for foreseeable functions that will be performed by the control room operators. Second, concepts were developed, tested, and refined to meet these requirements. 6 references, 3 figures

Geometry of Frictionless and Frictional Sphere Packings

We study static packings of frictionless and frictional spheres in three dimensions, obtained via molecular dynamics simulations, in which we vary particle hardness, friction coefficient, and coefficient of restitution. Although frictionless packings of hard-spheres are always isostatic (with six contacts) regardless of construction history and restitution coefficient, frictional packings achieve a multitude of hyperstatic packings that depend on system parameters and construction history. Instead of immediately dropping to four, the coordination number reduces smoothly from $z=6$ as the friction coefficient $\mu$ between two particles is increased.Comment: 6 pages, 9 figures, submitted to Phys. Rev.

Statistics of the contact network in frictional and frictionless granular packings

Simulated granular packings with different particle friction coefficient mu are examined. The distribution of the particle-particle and particle-wall normal and tangential contact forces P(f) are computed and compared with existing experimental data. Here f equivalent to F/F-bar is the contact force F normalized by the average value F-bar. P(f) exhibits exponential-like decay at large forces, a plateau/peak near f = 1, with additional features at forces smaller than the average that depend on mu. Computations of the force-force spatial distribution function and the contact point radial distribution function indicate that correlations between forces are only weakly dependent on friction and decay rapidly beyond approximately three particle diameters. Distributions of the particle-particle contact angles show that the contact network is not isotropic and only weakly dependent on friction. High force-bearing structures, or force chains, do not play a dominant role in these three dimensional, unloaded packings.Comment: 11 pages, 13 figures, submitted to PR

Post-release treatment uptake among participants of the Rhode Island Department of Corrections comprehensive medication assisted treatment program

The Rhode Island Department of Corrections (RIDOC) recently implemented the first state-wide, comprehensive medications for addiction treatment (MAT) program in the US. The objective of this study was to elucidate perceived barriers for individuals who participated in RIDOC's MAT program while incarcerated. Of the 588 individuals eligible for this study, 227 phone surveys were completed with 214 individuals. Data relevant to demographic characteristics, probation/parole status, retention in MAT treatment, MAT type received during incarceration, MAT treatment history, location where they received community treatment, perceived barriers to treatment, and future goals for MAT were collected. Simple percentages, frequencies, means, and standard deviations were calculated with SPSS. Most participants (82.4%) reported continuing MAT post-release and a majority (74.3%) received treatment at an opioid treatment program. Those who did not connect with treatment post-release reported transportation issues (23.1%) and not wanting to continue MAT (20.5%) as major reasons for not continuing treatment. The most commonly reported goal for treatment was to continue MAT long-term (43.5%). Results indicate that most participants linked to MAT treatment post-release. Participants reported reasons for why they did not continue MAT and had mixed intentions about continuing MAT in the future. Results provide identification of novel factors, such as side effects, time between release and treatment linkage, and family and friends' opinions that influence MAT continuation post-incarceration. Results highlight areas of exploration to influence treatment retention, including the role of probation/parole officers and the potential for peer support specialists to assist in reducing stigma and increasing interest in MAT

Situationally edited empathy: an effect of socio-economic structure on individual choice

Criminological theory still operates with deficient models of the offender as agent, and of social influences on the agent’s decision-making process. This paper takes one ‘emotion’, empathy, which is theoretically of considerable importance in influencing the choices made by agents; particularly those involving criminal or otherwise harmful action. Using a framework not of rational action, but of ‘rationalised action’, the paper considers some of the effects on individual psychology of social, economic, political and cultural structure. It is suggested that the climate-setting effects of these structures promote normative definitions of social situations which allow unempathic, harmful action to be rationalised through the situational editing of empathy. The ‘crime is normal’ argument can therefore be extended to include the recognition that the uncompassionate state of mind of the criminal actor is a reflection of the self-interested values which govern non-criminal action in wider society

Self-consistent scattering description of transport in normal-superconductor structures

We present a scattering description of transport in several normal-superconductor structures. We show that the related requirements of self-consistency and current conservation introduce qualitative changes in the transport behavior when the current in the superconductor is not negligible. The energy thresholds for quasiparticle propagation in the superconductor are sensitive to the existence of condensate flow ($v_s\neq 0$). This dependence is responsible for a rich variety of transport regimes, including a voltage range in which only Andreev transmission is possible at the interfaces, and a state of gapless superconductivity which may survive up to high voltages if temperature is low. The two main effects of current conservation are a shift towards lower voltages of the first peak in the differential conductance and an enhancement of current caused by the greater availability of charge transmitting scattering channels.Comment: 31 pages, 10 PS figures, Latex file, psfig.sty file is added. To appear in Phys. Rev. B (Jan 97

Pre-exposure prophylaxis awareness and interest among participants in a medications for addiction treatment program in a unified jail and prison setting in Rhode Island

People who are incarcerated are at increased risk for HIV (human immunodeficiency virus) acquisition upon release, and one possible intervention for prevention is the use of pre-exposure prophylaxis (PrEP) upon release. The present study assessed HIV risk perceptions as well as PrEP awareness and interest among 39 people who were incarcerated and enrolled in a structured Medication for Addiction Treatment (MAT) program at the Rhode Island Department of Corrections using semi-structured, qualitative interviews. Analysis was conducted using a generalized, inductive method in NVivo 12. While PrEP awareness was low across the study sample, some participants were interested in PrEP uptake or learning more about PrEP after they were provided with an overview of it. PrEP interest strongly related to current perceived HIV risk. Potential barriers included side effects, adherence, and reluctance to take medications in general. MAT programs for people who are criminal justice (CJ) involved may serve as useful linkage spaces to PrEP information, access, and retention

Estimating the impact of wide scale uptake of screening and medications for opioid use disorder in US prisons and jails

Background: Medications for opioid use disorder (OUD) are the most effective treatment for OUD, but uptake of these life-saving medications has been extremely limited in US prisons and jail settings, and limited data are available to guide policy decisions. The objective of this study was to estimate the impact of screening and treatment with medications for OUD in US prisons and jails on post-release opioid-related mortality. Methods: We used data from the National Center for Vital Statistics, the Bureau of Justice Statistics, and relevant literature to construct Monte Carlo simulations of a counterfactual scenario in which wide scale uptake of screening and treatment with medications for OUD occurred in US prisons and jails in 2016. Results: Our model predicted that 1840 (95% Simulation Interval [SI]: -2757 – 4959) lives would have been saved nationally if all persons who were clinically indicated had received medications for OUD while incarcerated. The model also predicted that approximately 4400 (95% SI: 2675 – 5557) lives would have been saved nationally if all persons who were clinically indicated had received medications for OUD while incarcerated and were retained in treatment post-release. These estimates correspond to 668 (95% SI: -1008 – 1812) and 1609 (95% SI: 972 – 2037) lives saved per 10,000 persons incarcerated, respectively. Conclusions: Prison and jail-based programs that comprehensively screen and provide treatment with medications for OUD have the potential to produce substantial reductions in opioid-related overdose deaths in a high-risk population; however, retention on treatment post-release is a key driver of population level impact

Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study

Background: We examined the impact of expanded access to medications for opioid use disorder (MOUD) in a unified prison and jail system on post-release, opioid-related overdose mortality. Methods: We developed a microsimulation model to simulate a population of 55,000 persons at risk of opioid-related overdose mortality in Rhode Island. The effect of an extended-release (XR) naltrexone only intervention and the effect of providing access to all three MOUD (i.e., methadone, buprenorphine, and XR-naltrexone) at release from incarceration on cumulative overdose death over eight years (2017–2024) were compared to the standard of care (i.e., limited access to MOUD). Results: In the standard of care scenario, the model predicted 2385 opioid-related overdose deaths between 2017 and 2024. An XR-naltrexone intervention averted 103 deaths (4.3% reduction), and access to all three MOUD averted 139 deaths (5.8% reduction). Among those with prior year incarceration, an XR-naltrexone only intervention and access to all three MOUD reduced overdose deaths by 22.8% and 31.6%, respectively. Conclusions: Expanded access to MOUD in prison and jail settings can reduce overdose mortality in a general, at-risk population. However, the real-world impact of this approach will vary by levels of incarceration, treatment enrollment, and post-release retention