COVID-19 Restrictions In Jails And Prisons: Perspectives From Carceral Leaders.

COVID-19 has been an unprecedented challenge in carceral facilities. As COVID-19 outbreaks spread in the US in early 2020, many jails, prisons, juvenile detention centers, and other carceral facilities undertook infection control measures such as increased quarantine and reduced outside visitation. However, the implementation of these decisions varied widely across facilities and jurisdictions. We explored how carceral decision makers grappled with ethically fraught public health challenges during the pandemic. We conducted semistructured interviews during May-October 2021 with thirty-two medical and security leaders from a diverse array of US jails and prisons. Although some facilities had existing detailed outbreak plans, most plans were inadequate for a rapidly evolving pandemic such as COVID-19. Frequently, this caused facilities to enact improvised containment plans. Quarantine and isolation were rapidly adopted across facilities in response to COVID-19, but in an inconsistent manner. Decision makers generally approached quarantine and isolation protocols as a logistical challenge, rather than an ethical one. Although they recognized the hardships imposed on incarcerated people, they generally saw the measures as justified. Comprehensive outbreak control guidelines for pandemic diseases in carceral facilities are urgently needed to ensure that future responses are more equitable and effective.

"It was like you were being literally punished for getting sick": formerly incarcerated people's perspectives on liberty restrictions during COVID-19.

BACKGROUND: COVID-19 has greatly impacted the health of incarcerated individuals in the US. The goal of this study was to examine perspectives of recently incarcerated individuals on greater restrictions on liberty to mitigate COVID-19 transmission. METHODS: We conducted semi-structured phone interviews from August through October 2021 with 21 people who had been incarcerated in Bureau of Prisons (BOP) facilities during the pandemic. Transcripts were coded and analyzed, using a thematic analysis approach. RESULTS: Many facilities implemented universal "lockdowns," with time out of the cell often limited to one hour per day, with participants reporting not being able to meet all essential needs such as showers and calling loved ones. Several study participants reported that repurposed spaces and tents created for quarantine and isolation provided "unlivable conditions." Participants reported receiving no medical attention while in isolation, and staff using spaces designated for disciplinary purposes (e.g., solitary housing units) for public health isolation purposes. This resulted in the conflation of isolation and discipline, which discouraged symptom reporting. Some participants felt guilty over potentially causing another lockdown by not reporting their symptoms. Programming was frequently stopped or curtailed and communication with the outside was limited. Some participants relayed that staff threatened to punish noncompliance with masking and testing. Liberty restrictions were purportedly rationalized by staff with the idea that incarcerated people should not expect freedoms, while those incarcerated blamed staff for bringing COVID-19 into the facility. CONCLUSIONS: Our results highlighted how actions by staff and administrators decreased the legitimacy of the facilities' COVID-19 response and were sometimes counterproductive. Legitimacy is key in building trust and obtaining cooperation with otherwise unpleasant but necessary restrictive measures. To prepare for future outbreaks facilities must consider the impact of liberty-restricting decisions on residents and build legitimacy for these decisions by communicating justifications to the extent possible.

Empowering mathematics teachers to meet evolving educational goals: the role of "epistemic objects” in developing actionable practice knowledge in tumultuous times

In recent decades, the aims and objectives of education–and therefore public discourse on the appropriate skills and attributes of mathematics teachers–have been rapidly shifting due to forces from outside the teaching profession. The forces driving change in mathematics are as diverse as the emergence of "Industry 4.0” and "STEM,” new directions in transnational education policy making, and the COVID-19 pandemic. This paper contributes to a growing literature seeking to empower teachers to respond to the complexity of such multifaceted change expansively rather than defensively. It does so through the refinement and application of practical theories of educational change and approaches to building actionable practice knowledge. Specifically, this paper will argue for the use of the epistemic object as a practical focus for changes to practice chosen by the profession. This argument will be made within the framework of practice architectures offered by Kemmis and others. The paper first considers the impact of some recent disruptions on teaching and then provides a "worked example” of using mathematical proficiencies as an epistemic object able to practically support teachers to develop actionable knowledge grounded in the specifics of their own professional context. © 2022 Australian Teacher Education Association.

COVID-19 vaccination hesitancy and uptake: Perspectives from people released from the Federal Bureau of Prisons.

People in United States (US) prisons and jails have been disproportionately impacted by the COVID-19 pandemic. This is due to challenges containing outbreaks in facilities and the high rates of health conditions that increase the risk of adverse outcomes. Vaccination is one strategy to disrupt COVID-19 transmission, but there are many factors impeding vaccination while in custody. We aimed to examine the perspectives of former residents in the Federal Bureau of Prisons (BOP) regarding COVID-19 vaccine hesitancy and acceptance. Between September-October 2021, we conducted semi-structured interviews with 21 recently released individuals who were incarcerated before and during COVID-19 and coded transcripts thematically. We assessed perceptions of the vaccine rollout and factors shaping vaccination uptake in custody and after release. The vaccine was available to seven participants in custody, of whom three were vaccinated. Interviewees had mixed attitudes about how vaccines were distributed, particularly with priority given to staff. Most were reluctant to get vaccinated in custody for varying reasons including observing staff declining to be vaccinated, lack of counseling to address specific questions about safety, and general lack of trust in the carceral system. By contrast, twelve got vaccinated post-release because of greater trust in community health care and stated they would not have done so while incarcerated. For residents in the BOP, COVID-19 vaccination was not simply a binary decision, instead they weighed the costs and benefits with most deciding against getting vaccinated. Institutions of incarceration must address these concerns to increase vaccine uptake as the pandemic continues.

Tales from the (disrupted) field: Contemplating interruptions, disruptions, and ethnography amidst a pandemic

Many ethnographers had to reconceptualize or withdraw from their fieldwork due to COVID-19. While the process of exiting the field has always interested ethnographers, the pandemic has spurred further thinking about the complexity of this element of the research process. This paper adds to the conversations around leaving a field site by unpacking the different situations that can trigger departure. Using data from our experience conducting ethnographic fieldwork before and during the pandemic to further our understanding of the complexity of exiting the field, we explore the concept of field collapsing events by elaborating on the differences between interruptions and disruptions. It is not the case that one form of stoppage has more weight, merit, or impact on an ethnographic project. Instead, we argue that to parse out the complexities of exiting the field, we must create more clarity around the kinds of exits that ethnographers experience.

A novel virtual simulation training improves providers' knowledge and confidence to manage obstetric emergencies

Objective: Maternal mortality in the United States (US) is rising and many deaths are preventable. We sought to determine the efficacy of virtual simulation training to optimize management of obstetric emergencies within low and moderate volume delivery hospitals that are disproportionately affected by adverse maternal outcomes. Study Design: The educational platform was designed and deployed within urban non-teaching and rural hospitals, with low and moderate delivery volumes, in the US during the COVID-19 pandemic. Self-paced, interactive, online didactics on postpartum hemorrhage and hypertensive disorders of pregnancy were followed by two, 2-hour live virtual simulation trainings and debriefings. In this innovative simulation modality, participants verbalized actions to their co-participants and the simulation faculty as scenarios evolved with images, vitals and videos displayed on a PowerPoint. Participants completed multiple-choice questionnaires and confidence and attitude surveys prior to, immediately after and 3-months post-training. The multiple-choice questions were evidence-based using information from published guidelines and were validated by local experts. Paired t-tests were performed to asses for changes in knowledge and confidence. Result(s): From December 2021 to March 2022, four hospitals received training (Table 1). Participants (n=22) were comprised of nurses (59%), certified nurse midwives (14%) and attending physicians (23%) in Obstetrics, Family Practice or Anesthesiology. The survey response rate was 59%. The mean difference in knowledge and confidence scores significantly improved immediately post-training compared to baseline (P < 0.05 for all, Table 2). This improvement was maintained 3 months following the training. Participants reported their preferred training format was hybrid (43%), virtual (35.7%) or in-person (21.4%). Conclusion(s): Virtual obstetric simulation is feasible and improves knowledge and confidence, which can be retained over time. This educational modality is sustainable, scalable and an accessible format to enhance education and training. [Formula presented] [Formula presented] Copyright © 2022

MODELING A NOVEL METHOD TO DIMINISH AIRBORNE COVID-19 TRANSMISSION IN A HOSPITAL ROOM

In this paper, we used a computational fluid dynamics model to evaluate the effects of a novel medical apparatus (“Felix-1”) on the spread of contagion in a hospital room. We found that Felix-1, consisting of nasal cannula and an oxygen mask, captured 96% of the mass of exhaled particles ranging from 0.1µm to 100µm. This is more effective than a surgical mask. It was less effective at capturing small particles, but their mass is insubstantial. The caregivers inhaled only 24 parts per billion of particle mass exhaled by the patients. Our model included a full hospital room with two patients and four caregivers, each represented using medical imagery and realistic nonuniform breathing rate curves. Room ventilation was also modeled, and we allowed over a minute of flow time for the room to reach quasi-steady-state, which we evaluated using flow statistics and particle tracking results. © 2021 Begell House Inc.. All rights reserved.

A Human Rights Framework for Advancing the Standard of Medical Care for Incarcerated People in the United States in the Time of COVID-19.

The COVID-19 pandemic has underscored the lack of resources and oversight that hinders medical care for incarcerated people in the United States. The US Supreme Court has held that "deliberate indifference" to "serious medical needs" violates the Constitution. But this legal standard does not assure the consistent provision of health care services. This leads the United States to fall behind European nations that define universal standards of care grounded in principles of human rights and the ideal of equivalence that incarcerated and non-incarcerated people are entitled to the same health care. In this paper, we review a diverse legal and policy literature and undertake a conceptual analysis of policy issues related to the standard of care in correctional health; we then describe a framework for moving incrementally closer toward a universal standard. The expansion of Medicaid funding and benefits to corrections facilities, alongside a system of comprehensive and enforceable external oversight, would meaningfully raise the standard of care. Although these changes on their own will not resolve all of the thorny health problems posed by mass incarceration, they present a tangible opportunity to move closer to the human rights ideal.

Unstable gynaecological patient with an ankle monitor: implications of US Immigration and Customs Enforcement's Alternatives to Detention programme in the healthcare setting.

We review the case of an unstable gynaecological patient in the USA who presented with profuse vaginal bleeding after spontaneous miscarriage and was ultimately diagnosed with a uterine arteriovenous malformation managed with interventional radiology embolisation of her uterine artery. Her case was complicated by the presence of an ankle monitoring device which had been placed by US Immigration and Customs Enforcement as part of the Alternatives to Detention programme in which she was enrolled during her immigration proceedings. The device prompted important considerations regarding the potential use of cautery, MRI compatibility and device-related trauma, in addition to causing significant anxiety for the patient, who was concerned about how the team's actions could affect her immigration case. Discussion of her course and shared perspective highlights the unique clinical and medicolegal considerations presented by the expanded use of ankle monitoring devices for electronic surveillance (or 'e-carceration') of non-violent immigrants and others.

Imagining "We" in the Age of "I": Romance and Social Bonding in Contemporary Culture

In the early twenty- first century, shifts in gender and sexuality, work and mobility patterns and especially technology have provoked interest in perceived threats to social bonding on a global scale. This edited collection explores the fracturing of couple culture but also its persistence. Looking at a variety of media sites- including film, television, popular print fiction, new media and new technologies- this volume's diverse range of contributors examine how mediated scenes of intimacy proliferate, while real- life experiences are cast in a newly uncertain light. The collection thus challenges a latent but growing tendency towards perceptions of romantic decline, in a variety of cultural contexts and with attention to the impact of COVID- 19. This is an accessible and timely collection suitable for scholars in gender studies, media, cultural studies and communication studies. © 2022 selection and editorial matter, Mary Harrod, Suzanne Leonard and Diane Negra;individual chapters, the contributors.