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1.
BMC Public Health ; 24(1): 1757, 2024 Jul 02.
Article in English | MEDLINE | ID: mdl-38956532

ABSTRACT

BACKGROUND: A growing literature has documented the social, economic, and health impacts of exclusionary immigration and immigrant policies in the early 21st century for Latiné communities in the US, pointing to immigration and immigrant policies as forms of structural racism that affect individual, family, and community health and well-being. Furthermore, the past decade has seen an increase in bi-partisan exclusionary immigration and immigrant policies. Immigration enforcement has been a major topic during the 2024 Presidential election cycle, portending an augmentation of exclusionary policies towards immigrants. Within this context, scholars have called for research that highlights the ways in which Latiné communities navigate exclusionary immigration and immigrant policies, and implications for health. This study examines ways in which Mexican-origin women in a midwestern northern border community navigate restrictive immigration and immigrant policies to access health-promoting resources and care for their well-being. METHODS: We conducted a grounded theory analysis drawing on interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. Interviews were conducted in English or Spanish, depending on participants' preferences, and were conducted at community-based organizations or other locations convenient to participants in 2013-2014. RESULTS: Women reported encountering an interconnected web of institutional processes that used racializing markers to infer legal status and eligibility to access health-promoting resources. Our findings highlight women's use of both individual and collective action to navigate exclusionary policies and processes, working to: (1) maintain access to health-promoting resources; (2) limit labeling and stigmatization; and (3) mitigate adverse impacts of immigrant policing on health and well-being. The strategies women engaged were shaped by both the immigration processes and structures they confronted, and the resources to which they had access to within their social network. CONCLUSIONS: Our findings suggest a complex interplay of immigration-related policies and processes, social networks, and health-relevant resources. They highlight the importance of inclusive policies to promote health for immigrant communities. These findings illuminate women's agency in the context of structural violence facing immigrant women and are particularly salient in the face of anti-immigrant rhetoric and exclusionary immigration and immigrant policies.


Subject(s)
Emigrants and Immigrants , Emigration and Immigration , Adult , Female , Humans , Middle Aged , Young Adult , Emigrants and Immigrants/psychology , Emigrants and Immigrants/statistics & numerical data , Emigration and Immigration/legislation & jurisprudence , Grounded Theory , Health Promotion/methods , Health Services Accessibility , Mexican Americans/psychology , Mexican Americans/statistics & numerical data , Michigan , Public Policy , Qualitative Research , Racism , Systemic Racism , Social Networking
2.
Lancet Reg Health Am ; 30: 100679, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38327278

ABSTRACT

Background: Incarceration is associated with drug-related harms among people who inject drugs (PWID). We trained >1800 police officers in Tijuana, Mexico on occupational safety and HIV/HCV, harm reduction, and decriminalization reforms (Proyecto Escudo). We evaluated its effect on incarceration, population impact and cost-effectiveness on HIV and fatal overdose among PWID. Methods: We assessed self-reported recent incarceration in a longitudinal cohort of PWID before and after Escudo. Segmented regression was used to compare linear trends in log risk of incarceration among PWID pre-Escudo (2012-2015) and post-Escudo (2016-2018). We estimated population impact using a dynamic model of HIV transmission and fatal overdose among PWID, with incarceration associated with syringe sharing and fatal overdose. The model was calibrated to HIV and incarceration patterns in Tijuana. We compared a scenario with Escudo (observed incarceration declines for 2 years post-Escudo among PWID from the segmented regression) compared to a counterfactual of no Escudo (continuation of stable pre-Escudo trends), assessing cost-effectiveness from a societal perspective. Using a 2-year intervention effect and 50-year time horizon, we determined the incremental cost-effectiveness ratio (ICER, in 2022 USD per disability-adjusted life years [DALYs] averted). Findings: Compared to stable incarceration pre-Escudo, for every three-month interval in the post-Escudo period, recent incarceration among PWID declined by 21% (adjusted relative risk = 0.79, 95% CI: 0.68-0.91). Based on these declines, we estimated 1.7% [95% interval: 0.7%-3.5%] of new HIV cases and 12.2% [4.5%-26.6%] of fatal overdoses among PWID were averted in the 2 years post-Escudo, compared to a counterfactual without Escudo. Escudo was cost-effective (ICER USD 3746/DALY averted compared to a willingness-to-pay threshold of $4842-$13,557). Interpretation: Escudo is a cost-effective structural intervention that aligned policing practices and human-rights-based public health practices, which could serve as a model for other settings where policing constitutes structural HIV and overdose risk among PWID. Funding: National Institute on Drug Abuse, UC MEXUS CONACyT, and the San Diego Center for AIDS Research (SD CFAR).

3.
Int J Equity Health ; 22(1): 199, 2023 09 28.
Article in English | MEDLINE | ID: mdl-37770859

ABSTRACT

BACKGROUND: Over the past decade, the United States (US) has seen a spike in migration across the US-Mexico border with an increase in hospital admissions of migrants and asylum-seekers under the custody of immigration law enforcement (ILE). This study aimed to determine how the presence of ILE officials affects patient care and provider experience in a teaching hospital setting. METHODS: This cross-sectional online survey solicited quantitative and qualitative feedback from medical students, residents, and attending physicians (n = 1364) at a teaching hospital system with two campuses in Arizona. The survey included participant demographics and addressed participants' experience caring for patients in ILE custody, including the perception of respect, violations of patients' privacy and autonomy, and the comfort level with understanding hospital policies and patient rights. Thematic analyses were also performed based on respondent comments. RESULTS: 332 individuals (24%) responded to the survey. Quantitative analyses revealed that 14% of participants described disrespectful behaviors of ILE officials, mainly toward detained patients. Qualitative thematic analyses of respondent comments revealed details on such disrespectful encounters including ILE officers violating the Health Insurance Portability and Accountability Act (HIPAA) and using intimidation tactics with patients. Nearly half of the respondents did not have knowledge of policies about ILE detainees' medical care, detainees' privacy rights, or ILE's authority in patient care. CONCLUSIONS: This study points out the complexities, challenges, and ethical considerations of caring for patients in ILE custody in the hospital setting and the need to educate healthcare professionals on both patient and provider rights. It describes the lived experiences and difficulties that providers on the border face in trying to achieve equity in the care they provide to detained migrant patients.


Subject(s)
Emigration and Immigration , Law Enforcement , Humans , United States , Mexico , Cross-Sectional Studies , Arizona , Hospitals, Teaching
4.
Lat Stud ; : 1-25, 2023 May 15.
Article in English | MEDLINE | ID: mdl-37358960

ABSTRACT

Latino immigrant families in the United States were disproportionately affected by intensified interior immigration enforcement under the Trump administration. US-citizen children are victimized by policies targeting their immigrant parents; research is sparse regarding how these polices affect children who experience parental deportation and children who are at risk for parental deportation. Additionally, anti-immigrant rhetoric can result in increased discrimination that also threatens children's psychological health. This qualitative study (N = 22) explores children's lived experiences of discrimination, parental deportation or threat of parental deportation, and perceived impacts on mental health. Interviews conducted from 2019 to 2020 revealed that children who are directly affected by or at risk for parental deportation experience detrimental impacts to their psychological well-being. Children experience discrimination as Latinos and children of immigrants, which is also detrimental to their mental/emotional health. Incorporating children's perspectives is critical to informing public health interventions. Findings demonstrate the need for family-friendly immigration reform.


Las familias inmigrantes latinas en los Estados Unidos se vieron desproporcionadamente afectadas por las acciones del servicio de inmigración bajo la administración de Trump. Los niños y niñas con ciudadanía estadounidense son víctimas de las políticas dirigidas a sus padres inmigrantes; las investigaciones son escasas con respecto a cómo estas políticas afectan a los menores afectados por la deportación de sus padres así como los que corren riesgo de que sus padres sean deportados. Además, la retórica antiinmigrante puede provocar un aumento en la discriminación, lo cual también representa una amenaza para la salud psicológica de estos niños y niñas. Este estudio cualitativo (N = 22) explora las experiencias de discriminación y de deportación o amenaza de deportación de los padres vividas por los menores así como los impactos percibidos en su salud mental. Las entrevistas realizadas entre 2019 y 2020 revelan que las niñas y niños directamente afectados por la deportación o el riesgo de deportación de sus padres sufren un impacto perjudicial en su bienestar psicológico. Los menores experimentan discriminación como latinos e hijos de inmigrantes, lo cual también perjudica su salud mental y emocional. Es crucial que se incorporen las perspectivas de estos menores al informar las intervenciones de salud pública. Los hallazgos demuestran la necesidad de una reforma migratoria que sea solidaria con las familias.

5.
Am J Ind Med ; 66(9): 775-779, 2023 09.
Article in English | MEDLINE | ID: mdl-37380600

ABSTRACT

BACKGROUND: To assess the incidence of suicides among Brazilian Federal Highway Police Officers (FHPO) between 2001 and 2020, as well as to describe their sociodemographic and occupational profile. METHODS: A retrospective study analyzed all suicides among FHPO of all Brazilian states between 2001 and 2020 based on personalized police record files. RESULTS: The average suicide rate was 18.7/100,000 persons per year. A total of 35 suicides were identified, of which 33 (91.4%) were by firearm. Most FHPO who died by suicide were male (94.3%), under the age of 40 (62.9%), working for 10 or more years (57.1%), married (65.7%), parents (68.6%), had health insurance (77.1%), and worked in alternating shifts (54.2%). CONCLUSION: The suicide rate among FHPO is high. Due to missing data on age and gender, standardized rates were not reported in the current study, therefore a careful interpretation of the rates reported should be considered.


Subject(s)
Suicide , Humans , Male , Female , Police , Retrospective Studies , Brazil/epidemiology , Cause of Death
6.
Work ; 74(2): 539-547, 2023.
Article in English | MEDLINE | ID: mdl-36278387

ABSTRACT

BACKGROUND: Police officers are exposed to specific occupational tasks, which require lifting, trunk flexion and rotation, carrying weight, and frequent standing periods, which may be associated with an increased risk of experiencing low back pain (LBP). OBJECTIVE: To describe the prevalence and intensity of chronic LBP (CLBP) in Brazilian Federal Highway Police officers (FHPO) from the Rio Grande do Sul state and evaluate its associated factors. METHODS: A total of 208 FHPOs participated in this study. The participants answered an electronic questionnaire containing sociodemographic, behavioral, and occupational questions, and CLBP history. Data analysis comprises descriptive statistics and Poisson regression models. RESULTS: Most of the FHPO were male, aged 41 or more, lived with a partner and were physically active. Sixty-seven percent of FHPO had CLBP, and the median pain intensity was 3.0 (IQR = 0- 5). Participants who lived with a partner were less likely to report CLBP (PR = 0.80; 95% CI = 0.64; 0.99). On the other hand, those who worked as FHPO for more than 11 years were more likely to report CLPB (PR = 1.32; 95% CI = 1.06; 1.63), and high pain intensity (ß= 0.95; 95% CI = 0.19; 1.71). CONCLUSIONS: The high CLBP prevalence among FHPO from Rio Grande do Sul state indicates a need to highlight the importance for police organizations to promote CLBP prevention and implement workplace management programs.


Subject(s)
Chronic Pain , Low Back Pain , Humans , Male , Female , Low Back Pain/etiology , Police , Cross-Sectional Studies , Prevalence , Surveys and Questionnaires , Chronic Pain/complications
7.
Front Sociol ; 8: 1113027, 2023.
Article in English | MEDLINE | ID: mdl-38192521

ABSTRACT

How does border enforcement affect the mobility of migrants and refugees in countries of transit? What impact does it have on migrants' bodily experiences of mobility and their reliance on actors of the migration industry? While the externalization of borders affects undocumented people by increasing their vulnerability to violence during transit, the impact of the migration regime on the social construction of inequalities in every-day interactions and its relationship to the capacity for mobility has not been studied in depth. This article intends to bridge this gap: based on ethnographic fieldwork I conducted between 2013 and 2019, this article analyzes the relation between immigration enforcement and the mobility strategies of migrants and refugees, particularly women. It focuses on the intertwining of border enforcement and violence and their impact on people's bodily mobility experiences in transit through Mexico along intersecting lines of inequality such as race, class, gender and nationality. First, I analyze how border enforcement contributes to internal bordering, thereby increasing the vulnerability and dependence of migrants on brokers for mobility; second, it looks at the bodily experiences of women in transit and the ways in which internal bordering shapes gendered power hierarchies among actors in the field of mobility. The analysis shows how women negotiate mobility and bodily integrity in social interactions with different actors and how they face constraints resulting from the gendered hierarchies to mobility on routes of transit. Furthermore, it demonstrates how women's bodies have become a privileged site for the construction of a 'body politic' exploitable by others, since border enforcement has contributed to weakening the possibilities of negotiating mobility and bodily integrity in transit.

8.
BrJP ; 6(supl.2): 75-79, 2023.
Article in English | LILACS-Express | LILACS | ID: biblio-1513796

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: Cannabis sativa is a plant that has been used by humankind for many years and is in the media spotlight due to its pharmacological features, being considered the great therapeutic option of the century. With the advent of the Drug Law (Lei de Drogas - Law No. 11,343/2006) there was a starting point for the situation of cannabis in Brazil. Thus, the objective of this narrative review was to discuss information about legal issues regarding cannabis in the Brazilian territory. CONTENTS: The Collegiate Directorate Resolution (Resolução da Diretoria Colegiada - RDC) No. 327 of December 2019, published by Brazilian Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA), provides on the procedures for granting health authorization for manufacturing and importation, as well as establishes requirements for marketing, prescription, storage, monitoring and surveillance of cannabis products for medicinal purposes to human use. The Bill of Law (Projeto de Lei - PL) No. 399/2015, proposed to amend article 2 of Law No. 11,343, of August 23, 2006, to enable planting and marketing of drugs containing extracts, substrates or parts of the cannabis plant. CONCLUSION: Cannabis cultivation in Brazil would make a great contribution not only to the pharmaceutical industry, but also to the agricultural industry, generating jobs and reducing raw material costs for drugs. However, the slow pace of Brazilian politics would be an obstacle. There is a need for more consolidated and specific legislation to regulate cannabis.


RESUMO JUSTIFICATIVA E OBJETIVOS: A Cannabis sativa é uma planta utilizada pela humanidade há muitos anos e está em evidência nas mídias devido ao seu caráter farmacológico, sendo considerada a grande opção terapêutica do século. Com o advento da Lei de Drogas (Lei nº 11.343/2006) houve um ponto de partida para a situação da cannabis no Brasil. Dessa forma, o objetivo desta revisão narrativa foi discorrer sobre informações acerca de questões legais quanto à cannabis no território brasileiro. CONTEÚDO: A Resolução da Diretoria Colegiada (RDC) nº 327, de dezembro de 2019, publicada pela Agência Nacional de Vigilância Sanitária (ANVISA), dispõe sobre os procedimentos para a concessão da autorização sanitária para a fabricação e a importação, bem como estabelece requisitos para a comercialização, prescrição, dispensação, monitoramento e a fiscalização de produtos de cannabis para fins medicinais de uso humano. O Projeto de Lei (PL) nº 399/2015, propôs alterar o artigo 2º da Lei nº 11.343, de 23 de agosto de 2006, para viabilizar o plantio e a comercialização de fármacos que contenham extratos, substratos ou partes da planta cannabis. CONCLUSÃO: O cultivo da cannabis no Brasil traria uma grande contribuição não só para a indústria farmacêutica, como também para a indústria agrícola, na geração de empregos e na redução dos custos da matéria-prima de fármacos. No entanto, a morosidade da política brasileira seria um empecilho. Há necessidade de uma legislação mais consolidada e específica para regulamentação da cannabis.

9.
BrJP ; 6(supl.1): 7-11, 2023. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1447551

ABSTRACT

ABSTRACT BACKGROUND AND OBJECTIVES: In recent decades, the United States (USA), after banning the use, possession, and commerce of the CS plant for medicinal and social purposes for nearly a century, has embarked on law reform processes and movements at the state level to legalize the plant, forging regulated markets to support these changes. The present study's objective was to describe the history of prohibition and eventual legalization, observing the social, political, and economic components that contributed to this paradigm shift. CONTENTS: Qualitative research, using observation, literature review, and analysis of practical experience in advocacy processes, law reform, and building regulated markets to replace prohibition. The historical, social, and economic processes that made up the end of the prohibition of CS and its later regulation as a substance for medicinal and social use were described. CONCLUSION: CS during the last century has been labeled as a drug with no medicinal potential for purely political and non-scientific reasons. A number of civil society movements in the US led to the legalization of CS due to its therapeutic properties. These movements have succeeded in redefining the plant as a medicine rather than a drug, while also taking into account the high social and economic costs of criminalizing it.


RESUMO JUSTIFICATIVA E OBJETIVOS: Nas últimas décadas, os Estados Unidos (EUA), depois de proibir o uso, a posse e a comercialização da planta Cannabis sativa para fins medicinais e sociais por quase um século, embarcou em processos e movimentos de reforma de lei em nível estadual para legalizar a planta, forjando mercados regulamentados para amparar essas mudanças. O objetivo deste estudo foi descrever o histórico da proibição e da eventual legalização, observando os componentes sociais, políticos e econômicos que contribuíram para essa mudança de paradigma. CONTEÚDO: Utilizou-se de revisão de literatura, amparada por análise de experiência prática em processos de "advocacy" e construção de mercados regulamentados em substituição a proibição. Foram descritos os processos históricos, sociais e econômicos que compuseram o fim da proibição da Cannabis sativa e sua eventual regulamentação como substância para uso medicinal e social nos EUA. CONCLUSÃO: Durante o último século, a Cannabis sativa foi rotulada como droga sem potencial medicinal por motivos puramente políticos e não científicos. Uma série de movimentos da sociedade civil nos EUA levou à legalização da Cannabis sativa devido a suas propriedades terapêuticas. Esses movimentos tiveram êxito ao redefinirem a planta como um remédio ao invés de uma droga, levando em conta também o alto custo social e econômico de sua criminalização.

10.
BMC Public Health ; 22(1): 1685, 2022 09 05.
Article in English | MEDLINE | ID: mdl-36064334

ABSTRACT

BACKGROUND: There are concerns about the representation of vulnerable and underrepresented racial-ethnic minorities in biomedical and public health research, particularly when the research requires the collection of biospecimens. The current paper reports on the acceptability, feasibility, and ethics of saliva collection in a study examining the relationship between chronic stressors among mostly mixed-status, Latinx families (N = 30) during high immigration enforcement. METHODS: Data for this study included anthropometric measures and salivary biospecimens from each family member (N = 110) and a household survey. Data for this analysis are from ethnographic field notes, which were analyzed using a bricolage of critical ethnography and case study analysis techniques. RESULTS: We discuss the feasibility, aversions, acceptability, and ethical implications of integrating salivary biomarkers with Mexican-origin mixed-status families living in an area with restrictive immigration enforcement policies. We present the recruitment and data collection strategies used by the research team to gain participants' trust, retain families, and maintain confidentiality. CONCLUSION: We recommend that researchers who obtain biospecimens from Latinx, Mexican-origin, and/or immigrant populations answer the participants' questions honestly and without fear that they will not understand the science to obtain voluntary assent and consent. We recommend that researchers be knowledgeable of the sociopolitical context that the Latinx, immigrant, and in particular, mixed-status families inhabit so that they are prepared to provide informational resources. Finally, we think it is imperative that the study team in the field be bilingual, multicultural Latinx persons who identify with the community.


Subject(s)
Emigrants and Immigrants , Emigration and Immigration , Fear , Feasibility Studies , Humans , Saliva
11.
J Health Polit Policy Law ; 47(2): 259-291, 2022 04 01.
Article in English | MEDLINE | ID: mdl-34522957

ABSTRACT

This study examines how Mexican-origin women construct and navigate racialized identities in a postindustrial northern border community during a period of prolonged restrictive immigration and immigrant policies, and it considers mechanisms by which responses to racialization may shape health. This grounded theory analysis involves interviews with 48 Mexican-origin women in Detroit, Michigan, who identified as being in the first, 1.5, or second immigrant generation. In response to institutions and institutional agents using racializing markers to assess their legal status and policing access to health-promoting resources, women engaged in a range of strategies to resist being constructed as an "other." Women used the same racializing markers or symbols of (il)legality that had been used against them as a malleable set of resources to resist processes of racialization and to form, preserve, and affirm their identities. These responses include constructing an authorized immigrant identity, engaging in immigration advocacy, and resisting stigmatizing labels. These strategies may have different implications for health over time. Findings indicate the importance of addressing policies that promulgate or exacerbate racialization of Mexican-origin communities and other communities who experience growth through migration. Such policies include creating pathways to legalization and access to resources that have been invoked in racialization processes, such as state-issued driver's licenses.


Subject(s)
Emigrants and Immigrants , Emigration and Immigration , Female , Humans , Michigan , Policy
12.
J Interpers Violence ; 37(5-6): 2681-2704, 2022 03.
Article in English | MEDLINE | ID: mdl-32659151

ABSTRACT

Using the recent 2016 National Survey on Household Dynamics (N = 98,768 heterosexual Mexican women currently married, cohabiting, separated, divorced, or dating with a noncohabiting partner), this study has three objectives: first, to assess the prevalence of different intimate partner violence (IPV) dynamics, including situational couple's violence (SCV), intimate terrorism (IT), and violent resistance (VR); second, to empirically operationalize VR; and, third, to study women's help-seeking behaviors in public institutions, whether these are associated with violent dynamics and the type of responses offered by public institutions. Descriptive and multivariate logistic analyses show that, in the year prior to the survey, 5.8% of women experienced SCV, 1.2% IT and 0.6% VR. SCV is the most prevalent, but separated and divorced women are involved in IT and VR to a greater extent. Only 8.3% of females involved in IPV sought formal help from public institutions. Help seeking from public institutions is contingent upon violent dynamics and sociodemographic characteristics. Law enforcement and public security institutions fail to accept all IPV complaints and investigate them (especially in the case of VR), perhaps because women who seek help do not meet the social representation of battered women. The need to educate civil servants and service providers on the different dynamics of IPV, and recommendations for guaranteeing women greater access to public institutions that might be instrumental in putting an end to the violence are discussed in the Mexican context.


Subject(s)
Battered Women , Intimate Partner Violence , Spouse Abuse , Female , Humans , Prevalence , Sexual Partners
13.
Harm Reduct J ; 18(1): 76, 2021 07 26.
Article in English | MEDLINE | ID: mdl-34311765

ABSTRACT

BACKGROUND: Police constitute a structural determinant of health and HIV risk of people who inject drugs (PWID), and negative encounters with law enforcement present significant barriers to PWID access to harm reduction services. Conversely, police may facilitate access via officer-led referrals, potentiating prevention of HIV, overdose, and drug-related harms. We aimed to identify police characteristics associated with support for officer-led referrals to addiction treatment services and syringe service programs (SSP). We hypothesized that officers who believe harm reduction services are contradictory to policing priorities in terms of safety and crime reduction will be less likely to support police referrals. METHODS: Between January and June 2018, police officers (n = 305) in Tijuana, Mexico, completed self-administered surveys about referrals to harm reduction services during the 24-month follow-up visit as part of the SHIELD police training and longitudinal cohort study. Log-binomial regression was used to estimate adjusted prevalence ratios and model policing characteristics and attitudes related to officers' support for including addiction treatment and SSP in referrals. RESULTS: Respondents were primarily male (89%), patrol officers (86%) with a median age of 38 years (IQR 33-43). Overall, 89% endorsed referral to addiction services, whereas 53% endorsed SSP as acceptable targets of referrals. Officers endorsing addiction services were less likely to be assigned to high drug use districts (adjusted prevalence ratio [APR] = 0.50, 95% CI 0.24, 1.08) and more likely to agree that methadone programs reduce crime (APR = 4.66, 95% CI 2.05, 9.18) than officers who did not support addiction services. Officers endorsing SSPs were younger (adjusted prevalence ratio [APR] = 0.96 95% CI 0.93, 0.98), less likely to be assigned to high drug use districts (APR = 0.50, 95% CI 0.29, 0.87), more likely to believe that methadone programs reduce crime (APR = 2.43, 95% CI 1.30, 4.55), and less likely to believe that SSPs increase risk of needlestick injury for police (APR = 0.44, 0.27, 0.71). CONCLUSIONS: Beliefs related to the occupational impact of harm reduction services in terms of officer safety and crime reduction are associated with support for referral to related harm reduction services. Efforts to deflect PWID from carceral systems toward harm reduction by frontline police should include measures to improve officer knowledge and attitudes about harm reduction services as they relate to occupational safety and law enforcement priorities. TRIAL REGISTRATION: NCT02444403.


Subject(s)
Substance Abuse, Intravenous , Adult , Female , Harm Reduction , Humans , Law Enforcement , Longitudinal Studies , Male , Mexico , Police , Referral and Consultation , Substance Abuse, Intravenous/complications , Substance Abuse, Intravenous/epidemiology
14.
Rev Bras Med Trab ; 18(4): 444-448, 2021 Mar 03.
Article in English | MEDLINE | ID: mdl-33688326

ABSTRACT

INTRODUCTION: Physical fitness is crucial for the work of military police officers. Over time, officers show a substantial decrease in physical fitness. State military officers must undergo a physical fitness test every year, but prior to 2015, failure on this test had no impact on career advancement. State Law No. 18.659/2015 included passage of the physical fitness test as a requirement for promotion for officers in the Paraná military police (Polícia Militar do Paraná). OBJECTIVES: To verify whether the obligation to undergo the physical fitness test had any effects on the physical performance of military police officers. METHODS: The physical fitness tests results from 2016-2019 (n = 1705) were entered into an electronic spreadsheet and stratified by year. The spreadsheet included scores on individual tests (shuttle run, upper body and 12-minute run) as well as the sum total across all tests. Then, descriptive statistics, normality test, Kruskal-Wallis H test, and post-hoc comparisons were performed using the Mann-Whitney U test. with a significance level of p < 0.05. RESULTS: Significant differences (p < 0.05) were observed on all variables in the physical fitness test when compared between the years of 2016, 2017, 2018 and 2019. Mean scores on the shuttle run (96.91 ± 7.54) and upper body tests (82.60 ± 24.81) were highest in 2019, while the mean score on the 12-minute run test was highest in 2017 (60.33 ± 28.38). The effect size of these differences (r) was small. CONCLUSIONS: The evidence suggests that the inclusion of the physical fitness test as a requirement for promotion can contribute to the improvement of physical performance in military police officers.

15.
Int Rev Law Econ ; 66: 105989, 2021 Jun.
Article in English | MEDLINE | ID: mdl-36536656

ABSTRACT

We provide empirical insight into the consequences of the Covid19 pandemic for the administration of justice. Drawing on a comprehensive monthly panel of Brazilian labor courts and using a difference-in-difference approach, we show that the pandemic has had a large and persistent deleterious effect on adjudicatory efficacy, leading to a massive decrease in the clearance rate and an increase in court backlogs. The pandemic has affected how courts dispose adjudication cases, expectedly causing a plummeting in the share of disputes resolved via trial hearings and, less predictably, exerting a temporally non-linear effect on the share of in-court settlements. Notably, we find no evidence of an effect of the pandemic on efficacy in enforcement. Although the pandemic led to an increase in the share of new filings requiring enforcement, any effect on the relative use of enforcement to execute court-ordered payments has been intermittent and temporary. The intensity of the pandemic has been an important moderating factor.

16.
Gac Sanit ; 35(4): 402-404, 2021.
Article in English | MEDLINE | ID: mdl-32682515

ABSTRACT

The initial high level of compliance with the Chilean comprehensive national smoke-free law in 2013 is fading, particularly in the hospitality sector. This paper draws attention to how using a simple and low-cost surveillance inquiry may help focus on the use of scarce inspection resources to improve compliance with the law in the hospitality sector. We conducted a cross-sectional assessment of second-hand smoke exposure in night entertainment venues in Santiago, Chile, by measuring particulate matter of less than 2.5µm (PM2.5). Smoking where prohibited by law was observed in 36% of the venues visited. Venues where smoking was spotted at the time of the observation had a median PM2.5 concentration 13 times higher than background concentration on the street. The study shows that a targeted approach for inspection to find pockets of venues with suboptimal compliance is feasible and affordable.


Subject(s)
Air Pollution, Indoor , Tobacco Smoke Pollution , Air Pollution, Indoor/analysis , Chile , Cross-Sectional Studies , Humans , Restaurants
17.
Subst Abuse Treat Prev Policy ; 15(1): 75, 2020 10 02.
Article in English | MEDLINE | ID: mdl-33008431

ABSTRACT

BACKGROUND: Law enforcement officers (LEOs) come into frequent contact with people who inject drugs (PWID). Through service referrals, LEOs may facilitate PWID engagement in harm reduction, substance use treatment, and other health and supportive services. Little is known about PWID and LEO attitudes and concerns about service referrals, however. The objective of this mixed-methods study was to examine the alignment of service referral preferences and acceptability among PWID and LEOs in Tijuana, Mexico. METHODS: We assessed service referral preferences and perceived likelihood of participation in health and social services, integrating data from structured questionnaires with 280 PWID and 306 LEOs, contextualized by semi-structured interviews and focus groups with 15 PWID and 17 LEOs enrolled in two parallel longitudinal cohorts in Tijuana, Mexico. RESULTS: Among potential service referral options, both PWID (78%) and LEOs (88%) most frequently cited assistance with drug- and alcohol-use disorders. Over half of PWID and LEOs supported including harm reduction services such as syringe service programs, overdose prevention, and HIV testing. The majority of PWID supported LEO referrals to programs that addressed basic structural needs (e.g. personal care [62%], food assistance [61%], housing assistance [58%]). However, the proportion of LEOs (30-45%) who endorsed these service referrals was significantly lower (p <  0.01). Regarding referral acceptability, 71% of PWID reported they would be very likely or somewhat likely to make use of a referral compared to 94% of LEOs reporting that they thought PWID would always or sometimes utilize them. These results were echoed in the qualitative analysis, although practical barriers to referrals emerged, whereby PWID were less optimistic that they would utilize referrals compared to LEOs. CONCLUSIONS: We identified strong support for LEO service referrals among both LEO and PWID respondents, with the highest preference for substance use treatment. LEO referral programs offer opportunities to deflect PWID contact with carceral systems while facilitating access to health and social services. However, appropriate investments and political will are needed to develop an evidence-based (integrated) service infrastructure.


Subject(s)
Law Enforcement/methods , Patient Compliance/statistics & numerical data , Referral and Consultation/statistics & numerical data , Substance Abuse, Intravenous/therapy , Adult , Attitude , Female , Harm Reduction , Humans , Interviews as Topic , Male , Mexico , Middle Aged , Patient Preference , Socioeconomic Factors
18.
Demography ; 57(5): 1597-1623, 2020 10.
Article in English | MEDLINE | ID: mdl-32914332

ABSTRACT

Immigration enforcement cooperation between final-destination and transit countries has increased in the last decades. I examine whether the Southern Border Plan, an immigration enforcement program implemented by the Mexican government in 2014, has curbed intentions of unauthorized migrants from El Salvador, Guatemala, and Honduras to migrate to the United States. I use the announcement of the Southern Border Plan to implement a difference-in-differences approach and compare the evolution of short-run intentions to engage in additional unauthorized crossings of Central American (treatment group) relative to Mexican deportees (comparison group). The findings suggest that increased enforcement in Mexico decreases the likelihood of attempting repeated unauthorized crossings.


Subject(s)
Emigration and Immigration/legislation & jurisprudence , Emigration and Immigration/statistics & numerical data , Law Enforcement , Undocumented Immigrants/statistics & numerical data , Central America/ethnology , Humans , Mexico/epidemiology , United States/epidemiology
19.
Trends psychiatry psychother. (Impr.) ; 42(3): 230-238, July-Sept. 2020. tab
Article in English | LILACS | ID: biblio-1139830

ABSTRACT

Abstract Introduction Brazil is one of the countries with the highest rates of alcohol-related traffic infractions, but little is known about the profile of the drivers who commit them. Identifying the characteristics of impaired drivers is essential for planning preventive actions. Objective To compare drug use and driving behavior profiles of drivers with and without alcohol-related infractions. Methods 178 drivers stopped at routine roadblocks were assessed by traffic agents who conducted standard roadblock procedures (document verification; request of a breathalyzer test [BT]). Drug use and driving behavior data were collected through semi-structured interviews. Subjects were divided into three groups: drivers who refused the BT (RDs, n = 72), drivers who tested positive on the BT (PDs, n = 34), and drivers who had committed other infractions (ODs, n = 72). Results The proportion of alcohol use in the last year was higher among RDs (100%) than in the PD and OD groups (97.1% and 72.2% respectively, p < 0.001). Lifetime prevalence of cannabis and cocaine use for the overall sample was 44.3% and 18.2%, respectively. Fewer individuals in the OD group (31.5%) reported having been stopped at roadblocks in the previous year compared to the PDs (55.9%) and RDs (48.6%, p = 0.03). However, a higher proportion of RDs reported drunk driving in the same period (87.5%; PD 69.7%; OD 26.9%; p < 0.001). Conclusion Essential differences among groups were observed. RDs had a higher proportion of alcohol use and drunk driving in the previous year; drivers who fit into this particular group may be unresponsive or less responsive to social deterrence and enforcement actions.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Automobile Driving/statistics & numerical data , Accidents, Traffic/statistics & numerical data , Substance-Related Disorders/epidemiology , Driving Under the Influence/physiology , Brazil/epidemiology , Cross-Sectional Studies , Police , Alcoholism/epidemiology
20.
Int. j. morphol ; 38(3): 731-736, June 2020. tab, graf
Article in English | LILACS | ID: biblio-1098313

ABSTRACT

Regardless of sex or body size, police tasks may require officers to change direction speed (CODS) under occupational loads. The purpose of this study was to investigate body composition and CODS in female and male police cadets in both unloaded and occupationally loaded conditions. Body composition and CODS of 51 female (FPC) and 70 male police cadets (MPC) were assessed. Six body composition indices were used: Body mass index (BMI), percent body fat (PBF), percent of skeletal muscle mass (PSMM), protein fat index (PFI), index of hypokinesia (IH), and skeletal muscle mass index (SMMI). The CODS was assessed by Illinois Agility Test (IAT) and IAT while carrying a 10-kg load (LIAT). An independent sample t-test was used to identify the differences between the sexes. The regression determined associations between body composition and LIAT. The alpha level was set at p < 0.05 a priori. MPC had significantly higher (p < 0.001) BMI, PSMM, PFI and SMMI and lower PBF and IH than FPC. MPC were also faster in IAT and LIAT, carrying lower relative loads that imparted less of an impact on CODS performance. Body composition was strongly associated with the time to complete LIAT (R2 = 0.671, p < 0.001). Difference in relative load and body composition influenced CODS performance in both unloaded and loaded conditions. Thus, optimizing body composition through increasing skeletal muscle mass and reducing fat mass could positively influence unloaded and loaded CODS performance and improve elements of police task performance.


El trabajo policial puede requerir que los oficiales cambien la velocidad de dirección (CVD) bajo cargas ocupacionales, indistintamente del sexo o tamaño corporal. El propósito de este estudio fue investigar la composición corporal y los CVD en cadetes de policía de ambos sexos, tanto en condiciones de descarga como de trabajo. Se evaluaron la composición corporal y los CVD de 51 mujeres (CPF) y 70 cadetes de policía masculinos (CPM). Se utilizaron seis índices de composición corporal: índice de masa corporal (IMC), porcentaje de grasa corporal (PGC), porcentaje de masa muscular esquelética (PMME), índice de grasa proteica (IGP), índice de hipocinesia (IH) e índice de masa muscular esquelética (IMME). El CVD fue evaluado por Illinois Agility Test (IAT) y IAT mientras transportaba una carga de 10 kg (LIAT). Se usó una prueba t de muestra independiente para identificar las diferencias entre los sexos. La regresión determinó asociaciones entre la composición corporal y LIAT. El nivel alfa se estableció en p <0,05 a priori. CPM registraron un IMC, PMME, PGC y IMME significativamente más altos (p <0,001) y PGC e IH más bajos que las mujeres (CPF). Los CPM también fueron más rápidos en IAT y LIAT, llevando cargas más bajas, las que tuvieron un impacto menor en el rendimiento de CVD. La composición corporal estaba asociada con el tiempo para completar LIAT (R2 = 0,671, p <0,001). La diferencia en la carga relativa y la composición corporal influyeron en el rendimiento de CVD tanto en condiciones descargadas como cargadas. Por lo tanto, la optimización de la composición corporal a través del aumento de la masa del músculo esquelético, y la reducción de la masa grasa podrían influir de manera positiva en el rendimiento de CVD descargados y cargados, mejorando el rendimiento del trabajo policial.


Subject(s)
Humans , Male , Female , Young Adult , Body Composition , Sex Characteristics , Police , Movement/physiology , Body Mass Index , Logistic Models , Sex Factors , Adipose Tissue , Workload
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