Captive in cycles of invisibility? Prisoners' work for the private sector

This article critiques a case of modern prison-labour by exploring prisoners’ attitudes towards the prison-work they undertake while incarcerated. The study is based at a privatised male prison in the UK, assigned the pseudonym ‘Bridgeville’. Bridgeville contracts with private-sector firms in providing market-focused prison-work – so-called real work – for inmates in some of its workshops. In exploring prisoners’ perceptions of this privatised prison-work, it is found that it mainly comprises mundane, low-skilled activities typical of informalised, poor-quality jobs that are socially, legally and economically devalued and categorised as forms of ‘invisible work’. At Bridgeville, such privatised prison-work largely fails in engaging or upskilling inmates, leaving them pessimistic about its value as preparation for employment post-release. Its rehabilitative credentials are therefore questioned. The article contributes to the debate around invisible work more generally by problematising this example of excluded work and the cycle of disadvantage that underpins it

Task shifting in maternal and newborn care: a non-inferiority study examining delegation of antenatal counseling to lay nurse aides supported by job aids in Benin

<p>Abstract</p> <p>Background</p> <p>Shifting the role of counseling to less skilled workers may improve efficiency and coverage of health services, but evidence is needed on the impact of substitution on quality of care. This research explored the influence of delegating maternal and newborn counseling responsibilities to clinic-based lay nurse aides on the quality of counseling provided as part of a task shifting initiative to expand their role.</p> <p>Methods</p> <p>Nurse-midwives and lay nurse aides in seven public maternities were trained to use job aids to improve counseling in maternal and newborn care. Quality of counseling and maternal knowledge were assessed using direct observation of antenatal consultations and patient exit interviews. Both provider types were interviewed to examine perceptions regarding the task shift. To compare provider performance levels, non-inferiority analyses were conducted where non-inferiority was demonstrated if the lower confidence limit of the performance difference did not exceed a margin of 10 percentage points.</p> <p>Results</p> <p>Mean percent of recommended messages provided by lay nurse aides was non-inferior to counseling by nurse-midwives in adjusted analyses for birth preparedness (β = -0.0, 95% CI: -9.0, 9.1), danger sign recognition (β = 4.7, 95% CI: -5.1, 14.6), and clean delivery (β = 1.4, 95% CI: -9.4, 12.3). Lay nurse aides demonstrated superior performance for communication on general prenatal care (β = 15.7, 95% CI: 7.0, 24.4), although non-inferiority was not achieved for newborn care counseling (β = -7.3, 95% CI: -23.1, 8.4). The proportion of women with correct knowledge was significantly higher among those counseled by lay nurse aides as compared to nurse-midwives in general prenatal care (β = 23.8, 95% CI: 15.7, 32.0), birth preparedness (β = 12.7, 95% CI: 5.2, 20.1), and danger sign recognition (β = 8.6, 95% CI: 3.3, 13.9). Both cadres had positive opinions regarding task shifting, although several preferred 'task sharing' over full delegation.</p> <p>Conclusions</p> <p>Lay nurse aides can provide effective antenatal counseling in maternal and newborn care in facility-based settings, provided they receive adequate training and support. Efforts are needed to improve management of human resources to ensure that effective mechanisms for regulating and financing task shifting are sustained.</p

An epistemic community comes and goes? Local and national expressions of heart health promotion in Canada

<p>Abstract</p> <p>Background</p> <p>The objective of this study is to examine the existence and shape of epistemic communities for (heart) health promotion at the international, national, provincial and regional levels in Canada. Epistemic community may be defined as a network of experts with an authoritative claim to policy relevant knowledge in their area of expertise.</p> <p>Methods</p> <p>An interpretive policy analysis was employed using 60 documents (48 provincial, 8 national and 4 international) and 66 interviews (from 5 Canadian provinces). These data were entered into NUD*IST, a qualitative software analysis package, to assist in the development of codes and themes. These codes form the basis of the results.</p> <p>Results</p> <p>A scientific and policy epistemic community was identified at the international and Canadian federal levels. Provincially and regionally, the community is present as an idea but its implementation varies between jurisdictions.</p> <p>Conclusion</p> <p>The importance of economic, political and cultural factors shapes the presence and shape of the epistemic community in different jurisdictions. The community waxes and wanes but appears robust.</p

Reducing health inequities: the contribution of core public health services in BC

BACKGROUND: Within Canada, many public health leaders have long identified the importance of improving the health of all Canadians especially those who face social and economic disadvantages. Future improvements in population health will be achieved by promoting health equity through action on the social determinants of health. Many Canadian documents, endorsed by government and public health leaders, describe commitments to improving overall health and promoting health equity. Public health has an important role to play in strengthening action on the social determinants and promoting health equity. Currently, public health services in British Columbia are being reorganized and there is a unique opportunity to study the application of an equity lens in public health and the contribution of public health to reducing health inequities. Where applicable, we have chosen mental health promotion, prevention of mental disorders and harms of substance use as exemplars within which to examine specific application of an equity lens. METHODS/DESIGN: This research protocol is informed by three theoretical perspectives: complex adaptive systems, critical social justice, and intersectionality. In this program of research, there are four inter-related research projects with an emphasis on both integrated and end of grant knowledge translation. Within an overarching collaborative and participatory approach to research, we use a multiple comparative case study research design and are incorporating multiple methods such as discourse analysis, situational analysis, social network analysis, concept mapping and grounded theory. DISCUSSION: An important aim of this work is to help ensure a strong public health system that supports public health providers to have the knowledge, skills, tools and resources to undertake the promotion of health equity. This research will contribute to increasing the effectiveness and contributions of public health in reducing unfair and inequitable differences in health among population groups. As a collaborative effort between public health practitioners/decision makers and university researchers, this research will provide important understanding and insights about the implementation of the changes in public health with a specific focus on health equity, the promotion of mental health and the prevention of harms of substance use

Microbial communities and processes in Arctic permafrost environments

In polar regions, huge layers of frozen ground, termed permafrost, are formed. Permafrost covers more than 25 % of the land surface and significant parts of the coastal sea shelfs. Its habitats are controlled by extreme climate and terrain conditions. Particularly, the seasonal freezing and thawing in the upper active layer of permafrost leads to distinct gradients in temperature and geochemistry. Microorganisms in permafrost environments have to survive extremely cold temperatures, freeze-thaw cycles, desiccation and starvation under long-lasting background radiation over geological time scales. Although the biology of permafrost microorganisms remains relatively unexplored, recent findings show that microbial communities in this extreme environment are composed by members of all three domains of life (Archaea, Bacteria, Eukarya), with a total biomass comparable to temperate soil ecosystems. This chapter describes the environmental conditions of permafrost and reviews recent studies on microbial processes and diversity in permafrost-affected soils as well as the role and significance of microbial communities with respect to global biogeochemical cycles