A randomized clinical trial of tailored interventions for health promotion and recidivism reduction among homeless parolees: outcomes and cost analysis

Objectives

This study conducted a randomized controlled trial with 600 recently released homeless men exiting California jails and prisons.

Methods

The purpose of this study was to primarily ascertain how different levels of intensity in peer coaching and nurse-partnered intervention programs may impact reentry outcomes; specifically: (a) an intensive peer coach and nurse case managed (PC-NCM) program; (b) an intermediate peer coaching (PC) program with brief nurse counseling; and (c) the usual care (UC) program involving limited peer coaching and brief nurse counseling. Secondary outcomes evaluated the operational cost of each program.

Results

When compared to baseline, all three groups made progress on key health-related outcomes during the 12-month intervention period; further, 84.5 % of all participants eligible for hepatitis A/B vaccination completed their vaccine series. The results of the detailed operational cost analysis suggest the least costly approach (i.e., UC), which accounted for only 2.11 % of the total project expenditure, was as effective in achieving comparable outcomes for this parolee population as the PC-NCM and PC approaches, which accounted for 53.98 % and 43.91 %, respectively, of the project budget.

Conclusions

In this study, all three intervention strategies were found to be comparable in achieving a high rate of vaccine completion, which over time will likely produce tremendous savings to the public health system.

     

Analysis of some commonly found inhalants using gas chromatography-mass spectrometry (GC MS) – Effect of substrates on the identification of inhalants

Inhalant abuse is a serious and ever-evolving problem for our society. Inhalants are abused more commonly by teenagers and adolescents. Inhalants such as glue, paint thinners, correction fluid, and nail paint remover are easily available in the market which makes them readily abused. Out of various methods of abuse, huffing (placing a piece of cloth soaked with inhalant is placed in the mouth), bagging (placing head in a polythene bag containing inhalant), and ballooning (balloons filled with inhalant are used for inhaling vapors through the mouth) are most common. Inhalant abuse results in multiple target organ dysfunction with neuritis and brain damage due to the dissolution of the myelin sheath. In acute poisoning cases, it might cause death due to asphyxia and sudden sniffing syndrome. In such cases, various articles containing traces of inhalants could be retrieved from the scene of incidence and to detect these traces become an important facet of the investigation. However, it might be difficult due to the rapid evaporation of inhalants and the formation of reaction product species. In the present study, an attempt has been made to study the effect of three substrates (balloon, cloth, polythene) on component profiles of four paint thinners and four nail paint removers. The study suggests that although some components are retained, there is the formation of a large number of reaction product species and these must be taken into consideration before furnishing the opinion. These reaction product species might also be inhalant specific which must be further explored.     

Cash or In-kind Transfers? Evidence from a Randomised Controlled Trial in Delhi,India

Abstract

This article examines a randomised intervention in Delhi, India, that provided unconditional cash transfers to a group of households as a replacement for the food security offered by a below-poverty-level card. The experimental approach can differentiate beneficial effects due to either unconditional cash transfers or newly opened bank accounts. The unconditional cash transfer does not induce a decline in food security; rather, it provides opportunities for households to shift to other nutritious options in non-cereal product categories.     

The Evolution of ‘Homegrown Conditionality’ in India: IMF Relations

This article explores the historical relationship between the Government of India (GOI) and the International Monetary Fund (IMF) as a successful model for the ways in which a developing country can learn to work with and through multilateral organisations to promote economic and political development while sustaining democratic institutions and relative international political autonomy. In the mid-1960s, India's relations with the USA, IMF, and World Bank were strained after an attempt by these institutions to exert ‘leverage’ over Indian economic policies was exposed to parliamentary debate and the scrutiny of a free press. By the late 1970s, the GOI charted a new course in its interaction with the IMF. In 1981, India was awarded the largest IMF loan to a developing country up to that time. This article will evaluate India's economic reform strategy in the early 1980s and explain the development of the concept of ‘homegrown conditionality’ within the GOI.     

Analyzing Afghanistan: The Wartime Culture of Migrants and Militants

Abstract

Three recent texts provide a set of overlapping insights on Afghan culture and society as well as the relationship between militancy and migration, from the Soviet invasion to the present.     

Time- and Temperature-Dependent Changes in Cytochrome c Oxidase Activity and Cyanide Concentration in Excised Mice Organs and Mice Cadavers

Postmortem stability of cyanide biomarkers is often disputed. We assessed the time and temperature-dependent changes in cytochrome c oxidase (CCO) activity and cyanide concentration in various organs of mice succumbing to cyanide. Immediately after death, excised mice organs and mice cadavers were stored at room temperature (35°C ± 5°C) or in frozen storage (−20°C ± 2°C). At various times after death, CCO activity and cyanide concentrations were measured in excised mice organs or organs removed from mice cadavers. The study revealed that (i) measuring both the biomarkers in mice cadavers was more reliable compared to excised mice organs, (ii) measuring temporal CCO activity and cyanide concentration in vital organs from mice cadavers (room temperature) was reliable up to 24 h, and (iii) CCO activity in the brain and lungs and cyanide concentration in organs from mice cadavers (frozen) were measurable beyond 21 days. This study will be helpful in postmortem determination of cyanide poisoning.     

Regional International Organizations and Individual Immigration Attitudes: Results from Finite Mixture Models

When are individuals more likely to support immigration? We suggest here that regional international organizations (IOs; for example, the European Union) publicly release reports about the scale and benefits of immigration to member states in the region in which these IOs operate. We argue that unlike individuals who are uninformed about immigration, informed individuals who have more knowledge of the main regional IO in which their country participates will be more likely to employ immigration reports released by their regional IO to construct their immigration attitudes. They will also perceive that these reports are credible. The credibility of these reports helps individuals with more knowledge about their region’s main IO to view immigrants favorably, which translates to support for immigration. We test our prediction by developing a finite mixture model that statistically accounts for the econometric challenges that emerge when uninformed individuals “save face” by disproportionately opting for the middle “status quo” category in ordinal survey response variables of immigration support. Results from the finite mixture model corroborate our prediction and are more reliable than estimates from a standard ordered probit model.