1,721,160 research outputs found
Polysocial Risk Scores for Assessing Social Determinants of Health
No full textTo the Editor Dr Figueroa and colleagues1 recognized the importance of social determinants in shaping health outcomes. Echoing a recommendation to study marginalized populations,2 they recommended multisectoral data linkage as a promising means of examining these complex relationships. We agree with this recommendation but urge caution in pursuing development of a polysocial risk score for 4 reasons.
First, unlike genes, social determinants vary in intensity and duration of exposure, exerting different influences at different ages and in different social, cultural, and economic circumstances. To adequately capture this heterogeneity in a single risk score would be difficult. Second, the optimal risk score could differ across health outcomes and, as Figueroa and colleagues1 noted, may vary over time, such that a single polysocial risk score for poor health outcomes writ large may have limited utility. Third, the mechanistic conceptualization of social determinants “causing” poor health outcomes, just as genetic factors “cause” disease, may be reductionist. The effect of psychosocial exposures on health is mediated by numerous factors including resilience, itself a complex and multifaceted construct that remains poorly understood.3
Fourth, unlike in the field of genetics, the “treatment” for social determinants of health is often a policy shift. Demonstrating an association between a polysocial risk score and health outcomes may reaffirm the importance of social determinants but is insufficient to inform decision makers, who are often only able to pull one policy lever at a time. Figueroa and colleagues1 argued that stratification on polysocial risk score could “…facilitate testing of social interventions that may be effective in these populations,” but this begs the question: Which interventions are indicated for individuals with a high score?
The argument for a polysocial risk score evokes comparison with the literature on adverse childhood experiences (ACEs). A global meta-analysis revealed that individuals exposed to 4 or more ACEs were at increased risk of poor health outcomes in adulthood.4 Although compelling, it does not follow that a poly-ACE risk score would facilitate targeted policy responses. Similarly, although the proposed polysocial risk score may predict poor health outcomes, it may have limited utility for individuals tasked with developing tangible responses.5
Multisectoral data linkage is an important tool for examining social determinants of health and can provide data necessary for generating polysocial risk scores. However, although such scores may be able to predict poor health outcomes, they may do little to help prevent or improve those outcomes.No Full Tex
The absence of women involved in the criminal justice system from Australia’s national discussion on preventing family and domestic violence (Letter)
No full textTo the Editor: The Standing Committee on Social Policy and Legal Affairs recently completed its inquiry and final report into family, domestic and sexual violence in Australia.1 This comprehensive report made 88 recommendations to inform Australia’s next National Plan to Reduce Violence Against Women and their Children (National Plan).No Full Tex
Fatal overdoses after release from prison in British Columbia: a retrospective data linkage study
Full text linkBACKGROUND: People recently released from prison are at increased risk of preventable death; however, the impact of the current overdose epidemic on this population is unknown. We aimed to document the incidence and identify risk factors for fatal overdose after release from provincial prisons in British Columbia. METHODS: We conducted a retrospective, population-based, open cohort study of adults released from prisons in BC, using linked administrative data. Within a random 20% sample of the BC population, we linked provincial health and correctional records from 2010 to 2017 for people aged 23 years or older as of Jan. 1, 2015, who were released from provincial prisons at least once from 2015 to 2017. We identified exposures that occurred from 2010 to 2017 and deaths from 2015 to 2017. We calculated the piecewise incidence of overdose-related and all-cause deaths after release from prison. We used multivariable, mixed-effects Cox regression to identify predictors of all-cause death and death from overdose. RESULTS: Among 6106 adults released from prison from 2015 to 2017 and followed in the community for a median of 1.6 (interquartile range 0.9-2.3) years, 154 (2.5%) died, 108 (1.8%) from overdose. The incidence of all-cause death was 16.1 (95% confidence interval [CI] 13.7-18.8) per 1000 person-years. The incidence of overdose deaths was 11.2 (95% CI 9.2-13.5) per 1000 person-years, but 38.8 (95% CI 3.2-22.6) in the first 2 weeks after release from prison. After adjustment for covariates, the hazard of overdose death was 4 times higher among those who had been dispensed opioids for pain. INTERPRETATION: People released from prisons in BC are at markedly increased risk of overdose death. Overdose prevention must go beyond provision of opioid agonist treatment and naloxone on release to address systemic social and health inequities that increase the risk of premature death
Universal health coverage and incarceration
No full textGlobal progress towards universal coverage of essential health services, a component of UN Sustainable Development Goal (SDG) 3.8, is measured at the country level using the WHO Service Coverage Index. However, data collection for this crucial metric excludes prisons and youth detention centres, despite the health needs in these settings, chronic underinvestment in custodial health care, and poor health outcomes for people released from custody in most countries. Particularly in countries with high incarceration rates, failure to include custodial settings in calculations of the service coverage index might result in overestimation of progress towards SDG 3.8.1, and mask important health inequalities. In this Viewpoint, we explore how failure to consider custodial settings in calculation of the service coverage index contributes to health inequalities and impedes progress towards SDG 3. We recommend explicitly considering all custodial settings in future estimates of progress towards universal health coverage.Full Tex
Prisons and custodial settings are part of a comprehensive response to COVID-19.
Full text linkComment:
Prisons are epicentres for infectious diseases because of the higher background prevalence of infection, the higher levels of risk factors for infection, the unavoidable close contact in often overcrowded, poorly ventilated, and unsanitary facilities, and the poor access to health-care services relative to that in community settings. Infections can be transmitted between prisoners, staff and visitors, between prisons through transfers and staff cross-deployment, and to and from the community. As such, prisons and other custodial settings are an integral part of the public health response to coronavirus disease 2019 (COVID-19)
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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