Beatrice Annaheim, Tenzin Wangmo, Wiebke Bretschneider, Violet Handtke, Bernice S. Elger, Angelo Belardi, Andrea H. Meyer, Raphael Hösli and Monika Lutters
The purpose of this paper is to determine the prevalence of polypharmacy and drug–drug interactions (DDIs) in older and younger prisoners, and compared if age group is associated…
Abstract
Purpose
The purpose of this paper is to determine the prevalence of polypharmacy and drug–drug interactions (DDIs) in older and younger prisoners, and compared if age group is associated with risks of polypharmacy and DDIs.
Design/methodology/approach
For 380 prisoners from Switzerland (190 were 49 years and younger; 190 were 50 years and older), data concerning their medication use were gathered. MediQ identified if interactions of two or more substances could lead to potentially adverse DDI. Data were analysed using descriptive statistics and generalised linear mixed models.
Findings
On average, older prisoners took 3.8 medications, while younger prisoners took 2.1 medications. Number of medications taken on one reference day was higher by a factor of 2.4 for older prisoners when compared to younger prisoners (p = 0.002). The odds of polypharmacy was significantly higher for older than for younger prisoners (>=5 medications: odds ratio = 5.52, p = 0.035). Age group analysis indicated that for potentially adverse DDI there was no significant difference (odds ratio = 0.94; p = 0.879). However, when controlling for the number of medication, the risk of adverse DDI was higher in younger than older prisoners, but the result was not significant.
Originality/value
Older prisoners are at a higher risk of polypharmacy but their risk for potentially adverse DDI is not significantly different from that of younger prisoners. Special clinical attention must be given to older prisoners who are at risk for polypharmacy. Careful medication management is also important for younger prisoners who are at risk of very complex drug therapies.
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Tenzin Wangmo, Sirin Hauri, Andrea H. Meyer and Bernice S. Elger
The purpose of this paper is to identify primary health concerns prompting older and younger prisoners in Switzerland to consult a nurse or a general practitioner (GP) within the…
Abstract
Purpose
The purpose of this paper is to identify primary health concerns prompting older and younger prisoners in Switzerland to consult a nurse or a general practitioner (GP) within the prison healthcare setting, and explores if these reasons for visits differ by age group (49 years and younger vs 50 years and older). The authors used 50 years and older as the benchmark for older prisoners in light of literature indicating accelerated aging among prisoners.
Design/methodology/approach
Retrospective information from medical records of 406 prisoners were collected for a period of six months. This study analyzed the reasons for which prisoners visited the nurses and GPs available to them through the prison healthcare service. These reasons were coded using the International Classification of Primary Care-version 2. Data were analyzed descriptively and four generalized linear models were built to examine whether there was an age group difference in reasons for visiting nurses and GPs.
Findings
The health reasons for visiting nurses and GPs by 380 male prisoners from 13 Swiss prisons are presented. In the six month period, a total of 3,309 reasons for visiting nurses and 1,648 reasons for visiting GPs were recorded. Prisoner participants’ most common reasons for both visits were for general and unspecified complaints and musculoskeletal problems. Older prisoners sought significantly more consultations for cardiovascular and endocrine problems than younger prisoners.
Research limitations/implications
Nurses play an important role in addressing healthcare demands of prisoners and coordinating care in Swiss prisons. In light of age-related healthcare demands, continuing education and training of both nurses and GPs to adequately and efficiently address the needs of this prisoner group is critical. Allowing prisoners to carry out some care activities for minor self-manageable complaints will reduce the demand for healthcare.
Originality/value
This study presents unique data on healthcare concerns for which prisoners visit prison nurses and GPs. It highlights the varied needs of older prisoners as well as how these needs are addressed based on the availability of the primary healthcare provider within the prison.
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Helene Merkt, Sophie Haesen, Leila Meyer, Reto W. Kressig, Bernice S. Elger and Tenzin Wangmo
In the literature, 65 years is commonly used as the age to designate an older person in the community. When studying older prisoners, there is much variation. The purpose of this…
Abstract
Purpose
In the literature, 65 years is commonly used as the age to designate an older person in the community. When studying older prisoners, there is much variation. The purpose of this paper is to investigate how researchers define older offenders and for what reasons.
Design/methodology/approach
The authors reviewed articles on health and well-being of older offenders to assess terminology used to describe this age group, the chosen age cut-offs distinguishing younger offenders from older offenders, the arguments provided to support this choice as well as the empirical base cited in this context.
Findings
The findings show that the age cut-off of 50 years and the term “older” were most frequently used by researchers in the field. The authors find eight main arguments given to underscore the use of specific age cut-offs delineating older offenders. They outline the reasoning provided for each argument and evaluate it for its use to define older offenders.
Originality/value
With this review, it is hoped to stimulate the much-needed discussion advancing towards a uniform definition of the older offender. Such a uniform definition would make future research more comparable and ensure that there is no ambiguity when researchers state that the study population is “older offenders”.
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David Shaw, Helene Seaward, Felix Pageau, Tenzin Wangmo and Bernice S. Elger
This paper aims to describe and analyse Swiss prisoners’ and experts’ views on collective punishment, the practice where a group is punished for one person’s transgression.
Abstract
Purpose
This paper aims to describe and analyse Swiss prisoners’ and experts’ views on collective punishment, the practice where a group is punished for one person’s transgression.
Design/methodology/approach
A series of qualitative interviews with prisoners and stakeholders are reported following thematic analysis.
Findings
Despite being forbidden by the Geneva Convention and other international instruments, participants from this study expressed the view that collective punishment continues to be practiced in some form in prisons in Switzerland, violating the rights of prisoners via unjust and arbitrary decision-making, unjust rules, inequalities in prison structures and continuation of incarceration based on the behaviour of others. Families can also be both victims and vectors of collective punishment, and prolonging the detention of prisoners who would otherwise have been released because of rare high-profile cases of reoffending can also be considered a form of collective punishment.
Originality/value
These significant findings suggest that collective punishment in various forms continues to be used in Swiss prisons.
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This chapter explores the protest self-immolations since 2009 of over 100 Tibetans in China. It investigates whether these events have ecological as well as social causes and may…
Abstract
Purpose
This chapter explores the protest self-immolations since 2009 of over 100 Tibetans in China. It investigates whether these events have ecological as well as social causes and may thus be relevant to the emerging discipline of ‘EcoHealth’.
Method
Targeted literature review and reflective analysis, presented as a narrative.
Findings
Chinese citizens identifying as Tibetan have experienced substantial ethnically based discrimination for over 60 years, manifest as attempted cultural destruction, pervasive disrespect and linguistic suppression. Tibetans, now a minority in much of their former territory, have witnessed and at times been forced to participate in ecological destruction, much of it led by Chinese settlers, endorsed by occupying authorities. Tibetans have for decades protested against the Chinese they regard as invaders and occupiers, but Tibetan acts of protest self-immolation are a recent response. Academic analysis has been scarce, particularly by Chinese scholars. Until now, EcoHealth practitioners have also denied any relevance, as if in a waltz led by the Chinese government.
Practical and social implications
Attempts to identify rational causes for Tibetan self-immolation conflict with themes of liberation and fairness central to Communist Chinese ideology. Most Chinese analysis of Tibetan self-immolation is superficial, nationalistic and unsympathetic. Also disturbing is the reaction to these issues shown by the International Association of Ecology and Health. It is suggested that this illustrates a failure to translate rhetoric of ‘speaking truth to power’ to reality, a retreat from idealism common to many social movements.
Originality and value
Increasing human demand on a limited biosphere necessitates a deepened understanding of eco-social factors. Practitioners concerned with sustaining our civilisation are encouraged to explore the integrated dimensions revealed by this case study.
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Peter Ninnes, T.W. Maxwell, Wangchuck Rabten and Karchung Karchung
The Himalayan Kingdom of Bhutan was a signatory to the Jomtien Education for All agreement. Pursuing EFA in Bhutan presents a number of unique geographical, systemic, linguistic…
Abstract
The Himalayan Kingdom of Bhutan was a signatory to the Jomtien Education for All agreement. Pursuing EFA in Bhutan presents a number of unique geographical, systemic, linguistic and other challenges, and the Royal Government of Bhutan has adopted multigrade school development as one major strategy in moving towards EFA. This adoption can be considered a form of policy borrowing. In this chapter we explore how multigrade schooling has been enhanced and expanded in Bhutan to achieve EFA goals, and in particular, the conditions under which multigrade teaching has become an accepted and important form of educational delivery in Bhutan. We trace the development of multigrade teaching to a set of partly planned and partly coincidental events and contexts. We review the geographical setting of Bhutan, local and global political events, teacher training issues, teacher upgrade programmes, contemporary discourses of education, development and modernization, and local initiatives to promote and strengthen multigrade teaching as a key strategy in providing access to school for children in remote areas. We also identify a number of challenges facing multigrade teaching, including the linguistic context, local reservations about the desirability of multigrade classes and resource issues.
Godfred Matthew Yaw Owusu, Teddy Ossei Kwakye and Henry Duah
This study investigates how students' propensity towards indebtedness affects their savings behaviour. Additionally, the study examines the moderating role of financial literacy…
Abstract
Purpose
This study investigates how students' propensity towards indebtedness affects their savings behaviour. Additionally, the study examines the moderating role of financial literacy in the relationship between propensity towards indebtedness and savings behaviour.
Design/methodology/approach
Questionnaires were administered to undergraduate students from the University of Ghana Business School. A total of 370 valid responses were used in the empirical analysis. The hypothesised relationships were tested using partial least square – structural equation modelling.
Findings
The structural model results suggest that students' propensity towards indebtedness is negatively related to their savings behaviour. Further, the results demonstrate that financial literacy moderates the negative association between students' propensity towards debt and savings behaviour.
Originality/value
This study highlights students' propensity towards indebtedness and how it impacts their savings behaviour.