Monday, April 22, 2024

New study confirms community pharmacies can help people quit smoking

Pharmacists may play crucial role in addressing lack of access to tobacco cessation tools

UNIVERSITY OF CALIFORNIA - DAVIS HEALTH

A new study shows community pharmacies may play a key role in helping people quit smoking.

The findings came out in the article Closing the Tobacco Treatment Gap, published in the 10th anniversary special issue of Pharmacy. The results provide valuable insights into the implementation of tobacco cessation services within community pharmacies while identifying barriers to further improvements.

Tobacco use remains a leading preventable cause of death. Although two thirds of people who smoke would like to quit, many individuals trying to quit on their own are not successful. To address this gap, the study explored how pharmacists and pharmacy technicians could assist in providing tobacco cessation support.

Led by researchers at UC Davis Comprehensive Cancer Center and other academic institutions across the country, the study involved seven independent community pharmacies in California affiliated with the Community Pharmacy Enhanced Services Network. A total of 22 California pharmacists and 26 pharmacy technicians who underwent tobacco cessation training participated.

“Community pharmacies are important partners to expand access to tobacco cessation services,” said Elisa Tong, a UC Davis Health internist and director of the cancer center’s Tobacco Cessation Policy Research Center. “By state law, pharmacists can furnish all forms of nicotine replacement therapy (NRT) without a provider prescription.”

California’s law allowing pharmacists to provide the cessation tool took effect in 2014. Eligible pharmacists must complete two hours of tobacco training and follow the state-approved protocol, which consists of reviewing patients’ current tobacco use and prior quit attempts, screening for appropriateness of NRT, providing medication counseling, and addressing or referring patients for behavioral counseling. Tobacco cessation has been integrated into the curricula of California pharmacy schools since 2000, and many other training programs are available for pharmacies.

“After completing tobacco treatment training, our research showed that pharmacies successfully initiated cessation services,” said the study’s senior author Karen Hudmon from Purdue University College of Pharmacy. “Compatibility with existing workflows, staff buy-in and the crucial role of pharmacy technicians significantly helped.”

Continued research efforts are underway to study policy implementation strategies, especially for pharmacist reimbursement. California’s law authorizes Medi-Cal and private insurance to pay pharmacies for enhanced services including education and medication management.

“Pharmacists and pharmacy technicians play a pivotal role in providing effective support for tobacco treatment and other related health issues,” said Robin Corelli, a UC San Francisco pharmacy faculty member and study co-author. “Being part of the local community is important and we need sustainable models for providing these services.”

Solving barriers could help pharmacies reach more people

Given that 89% of Americans live within five miles of a community pharmacy, they can be convenient locations for receiving health care services. Pharmacists have shown to be effective in helping patients quit. They can reach uninsured and under-resourced patients as well as patients living in rural areas who might experience barriers to accessing primary care. However, the study showed certain barriers exist to making pharmacy cessation programs effective.

The research showed that billing complexities, software limitations and training gaps for handling complicated patient cases all pose challenges to successful implementation of tobacco cessation services at pharmacies.

However, the data collected implied a forward-thinking health care model where the pharmacists and their staff can play a fundamental and dynamic role in local health management, and ultimately, in cultivating a healthier population. The study serves as a valuable resource for policymakers, health care professionals and stakeholders in population health efforts to combat tobacco use.

This study was funded by the National Cancer Institute (R25 CA236637 to K Hudmon) and the Tobacco-Related Disease Research Program, which also supports the Tobacco Cessation Policy Research Center at UC Davis Comprehensive Cancer Center.

The cancer center’s new Tobacco Cessation Policy Research Center will continue to examine the role of pharmacies in helping people quit smoking. The center is also studying the integration of tobacco treatment at substance use disorder facilities. Other tobacco-related research focuses on equal access to tobacco treatment provided by public insurance plans and engaging with enforcement of flavored tobacco sales restrictions.

Other authors include:

Katy Ellis Hilts of Richard M. Fairbanks School of Public Health at Indiana University; Nervana Elkhadragy of University of Wyoming School of Pharmacy; Micah Hata of College of Pharmacy, Western University of Health Sciences, Pomona; and Francis M. Vitale of College of Pharmacy, Purdue University.

JOURNAL

Pharmacy

DOI

10.3390/pharmacy12020059

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Closing the Tobacco Treatment Gap: A Qualitative Study of Tobacco Cessation Service Implementation in Community Pharmacies

Study identifies signs of repeated blast-related brain injury in active-duty United States Special Operations Forces

Repeated exposure to explosive blasts has the potential to cause brain injuries, but there is currently no diagnostic test for these injuries.

MASSACHUSETTS GENERAL HOSPITAL

Repeated exposure to explosive blasts has the potential to cause brain injuries, but there is currently no diagnostic test for these injuries

In a study of 30 active-duty United States SOF personnel, researchers found that increased blast exposure was associated with structural, functional, and neuroimmune changes to the brain and a decline in health-related quality of life

The researchers are now designing a larger study to develop a diagnostic test for repeated blast brain injury

United States (US) Special Operations Forces (SOF) personnel are frequently exposed to explosive blasts during training and combat. However, the effects of repeated blast exposure on the brain health of SOF personnel are unclear, and there is currently no diagnostic test that can detect brain injury caused by the cumulative effects of subconcussive blast exposure.

As a result, SOF personnel may experience cognitive, psychological and physical symptoms for which the cause is never identified, and they may return to training or combat when their brains are vulnerable.

US Special Operations Command (USSOCOM) recognizes that the health and well-being of its elite SOF members is a critical element to develop and employ the world's finest warfighters. Because brain health is a key element to fielding a healthy force, USSOCOM willingly participated in this pilot study to help both the US Military and the medical community understand and identify signs related to repeated blast effects. Collectively, USSOCOM hopes that the impact of this study will benefit all US Military members with repeated blast exposure in the future.

To understand the effects of repeated blast exposure on SOF brain health and inform the development of a diagnostic test for repeated blast brain injury, a team at Massachusetts General Hospital, a founding member of the Mass General Brigham healthcare system, conducted the ReBlast study, a comprehensive, multimodal investigation of 30 active-duty US SOF. The University of South Florida, Institute of Applied Engineering coordinated and managed the study, which was supported by USSOCOM.

In a publication titled “Impact of Repeated Blast Exposure on Active-Duty United States Special Operations Forces,” published in Proceedings of the National Academy of Sciences of the U.S.A., the team reports that higher blast exposure was associated with structural, functional, and neuroimmune brain alterations and lower health-related quality of life.

The magnetic resonance imaging (MRI) and positron emission tomography (PET) findings converged at a region of the frontal lobe called the rostral anterior cingulate cortex (rACC), which is known to be a widely connected brain network hub that modulates cognition and emotion.

Three lines of evidence – structural MRI, functional MRI, and translocator protein PET – showed an association between cumulative blast exposure and changes in the rACC. Among all the findings, the association between cumulative blast exposure and structural MRI changes in the rACC was the most significant. These results suggest that the rACC may be particularly sensitive to blast waves that penetrate the openings in the skull behind the eyes.

Higher cumulative blast exposure was also associated with decreased health-related quality of life on self-reported questionnaires. However, blast exposure was not associated with changes in cognitive performance, post-traumatic stress disorder symptoms, or blood proteomics. No signs of blast-related brain injury were identified by conventional MRI scans.

Characteristics of Study Participants

SOF study participants represented all branches of the military and included both enlisted personnel and officers. On average, participants were 37 years old and had 17 years of military service. All participants had extensive combat exposure and reported levels of cumulative blast exposure at which individuals are likely to experience cognitive, physical or psychological symptoms. They also reported high levels of blunt impacts to the head, with half the cohort having more blows to the head than they could recall.

These blunt head impacts, as well as age and amount of combat exposure, were accounted for in statistical analyses that tested for associations between blast exposure and a broad spectrum of cognitive, physical symptom, psychological, neuroimaging and blood-based biomarkers.

“A key limitation of the study is that we were unable to measure the many additional exposures that SOF personnel experience during training and combat, such as inhalation of heavy metals, lack of oxygen during high-altitude jumping or deep-sea diving, and acceleration g-forces when flying in aircraft or traveling over waves at high speeds,” explains Brian L. Edlow, MD, principal investigator of the study. “As a result, the associations we observed between cumulative blast exposure and brain network disruption do not prove causation.”

Dr. Edlow is co-director of Mass General Neuroscience, associate director of the Center for Neurotechnology and Neurorecovery (CNTR) at Mass General, an associate professor of Neurology at Harvard Medical School and a Chen Institute MGH Research Scholar 2023-2028.

“Future studies with more comprehensive and objective exposure measurements, larger sample sizes, and a longitudinal design are needed to definitively link blast exposure to the imaging biomarkers that we observed,” adds Natalie Gilmore, PhD, first author of the study and a research fellow in the CNTR.

The researchers are now designing such a longitudinal study with the goal of developing a reliable diagnostic test for repeated blast brain injury. Although no specific blood-based biomarkers for brain injury were detected during the study, the researchers did find higher than expected levels of tau in the blood of study participants, a finding that could help in developing a portable diagnostic test.

“The availability of a reliable diagnostic test could improve Operators’ quality of life by ensuring that they receive timely, targeted medical care for symptoms related to repeated blast brain injury,” explains Yelena G. Bodien, PhD, co-senior author of the paper and an investigator in the CNTR. “A diagnostic test could also be used to inform decisions by Commanders about the combat readiness of individual Operators.”

“Ultimately, the goal of this research is to enhance the combat readiness, career longevity, and quality of life of the United States’ most elite forces,” Edlow says.

“These are American heroes who answered the call to serve after the terrorist attacks of September 11, 2001 and fought the most dangerous missions of the Global War on Terror for two decades. They deserve the best medical care, and while more research is needed, our results suggest that a diagnostic test for repeated blast brain injury is within reach.”

Authorship: In addition to Edlow, Bodien, and Gilmore, Tseng and Maffei were co-first authors.

Disclosures: Disclosure forms provided by the authors are available with the full text of this article.

Funding: This study was funded by the U.S. Department of Defense (USSOCOM Contract No. H9240520D0001). Support was also provided by the Navy SEAL Foundation.

Paper cited: Gilmore N*, Tseng CJ*, Maffei C*, et al. Impact of repeated blast exposure on active-duty United States Special Operations Forces. Proceedings of the National Academy of Sciences of the U.S.A. 2024. DOI: 10.1073/pnas.2313568121 (*co-first authors)

About Massachusetts General Hospital

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. MGH is a founding member of the Mass General Brigham healthcare system.

About the University of South Florida, Institute of Applied Engineering

The University of South Florida's Institute of Applied Engineering (IAE) represents a beacon of innovation and excellence. Skillfully blending academic prowess with practical application, the IAE addresses some of the nation's most critical challenges. Since its inception, the IAE has emerged as a vital partner to the Department of Defense, NASA, and other federal agencies, managing multimillion-dollar contracts to enhance the capabilities of our nation's defense mechanisms. With expertise spanning Integrated Systems, Software Systems, Intelligent Systems, and beyond, the Institute delivers comprehensive solutions through a synergistic approach that combines the talents of USF's esteemed faculty, a nationwide consortium of over 43 universities, and agile small businesses. The IAE's model of integrating research, development, rapid prototyping, and education is optimized to address the nation’s most complex issues.

About US Special Operations Command

USSOCOM develops, and employs, the world's finest SOF to conduct global special operations and activities as part of the Joint Force, in concert with the U.S. Government Interagency, Allies, and Partners, to support persistent, networked, and distributed combatant command operations and campaigns against state and non-state actors, all to protect and advance U.S. policies and objectives.

JOURNAL

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2313568121

METHOD OF RESEARCH

Imaging analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Impact of repeated blast exposure on active-duty United States Special Operations Forces

ARTICLE PUBLICATION DATE

22-Apr-2024

World’s oases threatened by desertification, even as humans expand them

Humans have artificially expanded many of the world’s oases, but the water-intensive practice is often not sustainable. Desertification has already led to the loss of about 52,000 square miles of oasis — and more will likely disappear

Peer-Reviewed Publication

AMERICAN GEOPHYSICAL UNION

American Geophysical Union
Press Release 24-16
22 April 2024
For Immediate Release

This press release is available online at: https://news.agu.org/press-release/oases-grow-desertification-threatens/

World’s oases threatened by desertification, even as humans expand them

AGU press contact:
Rebecca Dzombak, news@agu.org (UTC-4 hours)

Contact information for the researchers:
Dongwei Gui, Chinese Academy of Sciences, guidwei@ms.xjb.ac.cn (UTC+8)
Researchers should be contacted directly for interview requests.

By the numbers, from 1995 to 2020:

Oases gained 85,000 square miles, mostly from artificial expansion projects
Oases lost 52,000 square miles from desertification and water scarcity
Oases gained a net area of about 33,400 square miles, but that mostly artificial growth is not sustainable

WASHINGTON — Oases are important habitats and water sources for dryland regions, sustaining 10% of the world’s population despite taking up about 1.5% of land area. But in many places, climate change and anthropogenic activities threaten oases’ fragile existence. New research shows how the world’s oases have grown and shrunk over the past 25 years as water availability patterns changed and desertification encroaches on these wet refuges.

“Although the scientific community has always emphasized the importance of oases, there has not been a clear map of the global distribution of oases,” said Dongwei Gui, a geoscientist at the Chinese Academy of Science who led the study. “Oasis research has both theoretical and practical significance for achieving United Nations Sustainable Development Goals and promoting sustainable development in arid regions.”

The study found that oases around the world grew by more than 220,149 square kilometers (85,000 square miles) from 1995 to 2020, mostly due to intentional oasis expansion projects in Asia. But desertification drove the loss of 134,300 square kilometers (51,854 square miles) of oasis over the same period, also mostly in Asia, leading to a net growth of 86,500 square kilometers (about 33,400 square miles) over the study period.

The findings highlight the risk climate change and anthropogenic stressors pose to these wet sanctuaries and can inform water resource management and sustainable development in arid regions. The study was published in the AGU journal Earth’s Future, which publishes interdisciplinary research on the past, present and future of our planet and its inhabitants.

The birth and death of an oasis

Oases are important sources of water for humans, plants and animals in the world’s drylands, supporting a majority of productivity and life in deserts. They form when groundwater flows and settles into low-lying areas, or when surface meltwater flows downslope from adjacent mountain ranges and pools. The existence of an oasis depends primarily on having a reliable source of water that is not rainfall. Today, oases are found in 37 countries; 77% of oases are located in Asia, and 13% are found in Australia.

Gui and his co-investigators wanted to understand the global distribution and dynamic changes of oases and see how they respond to a changing environment, such as variations in climate, water resources and human activities. Using data from the European Space Agency’s Climate Change Initiative Land Cover Product, the team categorized the land surface into seven categories: forest, grassland, shrub, cropland, water, urban and desert.

The researchers used satellite data to look for green, vegetated areas within dryland areas, indicating an oasis, and tracked changes over 25 years. Changes in the greenness of vegetation indicated changes in land use and oasis health, the latter of which can be influenced by both human activity and climate change. They also looked at changes in land surface type to find conversions of land use.

The researchers found that global oasis area increased by 220,800 square kilometers (85,251 square miles) over the 25-year timeframe. Most of that increase was from humans intentionally converting desert land into oases using runoff water and groundwater pumping, creating grasslands and croplands. The increase was concentrated in China, where management efforts have contributed more than 60% of the growth, Gui said. For example, more than 95% of the population in China’s Xinjiang Uygur Autonomous Region lives within an oasis, motivating conservation and a 16,700 square kilometer (6,448 square mile) expansion of the oasis, Gui said.

Countering human efforts to expand oases, desertification contributed to oasis loss. Worldwide, the researchers found there was a loss of more than 134,000 square kilometers (51,738 square miles) of oasis land over the past 25 years. The researchers estimate that changes to oases have directly affected about 34 million people around the world.

Overall, between gains and losses, oases had a net growth of 86,500 square kilometers (33,397 square miles) from 1995 to 2020 — but most gains were from the artificial expansion of oases, which may not be sustainable in the future.

Long-term oasis sustainability

The study highlighted ways to sustain healthy oases, including suggestions for improving water resource management, promoting sustainable land use and management and encouraging water conservation and efficient use. These efforts are especially important as the climate continues to change, Gui said.

Humans’ overexploitation of dwindling groundwater can limit oasis sustainability, as well as long-term glacier loss. While higher temperatures increase glacier melt, temporarily boosting oases’ water supplies, “as glaciers gradually disappear, the yield of meltwater will eventually decrease, leading to the shrinkage of oases once again,” Gui said.

International cooperation plays a crucial role in oasis sustainability, Gui said.

“Due to the unique mechanism of oasis formation, a river basin often nurtures multiple oases across several countries, making transboundary cooperation key to addressing water scarcity and promoting sustainable development,” he said.

Notes for journalists:

This study is published in Earth’s Future, an open-access AGU journal. Neither this press release nor the study is under embargo. View and download a pdf of the study here.

Paper title:

“Distribution and growth drivers of oases at a global scale”

Authors:

Bochao Cui, Dongwei Gui (corresponding author), State Key Laboratory of Desert and Oasis Ecology, Key Laboratory of Ecological Safety and Sustainable Development in Arid Lands, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Xinjiang, China; Cele National Station of Observation and Research for Desert Grassland Ecosystem in Xinjiang, Cele, China; and University of Chinese Academy of Sciences, Beijing, China
Qi Liu, Yunfei Liu, State Key Laboratory of Desert and Oasis Ecology, Key Laboratory of Ecological Safety and Sustainable Development in Arid Lands, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Xinjiang, China; Cele National Station of Observation and Research for Desert Grassland Ecosystem in Xinjiang, Cele, China
Sameh Kotb. Abd-Elmabod, State Key Laboratory of Desert and Oasis Ecology, Key Laboratory of Ecological Safety and Sustainable Development in Arid Lands, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Xinjiang, China; Soils and Water Use Department, Agricultural and Biological Research Institute, National Research Centre, Cairo, Egypt; and Agriculture and Food Research Council, Academy of Scientific Research and Technology, Cairo, Egypt
Binbin Lu, School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, China

Related research of interest:

Drying and water loss threaten green areas in China’s drylands. Earth’s Future, March 2024

Rapid oasis expansion, increased irrigation water use, and biomass loss in China. Earth’s Future, March 2024

Water availability in China’s oases significantly decreased from 1987 to 2017. Earth’s Future, April 2023.

AGU (www.agu.org) is a global community supporting more than half a million advocates and professionals in Earth and space sciences. Through broad and inclusive partnerships, AGU aims to advance discovery and solution science that accelerate knowledge and create solutions that are ethical, unbiased and respectful of communities and their values. Our programs include serving as a scholarly publisher, convening virtual and in-person events and providing career support. We live our values in everything we do, such as our net zero energy renovated building in Washington, D.C. and our Ethics and Equity Center, which fosters a diverse and inclusive geoscience community to ensure responsible conduct.

JOURNAL

Earth's Future

DOI

10.1029/2023EF004086

ARTICLE TITLE

Distribution and growth drivers of oases at a global scale

ARTICLE PUBLICATION DATE

22-Apr-2024

National Jewish Health researchers identify connection between air pollutants and allergic diseases

NATIONAL JEWISH HEALTH

A new study by researchers at National Jewish Health published this month in the Annals of Allergy, Asthma & Immunology reports that air pollutants — including particulate matter, pollen, greenhouse gases, and other harmful substances — can contribute to the development and exacerbation of allergic diseases by disrupting the skin barrier.

“People are aware of the connection between pollution and respiratory disease, but we wanted to take the next step and investigate how global warming is damaging our skin,” said Donald Leung, MD, PhD, head of Pediatric Allergy & Clinical Immunology at National Jewish Health and senior author of the study. “We found that pollutants can damage the skin barrier and contribute to allergic diseases that can be passed on to future generations.”

National Jewish Health researchers have long studied the individual diseases associated with the atopic march, a term that refers to the progression of allergic diseases that often begin with very young children having atopic dermatitis (eczema) and then developing food allergies, asthma, and hay fever over the years. This recent study builds on previous research from National Jewish Health that found a connection between a child’s proximity to roads with high volumes of traffic and the development of atopic dermatitis.

"A baby's skin is susceptible to environmental hazards as its continuing to develop and adjust to its new environment outside of the womb," said Michael Nevid, MD, pediatric allergist and immunologist at National Jewish Health, and an author on the study. "Our research found that highly trafficked roads may have adverse ramifications on skin health in children, raising the risk of developing atopic dermatitis. This highlights the importance of having environmental interventions designed to decrease exposure to traffic in young children."

“Climate change and pollution have led to increased hay fever with longer allergy seasons and more allergenic plants. Pollens can be triggers for not only hay fever, but eczema and asthma too,” said Jessica Hui, MD, pediatric allergist and immunologist at National Jewish Health, and author on the study. “Our skin barrier protects us from external threats and the best way to treat the atopic march is to take preventive measures.”

Research has led to treatment advancements at National Jewish Health aimed at sealing the skin barrier and stopping the atopic march in its tracks — including early biomarker identification and “soak and seal” treatments that involve thoroughly moisturizing the skin in a warm bath, then trapping the moisture in with ointment.

While researchers continue to make progress in treating these conditions, the most effective approach to prevent allergic diseases resulting from air pollutants is to minimize exposure to these pollutants from an early age, keeping in mind that pollutants are not only present outdoors but also indoors as well. Researchers warn that there is a pressing need for a global policy initiative that prioritizes efforts to reduce air pollutant emissions and extremes of temperature.

National Jewish Health is the leading respiratory hospital in the nation. Founded 125 years ago as a nonprofit hospital, National Jewish Health today is the only facility in the world dedicated exclusively to groundbreaking medical research and treatment of children and adults with respiratory, cardiac, immune and related disorders. Patients and families come to National Jewish Health from around the world to receive cutting-edge, comprehensive, coordinated care. To learn more, visit njhealth.org or the media resources page.

JOURNAL

Annals of Allergy Asthma & Immunology

DOI

10.1016/j.anai.2023.11.014

ARTICLE TITLE

Air pollutants contribute to epithelial barrier dysfunction and allergic diseases

In the United States, the election of progressive prosecutors led to higher relative rates of property and overall crime, but not to higher relative rates of violent crime

Findings refute conservative criticisms, fears of surges in violence

Peer-Reviewed Publication

AMERICAN SOCIETY OF CRIMINOLOGY

In the United States, the number of so-called progressive prosecutors focused on criminal justice reform has risen, but few studies have addressed the relation between these prosecutors’ policies and crime rates. In a new study, researchers examined whether progressive prosecutors in the 100 most populated counties affected crime rates from 2000 to 2020. They found that the inauguration of these prosecutors led to higher relative rates of property crime and total crime, but not to higher relative rates of violent crime.

The study was conducted by researchers at the University of Miami, the University of California Irvine (UCI), and Arizona State University (ASU). It appears in Criminology & Public Policy, a publication of the American Society of Criminology.

“All but one prior study on this topic has examined crime rates at the city level,” notes Nick Petersen, associate professor of sociology and criminology at the University of Miami, who led the study. “By investigating crime rates at the county level, our study offers a more complete picture of the relation between crime rates and progressive prosecution policies across a prosecutor’s jurisdiction.”

In response to growing concerns about mass incarceration in recent decades, progressive prosecutors have been elected on platforms that emphasize reducing incarceration rates. These prosecutors differ from more traditional “law and order” prosecutors and typically focus on decarceration policies such as diversion from prison or jail, decriminalization of low-level drug crimes, and decreased use of mandatory minimum sentences.

In a 2022 Criminology & Public Policy article, study coauthor Ojmarrh Mitchell and colleagues noted that offices led by progressive prosecutors generally issued less harsh sentences and had fewer racial/ethnic disparities. Progressive prosecutors have been criticized for their “soft on crime” policies, and some have been recalled, impeached, or removed from office. This study sought to answer questions about the effect of these prosecutors on crime rates, which the authors consider crucial amid debates surrounding progressive prosecution and criminal justice reform.

Researchers coded the progressiveness of prosecutors elected between 2000 and 2020 in the 100 largest U.S. counties. They used prosecutors’ inauguration dates to measure changes in local crime rates, considering violent, property, and overall crime as reported by the FBI’s Uniform Crime Reporting program.

Compared to jurisdictions that maintained traditional chief prosecutors, areas that changed to progressive prosecutors had 7% higher relative rates of total crime, which were driven by 6.7% higher relative rates of property crime. These effects were strongest from 2013 to 2020. In contrast, violent crime rates were not statistically higher in jurisdictions that switched to progressive prosecutors over the study, although there were statistically higher relative rates of violent crime from 2014 to 2016.

The authors point out that the estimated effects are relative differences in crime trends, not absolute differences in crime. In absolute terms, crime rates fell over the study, but property and total crime rates declined more markedly in counties with traditional prosecutors. Yet for violent crimes, the election of progressive prosecutors had no reliable overall effect across the study, but it had significant effects on crime from 2014 to 2016.

Moreover, the effects of progressive prosecutors appear to vary by time in office, with relatively higher crime rates in the first decade and declining relative crime rates afterward.

“Despite concerns that the election of progressive prosecutors would lead to surging levels of violence, our findings suggest that progressive-oriented prosecutorial reforms led to relatively higher rates of property crime but had limited impact on rates of violent crime,” says Mitchell, professor of criminology, law, and society at UCI, who coauthored the study. “In fact, in absolute terms, crime rates fell in jurisdictions with traditional and progressive prosecutors.”

“Given that prior research has shown that progressive prosecutors reduced mass incarceration and racial inequalities, our study indicates that higher property crime rates may be the price for these advancements,” adds Shi Yan, assistant professor in ASU’s School of Criminology and Criminal Justice, who coauthored the study. “Whether this is a worthwhile tradeoff is ultimately a decision for local officials and the constituencies they represent.”

The University of Miami Provost’s Research Award funded the study.

JOURNAL

Criminology & Public Policy

DOI

10.1111/1745-9133.12666

ARTICLE TITLE

Do progressive prosecutors increase crime? A quasi-experimental analysis of crime rates in the 100 largest counties, 2000–2020

ARTICLE PUBLICATION DATE

18-Apr-2024

European Court of Human Rights is “backsliding” on legal protections for asylum seekers, study says

UNIVERSITY OF EXETER

The European Court of Human Rights is “backsliding” by surreptitiously reversing its principles established to protect asylum seekers, a new study says.
It is a decade since the Court first established that asylum seekers are inherently and particularly vulnerable in law.
The research shows that in recent years the Court has moved away from this position, albeit without actually acknowledging this or explaining why. The research warns that it is now uncertain what exactly is needed for any particular asylum applicant to be judged as sufficiently vulnerable to receive special protection under the European Convention on Human Rights.
The study, by Dr Ben Hudson from the University of Exeter Law School, is published in the International Journal of Law in Context.
Dr Hudson says: “The consequence of this backsliding is not only that the judicially recognised concept of asylum vulnerability is undermined, but that some of the most vulnerable applicants that come before the Court suffer renewed marginalisation, and, in some circumstances, exclusion from the ‘special protection’ to which they were previously afforded.
“The ECtHR is backsliding in its asylum-related jurisprudence when this is viewed through the lens of vulnerability. In the years since the Grand Chamber first affirmed asylum vulnerability the Court has subtly, but markedly, reversed its position to the point where it is now at risk of disappearing altogether.”
In some judgments, the ‘particular vulnerability’ of asylum seekers as a group has been recognised, but the Court has caveated this through a comparison with other asylum seekers in the same situation. The research says this has resulted in some applicants being excluded from special protection. It criticises the use of this caveat as causing uncertainty and being “highly impractical”.
Dr Hudson says: “It is improbable that the Court will ever have equivalent information pertaining to the situation of every asylum seeker within a particular detention centre or confinement zone for comparisons to be meaningful or warranted. There is seemingly nothing to stop the Court from introducing more and more points of contrast to distinguish between otherwise similarly located asylum seekers.”
In other judgments, the Court has failed to mention or give due regard to the inherent and particular vulnerability associated with being an asylum seeker under the Convention.
In others the Court has linguistically altered its vulnerability principle, that particular vulnerability is inherent to one’s situation as an asylum seeker, to the detriment of claimants.
Most of the judgments examined as part of the research came after 2018. In 2011 asylum seekers were classed by the court as ‘a particularly underprivileged and vulnerable population group in need of special protection’, with that vulnerability being inherent in their situation as asylum seekers.
Dr Hudson says: “The Court appears to have tacitly normalised the failure to recognise the vulnerability of asylum seekers and the resistance to employ its own vulnerability reasoning.
“Being an asylum seeker is no longer by itself determinative of particular vulnerability. On the Court’s discretion, an indeterminate range of other factors may also be considered such as being a minor or in fragile health.
“Without a pronounced turn of direction by the ECtHR, the hope that many had for vulnerability reasoning to provide a more inclusive, more humane, response to the threats to Convention rights of persons seeking refuge in Europe, will be dashed forever.”

JOURNAL

International Journal of Law in Context

DOI

10.1017/S1744552323000332

ARTICLE TITLE

Asylum Marginalisation Renewed: ‘Vulnerability Backsliding’ at the European Court of Human Rights

ARTICLE PUBLICA

Social programs save millions of lives, especially in times of crisis

A study in Brazil shows that primary health care, social pensions and conditional cash transfers have prevented 1.4 million all-age deaths over the past two decades

BARCELONA INSTITUTE FOR GLOBAL HEALTH (ISGLOBAL)

Primary health care, conditional cash transfers and social pensions have prevented 1.4 million deaths of all ages in Brazil over the past two decades, according to a study coordinated by the Barcelona Institute for Global Health (ISGlobal), a centre supported by “la Caixa” Foundation. If expanded, these programmes could avert an additional 1.3 million deaths and 6.6 million hospitalisations by 2030.

The COVID-19 pandemic has exacerbated poverty and social inequalities worldwide, particularly in low- and middle-income countries (LMICs). In addition, the economic consequences of the ongoing war in Ukraine and soaring inflation are expected to push even more people into poverty in the coming years. This is what we call a polycrisis: multiple crises interacting in such a way that their combined impact is greater than the sum of the parts.

In terms of public health, worsening socioeconomic conditions mean higher rates of disease and death, especially among the most vulnerable people in LMICs. But social programmes can mitigate the health consequences of economic crises. Brazil has led one of the largest welfare state expansions over the past two decades, implementing a public universal healthcare system along with conditional cash transfer programmes (Programa Bolsa Familia) for the poorest families and social pensions (Beneficio de Prestacao Continuada) for the elderly and disabled.

Reductions in hospitalisations and deaths

In this study, ISGlobal researcher Davide Rasella and his team evaluated the combined effect of these three programmes (conditional cash transfers, social pensions and primary health care) on hospitalisations and deaths over almost two decades (from 2004 to 2019). “This is the first study to conduct a nationwide combined evaluation of cash transfers, social pensions, and primary health care for a such long period in a LMIC,” says Rasella, who coordinated the study.

Using data from 2,548 Brazilian municipalities, they show that high coverage of the three programmes led to reductions in overall hospitalisation and mortality rates, particularly among children under five years of age and adults over 70. A total of 1.46 million deaths were averted between 2004 and 2019. The research team then used forecasting methods to show that extending the programmes to the newly poor and vulnerable could avert up to 1.3 million additional deaths by 2030.

“We clearly show that expanding these three programmes is a viable strategy to mitigate the health impact of the current global polycrisis,” says Daniella Cavalcanti, co-first author of the study. “On the contrary, fiscal austerity measures would only result in a large number of preventable deaths.”

Reference

Aransiola TJ, Ordoñez JA, Cavalcanti D et al. Current and Projected Mortality and Hospitalization Rates Associated with Conditional Cash Transfer, Social Pension, and Primary Health Care Programs in Brazil, 2000-2030. JAMA Network Open. 2024; 7(4):e247519. doi: 10.1001/jamanetworkopen.2024.7519

JOURNAL

JAMA Network Open

DOI

10.1001/jamanetworkopen.2024.7519

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Current and Projected Mortality and Hospitalization Rates Associated With Conditional Cash Transfer, Social Pension, and Primary Health Care Programs in Brazil, 2000-2030

ARTICLE PUBLICATION DATE

22-Apr-2024