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Purpose This paper is designed to critically review and analyze the body of research on a popular gang reduction strategy, implemented widely in the United States and a number of other countries, to: (1) assess whether researchers designed their evaluations to align with the theorized causal mechanisms that bring about reductions in violence; and (2) discuss how evidence on gang programs is generated and consumed. That review and assessment is then used to frame a research agenda for studying gang interventions. Design/methodology/approach A case study design is used to generate a multi-faceted understanding of the possible avenues for evaluation research on the law enforcement-based strategy known as the Group Violence Intervention. The paper discusses questions that remain to be answered about the strategy, such as “what type of deterrence is operating?” and if the model actually works by the threat of deterrence, and not by removing high-risk offenders and shootings from the street, what activities are needed to maintain the effect? Findings Across roughly two dozen impact evaluations of GVI, none have examined the likely cause and effect components of this multi-partner strategy in reducing the violence. Furthermore, there are many issues related to the production and generation of criminal justice evaluation research that have adversely pushed the balance of evidence on what works in gang reduction toward law enforcement programming. However, there are many strategies that researchers can use to think broadly about appropriate and holistic research and evaluation on gangs and gang programming. Practical implications The recommendations for research, if implemented, can help build a body of knowledge to move toward community-based and restorative models of gang violence reduction. Originality/value This original piece is one of the first essays to contextualize and discuss how aspects of the production of social science research on gangs may directly impact what programs and strategies are implemented on the ground.

A sizable group of individuals in the United States cycle in and out of jails, prisons, mental health hospitals, homeless shelters, and other expensive public institutions over time. This little-studied population represents significant unmet need and the inadequacy of services for complex consumers. The current study examined a sample ( N = 161) of chronically homeless frequent utilizers of jail and mental health systems in Chicago, Illinois. Cluster analysis was used to differentiate the sample into four reliable subgroups based on measures for prior homelessness, jail incarcerations, mental health hospitalizations, poor current mood, and limitations due to physical health. Logistic regression revealed that clusters differed significantly on reincarceration at 6 months postrelease. Implications for programming and policy for each cluster are discussed, including suggestions for targeting services to distinguishing characteristics for each subgroup. These findings argue for the importance of coordinating efforts across services systems to better identify and serve shared clients.

Members of hidden or hard-to-survey populations present challenges to social scientists seeking to engage them in empirical studies, especially if those efforts are longitudinal. In this article, we document the retention-related successes and failures of a longitudinal, social network-based study of active and desisting street gang members in Philadelphia, PA, and the District of Columbia. A purposive sample was used to identify and track 229 gang members at three points in time over 2 years to explore how the social networks of gang members change. Although gang members have many factors in common with other hidden populations, their criminal behavior and involvement with the justice system, coupled with the sensitivity of the social network survey questions for this study, created hurdles to maintaining research contact over time. With continued and systematic documentation of successes and challenges, academics can build an extensive backdrop from which to continue to study gang youth. If the field cannot devise cost-effective and transferable ways to study gangs beyond single-gang ethnographies, it will limit its understanding of important processes related to gang behavior, including gang joining and desistance.

PURPOSE: The purpose was to examine how fear of crime, crime victimization, and perceived level of community incivilities are related to physical activity participation and outdoor recreation among Latino adolescents. METHOD: The study utilized a mixed methods approach that included 25 qualitative interviews and 390 school-based surveys collected from youth across three schools in Little Village, Chicago, Illinois. RESULTS: Results showed that Latino adolescents who expressed greater fear of crime also engaged in less physical activity and outdoor recreation. There was no association between crime victimization and physical activity and outdoor recreation. Those who perceived greater levels of community incivilities also engaged in less outdoor recreation, but perception of incivilities had no significant association with physical activity levels. Interview data revealed most of the children believed crime was a serious problem in their neighborhood and it impacted their ability to be physically active and play outside. CONCLUSIONS: Fear of crime was related to lower physical activity and outdoor recreation. It is imperative that communities provide safe environments for children to be active. Increasing police and adult presence in parks and school grounds is recommended. Moreover, efforts must be made to reduce the gang problems in Latino communities. Language: en

To discuss the challenges faced in an experimental prisoner reentry evaluation with regard to managing the pipeline of eligible cases. This paper uses a case study approach, coupled with a review of the relevant literature on issues of case flow in experimental studies in criminal justice settings. Included are recommendations for researchers on the management of case flow, reflections on the major research design issues encountered, and a listing of dilemmas that are likely to plague experimental evaluations of prisoner reentry programs. Particularly in a jail setting, anticipating the timing of release of a prisoner to the community is probably impossible given the large number of issues that impact release, many of which will be unanticipated. A detailed pipeline study is critical to the success of an experimental study targeting returning prisoners. Pipeline studies should be conducted under what will be the true conditions and context for enrollment, given all eligibility criteria. With continued and systematic documentation of enrollment challenges in future experimental evaluations of reentry programs, as well as other experimental evaluations that involve individuals, academics can build a deep literature that would help facilitate future successful randomized experiments in the criminal justice field.

Studies have consistently found a positive relationship between alcohol outlet density and assault, but only a handful of studies have examined whether outlet density has an influence on domestic violence. Using a framework based in crime opportunity theories, this study estimates spatial econometric regression models to test whether the density of alcohol outlets across neighborhoods is positively associated with police calls for service for domestic violence. Models also were developed to test whether the relationships found were consistent across time periods associated with the use of alcohol outlets (weeknights and weekends). The findings indicate that off-premise outlets were associated with a significant increase in domestic violence, but on-premise outlets (specifically restaurants and nightclubs) were associated with a decrease in domestic violence. The risk for domestic violence in areas of high densities of off-premise outlets was found to be high during the weekend but not during the weeknight, suggesting different routine activities for domestic violence offenders during the week.

Background Although a number of studies have tested ecologic models that postulate relationships among social networks, the built environment, and active living, few neighborhood-based studies have considered the role of crime and violence. This study investigates the degree to which individual-level demographic characteristics and neighborhood-level physical and social characteristics are associated with increased fear of crime. Methods Data were analyzed in 2007 from a 2005 survey of 901 randomly selected individuals living in 55 neighborhoods in Washington DC. Multilevel ordered logit regression was used to examine associations between individual-level and neighborhood-level characteristics and how often fear of crime prevents a respondent from walking outdoors. Results Age and female gender were associated with an increase in fear; the percentage of a resident's life spent in the same neighborhood was associated with a decrease in fear. Results of cross-level interactions showed that at the neighborhood level, women were more fearful than men in neighborhoods without violence, but that the difference in fear between men and women shrinks as neighborhood violence increases. Collective efficacy was found to increase fear among black respondents and had no effect on fear among nonblack respondents. Conclusions If the study of neighborhoods and active living is to progress and contribute to both etiologic understanding and policy formation, it is essential that theoretical and empirical models consider the impact of violence and fear on walking. Efforts to increase active living in urban neighborhoods that do not account for the impact of crime and fear may fall short of their intended outcomes.

Scholars and practitioners alike in recent years have suggested that real and lasting progress in the fight against gun violence requires changing the social norms and attitudes that perpetuate violence and the use of guns. The Cure Violence model is a public health approach to gun violence reduction that seeks to change individual and community attitudes and norms about gun violence. It considers gun violence to be analogous to a communicable disease that passes from person to person when left untreated. Cure Violence operates independently of, while hopefully not undermining, law enforcement. In this article, we describe the theoretical basis for the program, review existing program evaluations, identify several challenges facing evaluators, and offer directions for future research.

Coronary heart disease clusters within families, but there may be several reasons for this phenomenon to occur. A possible way to elucidate this is to study biological relatives of affected individuals. The aim of our study was thus to compare a number of clinical, metabolic, clotting and immunologic factors between offspring with paternal history of premature myocardial infarction and controls and to propose a model which could safely allow to identify the high risk subgroup among them. Sixty-nine offspring of both sexes mean age 18.1 years old (cases) and thirty-two frequency matched relative to age and gender controls were studied. Cases compared to controls had significantly increased diastolic blood pressure levels (74.0+/-9.9 vs. 67.4+/-8.3 mmHg, P=0.002), leptin plasma levels (11.8+/-10.8 vs. 6.8+/-3 ng/ml, P=0.046) and fibrinogen, plasminogen, fibrin degradation products and plasminogen activator inhibitor-1 plasma levels (306.6+/-52.5 vs. 280.6+/-28.9 mg%, P=0.03, 97.4+/-23.5 vs. 83.6+/-15 mg%, P=0.0007, 292.0+/-148.5 vs. 219.2+/-69.4 ng/ml, P=0.036, 14.7+/-5.3 vs. 8.7+/-3.1 I.U./ml, P=0.0001, respectively), while cases had significantly decreased HDL-cholesterol serum levels (45.9+/-12.5 vs. 50.5+/-8.8 mg%, P=0.03) and protein S plasma levels (89.9+/-17.5 vs. 101.3+/-13.7%, P=0.001). Our findings suggest that offspring of affected individuals may be considered as a high risk group for cardiovascular disease.

Background Angiotensin-converting enzyme (ACE) gene polymorphism has been associated with an increased incidence of myocardial infarction. Recent studies have investigated a potential influence of ACE gene polymorphism on fibrinolysis or endothelial function. It has been previously established that essential hypertension is accompanied by endothelial dysfunction and fibrinolytic balance disorders. The aim of our study was to study the relation between ACE gene polymorphism and fibrinolytic/hemostatic factors as well as endothelial cell damage markers in patients with hypertension. Methods The following parameters were evaluated in 104 patients with previously untreated hypertension: plasminogen activator inhibitor-1 (PAI-1), tissue plasminogen activator (tPA) antigen, fibrinogen, D -dimer, and von Willebrand factor (vWF). The genotype of the ACE gene was also determined (by the polymerase chain reaction method), and patients were characterized according to the observed alleles as deletion/deletion (DD), insertion/insertion (II), or insertion/deletion (ID). Results Those with DD genotype (n = 42) had significantly higher plasma levels of PAI-1 antigen ( P =.012), tPA antigen ( P =.0001), fibrinogen ( P =.0002), D -dimer ( P =.0001) and vWF ( P =.0004) compared with ID (n = 30) or II (n = 32) genotypes. The ACE gene genotypes appeared to be significant predictors for plasma PAI-1 antigen, tPA antigen, fibrinogen, D -dimer, and vWF even after adjustment for age, sex, body mass index, triglyceride and cholesterol levels, and blood pressure. Conclusions Our findings suggest that the ACE/DD genotype is associated with hemostasis balance disturbances reflecting hypercoagulability and endothelial damage in patients with untreated hypertension. (Am Heart J 2000;140:760-5.)

Essential hypertension is often accompanied by abnormalities of the coagulation/fibrinolytic system, predisposing to a procoagulant state. The aim of the present study was to compare the effects of atenolol (β1-blocker agent) and irbesartan (angiotensin II type 1 receptor antagonist) on plasma levels of hemostatic/fibrinolytic and endothelial function markers in a cohort of previously untreated hypertensives. Fifty-four patients were randomly assigned to atenolol 25 to 150 mg (26 patients) or irbesartan 75 to 300 mg (28 patients). The plasma levels of plasminogen activator inhibitor-1 antigen, thrombomodulin, tissue factor pathway inhibitor antigen, fibrinogen, and factor XII were determined before and after 6 months of therapy. Age, gender distribution, body mass index, lipid profile, and baseline values of the measured markers were similar in both groups. Baseline values for systolic and diastolic blood pressure, as well as the reduction after treatment, were not significantly different between the two groups. Treatment with irbesartan was associated with a significant decrease in the levels of all the parameters. Similar findings were observed in the atenolol group, except for factor XII and tissue factor pathway inhibitor levels, which were not significantly decreased in this group. The reduction, however, of fibrinogen, plasminogen activator inhibitor-1, and thrombomodulin was significantly greater in the irbesartan than in the atenolol group. In conclusion, the results indicated that, despite an equally controlled blood pressure, 6-month therapy with irbesartan was associated with a more favorable modification of hemostatic/fibrinolytic status than atenolol.

Background:Path quality has not been well studied as a correlate of active transport to school. We hypothesize that for urban-dwelling children the environment between home and school is at least as important as the environment immediately surrounding their homes and/or schools when exploring walking to school behavior.Methods:Tools from spatial statistics and geographic information systems (GIS) were applied to an assessment of street blocks to create a walking path quality measure based on physical and social disorder (termed “incivilities”) for each child. Path quality was included in a multivariate regression analysis of walking to school status for a sample of 362 children.Results:The odds of walking to school for path quality was 0.88 (95% CI: 0.72−1.07), which although not statistically significant is in the direction supporting our hypothesis. The odds of walking to school for home street block incivility suggests the counter intuitive effect (OR = 1.10, 95% CI: 1.08−1.19).Conclusions:Results suggest that urban children living in communities characterized by higher incivilities are more likely to walk to school, potentially placing them at risk for adverse health outcomes because of exposure to high incivility areas along their route. Results also support the importance of including path quality when exploring the influence of the environment on walking to school behavior.

Within the realm of active living in urban neighborhoods in the United States, only a few studies have addressed the factors that promote or inhibit active living among residents in public housing. This paper examines the environmental and interpersonal factors associated with active living and health in public housing. We specifically examine the environmental predictors of fear of crime, and whether fear is related to moderate physical activity, and in turn, health and obesity. The analysis drew upon data from a sample of 328 African-American residents living in two severely distressed public housing developments in 2007. Structural equation modeling was used to calculate a path model of direct and indirect effects. Perceptions of violence were positively associated with fear, and both fear and physical activity predicted health. However, neither fear nor physical activity was associated with obesity. We discuss the implications of these findings for improving the quality of life of disadvantaged residents living in high-crime neighborhoods.

Background Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in ‘real-world’ services. Methods/Design The Psychosis early Intervention and Assessment of Needs and Outcome (PIANO) trial is part of a larger research program (Genetics, Endophenotypes and Treatment: Understanding early Psychosis - GET UP) which aims to compare, at 9 months, the effectiveness of a multi-component psychosocial intervention versus treatment as usual (TAU) in a large epidemiologically based cohort of patients with FEP and their family members recruited from all public community mental health centers (CMHCs) located in two entire regions of Italy (Veneto and Emilia Romagna), and in the cities of Florence, Milan and Bolzano. The GET UP PIANO trial has a pragmatic cluster randomized controlled design. The randomized units (clusters) are the CMHCs, and the units of observation are the centers’ patients and their family members. Patients in the experimental group will receive TAU plus: 1) cognitive behavioral therapy sessions, 2) psycho-educational sessions for family members, and 3) case management. Patient enrolment will take place over a 1-year period. Several psychopathological, psychological, functioning, and service use variables will be assessed at baseline and follow-up. The primary outcomes are: 1) change from baseline to follow-up in positive and negative symptoms’ severity and subjective appraisal; 2) relapse occurrences between baseline and follow-up, that is, episodes resulting in admission and/or any case-note records of re-emergence of positive psychotic symptoms. The expected number of recruited patients is about 400, and that of relatives about 300. Owing to the implementation of the intervention at the CMHC level, the blinding of patients, clinicians, and raters is not possible, but every effort will be made to preserve the independency of the raters. We expect that this study will generate evidence on the best treatments for FEP, and will identify barriers that may hinder its feasibility in ‘real-world’ clinical settings, patient/family conditions that may render this intervention ineffective or inappropriate, and clinical, psychological, environmental, and service organization predictors of treatment effectiveness, compliance, and service satisfaction. Trial registration ClinicalTrials.gov Identifier NCT01436331

The Urban Institute is an economic and social policy research organization; the Justice Policy Center (JPC) of the Urban Institute focuses its efforts on crime, justice, and community safety issues. Geographic information systems (GIS) and mapping play an important role in several major projects conducted by JPC, including program evaluations and comprehensive assessments of neighborhood-based issues such as crime and disorder. Below, we describe a few uses of GIS and mapping across some of our current research projects.

This study was aimed at investigating haemostasis parameters in patients (pts) with arterial hypertension (AH) before any medical treatment and to correlate these findings with those in healthy normal Greek population 83 pts (48 m, 35 w) mean age 49.8 +/- 10.1 yrs, body mass index 23.4 +/- 1.5 with mild to moderate AH and 42 healthy volunteers matched for sex (24 m, 18 w), age 51.2 +/- 10.5 yrs and body mass index 22.8 +/- 1.46 were studied. Fibrinogen, vWF, plasminogen, ECLT, a2 antiplasmin, tPA-Ag, PAI-1 in all pts and in the control group were measured. Mean age and BMI did not significantly differ between the two groups. The hypertensive patients had significantly higher levels of fibrinogen (327.75 +/- 51.36 vs. 272.84 +/- 46.8 mg/dl), tPA-Ag (8.81 +/- 3.32 vs. 5.76 +/- 2.54 ng/ml) and PAI-1 (11.8 +/- 10.9 vs. 7.91 +/- 5.5 IU/ml), whereas a2 antiplasmin level was significantly lower (98.71 +/- 15.40 vs. 107.84 +/- 17.52%). No differences were found between hypertensives and normal subjects in vWF, plasminogen and ECLT. These preliminary data suggest that in pts with mild to moderate AH, before any medical treatment, there are significantly higher levels of fibrinogen, tPA-Ag and PAI-1 compared with normal volunteers, whereas there are significantly lower a antiplasmin levels. These findings indicate a disturbance in the haemostasis balance with hypercoagulability and fibrinolytic deficiency.

A 22-year-old man reported cracking sound and acute pain during sexual intercourse followed by rapid penile detumescence and ecchymosis. He experienced more pain because he could not urinate and had a palpably full bladder. Moreover, his urethra was bleeding. Physical examination revealed swollen, ecchymotic and deviated penis and penis ultrasonography showed an injury of the tunica albuginea and Buck’s fascia with an expanding hematoma. Suprapubic catheter was positioned. Surgical exploration revealed a tear of tunica albuginea of both corpora cavernosa and complete urethral dissection. End-to-end urethral anastomosis and suture of corpora cavernosa lesion were performed. Vescical catheter was mantained for 6 days and suprapubic catheter for 3 months to allow a complete urethral healing. A pseudo diverticulum was found atanastomosis level on the urethrocistography 1 month after surgery. It disappeared by allowing micturition via the suprapubic catheter. The patient presented regular urinary flow and physiological erections 30 days later. In our experience, prompt surgical repair preserved erectile function and keeping the suprapubic catheter protected the urethra; this was the correct management for repairing the urethral lesion.

Passive Smoking Adversely Affects the Haemostasis/Fibrinolytic Parameters in Healthy Non-smoker Offspring of Healthy Smokers

Increased Heart Rate and Haemostatic Balance Disorders Pre-exist the Established Hypertension

Asthma is a widespread chronic respiratory disease with rising prevalence. Current state-of- the-art in practice of long-term asthma management at best comes down to usage of smartphone-based asthma- diary for manual entry of subjectively perceived symptoms, and provision of medication reminders and alerts on environmental asthma-triggers. Nevertheless, by interfacing smartphone to low power, minimally obtrusive sensors, collecting information on the condition of the patient and the environment may enhance quality of treatment. In this paper we give an overview of the ongoing development of proof-of-concept of such system utilizing two sensors, based on MSP430 and TMS320C5505 DSP. First is the respiratory sounds monitoring sensor, utilizing detection of asthmatic wheezing, a common symptom related to severity of asthma. The second sensor is the mobile air quality sensor measuring pollutant gas concentrations and meteorological conditions, used for identification of potential asthmatic triggers in the patients surroundings.