Impact of SARS-CoV-2 Alpha variant (B.1.1.7) on prisons, England.

OBJECTIVES: Prisons are high-risk settings for infectious disease outbreaks because of their highly dynamic and crowded nature. During late 2020, prisons in England observed a surge in COVID-19 infection. This study describes the emergence of the Alpha variant in prisons during this period. METHODS: Alpha and non-Alpha variant COVID-19 cases were identified in prisoners in England using address-matched laboratory notifications and genomic information from COG-UK. RESULTS: Of 14,094 COVID-19-positive prisoner cases between 1 October 2020 and 28 March 2021, 11.5% (n = 1621) had sequencing results. Of these, 1082 (66.7%) were identified as the Alpha variant. Twenty-nine (2.7%) Alpha cases required hospitalisation compared with only five (1.0%; P = 0.02) non-Alpha cases. A total of 14 outbreaks were identified with the median attack rate higher for Alpha (17.9%, interquartile range [IQR] 3.2%-32.2%; P = 0.11) than non-Alpha outbreaks (3.5%, IQR 2.0%-10.2%). CONCLUSION: Higher attack rates and increased likelihood of hospitalisations were observed for Alpha cases compared with non-Alpha. This suggests a key contribution to the rise in cases, hospitalisations and outbreaks in prisons in the second wave. With prisons prone to COVID-19 outbreaks and the potential to act as reservoirs for variants of concern, sequencing of prison-associated cases alongside whole-institution vaccination should be prioritised.

Epidemiology of COVID-19 in Prisons, England, 2020.

Using laboratory data and a novel address matching methodology, we identified 734 cases of coronavirus disease in 88 prisons in England during March 16-October 12, 2020. An additional 412 cases were identified in prison staff and household members. We identified 84 prison outbreaks involving 86% of all prison-associated cases.

Smoking on the margins: a comprehensive analysis of a municipal outdoor smoke-free policy.

BACKGROUND: This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada. METHODS: Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies. RESULTS: Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban's implementation, but that smoking practices vary in parks by location. We also found evidence of different levels of enforcement and compliance between settings, and between different populations of park and beach users. CONCLUSIONS: Overall success with the implementation of the bylaw is tempered by potential increases in health inequities because of variable enforcement of the ban; greatest levels of smoking appear to continue to occur in the least advantaged areas of the city. Jurisdictions developing such policies need to consider how to allocate sufficient resources to enhance voluntary compliance and ensure that such bylaws do not contribute to health inequities.

Patterns of functional activity associated with cocaine self-administration in the rat change over time.

RATIONALE: Although imaging studies in human addicts have been valuable for identifying the neural substrates of the effects of abused drugs, few studies have used this approach in animal models where conditions can be carefully controlled. OBJECTIVE: To define the substrates that mediate the effects of cocaine in a rodent model of cocaine self-administration using the 2-[(14)C]deoxyglucose method and to assess changes in these patterns over the course of drug exposure. METHODS: Male Sprague-Dawley rats self-administered cocaine (0.75 mg/kg per injection; FR2; 21 injections/session) and control rats received saline infusions in the same pattern as the cocaine rats for 5 or 30 days. Metabolic mapping was applied immediately after the final session. RESULTS: Following 5 days of self-administration, rates of glucose utilization were decreased in the nucleus accumbens, and increased in autonomic brainstem structures and in sensorimotor regions. After 30 days of cocaine exposure, self-administration reduced glucose utilization throughout the dorsal and ventral striatum, central nucleus of the amygdala, medial forebrain bundle, and infralimbic and prelimbic prefrontal cortices. In addition, at this time point glucose utilization was no longer elevated in any autonomic or sensorimotor brain regions. CONCLUSIONS: These data demonstrate that the distribution of functional activity associated with self-administered cocaine undergoes considerable change over the course of drug exposure. While increases in metabolic rates were largely found in autonomic and sensorimotor structures after short-term cocaine access, decreases were prominent in mesocorticolimbic regions after prolonged exposure. These differences in the patterns of brain activity that develop with long-term cocaine self-administration may play a role in the transition to habitual drug seeking behavior.

Changes in smoking behaviours following a smokefree legislation in parks and on beaches: an observational study.

OBJECTIVE: To examine the effect of an outdoor smokefree law in parks and on beaches on observed smoking in selected venues. METHODS: The study involved repeated observations in selected parks and beaches in Vancouver, British Columbia, Canada. The main outcome measure was changes in observed smoking rates in selected venues from prelaw to 12 months postlaw. RESULTS: No venue was 100% smokefree at the 12-month postlaw observation time point. There was a significant decrease in observed smoking rates in all venues from prelaw to 12-month postlaw (prelaw mean smoking rate=20.5 vs 12-month mean smoking rate=4.7, p=0.04). In stratified analysis by venue, the differences between the prelaw and 12-month smoking rates decreased significantly in parks (prelaw mean smoking rate=37.1 vs 12-month mean smoking rate=6.5, p=0.01) but not in beaches (prelaw mean smoking rate=2.9 vs 12-month mean smoking rate=1.0, p=0.1). CONCLUSIONS: Smokefree policies in outdoor recreational venues have the potential to decrease smoking in these venues. The effectiveness of such policies may differ by the type and usage of the venue; for instance, compliance may be better in venues that are used more often and have enforcement. Future studies may further explore factors that limit and foster the enforcement of such policies in parks and beaches.

Support for a smoke-free bylaw in parks and on beaches.

BACKGROUND: In September 2010, Vancouver, Canada enacted a smoke-free bylaw in parks and on beaches. OBJECTIVE: To examine demographic and attitudinal factors associated with the public opinion on Vancouver's outdoor smoke-free bylaw. METHODS: From 496 randomly selected Vancouver residents, information on demographics, smoking status, and opinions and support for or opposition to the smoke-free bylaw were obtained by telephone surveys. RESULTS: Approximately 84.2% of the sample endorsed the legislation; a greater proportion of non-smokers supported the bylaw than smokers (88.6% vs. 52.0%). In multivariate analysis, demographic variables significantly associated with supporting the smoke-free bylaw were being female, having completed community college/university or Post Graduate work (as compared to high school education or less), and being a nonsmoker. Furthermore, adjusting for demographic variables, all opinions regarding the smoke-free bylaw were significantly associated with its support, with the exception of the belief that the bylaw would increase stigma towards smokers. CONCLUSION: These findings suggest strong public support in Vancouver for the smoke-free bylaw in parks and on beaches. Jurisdictions considering such legislation should address attitudes which can promote or hinder its adoption. Examination of such policy support on diverse groups within the population may enhance the development of equitable public health policy.

A content analysis of media coverage of the introduction of a smoke-free bylaw in Vancouver parks and beaches.

The Board of Parks and Recreation in Vancouver, BC approved a smoke-free bylaw in the city's parks, beaches and recreational facilities, effective 1 September 2010. We analyzed local news coverage and portrayal of the bylaw to understand the potential influence of news media on public perception of the bylaw in order to inform the media advocacy work of public health interest groups. We compiled a data set of newspaper articles (n = 90) and conducted a quantitative content analysis to examine content related to the outdoor smoke-free policy, including article slant, topics related to smoking and tobacco control, and any equity-related concerns raised. Newspaper coverage in Vancouver was largely supportive of the outdoor smoke-free bylaw. However, concerns over rights were frequently discussed in letters to the editor. Such equity concerns were rarely discussed in news articles, showing a potential disconnect between the concerns expressed in the media by members of the public and the coverage provided by print media.