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Gear Blog
Duca Del Cosma Kuba Headlines 2018 Shoe Range
By Elliott Heath
Italian fashion brand, Duca Del Cosma, has released an eye-catching new range of premium golf shoes for Spring 2018 that can be worn both on and off the course.
Duca de Cosma released their ultra-lightweight spikeless golf shoes more than a decade ago and its latest range features options incorporating new designs and state-of-the-art shoe technology.
The brand philosophy is represented in a collection for men and women that takes its inspiration from award-winning Italian design combined with attention to detail.
Heading up the range is the Kuba, the white, red and green option in the colours of the Italian Flag.
The high class build quality is matched with advanced technology that includes a waterproof microfibre system acting like a breathable protective 'sock' within the shoe.
The waterproof membrane keeps the foot dry during play and is supported by a soft PU insert sole to provide extra comfort for the duration of the round.
The shoe also benefits from the addition of SKYFLEX technology outsole ergonomic design that provides grip during the downswing for a stable strike.
RELATED: Best Golf Shoes 2018
This lightweight TPU function sole has been designed together with a comfortable last to guarantee flexibility and a comfortable fit. Lateral stabilizers and 5mm cone-shaped nubs provide traction and stability, a heightened heel guarantees and optimal stance.
Additionally, special channels allow the shoe to bend and flex perfectly to the natural roll-off motion of the foot.
"Golfers who try them comment that our shoes are extremely comfortable from the very first time they wear them," said Tony Eccleston, General Manager for Duca del Cosma in the UK & Ireland.
Mr Eccleston adds "We pride ourselves on being the brand that pioneered the spikeless golf shoe and we continue to move forward with new shoe technologies, as well as an exceptional range of colours and design styles."
There's also the the Camelot (White/Lemon), and the La Spezia (White/Orange), while the women's collection features the Palm Springs (White/Taupe), Porto Ercole (White/Sand) as well as the Olbia (Gold).
The lightweight shoes are available in a variety of fashionable colour combinations.
Elliott Heath
Elliott Heath is our Senior Staff Writer and has been with Golf Monthly since early 2016 after graduating with a degree in Sports Journalism. He manages the Golf Monthly news, features, courses and travel sections as well as our large Facebook, Twitter and Instagram pages. Elliott has interviewed some huge names in the golf world including Sergio Garcia, Thomas Bjorn, Bernd Wiesberger and Scotty Cameron as well as a number of professionals on the DP World and PGA Tours. He covered the 2022 Masters from Augusta National as well as four Open Championships on-site including the 150th at St Andrews. He has played 35 of our Top 100 golf courses, with his favourites being both Sunningdales, Woodhall Spa, Old Head and Turnberry. He has been obsessed with the sport since the age of 8 and currently plays at West Byfleet Golf Club in Surrey, where his handicap index floats anywhere between 2-6. His golfing highlights are making albatross on the 9th hole on the Hotchkin Course at Woodhall Spa, shooting an under-par round, playing in the Aramco Team Series on the Ladies European Tour and making his one and only hole-in-one at the age of 15 - a long time ago now!
Elliott is currently playing:
Driver: Titleist TSR4
3 wood: TaylorMade SIM2 Max
Hybrid: TaylorMade SIM Max
Irons: Mizuno MP5 4-PW
Wedges: Cleveland RTX ZipCore 50, 54, 58
Putter: Odyssey White Hot OG #5
Ball: Titleist Pro V1x
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The Royal Greens Golf and Country Club in Saudi Arabia is expected to host the final event of the 14-tournament season


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About GameStop
(Common Stock)
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GameStop Announces Participation at 2020 ICR Conference on January 14, 2020
GRAPEVINE, Texas, Jan. 08, 2020 (GLOBE NEWSWIRE) -- GameStop Corp. (NYSE: GME), today announced that it will webcast a discussion of the business by George Sherman, chief executive officer, and Jim Bell, chief financial officer, at the 22nd Annual ICR Conference. The event will take place on Tuesday, January 14, 2020 at 10:30am ET. The fireside chat discussion will be available live and for replay on GameStop's investor relations web page at http://investor.GameStop.com/.
GameStop Corp., a Fortune 500 company headquartered in Grapevine, Texas, is the world's largest video game retailer, operates over 5,600 stores across 14 countries, and offers the best selection of new and pre-owned video gaming consoles, accessories and video game titles, in both physical and digital formats. GameStop also offers fans a wide variety of POP! vinyl figures, collectibles, board games and more. Through GameStop's unique buy-sell-trade program, gamers can trade in video game consoles, games, and accessories, as well as consumer electronics for cash or in-store credit. The company's consumer product network also includes www.gamestop.com and Game Informer® magazine, the world's leading print and digital video game publication.
General information about GameStop Corp. can be obtained at the company's corporate website. Follow @GameStop and @GameStopCorp on Twitter and find GameStop on Facebook at www.facebook.com/GameStop.
This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Such statements are based upon management's current beliefs, views, estimates and expectations, including as to the Company's industry, business strategy, goals and expectations concerning its market position, future operations, margins, profitability, capital expenditures, liquidity and capital resources and other financial and operating information, including expectations as to future operating profit improvement. Such statements include without limitation those about the Company's expectations for fiscal 2019, future financial and operating results, projections, expectations and other statements that are not historical facts. All statements regarding targeted and expected benefits of our transformation, capital allocation, profit improvement and cost-savings initiatives, and expected fiscal 2019 results, are forward-looking statements. Forward-looking statements are subject to significant risks and uncertainties and actual developments, business decisions and results may differ materially from those reflected or described in the forward-looking statements. The following factors, among others, could cause actual results to differ materially from those reflected or described in the forward-looking statements: the uncertain impact, effects and results of pursuit of operating, strategic, financial and structural initiatives, including the Reboot strategic plan; volatility in capital and credit markets, including changes that reduce availability, and increase costs, of capital and credit; our inability to obtain sufficient quantities of product to meet consumer demand, including due to supply chain disruptions on account of trade restrictions, political instability, labor disturbances and product recalls; the timing of release and consumer demand for new and pre-owned products; our ability to continue to expand, and successfully open and operate new stores for our collectibles business; risks associated with achievement of anticipated financial and operating results from acquisitions; our ability to sustain and grow our console digital video game sales; our ability to establish and profitably maintain the appropriate mix of digital and physical presence in the markets we serve; our ability to assess and implement technologies in support of our omnichannel capabilities; the impact of goodwill and intangible asset impairments; cost reduction initiatives, including store closing costs; risks related to changes in, and our continued retention of, executives and other key personnel and our ability to attract and retain qualified employees in all areas of the organization; changes in consumer preferences and economic conditions; increased operating costs, including wages; disruptions to our information technology systems including but not limited to security breaches of systems protecting consumer and employee information or other types of cybercrimes or cybersecurity attacks; risks associated with international operations; increased competition and changing technology in the video game industry; changes in domestic or foreign laws and regulations that reduce consumer demand for, or increase prices of, our products or otherwise adversely affect our business; our effective tax rate and the factors affecting our effective tax rate, including changes in international, federal or state tax, trade and other laws and regulations; the costs and outcomes of legal proceedings and tax audits; our use of proceeds from the sale of our Spring Mobile business; and unexpected changes in the assumptions underlying our outlook for fiscal 2019. Additional factors that could cause our results to differ materially from those reflected or described in the forward-looking statements can be found in GameStop's Annual Report on Form 10-K for the fiscal year ended February 2, 2019 filed with the SEC and available at the SEC's Internet site at http://www.sec.gov or http://investor.GameStop.com. Forward-looking statements contained in this press release speak only as of the date of this release. The Company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by any applicable securities laws.
GameStop Corp. Investor Relations
investorrelations@gamestop.com
Source: GameStop Inc.
GameStop is committed to driving exceptional financial performance and creating new opportunities for shareholder value and profitable growth.
Access the latest information and news concerning GameStop's strategic initiatives across its family of specialty retail brands.
Our family of associates constantly look for opportunities to serve and give back to those communities in which we live, work and play.
GameStop hires the best and brightest talent to manage and grow our family of specialty retail brands.
Shop gamestop.com
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redpajama_set_name: RedPajamaCommonCrawl


Black River Flooring offers pre-finished hardwood flooring to customers that like to differentiate themselves.
Their products are produced by trained technicians in state of the art facilities and are selected from trees based on their age and size.
Black River Flooring also ensures forests are environmentally managed in a responsible fashion.


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Disease A-Z
Home » Pneumoconiosis and other lung diseases caused by external agents
Pneumoconiosis and other lung diseases caused by external agents statistics
Pneumoconioses are a group of lung diseases caused by inhaled dust. Their symptoms include inflammation, coughing and fibrosis (thickening and scarring of the lungs). Breathing in dusts over the long term (such as through occupational exposure) can cause fibrosis, or scarring, of the lungs. This results in breathing problems and severe shortness of breath,
These statistics on pneumoconioses in the UK were compiled as part of our Respiratory Health of the Nation project by teams at St George's University of London, Nottingham University and Imperial College London.
Deaths from lung diseases due to external agents
Emergency hospital admissions
How many people died from lung diseases due to external agents in 2012?
From 2008 to 2011 the number of UK deaths from lung diseases due to external agents remained steady at around 3,700 per year.
However, in 2012 mortality increased to 4,200. During the period 2008-2012, the vast majority of deaths were due to "pneumonitis due to the inhalation of solids and liquids" (J69). This category is most likely not to be associated with occupational or environmental influences, and relates to inhalation of solids and liquids and subsequent medical complications. Indeed, consistently during this period, around 90% of deaths from lung diseases due to external agents were due to pneumonitis due to the inhalation of solids and liquids.
The increase in mortality that occurs from 2011 to 2012 is largely due to an increase in the number of deaths caused by pneumonitis due to the inhalation of solids and liquids and smaller increases in the number of deaths due to coal-worker's pneumoconiosis, pneumoconiosis due to asbestos and other mineral fibres.
UK deaths from lung diseases due to external agents compared with other lung diseases, 2012
How old were the people who died from pneumoconioses in 2012?
In 2012, of the 4,171 people who died from pneumoconioses:
five were aged 0–14 years;
320 were aged 15–64 years; and
3,846 were aged 65 and above.
How many males and females died from lung diseases due to external agents in each UK region in 2008–12?
Across the UK in 2008–12, 10,859 males and 8,005 females died from pneumoconioses.
England: The death rate from pneumoconioses was higher in the North East and North West compared with the UK overall. It was notably lower in Yorkshire and the Humber, London, the South East and South West, compared with the UK as a whole.
Scotland: The death rate was markedly higher than in the UK generally.
Wales: The death rate was slightly higher than in the UK generally.
Northern Ireland: The death rate was similar to rates in the UK generally.
Pneumoconioses mortality ratios by UK regions, males and females, 2008–12
How do rates of emergency admission to hospital for lung diseases due to external agents vary across the UK, 2008–12?
England: There were higher rates of emergency admission in London than in the UK generally. There were notably lower rates in the East Midlands, the South East and the South West.
Scotland: There were notably higher rates of emergency admission than in the UK generally.
Wales: There were lower rates of emergency admissions than in the UK generally.
Northern Ireland: There were notably higher rates of emergency admission than in the UK generally.
Pneumoconioses hospital admission ratios, males and females, in each UK region, 2008–12
How were these figures calculated?
Find out how the figures for deaths from pneumoconioses and hospital admissions were calculated: Methodology - numbers, deaths and admissions
Lung disease in the UK - the big picture
Acute lower respiratory tract infections
Chronic obstructive pulmonary disease: COPD
Lung diseases caused by external agents
Pulmonary vascular diseases
Tuberculosis: TB
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Fanzone Films Tackle Mental Health Stigma
Oct 6, 2015 | 2gether
People visiting and soaking up the atmosphere in Gloucester's Rugby World Cup Fanzone have been viewing films raising awareness about mental health issues.
The series of films, produced by national anti-stigma campaign Time to Change, have been shown on the Fanzone's big screen during breaks from the tournament's main action.
The initiative is all part of the county's successful 'Gloucestershire Tackles Stigma' campaign – run by a partnership of local health and community organisations – and part of the lead up to World Mental Health Day on Saturday October 10.
Professor Jane Melton, Director of Engagement and Integration for ²gether NHS Foundation Trust, said: "Like many people across Gloucestershire, we're really excited about the Rugby World Cup and the games being played in the county. We felt we could use this fantastic event to engage with our local community and visitors and show that Gloucestershire is mindful about mental health.
"Every year 1 in 4 people will experience a mental health problem. In the world of rugby this means that each team is likely to contain at least 3 players who are currently experiencing or will experience a mental illness in 2015.
"Time to Change is a fantastic campaign run by the national charities Mind and Rethink Mental Illness. It is aimed at breaking down the barriers and tackling the stigma that still surrounds mental illness. We are really grateful the city council has supported us to show the Time to Change films within the Fanzone."
The Glos Tackle Stigma campaign is promoted by a partnership of organisations, under the umbrella of NHS Gloucestershire Clinical Commissioning Group's (CCG) 'No Health Without Mental Health' agenda.
Since late 2014 a series of 'tea and talk' events have been held with local organisations and employers, including Gloucestershire Constabulary, UCAS, GE Aviation, and Gloucestershire Fire and Rescue Service, in order to promote healthy conversations about mental wellbeing in the workplace.
The films initiative – which also involves Time to Change films being shown at the rural cinema in the Corinium Cinema, Cirencester – is the latest part of the campaign.
Dr Andy Seymour, Deputy Clinical Chair at NHS Gloucestershire Clinical Commissioning Group said:
"Mental health tends to be something that people are reluctant to talk about, but the reality is that mental health issues can affect anyone, from sports professionals to spectators.
We want to help people in Gloucestershire to stay well, both physically and mentally and hope that raising awareness amidst the excitement of the Rugby World Cup will make people think about their own mental health, as well as that of their friends and families.
Cllr Kathy Williams, Gloucestershire County Council cabinet member for long term care, said; ""With high profile ex-internationals such as Jason Robinson, Alan Quinlan and Duncan Bell all speaking out over their own battles with mental health, it shows that even our sporting heroes can struggle sometimes.
"We want to remove the stigma around mental health, to encourage people to share their stories and raise awareness of where they can go for help. Let's kick the stigma around mental health into touch."
World Mental Health Day is an annual event coordinated by the World Health Organisation and marked on October 10. The theme of World Mental Health Day this year is 'Dignity'.
Other events being held to mark the occasion include a stand in the Market Square, Cirencester, from 9am until 2pm on Friday October 9, a stand in the ASDA supermarket, Gloucester, on the afternoon of Friday October 9.
There will also be a stand at Stroud Farmers Market on Saturday October 10, as well as a talk on tackling stigma at the Disabled Community Forum in Hester's Way, Cheltenham, on Wednesday October 7.
To find out more about Time to Change and view the films being shown click here.


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Is full (i.e. instrument and goal) central bank independence
Over the last decade 34 industrial and developing countries central banks have been released from the clutches as puppets from the government and have been given (or increased) independence. As apposed to only three such changes during the 1980s (Maxfield 1997). The degree of independence is the topic of this assignment, which is should a central bank be allowed to have both political and economic power or just economic power? Full independence means that a central bank has both economic (instrument) and political (goal) power. For example the Bundesbank in Germany has full independence. Instrument independence means a central bank has only have economic power (e.g. interest rate control). For example the Bank of England has partial independence, in that it has instrument control but not objective power. Grilli et al (1991) define political independence as "the ability of the central bank to select its objectives without influence from the government". The factors affecting these objectives are explained later. Grilli et al (1991) also define economic independence as "the ability to use instruments of monetary policy without restrictions". The factors affecting the instruments are explained later. Ideas seem to be the catalyst behind the framework of the three stages, described by Cottarelli and Giannini (1997), which influence the monetary institutions developing. First there is a period of incubation, second a crisis occurs which needs a reform and thirdly a consensus develops around a new framework. "The switch to Keynesian principles of "managed money" after World War II, the adoption of floating exchange rates and then monetary targets in the 1970s, and now the enthusiasm for central bank independence (CBI), all have owed much of their force to the power of academic ideas whose time has arrived" (Capie et al 1994).
To decide whether CBI should be full or partial one needs to look at empirical evidence and studies conducted showing both cases for and against full or partial independence.
Essays Related to Is full (i.e. instrument and goal) central bank independence
1. Finance, Banking, Trade and Tax Structure
Trade Practice in Myanmar Since, Myanmar has changed its economic course from a centrally planned economy into a market oriented system On 2010 according to the 2008 constitution, a series of structural reforms had been introduced and new legal policy instruments given the private sector including foreign investors and businessmen, the right to do business and to make investment in the country were enacted. ... All-out efforts are being made to encourage the active participation of private sectors in foreign trade and giving full support in every angle. ... Those exempt from license fees ...


Japanese artist Yoomoo caught my eye some time ago. The combination of needle felt and fabric in each piece strikes a perfect balance. Although I tend to prefer animals like the charming goat gentleman pictured below, the human sculptures are equally wonderful. I particularly like the portrait of Frida Kahlo (also below) They are doll-like, but definitely not playthings. The sculptures have a mystique about them that keeps me coming back again and again.
Where it really gets interesting for me though, are these cat sculptures. They appear to have sprung to life from the paintings of another Japanese artist, Higuchi Yuko. Or perhaps the paintings came after, it's hard to say. Either way, it is difficult to believe that they were not created by the same hand. Like the works above, there is an intentional quality about each of the materials – even where they differ slightly from the paintings, the works complement each other in an undeniable way. I would love to see these pieces hung beside each other in a gallery setting.
You can find more needle felt artwork by Yoomoo here: http://yoomoo.blog5.fc2.com/ and more illustrations and paintings by Higuchi Yuko here: http://higuchiyuko.tumblr.com/.
As always, thanks for reading! Would you like to be featured in this column? Discover a needle felt artist who you think I should profile? Please feel free to contact me! I would love to hear from you.


5 Chapter 2 Literature Review 2. 1 Data Mining The amount of data continues to grow at an enormous rate even though the data stores are already vast. ABSTRACT. The purpose of this study was to conduct a literature review on data mining (DM) technique in the LILACS and SciELO databases and specialized books. This article provides a comprehensive literature review and classification method for data mining techniques applied to academic libraries.
To achieve this, fortyone practical contributions over the period were identified and reviewed for IJRRAS 10 (1) January 2012 Hilage& Kulkarni Review of Literature on Data Mining 108 Anthony D Anna& Oscar H.
Gandy develop a more comprehensive understanding of data mining by examining the application of this technology in the marketplace. Data mining is one of the powerful new technologies that has emerged and It facilitates the users both individuals and organizations to dig and find data from a collection or a large cluster of data. A LITERATURE REVIEW ON DATAMINING. mining extends to Artificial intelligence, business, education, scientific fields, machine learning etc Literature Review and Challenges of Data Mining Techniques for Social 1341 and William Claster stated that Artificial Neural Network (ANN) is an area of The adoption of learning management systems in education has been increasing in the last few years.
Various data mining techniques like prediction, clustering and relationship mining can be 11 Literature review on data mining research current behaviour, the predictive model predicts a future outcome. The output attribute can be categorical or numeric.


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WisconsinWatch.org (https://www.wisconsinwatch.org/2012/12/mental-health-care-at-county-jails/)
County Jails
Ignored and underfunded, mental health care thin at county jails
Key Republican lawmaker wants to examine issue
By Rory Linnane, Tegan Wendland and Kate Golden | December 22, 2012
More on County Jails
Subscribe to County Jails
An inmate in the La Crosse County men's jail in 2006 has little to do but rest in his cell in a jail-issued uniform. Peter Thomson/La Crosse Tribune
• Wisconsin's county-run jails are overloaded with people with mental illness — but services are largely inadequate.
• The state Department of Corrections is charged with oversight but does not evaluate the quality of jails' mental health care.
• For nearly a quarter-century, the Legislature has required the DOC to collect and summarize annual reports on jails' mental health care, but most jails have not provided the information, and the DOC acknowledges it has not been asking for them.
• One-third of Wisconsin's jails have been cited for inadequate suicide prevention efforts.
Gaps remain in jails' suicide prevention
There have been 52 suicides in Wisconsin county jails from 2003 to 2012. Explore the Center's map.
In 2011, Dr. Ronald Shansky, court-appointed monitor for the Milwaukee County jails, found systemic problems in several areas, including record keeping, delayed access to medical services and medications. Read his letter and other documents about health care in the Milwaukee County jail system.
State and national research and reports on jail suicides and inmates' mental health.
For more than a decade, Milwaukee County's jail system has been under the scrutiny of a court-appointed medical monitor for its failure to provide adequate health care, including for inmates with mental illness.
In August, the monitor found mental health care in Milwaukee County's two jails was still in shambles. Among the problems: Vacancies in top medical positions left jailers to make medical decisions, such as when an inmate should be removed from suicide watch. A man who had threatened to kill himself stopped eating and drinking for four days and was never taken to a hospital. He died in his cell.
Mental health advocates and correctional officials agree that Wisconsin's 72 county-run jails are strapped for resources and not prepared to deal with the large numbers of inmates with mental illness they house. The state Department of Corrections (DOC) is charged with oversight of jails, but the agency's inspectors are not physicians and, the agency said, not responsible for assessing the quality of health care.
The DOC inspection checklist includes whether the facilities keep adequate records, have the correct staff and keep medications secure. In Milwaukee County, for example, the two jails' most recent DOC inspections last December give no hint of the problems identified by Dr. Ronald Shansky, the court-appointed physician.
Again and again, inspector Gregory Bucholtz marked an X for "meets approval" for each health-care standard, concluding that at Milwaukee County Correctional Facility-South, "Health care services at the facility continue to be good … Mental health services also remain good."
Shansky's take, in an inspection days before that DOC visit, was radically different. He found systemic problems in several areas, including record keeping, delayed access to medical services and medications, and "severely mentally ill patients being inappropriately placed in disciplinary cells."
In a more comprehensive August review, Shansky noted numerous other breakdowns, including in the case of the suicidal inmate who died and a similar case of an inmate with mental illness whose kidneys failed after he refused to drink water or eat a punishment food, Nutraloaf.
Just five counties' jails — Waukesha, Washington, Walworth, Fond du Lac and Dane — are accredited by the National Commission on Correctional Health Care, which uses health-care professionals to assess the quality of care at facilities.
More information needed
Rep. Garey Bies, R-Sister Bay, who chairs the Assembly Committee on Criminal Justice and Corrections, said he plans to ask the DOC to present information to his committee on how well jails are caring for their inmates.
As a former chief deputy sheriff, Bies used to oversee the Door County Jail. He said he is particularly interested in ensuring inmates are screened for mental health problems, which he said is crucial to providing proper care, helping them transition back into the community and avoiding crises that could arise while they're incarcerated.
The cell block in the old section of the La Crosse County Jail, in 2011. Even the La Crosse County Jail, which an inspector described as "a leader and model for other jails throughout the state and nation," wasn't properly documenting actions relating to potentially suicidal inmates. Erik Daily/La Crosse Tribune
"Do that (screening) up front, and it really cuts down on issues in the long run," Bies said.
In a 2009 DOC survey, less than half of the county jails that responded had a registered nurse or mental health professional doing the initial health screening of inmates; correctional officers did it in most jails.
The DOC makes preannounced inspections of county jails annually, and investigates after suicides and other incidents. Technically it has the ability to close jails, though it hasn't done so since the 1970s, according to a federal Department of Justice report. The agency sees its role as one of educating and advising jail managers.
"We mitigate risk by providing technical assistance and training, based on best correctional practice," said Kristi Dietz, director of the DOC's Office of Detention Facilities. The agency provides verbal or written feedback after inspections, but it doesn't punish jails with sanctions.
A DOC jail inspector added that her job does not include assessing the quality of health care.
"I cannot say what the proper treatment is; I'm not qualified for that," said Nancy Thelen, a DOC jail inspector. "That's for the doctors that the sheriff has on board with their facility to determine."
Lawsuits are frequently cited as an incentive for jails to improve.
But "you can't count on lawsuits to expose these types of problems," according to Larry Dupuis, legal director of the American Civil Liberties Union of Wisconsin, which sued Milwaukee County over its lack of jail health care services.
"There simply aren't enough lawyers who take on these types of issues," he said. "We need an effective, systematic inspection process."
LISTEN: ACLU wants changes at Milwaukee County Jail, from Wisconsin Public Radio
Ron Honberg, policy and legal director for the nonprofit National Alliance on Mental Illness (NAMI), said county jails nationwide have a "long, long way to go" in providing adequate mental health care.
Honberg ticked off the problems: "Lack of oversight, lack of treatment resources, lack of expertise, lack of qualified staff, overcrowded conditions."
More need, less attention
Dietz said communities are falling short at helping people with mental illnesses, "and as a result the jails and prisons, unfortunately, have been taking on more and more of that population."
A national study estimated the one in three female inmates and nearly one in six males suffers from mental illness — far higher than the general population estimate of 6 percent. Even after a substantial drop from 1990 to 2010, the national jail suicide rate is still three times greater than in the general population.
Jail officials and advocates statewide have been seeing more inmates with mental illness in recent years, although no specific estimates are available.
The problems in jails are often overshadowed by those in prisons. But mental health needs may actually be greater at these facilities, where inmates face uncertain fates, more stress and fewer services.
And jails aren't only for short-term detention — some inmates end up spending years there if they have consecutive sentences or their trials are delayed. Walworth County Jail Superintendent Howard Sawyers said his county almost always has inmates who have passed the one-year mark, some staying two or three years.
A 2005 U.S. Bureau of Justice Statistics study of mental health at jails and prisons found jail inmates were more likely than prisoners to have mania, major depression or psychotic disorders. Another revealed that jail inmates were more than three times more likely than prisoners to kill themselves.
Since 2003, 52 Wisconsin county jail inmates have taken their own lives. According to a Wisconsin Center for Investigative Journalism calculation, Wisconsin's jail suicide rate in recent years was 40 per 100,000 inmates, slightly higher than the 2007 national rate of 36.
EXPLORE: Interactive map of jail suicides
According to Dean Meyer, executive director of the Badger State Sheriff's Association, state-run prisons are "much better equipped" to provide health care.
"A prison has their own dentist, their own doctors and their own nurses. And for the majority of county jails, they contract that service out, and the providers only come when needed," Meyer said.
Jails ill-equipped
Another problem is that jails were never designed to deal with so many people suffering from mental illness. A Bureau of Justice Statistics suicide prevention guide for jails describes them as "conducive to suicidal behaviors."
Eric Tomlinson of Madison, in and out of jail, said he struggled with suicidal thoughts but never saw a counselor in jail. Rory Linnane/Wisconsin Center for Investigative Journalism
"Jails and prisons have become de facto mental health hospitals," NAMI's Honberg said. "Only they're not hospitals at all — they're environments that generally make people's symptoms worse."
Madison resident Eric Tomlinson can vouch for that. In and out of jail for child support, diagnosed with post-traumatic stress and attention deficit disorders and major depression, Tomlinson struggled with thoughts of killing himself. While in the Dane County Jail earlier this year, he said, he never saw a counselor.
Tomlinson said he spent time isolated in "the hole," a room he described as "a slab of concrete, a mattress, one blanket." There was nothing to read "other than the (jail) handbook, the Bible or another religious book," he said.
"If you go in with physical or mental problems, they put you in the hole," Tomlinson said. "If you complain about something, they put you in the hole. If you say you're suicidal, they put you in the hole."
Dane County Jail officials declined to comment on Tomlinson's account, saying privacy rules prevented them from discussing individual cases.
Services few for mentally ill
Mental health care varies greatly from county to county, and it can be thin at many county jails.
For example, while inmates in Sheboygan County's 286-person jail shared 40 hours a week of mental health services, those in comparably sized Marathon County received mental health services for "crisis situations." According to a December 2011 inspection report, the jail planned to begin offering mental health services 20 hours a week.
Mental health care can come in a variety of forms. Social workers do much of the work, according to a 2009 survey of county jails. Forty percent of jails reported having a psychiatrist and 26 percent a psychologist, with their weekly hours ranging from one to six. In more than half of jails, nurses were also helping with mental health care.
Jailers aren't medical professionals — but with limited staffing, sometimes they end up acting the part.
At the Milwaukee County jail, which has struggled with vacancies in its top medical positions, Shansky wrote that "several issues came up in which officers attempted to substitute their judgment for the judgment of health care staff," creating "potential catastrophes."
READ: Primary documents from the Milwaukee jail situation
Sawyers said his officers end up counseling inmates when mental health professionals aren't on deck.
"People in jail are under crisis. Maybe they've never been in there, and they need a talk to be calmed down, or maybe they're feeling down because of bad news from the outside," Sawyers said. "Jail's not a place where you get a lot of good news."
Danielle Densmore of Madison awaits an inmate's release at the Dane County Public Safety Building Jail on Dec. 18. The county's jail system is one of just five in Wisconsin that are accredited by the National Commission on Correctional Health Care. Kate Golden/Wisconsin Center for Investigative Journalism
Meyer said jailers sometimes miss mental health problems because they are stretched thin with other jobs.
"Quite often in smaller and medium-size jails, because they're limited staff-wise and they have many other duties and responsibilities, those needs might not get recognized soon enough," Meyer said.
Lawmakers may examine jails
Jails are required by a state law dating back to 1987 to provide the DOC with annual reports on mental health care services. Since 1989, the law has required the DOC to summarize and relay those findings to the Legislature. But the DOC acknowledges it has not been regularly asking jails for the reports, and has not prepared summaries for the Legislature, the Center found.
It's been five years since the Baraboo News Republic newspaper pointed out that the reports weren't being done. In 2007, DOC officials said they would address the shortcoming. This month, Dietz said her office "is going to take another look at that statute."
Even experts have trouble characterizing mental health problems in Wisconsin's jails. Kim Gilhuly, project director for the national advocacy group Human Impact Partners, said she had to rely on national numbers because of the lack of local data when researching a report this fall urging more use of alternatives to incarceration.
The Legislative Audit Bureau has recently evaluated mental health care in prisons but not jails. In the DOC's 2009 mental health survey of jails, only two-thirds responded, and individual answers were not provided in the summary.
Bies and a fellow lawmaker, Sen. Kathleen Vinehout, D-Alma, said they are concerned about mental health care in jails, but lack the information to tackle the issue.
Vinehout, a member of the Senate Committee on Education and Corrections, said she couldn't get information she wanted from the DOC about the types of inmates and the care they need. She believes the agency should strengthen its oversight of local jails to help inmates — and the general public.
"We want to be able to understand what's happening and do what we can to lower the cost and make Wisconsin a safer place," Vinehout said.
Powered by Tableau
Health care at the Milwaukee County jail:
Inspection reports and the letter from Dr. Ronald Shansky describing systemic problems in record keeping and access to medical services.
Further reading on jail suicides:
State and national reports on jail suicides and inmates' mental health.
by Wisconsin Watch, WisconsinWatch.org

Ignored and underfunded, mental health care thin at county jails

by Wisconsin Watch, WisconsinWatch.org
December 22, 2012

Key findings:

• Wisconsin's county-run jails are overloaded with people with mental illness — but services are largely inadequate.
 • The state Department of Corrections is charged with oversight but does not evaluate the quality of jails' mental health care.
 • For nearly a quarter-century, the Legislature has required the DOC to collect and summarize annual reports on jails' mental health care, but most jails have not provided the information, and the DOC acknowledges it has not been asking for them.
 • One-third of Wisconsin's jails have been cited for inadequate suicide prevention efforts.

Sidebar:

 Gaps remain in jails' suicide prevention

Interactive map:

There have been 52 suicides in Wisconsin county jails from 2003 to 2012. Explore the Center's map.

Primary documents:

In 2011, Dr. Ronald Shansky, court-appointed monitor for the Milwaukee County jails, found systemic problems in several areas, including record keeping, delayed access to medical services and medications. Read his letter and other documents about health care in the Milwaukee County jail system.

State and national research and reports on jail suicides and inmates' mental health.

For more than a decade, Milwaukee County's jail system has been under the scrutiny of a court-appointed medical monitor for its failure to provide adequate health care, including for inmates with mental illness.

In August, the monitor found mental health care in Milwaukee County's two jails was still in shambles. Among the problems: Vacancies in top medical positions left jailers to make medical decisions, such as when an inmate should be removed from suicide watch. A man who had threatened to kill himself stopped eating and drinking for four days and was never taken to a hospital. He died in his cell.

Mental health advocates and correctional officials agree that Wisconsin's 72 county-run jails are strapped for resources and not prepared to deal with the large numbers of inmates with mental illness they house. The state Department of Corrections (DOC) is charged with oversight of jails, but the agency's inspectors are not physicians and, the agency said, not responsible for assessing the quality of health care.

The DOC inspection checklist includes whether the facilities keep adequate records, have the correct staff and keep medications secure. In Milwaukee County, for example, the two jails' most recent DOC inspections last December give no hint of the problems identified by Dr. Ronald Shansky, the court-appointed physician.

Again and again, inspector Gregory Bucholtz marked an X for "meets approval" for each health-care standard, concluding that at Milwaukee County Correctional Facility-South, "Health care services at the facility continue to be good … Mental health services also remain good."

Shansky's take, in an inspection days before that DOC visit, was radically different. He found systemic problems in several areas, including record keeping, delayed access to medical services and medications, and "severely mentally ill patients being inappropriately placed in disciplinary cells."

In a more comprehensive August review, Shansky noted numerous other breakdowns, including in the case of the suicidal inmate who died and a similar case of an inmate with mental illness whose kidneys failed after he refused to drink water or eat a punishment food, Nutraloaf.

Just five counties' jails — Waukesha, Washington, Walworth, Fond du Lac and Dane — are accredited by the National Commission on Correctional Health Care, which uses health-care professionals to assess the quality of care at facilities.

More information needed

Rep. Garey Bies, R-Sister Bay, who chairs the Assembly Committee on Criminal Justice and Corrections, said he plans to ask the DOC to present information to his committee on how well jails are caring for their inmates.

As a former chief deputy sheriff, Bies used to oversee the Door County Jail. He said he is particularly interested in ensuring inmates are screened for mental health problems, which he said is crucial to providing proper care, helping them transition back into the community and avoiding crises that could arise while they're incarcerated.

"Do that (screening) up front, and it really cuts down on issues in the long run," Bies said.

In a 2009 DOC survey, less than half of the county jails that responded had a registered nurse or mental health professional doing the initial health screening of inmates; correctional officers did it in most jails.

The DOC makes preannounced inspections of county jails annually, and investigates after suicides and other incidents. Technically it has the ability to close jails, though it hasn't done so since the 1970s, according to a federal Department of Justice report. The agency sees its role as one of educating and advising jail managers.

"We mitigate risk by providing technical assistance and training, based on best correctional practice," said Kristi Dietz, director of the DOC's Office of Detention Facilities. The agency provides verbal or written feedback after inspections, but it doesn't punish jails with sanctions.

A DOC jail inspector added that her job does not include assessing the quality of health care.

"I cannot say what the proper treatment is; I'm not qualified for that," said Nancy Thelen, a DOC jail inspector. "That's for the doctors that the sheriff has on board with their facility to determine."

Lawsuits are frequently cited as an incentive for jails to improve.

But "you can't count on lawsuits to expose these types of problems," according to Larry Dupuis, legal director of the American Civil Liberties Union of Wisconsin, which sued Milwaukee County over its lack of jail health care services.

"There simply aren't enough lawyers who take on these types of issues," he said. "We need an effective, systematic inspection process."

LISTEN: ACLU wants changes at Milwaukee County Jail, from Wisconsin Public Radio

Ron Honberg, policy and legal director for the nonprofit National Alliance on Mental Illness (NAMI), said county jails nationwide have a "long, long way to go" in providing adequate mental health care.

Honberg ticked off the problems: "Lack of oversight, lack of treatment resources, lack of expertise, lack of qualified staff, overcrowded conditions."

More need, less attention

Dietz said communities are falling short at helping people with mental illnesses, "and as a result the jails and prisons, unfortunately, have been taking on more and more of that population."

A national study estimated the one in three female inmates and nearly one in six males suffers from mental illness — far higher than the general population estimate of 6 percent. Even after a substantial drop from 1990 to 2010, the national jail suicide rate is still three times greater than in the general population.

Jail officials and advocates statewide have been seeing more inmates with mental illness in recent years, although no specific estimates are available.

The problems in jails are often overshadowed by those in prisons. But mental health needs may actually be greater at these facilities, where inmates face uncertain fates, more stress and fewer services.

And jails aren't only for short-term detention — some inmates end up spending years there if they have consecutive sentences or their trials are delayed. Walworth County Jail Superintendent Howard Sawyers said his county almost always has inmates who have passed the one-year mark, some staying two or three years.

A 2005 U.S. Bureau of Justice Statistics study of mental health at jails and prisons found jail inmates were more likely than prisoners to have mania, major depression or psychotic disorders. Another revealed that jail inmates were more than three times more likely than prisoners to kill themselves.

Since 2003, 52 Wisconsin county jail inmates have taken their own lives. According to a Wisconsin Center for Investigative Journalism calculation, Wisconsin's jail suicide rate in recent years was 40 per 100,000 inmates, slightly higher than the 2007 national rate of 36.

EXPLORE: Interactive map of jail suicides

According to Dean Meyer, executive director of the Badger State Sheriff's Association, state-run prisons are "much better equipped" to provide health care.

"A prison has their own dentist, their own doctors and their own nurses. And for the majority of county jails, they contract that service out, and the providers only come when needed," Meyer said.

Jails ill-equipped

Another problem is that jails were never designed to deal with so many people suffering from mental illness. A Bureau of Justice Statistics suicide prevention guide for jails describes them as "conducive to suicidal behaviors."

"Jails and prisons have become de facto mental health hospitals," NAMI's Honberg said. "Only they're not hospitals at all — they're environments that generally make people's symptoms worse."

Madison resident Eric Tomlinson can vouch for that. In and out of jail for child support, diagnosed with post-traumatic stress and attention deficit disorders and major depression, Tomlinson struggled with thoughts of killing himself. While in the Dane County Jail earlier this year, he said, he never saw a counselor.

Tomlinson said he spent time isolated in "the hole," a room he described as "a slab of concrete, a mattress, one blanket." There was nothing to read "other than the (jail) handbook, the Bible or another religious book," he said.

"If you go in with physical or mental problems, they put you in the hole," Tomlinson said. "If you complain about something, they put you in the hole. If you say you're suicidal, they put you in the hole."

Dane County Jail officials declined to comment on Tomlinson's account, saying privacy rules prevented them from discussing individual cases.

Services few for mentally ill

Mental health care varies greatly from county to county, and it can be thin at many county jails.

For example, while inmates in Sheboygan County's 286-person jail shared 40 hours a week of mental health services, those in comparably sized Marathon County received mental health services for "crisis situations." According to a December 2011 inspection report, the jail planned to begin offering mental health services 20 hours a week.

Mental health care can come in a variety of forms. Social workers do much of the work, according to a 2009 survey of county jails. Forty percent of jails reported having a psychiatrist and 26 percent a psychologist, with their weekly hours ranging from one to six. In more than half of jails, nurses were also helping with mental health care.

Jailers aren't medical professionals — but with limited staffing, sometimes they end up acting the part.

At the Milwaukee County jail, which has struggled with vacancies in its top medical positions, Shansky wrote that "several issues came up in which officers attempted to substitute their judgment for the judgment of health care staff," creating "potential catastrophes."

READ: Primary documents from the Milwaukee jail situation

Sawyers said his officers end up counseling inmates when mental health professionals aren't on deck.

"People in jail are under crisis. Maybe they've never been in there, and they need a talk to be calmed down, or maybe they're feeling down because of bad news from the outside," Sawyers said. "Jail's not a place where you get a lot of good news."

Meyer said jailers sometimes miss mental health problems because they are stretched thin with other jobs.

"Quite often in smaller and medium-size jails, because they're limited staff-wise and they have many other duties and responsibilities, those needs might not get recognized soon enough," Meyer said.

Lawmakers may examine jails

Jails are required by a state law dating back to 1987 to provide the DOC with annual reports on mental health care services. Since 1989, the law has required the DOC to summarize and relay those findings to the Legislature. But the DOC acknowledges it has not been regularly asking jails for the reports, and has not prepared summaries for the Legislature, the Center found.

It's been five years since the Baraboo News Republic newspaper pointed out that the reports weren't being done. In 2007, DOC officials said they would address the shortcoming. This month, Dietz said her office "is going to take another look at that statute."

Even experts have trouble characterizing mental health problems in Wisconsin's jails. Kim Gilhuly, project director for the national advocacy group Human Impact Partners, said she had to rely on national numbers because of the lack of local data when researching a report this fall urging more use of alternatives to incarceration.

The Legislative Audit Bureau has recently evaluated mental health care in prisons but not jails. In the DOC's 2009 mental health survey of jails, only two-thirds responded, and individual answers were not provided in the summary.

Bies and a fellow lawmaker, Sen. Kathleen Vinehout, D-Alma, said they are concerned about mental health care in jails, but lack the information to tackle the issue.

Vinehout, a member of the Senate Committee on Education and Corrections, said she couldn't get information she wanted from the DOC about the types of inmates and the care they need. She believes the agency should strengthen its oversight of local jails to help inmates — and the general public.

"We want to be able to understand what's happening and do what we can to lower the cost and make Wisconsin a safer place," Vinehout said.

Interactive map:

 http://public.tableausoftware.com/javascripts/api/viz_v1.js

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Health care at the Milwaukee County jail:

 Inspection reports and the letter from Dr. Ronald Shansky describing systemic problems in record keeping and access to medical services.

http://s3.documentcloud.org/embed/loader.js

Further reading on jail suicides:

 State and national reports on jail suicides and inmates' mental health.

http://s3.documentcloud.org/embed/loader.js

This article first appeared on WisconsinWatch.org and is republished here under a Creative Commons license.
Story impact: Lawmakers hold up funding for GPS tracking, call for study
A Wisconsin Center for Investigative Journalism report on problems regarding the use of GPS devices to monitor convicted offenders was a factor in the decision of state lawmakers to delay approval of some funding sought by the state Department of Corrections for program expansion, and seek a study on the program's effectiveness.
"People are concerned with the accuracy of the GPS monitoring devices," said state Rep. Jon Richards, D-Milwaukee, citing the Center's report.