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Predisposing factors contributing to otitis externa include excessive local moisture and increased pH, trauma, obstruction of the ear canal, primary otitis media, systemic diseases, and treatment effects ( Jacobson, 2002 Moriello, 2013).

Secondary causes of otitis externa affect abnormal ear and include bacteria, fungi, medication reactions, over-cleaning, and yeast overgrowth ( Crespo et al., 2000 Jacobson, 2002 Hariharan et al., 2006 Shokri et al., 2010 Kennis, 2013 Moriello, 2013 Kittl et al., 2018).

These primary causes are usually unnoticed clinically, but they alter the ear environment and, therefore, facilitate secondary infections. Primary causes of otitis externa affect normal ear and include foreign bodies, parasites, fungi (e.g., Aspergillus, Sporothrix, and Stephanoascus), allergy, autoimmune and immune-mediated diseases, endocrine and glandular disorders, viruses, and miscellaneous ( Dion and Speckmann, 1978 Jacobson, 2002 Shokri et al., 2010 Kennis, 2013 Moriello, 2013 dos Reis Gomes et al., 2014 Mascarenhas et al., 2019). Collectively, these causes and factors are referred to as the primary secondary predisposing perpetuating (PSPP) classification system ( Jacobson, 2002 Moriello, 2013). This dermatological disorder may be acute or chronic ( Moriello, 2013).Ĭauses of otitis externa could be primary or secondary, with a variety of predisposing and perpetuating factors that contribute to/or promote the disease. Otitis externa is the inflammation of the external ear canal, outside of the tympanic membrane, and sometimes the pinna ( Rosser et al., 2004 Kennis, 2013 Bollez et al., 2018). Through these strategies, Pew aims to help policymakers enact data-driven reforms that deliver lasting results.Feline otitis is etiologically a complex disease, which can be clinically challenging ( Shokri et al., 2010 Kennis, 2013).

Identifying and reforming policies and practices that contribute to disparities based on gender, race, class, ability, and ethnicity in people’s experiences and outcomes within the criminal and juvenile legal system, and that limit opportunities for people of color and disabled people to avoid becoming embroiled in the criminal and juvenile legal systems or to exit those systems.

Aligning the amount of time young people stay in residential facilities with research on effective practices, and improving the quality of supervision, services, and supports available in their home communities.

Reducing the number of young people who enter the juvenile court system and are subjected to its orders and sent away from their families to residential facilities.

Decreasing the size of probation and parole populations so that community supervision agencies can focus their limited resources on the individuals with the greatest needs, implement best practices to increase successful outcomes, and reduce returns to jail and prison for new offenses and technical violations (i.e., noncompliance with one or more supervision rules).

Safely reducing admissions to and the length of time people spend in jail, expanding strategies to ensure that people accused of crimes appear in court, reducing the likelihood of re-arrest while awaiting trial, supporting crime victims, and better aligning public safety practices and investments with research and constitutional principles.

Since 2005, The Pew Charitable Trusts and its partners have conducted research, provided technical assistance and legislative support to governments, and made strategic grants to advance fiscally sound, data-driven criminal and juvenile justice policies and practices that protect public safety and reduce correctional populations and costs.īuilding on this record, Pew is working with state and local officials and community stakeholders around the country to reform jail, community supervision, and juvenile legal systems by:

But decades of research have revealed a range of strategies that are more effective for achieving public safety. Crime and correctional control-any court-ordered supervision of an individual, whether in the community, as with probation or parole, or in a facility, such as a jail or prison-create substantial burdens for governments and taxpayers, as well as for people in confinement or under supervision and their families.