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Wolf G, Bagaric M. Addressing a Human Rights Crisis: Health Care for Prisoners in Australia. J Law Med 2024; 31:42-69. [PMID: 38761389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/20/2024]
Abstract
People are sent to prison as punishment and not to experience additional punishment. Nevertheless, this principle is habitually violated in Australia: prisoners frequently receive health care that is inferior to health care that is available in the general community. Numerous official inquiries have identified deficiencies in prisoner health services, notwithstanding the apparent intention of legislative provisions and non-statutory guidelines and policies in various jurisdictions to ensure prisoners receive appropriate health care. This article proposes law reforms to address this human rights crisis. It recommends the passage of uniform legislation in all Australian jurisdictions that stipulates minimum prison health care service standards, as well as mechanisms for ensuring they are implemented. The article also suggests that, in the short-term, until prison health care is significantly improved, substandard health care for prisoners should be treated as a potentially mitigating sentencing factor that can reduce the length of a defendant's prison term.
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Affiliation(s)
- Gabrielle Wolf
- Associate Professor, School of Law, Faculty of Business & Law, Deakin University, Melbourne Burwood Campus, Australia
| | - Mirko Bagaric
- School of Business, Law and Entrepreneurship, Swinburne University of Technology
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2
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Kelly K, Carrion A. A Case of Invasive Metastatic Tonsillar Squamous Cell Carcinoma Complicated by Polymicrobial Wound Infection in a Previously Healthy 34-Year-Old Inmate. Cureus 2024; 16:e58190. [PMID: 38741832 PMCID: PMC11089928 DOI: 10.7759/cureus.58190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
This case report describes a distinctive presentation of invasive metastatic tonsillar head and neck squamous cell carcinoma (HNSCC) that recurred in a 34-year-old African American inmate, defying the expectations of conventional risk factors. This case underscores the significance of nuanced care in atypical HNSCC scenarios. The patient presented in October 2021 with bilateral lymphadenopathy and dysphagia, which led to the diagnosis of tonsillar squamous cell carcinoma. The patient's treatment trajectory included radiation therapy with concurrent cisplatin, a subsequent radical right neck dissection, and immunotherapy. Complications, including abscess formation, neutropenic fever, and anemia, necessitated a multidisciplinary approach and admission to Reception and Medical Center Hospital. Cultures revealed a distinct neck mass that cultured positively for a variety of bacteria. The patient's condition was significantly improved by strategic interventions and meticulous daily wound care. This case prompts exploration into unknown factors contributing to HNSCC development in a seemingly low-risk individual, challenging conventional risk profiles. Treatment challenges, including radiation, surgery, and immunotherapy, underscore the need for a multifaceted approach. The central role of intense wound care in mitigating complications and improving the patient's quality of life is pivotal. The patient's tumor and infection highlight the urgency of improving prison sanitation. Enhanced hygiene and health screenings could have lessened the severity of the patient's condition, underscoring the need for comprehensive health measures in correctional facilities. Moreover, specialized wound care has the potential to improve outcomes and reduce health risks within incarcerated populations.
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Affiliation(s)
- Kaylan Kelly
- Osteopathic Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA
| | - Arturo Carrion
- Correctional Medicine, Reception and Medical Center, Lake Butler, USA
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Perrett SE, Craddock C, Gray BJ. Dying whilst on probation: a scoping review of mortality amongst those under community justice supervision. Perspect Public Health 2024:17579139231223714. [PMID: 38294342 DOI: 10.1177/17579139231223714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
AIM Data suggest mortality rates of those under community justice services such as probation or parole have been increasing year on year. Little is known about why and how these individuals are dying. This scoping review explores the causes and contributing factors of mortality in those under community justice supervision. METHODS Studies published between 2011 and 2021 were identified across CINAHL, Embase, Global Health, Ovid Medline and PsycINFO. Articles were included if they presented original data on either mortality rates among those under community justice supervision or risk factors associated with the mortality of those under community justice supervision. RESULTS Searches identified 101 unique articles of which 13 were included in the review. Articles were representative of five countries. All articles were either retrospective reviews or retrospective cohort studies. The studies fell into the categories of all-cause mortality, self-inflicted deaths or drug-related deaths. CONCLUSION Mortality rates of those under community justice supervision were found to be consistently higher than mortality rates for the general population regardless of cause of death. Factors identified as affecting mortality included history of drug use, history of self-harm and previous imprisonment including length of time in custody and experience of hospitalisation or solitary confinement while in custody.
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Affiliation(s)
- S E Perrett
- Nurse Consultant, Health Protection, Public Health Wales, Cardiff CF10 4BZ, UK
| | - C Craddock
- Senior Nurse for Health and Justice and Sexual Health, Health Protection, Public Health Wales, Cardiff, UK
| | - B J Gray
- Principal Researcher, Health Protection, Public Health Wales, Cardiff, UK
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Valentim JLRS, Dias-Trindade S, Oliveira ESG, Romão MH, Fernandes F, Caitano AR, Bonfim MAA, Dias AP, Gusmão CMG, Morais PSG, Melo RS, Fontoura de Souza G, Medeiros KC, Rêgo MCFD, Ceccim RB, Valentim RAM. Evaluation of massive education in prison health: a perspective of health care for the person deprived of freedom in Brazil. Front Public Health 2023; 11:1239769. [PMID: 37680276 PMCID: PMC10480506 DOI: 10.3389/fpubh.2023.1239769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023] Open
Abstract
Education, with an emphasis on prison health, has acted as a policy inducing changes in work processes, which the Brazilian National Health System (SUS) has used, and which is present in permanent health education, which promotes health care for people deprived of liberty. This article aims to present an analysis of the impacts of the strategy of massive education on prison health in Brazil from the perspective of health professionals and other actors operating in the Brazilian prison system. The data used in the study come from a questionnaire consisting of 37 questions applied nationwide between March and June 2022. Responses were collected from students who completed the course "Health Care for People Deprived of Freedom" of the learning pathway "Prison System", available in the Virtual Learning Environment of the Brazilian Health System (AVASUS). This course was offered nationally, whose adhesion (enrollment) occurred spontaneously, i.e., the course was not a mandatory. The data collected allowed us to analyze the impacts of massive education on prison health. The study also shows that the search for the course is made by several areas of knowledge, with a higher incidence in the health area, but also in other areas, such as humanities, which also work directly with the guarantee of the rights of people deprived of liberty, which are professionals in the areas of social work, psychology, and education. The analysis based on the data suggests that the massive education mediated by technology through the courses of the learning pathway, besides disseminating knowledge-following the action plan of the 2030 Agenda of the United Nations Educational, Scientific and Cultural Organization (UNESCO)-, are an effective tool to promote resilience in response to prison health and care demands of people deprived of liberty.
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Affiliation(s)
- Janaína L. R. S. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
| | - Sara Dias-Trindade
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
- Department of History, Political and International Studies (DHEPI), Faculty of Arts, University of Porto, Porto, Portugal
| | - Eloiza S. G. Oliveira
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
- Institute of Human Formation With Technologies, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Manoel H. Romão
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
| | - Felipe Fernandes
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
| | - Alexandre R. Caitano
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
| | - Marilyn A. A. Bonfim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
- Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Aline P. Dias
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
| | - Cristine M. G. Gusmão
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
- Department of Biomedical Engineering, Federal University of Pernambuco, Recife, Brazil
- International Council for Open and Distance Education, Oslo, Norway
| | - Philippi S. G. Morais
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
| | - Ronaldo S. Melo
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
- Institute of Human Formation With Technologies, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Gustavo Fontoura de Souza
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
| | - Kelson C. Medeiros
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
| | - Maria C. F. D. Rêgo
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
- Postgraduate Program in Education, Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
| | - Ricardo B. Ceccim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
- Postgraduate Program in Education, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, State of Rio Grande do Sul, Brazil
| | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, State of Rio Grande do Norte, Brazil
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Hale AJ, Mathur S, Dejace J, Lidofsky SD. Statewide Assessment of the Hepatitis C Virus Care Cascade for Incarcerated Persons in Vermont. Public Health Rep 2023; 138:265-272. [PMID: 35264027 PMCID: PMC10031835 DOI: 10.1177/00333549221077070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Incarcerated persons in the United States have a high burden of hepatitis C virus (HCV) infection. This study assessed the impact of a statewide effort in Vermont to treat HCV in this group. METHODS We performed a retrospective, observational cohort study of all HCV-infected persons who were imprisoned in Vermont during the 19-month study period (December 2018-June 2020). The cascade of care comprised opt-out HCV screening, full access to direct-acting antiviral treatment (without hepatic fibrosis-based treatment restrictions), HCV specialist involvement, and medication-assisted treatment for patients with opioid use disorder. The primary outcome was sustained virologic response at 12 weeks after treatment completion (SVR12). RESULTS The study included 217 HCV-infected patients; the median age was 35 years (range, 18-73 years), 89% were male, 76% had opioid use disorder, 67% had a psychiatric comorbidity, and 9% had cirrhosis. Of the 217 patients, 98% had a liver fibrosis assessment, 59% started direct-acting antiviral treatment, 55% completed direct-acting antiviral treatment, and 51% achieved documented SVR12. Of the 129 HCV-infected persons who started direct-acting antiviral treatment, 92% completed therapy and 86% achieved documented SVR12. Psychiatric comorbidity was not significantly associated with achieving SVR12 (odds ratio = 0.67; 95% CI, 0.27-1.65; P = .38), nor was receiving medication-assisted treatment for patients with opioid use disorder (odds ratio = 1.45; 95% CI, 0.62-2.56; P = .45). CONCLUSIONS This study reports the highest SVR12 rate achieved in a state incarcerated population to date. HCV treatment in incarcerated populations is a practical and efficacious strategy that should serve a foundational role in HCV elimination.
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Affiliation(s)
- Andrew J. Hale
- University of Vermont Medical Center,
Burlington, VT, USA
- Larner College of Medicine, University
of Vermont, Burlington, VT, USA
| | - Shivani Mathur
- Larner College of Medicine, University
of Vermont, Burlington, VT, USA
| | - Jean Dejace
- University of Vermont Medical Center,
Burlington, VT, USA
- Larner College of Medicine, University
of Vermont, Burlington, VT, USA
| | - Steven D. Lidofsky
- University of Vermont Medical Center,
Burlington, VT, USA
- Larner College of Medicine, University
of Vermont, Burlington, VT, USA
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Fiore V, De Matteis G, Pontali E, De Vito A, Panese S, Geremia N, Maida I, Artioli S, Starnini G, Madeddu G, Babudieri S. Quick diagnosis, staging, and treatment of HCV infection among people living in prison: Opinion expert panel. Front Public Health 2022; 10:926414. [PMID: 36268000 PMCID: PMC9577224 DOI: 10.3389/fpubh.2022.926414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/23/2022] [Indexed: 01/24/2023] Open
Affiliation(s)
- Vito Fiore
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy,*Correspondence: Vito Fiore
| | - Giuseppe De Matteis
- Health Protection for Adults and Youth Unit, Penitentiary Institute, Salerno, Italy
| | | | - Andrea De Vito
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sandro Panese
- Unit of Infectious Diseases, Department of Clinical Medicine, Dell'Angelo Hospital, Venice, Italy
| | - Nicholas Geremia
- Unit of Infectious Diseases, Department of Clinical Medicine, Dell'Angelo Hospital, Venice, Italy
| | - Ivana Maida
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Stefania Artioli
- Infectious Diseases and Hepatology Unit, Sant'Andrea Hospital La Spezia, La Spezia, Italy
| | - Giulio Starnini
- Medicina Protetta-Unit of Infectious Diseases, Belcolle Hospital, Viterbo, Italy
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Sergio Babudieri
- Unit of Infectious Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Valentim JLRS, Dias-Trindade S, Oliveira ESG, Moreira JAM, Fernandes F, Romão MH, Morais PSG, Caitano AR, Dias AP, Oliveira CAP, Coutinho KD, Ceccim RB, Valentim RAM. The relevancy of massive health education in the Brazilian prison system: The course "health care for people deprived of freedom" and its impacts. Front Public Health 2022; 10:935389. [PMID: 36033741 PMCID: PMC9399509 DOI: 10.3389/fpubh.2022.935389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Brazil has one of the largest prison populations globally, with over 682,000 imprisoned people. Prison health is a public health emergency as it presents increasingly aggravating disease rates, mainly sexually transmitted infections (STI). And this problem already affects both developed and developing nations. Therefore, when thinking about intervention strategies to improve this scenario in Brazil, the course "Health Care for People Deprived of Freedom" (ASPPL), aimed at prison health, was developed. This course was implemented in the Virtual Learning Environment of the Brazilian Health System (AVASUS). Given this context, this study analyzed the aspects associated with massive training through technological mediation and its impacts on prison health. Methods This cross-sectional study analyzed data from 8,118 ASPPL course participants. The data analyzed were collected from six sources, namely: (i) AVASUS, (ii) National Registry of Health Care Facilities (CNES), (iii) Brazilian Occupational Classification (CBO), (iv) National Prison Department (DEPEN); (v) Brazilian Institute of Geography and Statistics (IBGE); and the (iv) Brazilian Ministry of Health (MoH), through the Outpatient Information System of the Brazilian National Health System (SIA/SUS). A data processing pipeline was conducted using Python 3.8.9. Results The ASPPL course had 8,118 participants distributed across the five Brazilian regions. The analysis of course evaluation by participants who completed it shows that 5,190 (63.93%) reported a significant level of satisfaction (arithmetic mean = 4.9, median = 5, and standard deviation = 0.35). The analysis revealed that 3,272 participants (40.31%) are health workers operating in distinct levels of care. The prison system epidemiological data shows an increase in syphilis diagnosis in correctional facilities. Conclusions The course enabled the development of a massive training model for various health professionals at all care levels and regions of Brazil. This is particularly important in a country with a continental size and a large health workforce like Brazil. As a result, social and prison health impacts were observed.
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Affiliation(s)
- Janaína L. R. S. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil,Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
| | - Sara Dias-Trindade
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal,Centre for Interdisciplinary Studies, Faculty of Arts and Humanities, University of Coimbra, Coimbra, Portugal
| | - Eloiza S. G. Oliveira
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil,Institute of Human Formation with Technologies, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Paraná, Brazil
| | - José A. M. Moreira
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal,Department of Education and Distance Learning (DEED), Open University (Universidade Aberta), Lisbon, Portugal
| | - Felipe Fernandes
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil,*Correspondence: Felipe Fernandes
| | - Manoel H. Romão
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Philippi S. G. Morais
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Alexandre R. Caitano
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Aline P. Dias
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Carlos A. P. Oliveira
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil,Institute of Human Formation with Technologies, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Paraná, Brazil,International Council for Open and Distance Education, Oslo, Norway
| | - Karilany D. Coutinho
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Ricardo B. Ceccim
- Postgraduate Program in Education, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
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Groenewegen P, Dirkzwager A, van Dam A, Massalimova D, Sirdifield C, Smith L; EFPC working group on Prison Health. The health of detainees and the role of primary care: Position paper of the European Forum for Primary Care. Prim Health Care Res Dev 2022; 23:e29. [PMID: 35574709 DOI: 10.1017/S1463423622000184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This position paper aims to increase awareness among primary care practitioners and policymakers about the specific and complex health needs of people who experience incarceration. We focus on the importance of primary care and of continuity of care between prison and community. We highlight what is known from the literature on the health of people who experience incarceration, on the organisation of prison health care, and on the role of primary care both during and after detention. We present three case descriptions of detainees' encounters with the organisation of prison health care in three European countries. Finally, we describe the position that the European Forum for Primary Care takes. Prisoners and ex-prisoners have a worse physical and mental health compared with a cross-section of the population. However, access to good quality treatment and care is often worse than in the outside situation. In particular, well-organised primary care in the prison context could benefit prisoners and, indirectly, society at large. Moreover, continuity of care between the community and the prison situation needs improvement.
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Abuzour AS, Magola-Makina E, Dunlop J, O'Brien A, Khawagi WY, Ashcroft DM, Brown P, Keers RN. Implementing prescribing safety indicators in prisons: A mixed methods study. Br J Clin Pharmacol 2021; 88:1866-1884. [PMID: 34625991 PMCID: PMC9297974 DOI: 10.1111/bcp.15107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 01/01/2023] Open
Abstract
Aims To examine the prevalence of potentially hazardous prescribing in the prison setting using prescribing safety indicators (PSIs) and explore their implementation and use in practice. Methods PSIs were identified and reviewed by the project team following a literature review and a nominal group discussion. Pharmacists at 2 prison sites deployed the PSIs using search protocols within their electronic health record. Prevalence rates and 95% confidence intervals (CIs) were generated for each indicator. Semi‐structured interviews with 20 prison healthcare staff across England and Wales were conducted to explore the feasibility of deploying and using PSIs in prison settings. Results Thirteen PSIs were successfully deployed mostly comprising drug–drug interactions (n = 9). Five yielded elevated prevalence rates: use of anticholinergics if aged ≥65 years (Site B: 25.8% [95%CI: 10.4–41.2%]), lack of antipsychotic monitoring for >12 months (Site A: 39.1% [95%CI: 27.1–52.1%]; Site B: 28.6% [95%CI: 17.9–41.4%]), prolonged use of hypnotics (Site B: 46.3% [95%CI: 35.6–57.1%]), antiplatelets prescribed with nonsteroidal anti‐inflammatory drugs without gastrointestinal protection (Site A: 12.5% [95%CI: 0.0–35.4%]; Site B: 16.7% [95%CI: 0.4–64.1%]), and selective serotonin/norepinephrine reuptake inhibitors prescribed with nonsteroidal anti‐inflammatory drugs/antiplatelets without gastrointestinal protection (Site A: 39.6% [95%CI: 31.2–48.4%]; Site B: 33.3% [95%CI: 20.8–47.9%]). Prison healthcare staff supported the use of PSIs and identified key considerations to guide its successful implementation, including staff engagement and PSI 'champions'. To respond to PSI searches, stakeholders suggested contextualised patient support through intraprofessional collaboration. Conclusion We successfully implemented a suite of PSIs into 2 prisons, identifying those with higher prevalence values as intervention targets. When appropriately resourced and integrated into staff workflow, PSI searches may support prescribing safety in prisons.
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Affiliation(s)
- Aseel S Abuzour
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Suicide, Risk and Safety Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Esnath Magola-Makina
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Suicide, Risk and Safety Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - James Dunlop
- Suicide, Risk and Safety Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Amber O'Brien
- Her Majesty's Prison Berwyn, Wrexham Industrial Estate, Wrexham, UK
| | - Wael Y Khawagi
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Kingdom of Saudi Arabia
| | - Darren M Ashcroft
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Suicide, Risk and Safety Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
| | - Petra Brown
- Suicide, Risk and Safety Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.,Pharmacy Department, Pennine Care NHS Foundation Trust, Ashton-Under-Lyne, UK
| | - Richard N Keers
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.,Suicide, Risk and Safety Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
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Abstract
Contraception is an important health care service for incarcerated women, yet its availability in U.S. prisons, jails, and juvenile detention systems is unknown. We surveyed 6 jails, 22 state prisons, and 3 juvenile detention systems (N = 31 sites) on their contraception policies in 2016. Twenty (65%) sites had formal written contraception policies. All sites allowed people to continue a preincarceration contraceptive method with restrictions on the type of contraception and reason for use. Two sites (6%) did not allow continuation of oral contraceptive pills, 3 sites (10%) did not allow continuation of contraceptive injection, 21 sites (68%) did not allow continuation of contraceptive ring, and 23 sites (74%) did not allow continuation of contraceptive patch. Twenty-eight (90%) sites allowed people to initiate a contraceptive method in custody. Contraception policies in incarceration settings in the United States are varied and may restrict women's ability to continue or initiate the contraception of their choice.
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Affiliation(s)
- Aneesha Cheedalla
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carolyn B Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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11
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Matthys J, Hallyn M, Miclotte A, Van Maele G, Avonts D. Differences in triage and medical confidentiality between prisons of Belgium and the Netherlands. Acta Clin Belg 2021; 76:190-196. [PMID: 31829109 DOI: 10.1080/17843286.2019.1703090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: The aim of this study is to describe the opinions of prison doctors, and to compare the primary health care in prisons between Belgium and the Netherlands.Methods: Structured interviews, audio-recorded and transcribed verbatim, were conducted with prison doctors in Dutch-speaking prisons in Flanders/Belgium and in the Netherlands. Two investigators analysed the content of the interviews and discussed each individual interview.Results: In total 37 interviews were conducted in 28 prisons (14 in each country). In Belgium, 14 of 17 prison doctors, compared to 1 of 12 in the Netherlands, experienced higher time pressure during their consultations in prison, compared to their private medical work (P < 0.001). In the Netherlands, compared to Belgium, there is more access to psychiatric support (14/14 vs 11/22, P = 0.002), psychological care (13/13 vs 7/22, P < 0.001), and interpreter facilities (15/22 vs 0/14, P < 0.001). Prison doctors in both countries agree that the possibility for a strictly personal encounter with the patient - without the presence of other medical staff - can be very useful (21/22 in Belgium vs 15/15 in the Netherlands). In Belgium, individual consultations with the detainee are not possible.Conclusions: Compared to the situation in the Netherlands, the medical work of prison doctors in Belgium is characterized by time pressure and lack of psychiatric and psychological support. The absence of interpreter facilities in Belgium handicaps the quality of the primary health care in prisons. In addition, the lack of private encounters with a doctor in Belgian prisons violates the patient rights of the detainee.
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Affiliation(s)
- Jan Matthys
- Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium
| | - Mathieu Hallyn
- Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium
| | - Anneleen Miclotte
- Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium
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Zendo S, Donelle L, Magalhaes L. Health Access of Women in Provincial Correctional Institutions. Soc Work Public Health 2021; 36:232-245. [PMID: 33427590 DOI: 10.1080/19371918.2020.1864556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Historically, there has been a disparity between men and women rates of incarceration, even though there has been a significant increase in the number of women imprisoned over the past 20 years, globally. Women have unique health care needs that are often not adequately addressed within the correctional institutions in which they are held. The focus of this study was to explore women's experiences when accessing health services within Canadian provincial correctional institutions. Narrative inquiry was used to investigate the life stories of five women who accessed health care in provincial correctional institutions. A total of two storylines and five sub-storylines resulted from the analysis of interviews conducted with the participants. The findings suggest that during incarceration, participants experienced compromising conditions that contributed to the worsening of their health, and faced difficulties accessing their prescribed treatments and medications. Consequently, this contributed to the worsening of their physical and mental wellbeing.
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Affiliation(s)
- Shamiram Zendo
- Faculty of Information and Media Studies, Western University, London, Canada
| | - Lorie Donelle
- Arthur Labatt Family School of Nursing, Western University, London, Canada
| | - Lilian Magalhaes
- Federal University of Sao Carlos, Sao Carlos, Brazil
- Western University Emeritus Professor, London, Canada
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13
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Venske Bierhals D, Busatto C, Silveira MDPDR, da Matta Talaier E, Silva ABS, Reis AJ, von Groll A, da Silva PEA, Ramis IB. Tuberculosis cases in a prison in the extreme south of Brazil. J Med Microbiol 2021; 70. [PMID: 33555247 DOI: 10.1099/jmm.0.001319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Tuberculosis (TB) control is a challenge, especially in vulnerable populations, such as prisoners.Hypothesis. In prison houses, the transmission of micro-organisms that cause infectious diseases can occur due to the susceptibility and immune compromise of prisoners, and due to the precarious physical conditions of the prison houses. However, strategies such as monitoring by health professionals, can mitigate the transmission of these micro-organisms, as well as, reduce the number of coinfections and antimicrobials resistance.Aim. This study attempted to analyse the dynamics of transmission and the antimicrobial resistance profile of Mycobacterium tuberculosis strains obtained from prisoners and to characterize the epidemiological, clinical and laboratory profiles of prisoners diagnosed with TB.Methodology. A cross-sectional and retrospective study was conducted with sputum samples collected from 228 distinct prisoners who were treated at the Health Unit located in the Regional Penitentiary of Rio Grande, Rio Grande do Sul, Brazil. The antimicrobial resistance profile of the strains was evaluated using the Resazurin Microtiter Assay and the transmission dynamics was investigated using 15-loci MIRU-VNTR.Results. Thirty-five patients (15.4 %) were diagnosed with TB, and when a TB/HIV coinfection was assessed, 8.6 % (3/35) of the patients were positive. In addition, all patients with results available for HBV, HCV, syphilis and diabetes mellitus were negative. Based on the genotypic profile, 55.9 % of the clinical isolates were grouped into five groups. One isolate with mono-resistance to isoniazid and two with mono-resistance to streptomycin were found.Conclusion. The presence of a Health Unit may have influenced the low numbers of TB/HIV, TB/HBV, TB/HCV, TB/syphilis coinfections and TB cases resistant to antimicrobials. Recent M. tuberculosis transmission can be inferred based on the high percentage of formatting of clusters. This situation stresses the need to improve active and passive detection, the screening of individuals for TB upon entrance into prison for early detection, and the implementation of prophylactic measures to reduce M. tuberculosis transmission.
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Affiliation(s)
- Dienefer Venske Bierhals
- Medical Microbiology Research Center, Faculty of Medicine, Federal University of Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Caroline Busatto
- Medical Microbiology Research Center, Faculty of Medicine, Federal University of Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | | | - Edilon da Matta Talaier
- Rio Grande City Hall, Basic Prison Health Unit - SMS/PERG, Rio Grande, Rio Grande do Sul, Brazil
| | - Ana Bárbara Scholante Silva
- Medical Microbiology Research Center, Faculty of Medicine, Federal University of Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Ana Julia Reis
- Medical Microbiology Research Center, Faculty of Medicine, Federal University of Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Andrea von Groll
- Medical Microbiology Research Center, Faculty of Medicine, Federal University of Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Pedro Eduardo Almeida da Silva
- Medical Microbiology Research Center, Faculty of Medicine, Federal University of Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| | - Ivy Bastos Ramis
- Medical Microbiology Research Center, Faculty of Medicine, Federal University of Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
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Freckelton I. COVID-19: Criminal Law, Public Assemblies and Human Rights Litigation. J Law Med 2020; 27:790-806. [PMID: 32880398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Australia's criminal law was affected by the COVID-19 pandemic from the outset and then progressively as statutory measures and judicial rulings on matters such as bail entitlements, judge-alone trials, sentences and applications for demonstrations and public assemblies were made by courts. This column identifies some of the major decisions made during the period of the lockdown measures between March and July 2020, and reviews significant New South Wales judgments in relation to the lawfulness of mass gatherings during the period of lockdown as expert assessments of risks of community transmission of the virus waxed and waned. It explores the importation into Australia's criminal law of public health principles for the protection of the community, and its compatibility with traditional principles of criminal justice.
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Affiliation(s)
- Ian Freckelton
- Barrister, Castan Chambers, Melbourne, Australia; Professorial Fellow of Law and Psychiatry, University of Melbourne; Adjunct Professor of Forensic Medicine, Monash University; Adjunct Professor, Johns Hopkins University
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Akbar H, Kahloon R, Akbar S, Kahloon A. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Mimicking as Pulmonary Tuberculosis in an Inmate. Cureus 2020; 12:e8464. [PMID: 32528785 PMCID: PMC7282355 DOI: 10.7759/cureus.8464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an emerging global infectious disease with emerging medical knowledge. Clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is very variable amongst patients, and the literature about unusual presentations is growing rapidly. This lack of knowledge leads to diagnostic, therapeutic, and management challenges in such patients. Here, we describe a case of SARS-CoV-2 infection in a low prevalence area which was initially diagnosed and managed as pulmonary tuberculosis (TB) in a high-risk inmate population. These ambiguous presentations can lead to mismanagement of such patients resulting in potentially fatal outcomes and public health crises in confined facilities. This also highlights the significance of a high index of clinical suspicion for SARS-CoV-2 especially in high risk and vulnerable populations.
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Affiliation(s)
- Hina Akbar
- Internal Medicine, University of Tennessee Health Science Center, Memphis, USA.,Internal Medicine, Regional One Hospital, Memphis, USA
| | - Rehan Kahloon
- Cardiology, Erlanger Health System/University of Tennessee College of Medicine, Chattanooga, USA
| | - Sobia Akbar
- Internal Medicine, Postgraduate Medical Institute, Lahore, PAK
| | - Arslan Kahloon
- Gastroenterology, Erlanger Health System/University of Tennessee College of Medicine, Chattanooga, USA
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Abstract
The United Nations states that prisoners should enjoy the same standards of health care that are available in the community. Despite this, persons in prison experience barriers to care and face unique health challenges. Given the ways in which prisons shape health outcomes for incarcerated persons, it is important to interrogate how the provision of health care is governed in custodial settings. In this article, we examine one important aspect of governance: legislation governing the provision of health care in prisons. We view this issue through a critical lens, building on a body of poststructural scholarship which has illuminated how laws and policies are not merely tools of governance but also key sites for the production of meanings around social "problems," including the "problem of health." Taking Canada's Corrections and Conditional Release Act as a case example and applying Carol Bacchi's "What's the Problem Represented to Be" analytical framework, we examine how the specific representation of "health" in this legislation works to produce effects for persons in federal prison. Three key themes are formed through this analysis. First, what constitutes "essential services" in the context of federal prisons is more limited compared with the broader community. Second, the dichotomy between the rights of persons in prison versus the protection of society that is produced in development of these laws has significant bearing on the treatment of those in prison. Third, this representation has negative effects on the health of persons in prison. In order to meet United Nations standards, greater attention must be paid to the ways in which laws and other governing practices reproduce inequities in health care provision in prisons.
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Affiliation(s)
| | - Kari Lancaster
- Centre for Social Research in Health, UNSW Sydney, Australia
| | - Fiona Kouyoumdjian
- McMaster University, Canada; Centre for Urban Health Solutions, St. Michael's Hospital, Canada
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Hanssens LGM, Vyncke V, Steenberghs E, Willems SJT. The role of socioeconomic status in the relationship between detention and self-rated health among prison detainees in Belgium. Health Soc Care Community 2018; 26:547-555. [PMID: 29488259 DOI: 10.1111/hsc.12552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2018] [Indexed: 06/08/2023]
Abstract
Prisoners are known to report worse health than the general population. Research has also shown that the prison population counts disproportionally more people with a lower socioeconomic status (SES), making it difficult to determine whether the worse self-reported health of prisoners is an effect of their detention or of their lower SES. This study assesses the influence of being in prison on self-rated health and if (and how) this relationship is mediated by SES. Data from detainees were collected in 12 Flemish prisons. To compare with the general population, data from the Belgian national health survey 2013 were used. To estimate the direct and indirect effect of being in prison on self-reported health, mediation analysis was carried out by means of natural effect models using nested counterfactuals. Following previous literature we find that prisoners report worse health than the general population and that SES has a significant influence on subjective health. Our results showed that the direct effect (exp(B) = 3.43; [95% CI: 2.924-4.024]) of being in prison on self-reported health is larger than the indirect effect (through SES) (exp(B) = 1,236; [95% CI: 1.195-1.278]), thus contradicting the hypotheses in previous literature that the SES is the main explanation for variation in self-reported health among prisoners. Lastly, the effect of SES on health is more important for the general population compared to detainees, suggesting that for prisoners the effect of being in prison seems to surpass the effect of SES on health.
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Affiliation(s)
- Lise G M Hanssens
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
| | - Veerle Vyncke
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
| | - Eva Steenberghs
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
| | - Sara J T Willems
- Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
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Vail WL, Niyogi A, Henderson N, Wennerstrom A. Bringing it all back home: Understanding the medical difficulties encountered by newly released prisoners in New Orleans, Louisiana - a qualitative study. Health Soc Care Community 2017; 25:1448-1458. [PMID: 28370837 DOI: 10.1111/hsc.12445] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/17/2017] [Indexed: 05/27/2023]
Abstract
Formerly incarcerated persons (FIPs) face a disproportionate risk of death and serious illness in the immediate post-release period. Therefore, it is a critical time to initiate community-based care for chronic illnesses and behavioural disorders. Little is known about the unique transitional health and social support needs of FIPs in Louisiana, which has the highest incarceration rate in the world. As the average age of prisoners in the United States rises, the release of older prisoners with chronic conditions will become increasingly common. The aim of this study was to explore the healthcare experiences of FIPs in Louisiana in order to inform delivery of services tailored to this population. This research was done in partnership with a community organisation that advocates for restoration of voting rights to FIPs and helps newly released individuals transition back into society. This organisation identified FIPs in the Greater New Orleans area, and from January to May 2015, we conducted 24 semi-structured, in-person, audio-recorded interviews at the community organisation's transitional living facility. The interviews assessed FIPs' experiences with and barriers to receiving healthcare during and after incarceration. These discussions also explored FIPs' desires for services and attitudes towards health and healthcare. Interviews were transcribed and independently coded by two researchers. Interviewees reported negative experiences with healthcare during incarceration, and limited health guidance during the pre-release process. Post-release concerns included lack of insurance, difficulty accessing care and medication, and interest in learning about healthy lifestyles. Results suggest a need for a formalised system of transitional healthcare for FIPs. Findings are being used to inform a pilot transitional care clinic in New Orleans, Louisiana.
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Affiliation(s)
- William Lee Vail
- Tulane Medical School and School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Albert Einstein College of Medicine / Montefiore Medical Center: Department of Medicine, The Bronx, New York, USA
| | - Anjali Niyogi
- Tulane University School of Medicine: Section of General Internal Medicine, New Orleans, Louisiana, USA
| | | | - Ashley Wennerstrom
- Tulane University School of Medicine: Section of General Internal Medicine, New Orleans, Louisiana, USA
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Abstract
This study aimed to improve understanding of obesity in prison by investigating prison nurses' perceptions of weight gain and obesity. In-depth semistructured interviews were carried out with 17 nurses who worked in two male prisons in the United Kingdom. Nurses identified a variety of factors that they believed contributed to obesity and weight gain in the prison setting. These included factors caused by prisoner behavior, such as poor food choices and sedentary lifestyle. Factors influenced by the prison environment, such as stress of imprisonment, prison regime, and prison culture, were also seen as significant. These factors were seen as barriers to the role of nurses delivering care in prison. Nurses explained how they adapted their role to overcome these barriers.
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Affiliation(s)
- Khurshid Choudhry
- 1 Department of Primary Care & Public Health Sciences, King's College London, London, UK
| | - David Armstrong
- 1 Department of Primary Care & Public Health Sciences, King's College London, London, UK
| | - Alexandru Dregan
- 1 Department of Primary Care & Public Health Sciences, King's College London, London, UK
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Abstract
Worldwide, women are increasingly being incarcerated. One unintended consequence is the increase in unhealthy female offenders. Among the more serious health concerns are HIV and AIDS. Challenges associated with caring for women with HIV/AIDS impacts not only disease management and infection control within correctional facilities but also the prisoners' home communities where they will need health care, drug and alcohol rehabilitation, housing assistance, and employment opportunities. No bridging theory has been presented that links prison and community health concerns with criminal justice policy. This article not only presents recommendations for effective HIV/AIDS policy but also suggests epidemiological criminology as a means of explicit merging of health with justice issues and consequently provides a bridging framework.
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Affiliation(s)
- Mark M Lanier
- University of Alabama Cyber Institute, University of Alabama, Tuscaloosa, AL, USA
| | - Barbara H Zaitzow
- Department of Government and Justice Studies, Appalachian State University, Boone, NC, USA
| | - C Thomas Farrell
- Department of Public Health, Western Kentucky University, Bowling Green, KY, USA
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Abstract
Aim: The information about prisoners’ health in transitional countries including Albania is limited. The aim of our study was to assess the health status and its correlates among adult prisoners in Albania, a post-communist country in Southeast Europe. Methods: This was a cross-sectional study conducted in 2013 including 401 prisoners in Albania [290 (72%) males and 111 (28%) females]. All participants were administered an anonymous and structured questionnaire including information on self-perceived health status, health-related problems, lifestyle factors (smoking, alcohol intake and drug use) and demographic and socioeconomic characteristics (age, sex, educational attainment and income level). Binary logistic regression was used to assess the association between self-reported health status and covariates. Results: Overall, 173 (43.1%) of prisoners included in this study reported a poor health status, with a clear predominance of the female gender (P<0.01). Overall, 28.1% of prisoners reported the presence of at least one disease. The overall prevalence of smoking, excessive alcohol consumption and drug use were 59.1%, 34.9% and 10.2%, respectively. Upon multivariable-adjustment, poor self-perceived health status was positively associated with female gender (OR=2.01, 95%CI=1.41-2.96), smoking (OR=1.58, 95%CI=1.29-2.04), excessive alcohol consumption (OR=1.71, 95%CI=1.38-2.13) and the presence of diseases (OR=1.86, 95%CI=1.52-2.87). Conclusion: This study provides important information about the health status among Albanian prisoners. There is an urgent need for Albania to make a significant progress in health services provision for prisoners, which constitute a particularly vulnerable population subgroup.
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Affiliation(s)
- Drita Jaka
- General Directorate of Prisons, Tirana, Albania
| | | | - Genc Burazeri
- Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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