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PubMed1996

Burns in prisoners: an assessment of problems in handling prisoners in a burns unit.

All burns units look after members of the prison population at times. This can cause anxiety among the staff and unique problems with management. Four cases-were reviewed from Her Majesty's Prison (HMP) Perth, Scotland, all of whom required resuscitation, and a survey undertaken of the nursing staff in our unit to assess attitudes to caring for burns prisoners in particular. Despite a careful search of the literature, no reference to the problems of managing prisoners in a burns unit could be found. However, it was found that the handling of violent offenders can be a significant cause of anxiety for nursing staff, and the presence of prison officers a reassurance rather than a hindrance in the management of burned prisoners. It is therefore recommended that prison officers be present at all times while managing burned prisoners.

Adolescent↗
PubMed1995

Psychiatric morbidity among Finnish prisoners with special reference to socio-demographic factors: results of the Health Survey of Finnish Prisoners (Wattu Project).

The present study is part of the Health Survey of Finnish Prisoners (Wattu Project). The project dealt with a sample of 1099 Finnish prisoners, of which 82% participated in the study. Because of the representativeness of the sample the results can be generalized to all Finnish prisoners. The methods used consisted of questionnaires, interviews, a clinical examination by prison physicians and gathering of register data. The total prevalence rate of psychiatric cases was 56%. This is much higher than the rate for the Finnish population in general. The high number of mental disorders was due to alcoholism (43%) and personality disorders (18%). These disorders became even more prevalent as the number of prison sentences increased. There was no difference between the prisoners and the general population in the prevalence of psychoses and neuroses. Alcoholism is the most important mental disorder in Finnish prisoners, while drug abuse is rarely found among them in comparison to prisoners in many other countries.

Adolescent↗
PubMed2007

Metabolic improvement of male prisoners with type 2 diabetes in Fukushima Prison, Japan.

Imprisonment often improves metabolic control in prisoners with type 2 diabetes; however, the reasons for this remain unclear. Here, we investigated the metabolic control of male prisoners with type 2 diabetes in Japan. Retrospective analysis of 4385 medical charts of male prisoners in Fukushima Prison from 1998 to 2004 revealed 109 prisoners (all Asian) with type 2 diabetes (mean+/-S.D.: 51+/-10 years). All were followed up during their imprisonment (14+/-10 months). During imprisonment, mean fasting plasma glucose and hemoglobin Alc (HbA1c) levels dramatically decreased from 184+/-74 to 113+/-38mg/dl (p<0.001) and 8.4+/-2.1 to 5.9+/-1.2% (p<0.001), respectively. In addition, 5 of 18 prisoners (28%) treated with insulin and 17 of 34 (50%) treated with oral hypoglycemic agents were able to discontinue their treatment and maintain good metabolic control. Most prisoners in Japanese prisons work 8h a day 5 days a week, consuming a high dietary fiber diet including boiled rice with barley, "Mugimeshi". These findings suggest that a well-regulated lifestyle and long-term intake of high dietary fiber may have beneficial effects on metabolic control in patients with type 2 diabetes.

Blood Glucose↗
PubMed2001

Health of elderly male prisoners: worse than the general population, worse than younger prisoners.

BACKGROUND: Assessment of the health of men aged 60 and over in English and Welsh prisons. METHODS: 203 men were interviewed from 15 prisons, comprising one-fifth of all sentenced men in this age group in England and Wales. Assessment included semi-structured interviews covering chronic and acute health problems, and recording of major illnesses from the medical notes and prison reception health screen. RESULTS: 85% of the elderly prisoners had one or more major illnesses reported in their medical records, and 83% reported at least one chronic illness on interview. The most common illnesses were psychiatric, cardiovascular, musculoskeletal and respiratory. CONCLUSION: The rates of illness in elderly prisoners are higher than those reported in other studies of younger prisoners and surveys of the general population of a similar age. The increasing number of elderly people in prison poses specific health challenges for prison health-care services.

Adult↗
PubMed2003

Does insomnia in prison improve with time? Prospective study among remanded prisoners using the Pittsburgh Sleep Quality Index.

Insomnia is a frequent health problem in prison, but little is known about its severity and duration. The objective was to find out whether subjective sleep quality improves during time and which factors influence improvement. Fifty-two randomly chosen prisoners complaining of insomnia at the Geneva remand prison were interviewed (T1) and followed up ten days (T2) and two months (T3) later. They received hypnotics habitually prescribed by prison physicians (benzodiazepines, chloralhydrate, zolpidem). After ten days 40 patients were still in prison and agreed to participate and after two months 16 prisoners could be re-evaluated. Total Pittsburgh Sleep Quality Index (PSQI) scores at T1 were 12.3 +/- 4.7. At T2 and T3, PSQI scores improved significantly, whereas General Health Questionnaire (GHQ) scores and conditions of imprisonment were similar. Only 12.5% of patients at T2, and 6.25% at T3, were 'good sleepers' (PSQI scores =/< 5). Cocaine users and prisoners with a healthy lifestyle reported the greatest improvement of PSQI scores. Our study shows that significant improvement of PSQI scores takes place in the first one to two weeks. However, in spite of regular drug treatment during the following weeks, PSQI scores persisted at a clinically significant level two months later. Drug treatment in prison only partially improves insomnia.

Adult↗
PubMed1996

Prison deprivation and protein nutritional status of inmates of a developing community prison.

OBJECTIVE: This study assesses the protein nutritional status of inmates of a small prison, in the light of a changing serum protein pattern in the environment. DESIGN: Survey of prison inmates. SETTING: A male prison and low social class hospital workers. SUBJECTS: 81 inmates and 62 randomly selected controls, of which 42 of the former and 28 of the latter were further randomly selected. METHODS: Nutritional and confinement history were obtained by a questionnaire, Weights and heights were measured and serum and urine samples collected for protein estimations. RESULTS: The prisoners were confined for 229.1 (SD 210.1) days. 48.1% had BMI < 20 kg/m2 compared to 28.6% of controls (p = 0.04). Their diet was predominantly carbohydrate. Mean total serum protein was 81.5gm/L (6.1) (95% CI = 79.3-83.5) (prisoners); 88.7 gm/L (8.1) (95% CI = 85.7-91.7) (controls). Serum globulin was 44.9 gm/L (6.3) (95% CI = 42.9-46.9) (prisoners); 55.4 gm/L (8.2) (95% CI = 52.3-58.5) (controls) (p <0.001 respectively). More prisoners than controls had severe hypo- albuminaemia (p =0.001). All values were lower in those awaiting trial compared to convicted inmates. Total protein and albumin weakly correlated with duration of confinement (r = -0.23 and -0.15, respectively). CONCLUSION: The study suggest that the prisoners might be undernourished with lower serum proteins than controls, within an average of seven months confinement. The picture appears worse in those awaiting trial and with prolonged duration of confinement.

Adolescent↗
PubMed1976

Prison homosexuality and its effect on post-prison sexual behavior.

Although there has grown up to a considerable literature on sex experiences in prison, little has been written on the post-prison behavioral patterns of those who, voluntarily or involuntarily, become initiated into homosexuality while incarcerated. In the light of the considerable number of prisoners and ex-prisoners in the original Kinsey sample, it is possible that the Institute for Sex Research might have in its files material that would shed light on this problem. To date, nothing has been forthcoming. In one of the few references to the subject, Kirkham (1972, p. 42) suggests that sexual experiences in prison may have permanent effects on the lives of some of the participants: "Can such men return to conventional heterosexual lives after release, or has the experience of being forced into acts of passive homosexuality been so traumatic as to preclude the resumption of sexual relations with members of the opposite sex?" In a search for an answer to his question, the present paper studies ex-prisoners whose initiation into homosexuality occurred during prison.

Age Factors↗
PubMed2006

Psychopathy checklist score predicts negative events during the sentences of prisoners with Hare psychopathy: a prospective study at a German prison.

OBJECTIVE: This study examined the predictive validity of the German translation of the Psychopathy Checklist-Screening Version (PCL-SV) for negative events during the course of the prison sentence of German prisoners. METHOD: Using the PCL-SV, we investigated 145 offenders in a German prison at the start of their sentences. We then compared the extreme groups identified by the PCL-SV--the high and low scorers--using a prospective design with respect to negative events and factors during the course of the sentences. This involved the standardized collection of data on both objective records of disciplinary incidents and subjective impressions from prison staff on the basis of operationalized criteria. RESULTS: The high scorers were involved in significantly more disciplinary incidents and were also rated significantly less favourably by prison staff than the low scorers. CONCLUSION: Until now, the PCL has only been shown to predict recidivism following release from prison. The results of our study show that the PCL also has predictive validity for problems during the course of the sentence. It is therefore recommended that the PCL be used routinely at the start of the prison sentence to estimate the likelihood of subsequent difficulties.

Antisocial Personality Disorder↗
PubMed1998

Predictors of adherence to tuberculosis treatment in a supervised therapy programme for prisoners before and after release. Study Group of Adherence to Tuberculosis Treatment of Prisoners.

The prison population is a high-risk group for tuberculosis (TB). This investigation aimed to study predictive factors of treatment adherence among prisoners involved in a pilot programme of supervised treatment. The study included TB patients from the Men's Penitentiary Center of Barcelona (MPCB) in 1995. Directly observed therapy (DOT) was carried out in the infirmary or in a methadone programme. Released prisoners were referred to the municipal maintenance methadone programmes (MMP) and other social resources. Incentives and enablers were used to improve compliance (economic aid for nutritional and housing needs, methadone programmes and admittance to a sociosanitary centre). The outcome of the patients' adherence was classified as follows: completed, defaulted, dead or transferred out. Factors associated with adherence were investigated through logistic regression. The programme included 62 patients, 43 of whom were intravenous drug users (IVDU) and 46 were infected with the human immunodeficiency virus (HIV). Nineteen had previously had TB and 32 were released from prison during TB treatment. Overall adherence was 89%; 97% among those who completed treatment in prison, and 79% among those who completed treatment outside prison (p=0.05). Ninety-five per cent of IVDU in an MMP completed treatment. Homeless or alcoholic exprisoners completed treatment only if they were admitted to sociosanitary centres. DOT throughout treatment resulted in better adherence (odds ratio (OR)= 16.80; confidence interval (CI): 2.42-116.2)). Those who were incarcerated throughout treatment also showed better adherence (OR= 7.36; CI: 0.79-48.16). Antituberculosis treatment adherence in prisoners was high even after release with adequate co-ordination among intrapenitentiary and extrapenitentiary programmes. Maintenance methadone programmes proved very useful in intravenous drug users, as did admittance to sociosanitary centres for indigent or alcoholic exprisoners undergoing treatment.

AIDS-Related Opportunistic Infections↗
PubMed2000

The transfer of harm-reduction strategies into prisons: needle exchange programmes in two German prisons.

In Autumn 1995, the Minister of Justice of Lower Saxony (a northern state of Germany) gave the green light for the implementation of a 2-year pilot project. This project provided for the distribution of sterile injection equipment and provision of communicative methods of prevention to drug addicted inmates in a women's prison with 170 inmates (Vechta) and a men's prison with 230 inmates (Lingen). The decision to go ahead with the project was based on positive experiences in Swiss prisons and the supporting recommendations of a panel of experts. The pilot project in Vechta started on 15 April 1996, using five dispensing machines which allow a needle exchange to guarantee an anonymous access. The project in the men's prison started on 15 July 1996. Here the staff of the drug counselling service and of the health care unit hand out sterile syringes to inmates. The social scientific evaluation was carried out by the Carl von Ossietzky University in Oldenburg. The study focused on the aim of the project which is to assess the feasibility, usefulness and efficacy of the measures undertaken. Of special interest was whether and how changes occured in the prison system itself (i.e. acceptance of the measures by staff, medical service and management), and in the drug user's behaviour and knowledge (i.e. development of needle sharing, change in drug use patterns). The study used a multi-methodological approach: documentation of the project practice, half standardized, longitudinal examination of inmates (n=224) and staff (n=153), qualitative examination of management, selected groups of prisoners, staff and external organisations (AIDS-Help-Groups; n=75) for at least two times. The evaluation intended to be dynamic, process accompanying, in order to communicate the empirical data and developments with the practice already during the pilot phase. Results of the final report of the study are presented here. Finally this paper discusses shortly what is known so far about the impact of needle exchange programmes in prisons in Germany and Switzerland.

Journal Article↗
PubMed1982

Hepatitis B virus infection in prisons. A seroepidemiological survey in prisoners and attending staff.

Prisoners and attending staff from six houses of detention were screened for serum HBsAg, anti HBs, antiHBc and transaminases. Both prisoners and warders showed an increased prevalence of HBV serum markers with respect to age- and sex-matched general population control groups. The HBsAg carrier rate was 6.7% in prisoners and 6.6% in staff. Sixty-five per cent of the HBsAg-positive subjects were antiHBe-positive. When the blood samples were taken, all the HBsAg-positive subjects were asymptomatic; transaminases were normal in 80% and only slightly elevated in 20%. Illicit drug abuse was found to be a relevant risk factor for HBV infection among prisoners under 35 yearts of age, but not in the older group, whereas no correlation emerged between presence of HBV serum markers and tattoos or admitted homosexuality. A high prevalance of HBV serum markers as also found among young warders who had been in service for a short time: most of them, however, come from areas of Italy with a particularly elevated HBV circulation. Although the results suggest that many of the HBV infections are not recently acquired within the institution, this survey confirms that prisons should be regarded as high risk areas for HBV infection, both for prisoners and warders.

Adult↗
PubMed2005

Preventive care for women in prison: a qualitative community health assessment of the Papanicolaou test and follow-up treatment at a California state women's prison.

Growing evidence indicates that women in prison are particularly vulnerable to many negative health outcomes, including cervical cancer. The Papanicolaou (Pap) test is an effective tool to screen for this disease. To determine what is and is not working with the Pap test and follow-up treatment, we performed qualitative interviews with women prisoners and key informants at a California state women's prison. Our assessment revealed that the process of administering Pap tests at this institution was not meeting the health care needs of the women interviewed. Women reported having negative experiences during the test and with their health care providers. Additionally the prison's culture and infrastructure create obstacles that hinder prisoners from receiving quality care and providers from delivering that care. In response, women prisoners use self-and community advocacy to meet their health care needs and cope with these challenges.

Adaptation, Psychological↗
PubMed1984

Health of prisoners admitted to and discharged from Bedford Prison.

The age, smoking and drinking habits, active health problems, and occupational fitness of prisoners entering Bedford prison, and the health and willingness of prisoners being discharged from prison to take a letter to their general practitioner were surveyed. This group of men had a high level of illness, neglected their health, and had a high alcohol intake. Fewer problems were found than in a survey in New York City. Many prisoners with active medical problems on discharge from prison were unwilling to take a letter to their own general practitioner.

Adult↗
PubMed2002

The National Survey of Psychiatric Morbidity among prisoners and the future of prison healthcare.

It has long been known that psychiatric disorders are highly prevalent among prisoners (Coid, 1984; Gunn et al., 1991; Maden et al., 1995; Joukamaa, 1995; Bland et al., 1998; Lamb and Weinberger, 1998). However, the Survey of Psychiatric Morbidity Among Prisoners in England and Wales (Singleton et al., 1998) represents a considerable advance on earlier surveys. By using the same standardized psychiatric assessment procedures, and similar questions on medication, service use and social functioning, its findings can be compared with previous national surveys of adults living in private households (Meltzer et al., 1995), residents in institutions (Meltzer et al., 1996), homeless persons (Gill et al., 1996), and with the forthcoming household survey in England, Wales and Scotland. It should also inform the future organisation of healthcare for prisoners, following recent recommendations from a joint Home Office/Department of Health Working Party that Health Authorities must work with prisons in their catchment areas to carry out joint health needs assessments, agree prison healthcare improvement strategies and jointly plan and commission services (HM Prison Service and NHS Executive 1999). The ultimate test of the survey will be whether it provides a benchmark to evaluate the future effectiveness of the new policy changes.

England↗
PubMed2004

Beyond the prison paradigm: from provoking violence to preventing it by creating "anti-prisons" (residential colleges and therapeutic communities).

Prisons were supposedly created for the purpose of the tertiary prevention of violence (i.e., reducing the frequency and severity of future violence on the part of people who have already become violent). However, there is much evidence that this method of attempting to prevent violence is often, though not always, either ineffectual or counterproductive, in which case it is either a waste of money or actually exacerbates the problem it was ostensibly intended to solve. This article reviews evidence concerning those questions including an analysis of the effect of punishment (one of the main purposes of prisons) on violent behavior. Punishment--the infliction of pain--will be distinguished from restraint (incapacitation, separation from the community). Successful examples of violence prevention in unconventional prison programs, emphasizing therapy and education rather than punishment, and restorative rather than retributive justice, will be summarized, together with evidence that these programs reduce re-incarceration rates so substantially that they actually save the taxpayers more money than they cost, in addition to enhancing the safety of the general public. The position is taken that traditional prisons provoke more violence than they prevent and are so fundamentally flawed that they cannot be reformed; we argue that they should instead be abolished and replaced by "anti-prisons," that is, locked, secure residential colleges, therapeutic communities, and centers for human development. Prisons will come to be seen as a well-meaning experiment that failed, rather like the use of leeches in medicine.

Female↗
PubMed1995

Screening prison inmates for mental disorder: an examination of the relationship between mental disorder and prison adjustment.

The rapidly expanding population of prison inmates has severely challenged the prison system's ability to effectively screen incoming inmates for mental disorders and mental health service needs. This study describes a comprehensive mental health screening of inmates at a maximum security prison, using a modified version of the Referral Decision Scale (RDS), a screening measure developed from the Diagnostic Interview Schedule. Modified items and adjusted cut-off scores were used in order to reduce the rate of false positives. Survey results indicate that this modified version of the RDS may be an effective screening measure for correctional settings. Subjects who were positive on the RDS were compared to negative subjects on a variety of offense and prison adjustment variables. Findings indicate that while subjects who were positive on the RDS experienced some initial adjustment problems within the prison, they were generally not found to be involved in an elevated rate of prison violence and were not more often remanded to disciplinary units than those subjects who were negative on the RDS.

Adaptation, Psychological↗
PubMed2000

[Addiction problems behind prison walls--view of the prison administration].

As Head of the Prison Administration of Saxony, the author describes the difficulties and problems that exist in the care and treatment of prisoners who are addicted to drugs or alcohol. Up to now, these problems have been dealt with in a manner that was too much concentrated on ideas and aspects of security by using systems of control and restrictions. Social contacts inside and outside of the prison and a sense of freedom are, however, the requirements of the legal concept of resettling prisoners. There is a great need for more counselling and therapy. It should also be attempted to improve the conditions for the individual prisoners, e.g. by setting up drug-free units and, thus, provide a environment to the addicts that enables them to live their lives without the daily struggle for drugs and alcohol.

Alcoholism↗
PubMed2003

Measuring therapeutic attitudes in the prison environment: development of the Prison Attitude to Drugs scale.

AIMS: To develop and test the validity of a scale measuring therapeutic attitudes among prison staff working with drug misusers. DESIGN: A cross-sectional postal questionnaire study using 27 statements with a five-point Likert scale. SETTING: Four prisons in the south-west of England PARTICIPANTS: A total of 252 prison staff (response rate 70%), including 67 for test-retest (response rate 57%). FINDINGS: The study resulted in a three-dimensional, nine-item scale: the Prison Attitude to Drugs scale (PAD). The three subscales measure confidence in skills (four items), personal rewards (three items) and job satisfaction (two items). Test-retest correlations for the questions were above 0.7, with each factor having an internal coherence (coefficient alpha) of greater than 0.7. CONCLUSIONS: The PAD is a reliable tool that can be used in the prison environment.

Adult↗