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PubMed2004

Cost-effectiveness analysis of telemedicine to evaluate diabetic retinopathy in a prison population.

OBJECTIVE: A cost-effectiveness analysis was conducted to investigate the clinical and economic impact of teleophthalmology in evaluating diabetic retinopathy in prison inmates with type 2 diabetes. RESEARCH DESIGN AND METHODS: Based on a hypothetical teleophthalmology system to evaluate diabetic retinopathy patients with type 2 diabetes in a prison care setting, a Markov decision model was developed with probability and cost data derived primarily from published epidemiological and outcome studies. A 40-year-old African-American man with type 2 diabetes was used as a reference case subject. The number of quality-adjusted life-years (QALYs) gained was used as the clinical outcome, and the cost in U.S. dollars from the year 2003 was used as the economic outcome. Teleophthalmology and nonteleophthalmology strategies were compared using an expected QALYs calculation and two types of sensitivity analyses: probabilistic and traditional n-way sensitivity analyses. RESULTS: The teleophthalmology strategy dominates in the cost-effectiveness analysis for the reference case subject: 16,514/18.73 dollars QALYs for teleophthalmology and 17,590/18.58 dollars QALYs for nonteleophthalmology. Ninety percent of the Monte Carlo simulations showed cost effectiveness (annual cost/QALYs < or = 50,000 dollars) in the teleophthalmology strategy based on an assumed inmate population. Teleophthalmology is the better strategy if the number of diabetic inmates in the prison community is >500. CONCLUSIONS: Our cost-effectiveness analysis demonstrates that teleophthalmology holds great promise to reduce the cost of inmate care and reduce blindness caused by diabetic retinopathy in type 2 diabetic patients.

Blindness↗

PubMed1998

Studies of validity for the Prison Control Scale.

Locus of control seems to be important in the adjustment of prisoners both during incarceration and upon release. The Prison Control Scale is one of two measures of locus of control specific to prisons. This paper is an account of validity studies conducted on the scale. Assessments included four tests of construct validity and one each of concurrent and known-groups validity. The results support the validity of the scale. Suggestions for further scale assessment and other research are briefly discussed.

Adult↗

PubMed1974

Absence of drug abuse in prisoners in a major correctional institution.

Laboratory evaluation of illicit drug abuse was conducted in a major correctional institution. Fifty-eight prison inmates were screened for common drugs of abuse in conjunction with a triazolo-benzodiazipine compound tolerance protocol. Urine specimens were collected on days -1, 1, 15, 29, and 49 and assayed for amphetamines, opiates, barbiturates, and alcohol. Quinine was detected in two individuals and was probably derived from cold remedy preparations rather than the illegal use of heroin. While occasional illicit drugs may find their way into a prison population, this study showed no evidences of drug abuse in one correctional institution whose prisoners participated in Phase I drug evaluations.

Adult↗

PubMed2000

Fifty years of prison suicide in Austria: does legislation have an impact?

The absolute and relative frequency of suicides in jails and prisons in Austria over the 50 years from 1947 to 1996 is described. Important legislational changes regarding the criminal justice system are discussed with regard to possible consequences for the incidence of prisoners' suicides. Within the five decades a significant increase in the absolute numbers of jail and prison suicides was evident in spite of the considerable decrease in the total inmate population. Therefore, the suicide rate of inmates of correctional facilities increased significantly. Possible reasons for this phenomenon are discussed in relation to changes of the criminal law.

Austria↗

PubMed2003

Palliative care behind bars: the New Zealand prison hospice experience.

The provision of palliative care for convicted criminals ignites debate about morality and equality. The New Zealand prison population includes a higher proportion of smokers, Maori (native New Zealanders), and intravenous drug users than is found in the general community; prisoners as a group are therefore at greater risk of developing a terminal illness. The sparse literature mostly originates from America, which necessitates consideration of the relevance to corrections systems in other societies. This paper examines some of the issues surrounding the provision of palliative care for prisoners in the New Zealand correction system. These issues may challenge some of the basic principles on which modern hospice care has been developed.

Analgesics, Opioid↗

PubMed2003

New policy on methadone maintenance treatment in prisons established in Alberta.

The right of a prisoner to access methadone maintenance treatment (MMT) while incarcerated in a correctional institution has recently been raised and examined in the Alberta Court of Queen's Bench case of Milton Cardinal v The Director of the Edmonton Remand Centre and the Director of the Fort Saskatchewan Correctional Centre. This is a significant, precedent-setting case. For the first time, a Canadian court has ordered that a prisoner be provided with MMT during his or her period of incarceration. As a result of the case, and just before it was to proceed to trial, Alberta changed its policy and is now providing MMT to its provincial prisoners--at least when they had been receiving MMT prior to their incarceration.

Alberta↗

PubMed2004

[Are psychiatric disorders identified and treated by in-prison health services?].

BACKGROUND: The prevalence in Norwegian prisons of psychiatric disorders in relation to the treatment potential in the prison health system has not been properly examined. MATERIAL AND METHOD: The prevalence of psychiatric disorders, drug problems and personality disorders was examined in a prison population in the western health region in Norway. Additionally, treatments of these disorders were surveyed. The methods used were structured clinical interviews, self reports and reviews of medical case notes. RESULTS: Psychiatric disorders in need of treatment were found in 18 out of 40 interviewed inmates. Of these 18, 13 actually received treatment with psychoactive medication. Criteria for alcohol and drug addiction or misuse were fulfilled by over 90%. Personality disorders were found in 80% and antisocial personality disorder in more than 60%. INTERPRETATION: The prevalence of psychiatric disorders including personality disorders and drug addiction is high among inmates. Compared to international studies, more of the inmates with psychiatric disorders that we interviewed receive psychoactive medication.

Behavioral Symptoms↗

PubMed1990

Suicidal behavior in jails and prisons in The Netherlands: incidence, characteristics, and prevention.

In most countries, the incidence of suicidal behavior in correctional institutions is higher than in the population at large. In the current study, information was processed on 44 completed suicides (that occurred during the period 1973-1984) and on 198 attempted suicides (1980-1984) by jail and prison inmates in The Netherlands. Demographic, legal, and medical data for victims were compared to similar data for nonsuicidal inmates. Twenty-five inmates who had recently attempted suicide were interviewed, as well as 26 correctional officers and staff members. The majority of suicide completers died by hanging; most attempted suicides were performed impulsively by cutting wrists. Suicidal crises often occurred during the first period of confinement. Inmates born outside The Netherlands and long-term prisoners were high-risk groups. The incarceration of alcohol and/or drug abusers was a complicating issue. Correctional officers and prison staff often viewed suicide attempts as manipulative gestures, although this only partially reflected inmates' true intentions. Several preventive measures are discussed, with special consideration of the identification of suicide risk.

Adult↗

PubMedDate not supplied

[Prison psychosis: apropos of a case].

We have realized a review and actualization of prisons psychosis; an important problem at present in prison's ambit because it generates a great number of recoveries and graves questions to prison's doctors and psychiatry's doctor which they work in this world. Also, this problem origins a numbers judicial's questions in relation with the imputability. Further, we expose a clinic case of our practice.

Adult↗

PubMed1983

Suicides in jails and prisons.

Suicide is the leading cause of death in jails and prisons and the rate is at least 3 times higher than the national average. Nonetheless, suicides in jails and prisons have received little professional psychiatric attention. A review of the relevant literature reveals a limited number of studies, many of which contain serious methodological flaws. The current literature does suggest that the psychiatric morbidity in jails and prisons is increasing and that administrative and environmental variables appear to be at least equal to personal characteristics in contributing to inmate suicides. Recommendations for future research efforts and practical applications are made.

Adult↗

PubMedDate not supplied

A cross-sectional seroprevalence survey for HIV-1 and high risk sexual behaviour of seropositives in a prison in India.

This study was conducted to know whether prisoners constitute a "high risk group" for HIV transmission in India today. A sero-epidemiological period prevalence survey was conducted in Central Prison, Bangalore, South India covering 1007 undertrials and 107 permanent convicts during January to December 1993. Twenty (1.98%) undertrials and none of the permanent convicts were seropositive for HIV infection. All of them were males and 1.6(80%) of them were in the age group of 20-30 years. Low literacy, poor income, sexual promiscuity and low condom usage were observed among the seropositives. Thus, prisoners constitute a high risk group and routine screening and counselling are recommended.

Adult↗

PubMed1978

Increased prevalence of seizure disorders among prisoners.

In an effort to determine the prevalence of seizure disorders among persons confined to jails and prison, the prescription rates for anticonvulsant medications in ten Illinois correctional institutions were surveyed. The institutions housed 12,030 persons at the time of the survey. Analysis of the results of the survey suggests a point prevalence of seizure disorders of 1.9% among the Illinois prison and jail population. This estimated prevalence of seizure disorders is approximately three times higher than among middle-class nonprisoner populations on which previous epidemiologic studies of epilepsy have been based. Special programs and resources for the detection, treatment, and prevention of seizure disorders among prisoners appear necessary. Provisions to ensure continuity of care after release from incarceration are also needed.

Anticonvulsants↗

PubMed1981

Differentiating violent and nonviolent prison inmates by use of selected MMPI scales.

Used multivariate procedures to determine whether prisoners who committed violent acts while in prison could be differentiated from those who did not. Ss were 141 adult male inmates in maximum security prisons. Multiple variable profile analysis that employed 22 MMPI scales and four demographic items significantly differentiated between violet and nonviolent inmates. Discriminant analysis that used all 26 variables yielded a significant root that accounted for 34.9% of the variance between violent and nonviolent inmates. The MMPI scales that contributed most to prediction of group membership were F, PA, PT, and SC, all of which had discriminant load values above .40. Finally, a discriminant function prediction equation was derived to predict the criterion variable (violent or nonviolent behavior). Applying this equation without knowledge of the S's actual group membership correctly classified 72.9% of the violent and 80.6% of the nonviolent inmates.

Adolescent↗

PubMed2004

The language of the psychopath: characteristics of prisoners' performance in a sentence completion test.

AIM AND BACKGROUND: Verbal productions of prisoners were studied as possible correlates of psychopathic personality. METHOD: A sample of 76 inmates of a German high-security prison were administered a new sentence completion test (SCT). The subjects' verbal responses to 63 sentence cues were coded using 23 content and linguistic categories which had been derived from Loevinger's stage model of ego development. Moreover, the Psychopathy Checklist Revised (PCL R) was scored for each subject after a clinical interview and a perusal of the prisoner's file. RESULTS: Moderate positive correlations were found between PCL R scores and cognitive and linguistic characteristics in the SCT (concerns with exerting power and being dominated, use of coarse language and the expression of dysphoric emotions). These characteristics were highly sensitive but not specific to psychopaths. CONCLUSIONS: In the context of recent research, verbal patterns are seen, together with interpersonal behaviour patterns and linguistic properties, as valid indicators of psychopathy and might be particularly useful when biographical information is lacking.

Adult↗

PubMed2005

Correlates of HIV, HBV, and HCV infections in a prison inmate population: results from a multicentre study in Italy.

A cross-sectional study was undertaken on the correlates of infection for the human immunodeficiency virus (HIV) and hepatitis viruses B and C (HBV and HCV) in a sample of inmates from eight Italian prisons. A total of 973 inmates were enrolled [87.0% males, median age of 36 years, 30.4% intravenous drug users (IDUs), 0.6% men who have sex with men (MSWM)]. In this sample, high seroprevalence rates were found (HIV: 7.5%; HCV: 38.0%; anti-HBc: 52.7%; HBsAg: 6.7%). HIV and HCV seropositivity were associated strongly with intravenous drug use (OR: 5.9 for HIV; 10.5 for HCV); after excluding IDUs and male homosexuals, the HIV prevalence remained nonetheless relatively high (2.6%). HIV prevalence was higher for persons from Northern Italy and Sardinia. The age effect was U-shaped for HIV and HCV infections; HBV prevalence increased with age. Tattoos were associated with HCV positivity (OR: 2.9). The number of imprisonments was associated with HIV infection, whereas the duration of imprisonment was only associated with anti-HBc. The probability of being HIV-seropositive was higher for HCV-seropositive individuals, especially if IDUs. In conclusion, a high prevalence of HIV, HCV, and HBV infections among inmates was observed: these high rates are in part attributable to the high proportion of IDUs. Frequency of imprisonment and tattoos were associated, respectively, with HIV and HCV positivity. Although it is possible that the study population is not representative of Italy's prison inmate population, the results stress the need to improve infection control measures users was prisons.

Adult↗

PubMed1996

[Risk factors in self-injurious behavior in a Swiss prison].

Suicide is reported to be one of the leading causes of death in prison (25-45% of deaths), and attempted suicide is observed more frequently in prison than in the general population. The purpose of this study is to identify the risk factors of the suicidal gestures (including wrist slashing) in the Geneva prison, and their impact; with a view to elaborating possible preventive measures. A case-control study (172 cases and 169 controls) was conducted retrospectively on the basis of medical records. Demographic and medical data for cases were compared to similar data for non-suicidal inmates. A multivariate analysis of the data revealed that the risk of suicidal inmates. A multivariate analysis of the data revealed that the risk of suicidal gestures increased for the following characteristics: age less than 25 years (RR = 4.4), previous suicide attempts (RR = 4.7), a past history of psychiatric treatment (RR = 2.5), and finally, opiate drug dependence (RR = 2.8).

Adolescent↗

PubMed1996

Experiences of torture and ill-treatment and posttraumatic stress disorder symptoms among Palestinian political prisoners.

The relationship between the nature and severity of experiences of torture and ill-treatment and posttraumatic stress disorder (PTSD) symptoms was studied in 550 male nonhelp-seeking Palestinian political ex-prisoners from the Gaza Strip. Results showed that the more a prisoner had been exposed to physical, chemical and electric torture, psychological ill-treatment, and sensory deprivation or bombardment, the more he subsequently suffered from intrusive reexperiencing, withdrawal and numbness, and hyperarousal. Existential problems were not related to torture experiences. Furthermore, duration of imprisonment, health problems during the imprisonment, harassment during arrest and after release, family, marriage and economic difficulties all predicted intrusive reexperiences of trauma. Also, ex-prisoners who continued to be harassed by military authorities and had economic problems suffered more from withdrawal, numbness, and hyperarousal than others.

Adaptation, Psychological↗

PubMed2005

[Human immunodeficiency virus-associated tuberculous meningoencephalitis causing abnormal behaviour in a prisoner].

Little is known about the type and frequency of psycho-organic syndromes among prisoners. We report the case of a 20-year-old African HIV-I-positive male asylum seeker who developed increasingly bizarre behaviour in prison. The observation of complex behavioural disturbances with a hallucinatory-delusional state led to the diagnosis of delirium caused by AIDS-defining tuberculous meningoencephalitis. The patient improved with specific, symptomatic treatment. This case illustrates the difficulties in diagnosis when communication is impeded. Scrupulous differential diagnosis is necessary for all prisoners manifesting behavioural disturbances. We discuss the pathogenesis and diagnostic procedures of tuberculous meningoencephalitis.

AIDS Dementia Complex↗