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PubMed2005

An outbreak of Q fever in a prison in Italy.

We observed an outbreak of Q fever in a prison population. Overall, 65 of the 600 prison inmates developed the disease. The location of the prison cells had no apparent effect on the risk of infection. The outbreak was probably due to exposure to dust contaminated by a passing flock of sheep, which at the time of the outbreak was engaged in lambing. These findings highlight the possible emergence of Q fever in settings and populations not normally thought of as being at risk of exposure to the infection.

Adult↗
PubMed2005

A syringe exchange programme in prison as prevention strategy against HIV infection and hepatitis B and C in Berlin, Germany.

In two prisons in Berlin, Germany, provision of sterile injection equipment for injecting drug users (IDUs) started in 1998. To assess the programme's impact, the frequency of injecting drug use and syringe sharing, and the incidence of HIV, HBV, and HCV infection were determined in a follow-up study. Of all IDUs (n=174), 75% continued to inject. After the project start the level of syringe sharing declined from 71% during a 4-month period of previous imprisonment to 11% during the first 4 months of follow-up, and to virtually zero thereafter. Baseline seroprevalences for HIV, HBV, and HCV were 18, 53, and 82%. HIV and HCV seroprevalence at baseline was significantly associated with drug injection in prison prior to the project start. No HIV and HBV seroconversions, but four HCV seroconversions occurred. The provision of syringes for IDUs in appropriate prison settings may contribute to a substantial reduction of syringe sharing. However, the prevention of HCV infection requires additional strategies.

Adult↗
PubMed2000

Successfully treating aggression in mentally ill prison inmates.

The population of prison inmates in the United States is rapidly growing; in 1994 it was estimated that 1.7 million Americans were incarcerated. Changes in the complexion of the prison population highlight the need for successful mental health interventions for special populations. Specifically, increasing numbers of women, middle aged inmates, physically ill inmates, and inmates with severe mental illness have challenged an already taxed system. Many inmates have complex pathology in which substance abuse, psychosis, affective disorders, personality disorders and medical illnesses play overlapping roles. One of the most challenging aspects of care involves management of inmates who are aggressive to themselves or others. This article discusses the approach to managing inmates with aggressive behavior and complex mental health issues. Specific diagnoses are discussed as are the general approaches best used to assess new onset violent behavior in a mentally ill prison inmate.

Adult↗
PubMed1999

Seroprevalence of HIV, HCV and syphilis in Brazilian prisoners: preponderance of parenteral transmission.

Between November 1993 and April 1994, our physicians' team interviewed and took blood samples of 631 prisoners randomly drawn from the largest prison of South America, which counted about 4700 inmates at that time. The interview consisted of questions related to risk behaviour for HIV infection, and the subjects were asked to provide blood for serological tests for HIV, hepatitis C and syphilis. Our main purpose was to investigate the relationship between HCV and injecting drug use as related to HIV seropositivity. Participation in the study was voluntary and confidentiality was guaranteed. Overall prevalences found were as follows: HIV: 16% (95% confidence interval (CI): 13-19%); HCV: 34% (95% CI: 30-38%), and syphilis: 18% (95% CI: 15-21%). Acknowledged use of ever injecting drug was 22% and no other parenteral risk was reported. Our results, as compared with other studies in the same prison, suggest that HIV prevalence has been stable in recent years, and that the major risk factor for HIV infection in this population is parenteral exposure by injecting drug use.

Adolescent↗
PubMed2002

The relation of appraisal, coping efforts, and acuteness of trauma to PTS symptoms among former political prisoners.

We examined how trauma-specific appraisals and coping efforts mediate between traumatic experiences, acuteness of trauma, and length of imprisonment and posttraumatic stress symptoms (PTS) among 103 Palestinian former political prisoners. The findings provide support for both direct and mediated models of trauma. The acuteness of trauma (time since release), appraisal of prison experience as harmful and involving loss, and use of both emotion- and problem-focused coping efforts were associated with high levels of PTS symptoms. Torture and ill-treatment had a direct association with intrusion, and recent release from prison with avoidance symptoms. Acuteness of trauma turned out to be important in the coping and symptom association: emotion-focused coping was associated with a low level of PTS symptoms in the long run, whereas problem-focused coping was associated with a low level of PTS symptoms in the short run.

Adaptation, Psychological↗
PubMed2002

Personality disorders in prison: aren't they all antisocial?

The provision of mental health services in the correctional system is challenging at best for various clinical, administrative, and structural reasons. Among the complicating factors is the assessment and management of character pathology which either confounds the treatment of more "serious" mental illnesses, e.g. Axis I disorders, and/or presents itself as the primary focus for intervention. In this paper we review the prevalence of personality disorders on the prison mental health services caseload in New York State. We compare inpatient and out-patient rates among the various disorders documented in the prison system, as well as look at these rates within the context of the rates of personality disorder in the state mental health system generally. Assessment of personality disorder will be addressed with particular attention to the confounding influence of the prison environment. Finally, treatment options will be discussed, including discussion of new initiatives that attempt to address inmates with serious mental illness and personality traits that lead to disciplinary housing.

Adult↗
PubMed2004

Peer suicide prevention in a prison.

Suicide rates among inmate populations in prisons are considerably higher than in the general population. Suicide prevention is a common need among penal institutions around the world. Traditional approaches involving only correctional staff in suicide prevention efforts have proven to have their limitations. The involvement of inmates in peer prevention efforts seems to be a reasonable alternative approach. This study examines such a program, called SAMS in the Pen, operated jointly between the prison and the Samaritans of Southern Alberta. This service, the first of its kind in Canada, involved inmate volunteers, known as SAMS, who were trained in listening skills, suicide prevention, and risk assessment. Data was collected for the research from volunteers, correctional staff, general inmate population, and professional staff. However, given the low absolute number in the one institution where the study was carried out, statistical analyses were not practical. As with any new service, the SAMS in the Pen experienced some developmental problems but was perceived to be a worthwhile service to both inmates and staff of the prison.

Adolescent↗
PubMed1994

Food restriction and binge eating: a study of former prisoners of war.

Food restriction is correlated with binge eating, but evidence that restriction leads to binge eating is scanty. In this study we investigated postwar binge eating in 67 World War II combat veterans and 198 former prisoners of war. As predicted, binge eating was relatively rare in combat veterans but was significantly more prevalent in veterans who, as prisoners in German prisoner of war camps, lost significant amounts of weight during their captivity. Our data thus support the contention that starvation or dieting seems to precede binge eating.

Aged↗
PubMed2003

Prison-based syringe exchange programmes: a review of international research and development.

Journal publications and conference presentations on prison-based syringe exchange (PSE) programmes were identified by a comprehensive search of electronic databases. Experts involved with development and evaluation of current PSE programmes or policy were contacted for reports, documents and unpublished material. Spanish information on PSE was translated for this review. We identified 14 papers specifically on PSE programmes in Switzerland (six papers), Germany (four) and Spain (four). The first PSE programme started in 1992 in Switzerland. As of December 2000, seven PSEs were operating in Switzerland, seven in Germany and five in Spain. There have been six evaluations of prison syringe exchange programmes and all have been favourable. Reports of drug use decreased or remained stable over time. Reports of syringe sharing declined dramatically. No new cases of HIV, hepatitis B or hepatitis C transmission were reported. The evaluations found no reports of serious unintended negative events, such as initiation of injection or of the use of needles as weapons. Staff attitudes were generally positive but response rates to these surveys varied. Overall, this review indicated that prison syringe exchange programmes are feasible and do provide benefit in the reduction of risk behaviour and the transmission of blood-borne infection without any unintended negative consequences.

Germany↗
PubMed1998

Prevalence and determinants of hepatitis A virus exposure among prison entrants in Queensland, Australia: implications for public health control.

In September 1997, a multicentre outbreak of hepatitis A virus (HAV) infection occurred in the Queensland prison system following a prolonged community-based HAV epidemic among illicit drug users. As part of the public health response, a cross-sectional survey was undertaken to estimate the sero-prevalence of, and identify the determinants for, recent and past HAV infection among the incoming male prisoner population. Exposure data were collected through face-to-face interviews with 214 consenting inmates, whose sera were screened for immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to HAV. Overall, 81 (37.9%) inmates were HAV-IgG seropositive, and four inmates were HAV-IgM seropositive, HAV-IgG seropositivity was strongly associated with year of birth (age) (Ptrend < 0.0001), being born outside Australia (relative risk (RR) 1.9, 95% CI 1.4-2.7) and being of a non-English speaking background (RR 2.5, 95% CI 1.7-3.7). Lifestyle exposures (such as occupation, overseas travel and illict drug use) were not associated with an increased risk of HAV-IgG seropositivity. In contrast, all four HAV-IgM seropositive inmates were English-speaking, Australian-born males who used illicit drugs. These findings suggest that the risk factors for recent and past HAV infections among prisoners differ, with implications for HAV control in correctional settings. Strategies for HAV prevention, including routine screening of inmates and vaccination of susceptibles, are considered in the context of current models of disease transmission.

Adult↗
PubMed2001

[Psychiatric treatment of prisoners in general psychiatric wards exemplified by North Rhine-Westphalia and Rhineland-Pfalz].

OBJECTIVE: The study was intended to provide information on the frequency and general condition of inpatient and outpatient treatment of mentally disturbed prisoners in general psychiatry in Germany. METHODS: Directors of psychiatric institutions and chief physicians of prisons in Nordrhein-Westfalen and Rheinland-Pfalz were interviewed via a standardized questionnaire. RESULTS: The use of inpatient psychiatric treatment was approximately 0.1 to 2.3% in 1997 with reference to the total admissions in 1997. CONCLUSION: The rare use of psychiatric beds in general psychiatry may reflect obstacles concerning the status of prisoners and reservations regarding difficult patients.

Ambulatory Care↗
PubMed1975

Operation homecoming: psychological observations of repatriated Vietnam prisoners of war.

While in military service as a psychiatrist stationed at Scott Air Force Base, I had the opportunity to do the psychiatric evaluations on a number of the prisoners of war returning from North Vietnam. Scott Air Force Base is an area medical center (North Central United States), and was responsible for administering the medical and psychiatric examinations on all the men whose homes were in this area. Our hospital processed 29 returning POWS, of whom I saw 14. This group of POWS was probably unique in military history in that it was comprised almost entirely of officers. Their period of confinement was considerably longer than that of the prisoners of World War II and the Korean War, with the typical Vietnam POW being in captivity about six or seven years. This paper is an attempt to share my observations and thoughts on the experience of being a Vietnam Prisoner of War.

Adaptation, Psychological↗
PubMed2006

Screening for viral hepatitis among male non-drug-abuse prisoners.

OBJECTIVE: To describe the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and the associated risk factors in a prison population. MATERIAL AND METHODS: In this cross-sectional study, from November 2004 to February 2005, all 297 newly sentenced prisoners (mean age 37.5+/-11.7 years, age range 16-69 years), who had never used illicit drugs received routine blood check-ups and completed a face-to-face interview. Hepatitis B surface antigen (HBsAg) and anti-HCV antibodies were tested using the t-test, chi-square test, and logistic regression. RESULTS: Among the 297 subjects, 13.1% were positive for HBsAg, 8.4% were positive for anti-HCV, and 1.7% were positive for combined HBsAg and anti-HCV. Logistic regression analysis demonstrated that tattooing (odds ratio=2.24, 95% CI=1.03-4.88) and an elevated alanine aminotransferase (ALAT) level (odds ratio=4.10, 95% CI=1.61-10.40) were independently related to HCV infection. CONCLUSIONS: Screening of HBV and HCV infection in prison populations remains necessary. Tattooing and elevated ALAT level are identified as the related factors of HCV infection.

Adolescent↗
PubMedDate not supplied

Dr. Leary's Concord Prison Experiment: a 34-year follow-up study.

This study is a long-term follow-up to the Concord Prison Experiment, one of the best-known studies in the psychedelic psychotherapy literature. The Concord Prison Experiment was conducted from 1961 to 1963 by a team of researchers at Harvard University under the direction of Timothy Leary. The original study involved the administration of psilocybin-assisted group psychotherapy to 32 prisoners in an effort to reduce recidivism rates. This follow-up study involved a search through the state and federal criminal justice system records of 21 of the original 32 subjects, as well as personal interviews with two of the subjects and three of the researchers: Timothy Leary, Ralph Metzner and Gunther Weil. The results of the follow-up study indicate that published claims of a treatment effect were erroneous. This follow-up study supports the emphasis in the original reports on the necessity of embedding psilocybin-assisted psychotherapy with inmates within a comprehensive treatment plan that includes post-release, nondrug group support programs. Despite substantial efforts by the experimental team to provide post-release support, these services were not made sufficiently available to the subjects in this study. Whether a new program of psilocybin-assisted group psychotherapy and post-release programs would significantly reduce recidivism rates is an empirical question that deserves to be addressed within the context of a new experiment.

Adult↗
PubMedDate not supplied

Comparison of background characteristics and behaviors of African-American, Hispanic, and white substance abusers treated in Federal prison: results from the TRIAD Study.

The lack of empirical literature describing minority substance abusers who seek treatment serves as an obstacle for providing empirically-driven, culturally-relevant substance abuse treatment to minorities in both prison-based and community-based programs. The purpose of this study was to address this gap in the literature by describing and comparing the background characteristics and preincarceration behaviors and social environments of adult African-American, Hispanic, and white substance abusers who were treated in Federal Bureau of Prisons' (BOP) residential drug abuse treatment programs. The study sample included 279 African-American, 72 Hispanic, and 512 white male substance abusers who were treated in 16 prison-based residential drug treatment programs from 1991 to 1995. Consistent with the limited literature, this study tested the hypothesis that there would be significant differences among the groups on most of the variables, with the greatest differences to be noted between African-American and white participants. The results indicated that there were numerous significant differences in demographic and background, family background and criminal history characteristics, but there were only a few differences in preincarceration behaviors and social environment among participants. The findings suggested that addressing participants' treatment needs within the context of their cultural characteristics would enhance treatment for participants.

Adult↗
PubMed1999

Knowledge of prophylaxis treatment therapy among HIV-positive prisoners.

The present study examined the level of knowledge and understanding of Pneumocystis Carinii Pneumonia (PCP) treatment therapy among heterosexual and non-heterosexual inmates (prisoners) with HIV-infection. This study seeks to determine if any differences exist between HIV-positive inmates based on sexual orientation, with reference to PCP treatment therapy. It is our contention that this effort will provide health professionals with valuable insight regarding delivering expanded care for HIV-infected individuals in incarcerated settings. The participants for this study were 99 HIV-positive inmates recruited between May and June 1995. These individuals were drawn from a list of all HIV/AIDS prisoners at the facility. More than 56% of the sample admitted their preferred sexual orientation as heterosexual compared to 43.4% non-heterosexual. More non-heterosexual seropositive inmates were likely to report PCP was preventable (OR = 1.17, 95% CI = 0.56, 2.42), as well as noting its contagious attributes (OR = 1.41, 95% CI = 0.90, 2.21). Furthermore, non-heterosexual inmates were more likely to report they were taking prescribed medications for their infections (OR = 1.34, 95% CI = 0.76, 2.36) and that they knew the names of the prescriptions they were taking (OR = 1.13, 95% CI = 0.59, 2.14). Regardless of sexual orientation, it is consistent with the research that HIV-positive individuals may engage in risky sexual behaviour that may place non-infected individuals at risk of contracting the virus. Prison provides an opportunity to provide education to multiple at-risk populations.

AIDS-Related Opportunistic Infections↗
PubMed2001

Treatment process in prison therapeutic communities: motivation, participation, and outcome.

Although the largest effects of prison-based therapeutic community (TC) programs are associated with entry into aftercare, only a minority of prisoners volunteer for these aftercare programs. The study addresses the gap in our knowledge concerning these low rates of voluntary entry. A theoretical formulation of the TC process involving the effect of the interaction of clients' motivation and participation in the activities of the TC on entry into aftercare was tested on a sample of 110 volunteers in a prison-based TC for whom there were client and staff ratings of 3-month participation and 12-month follow-up data on relapse and recidivism. Path analyses support a model in which the interaction of motivation and 3-month participation ratings have a direct effect on the selection of aftercare, and aftercare has a direct effect on relapse and recidivism. The use of a combination of enhanced motivation and early program participation as a means of increasing the utilization and effectiveness of aftercare is discussed.

Adolescent↗
PubMed2002

The role of drugs in crime: insights from a group of incoming prisoners.

The present study was designed to evaluate whether drug dependence is associated with any specific perception of the role of drugs in crime. In the summers of 1997 and 1998, face-to-face interviews were conducted with members of a group of incoming prisoners at the Cuyahoga County Jail in Cleveland. Ohio. "Incoming prisoners" denotes persons whose criminal cases had been adjudicated and who were of their way to one of Ohio's prisons. Respondents were asked whether they themselves perceived that drugs had been a factor in the crimes for which they had been arrested. Those respondents classified as dependent on at least one illicit drug tended to answer affirmatively. This sub-group was also more likely than their non-dependent counterparts to admit to using drugs in the two days following the commission of their crimes. Specifically, these respondents viewed the need to obtain drugs for personal use as one of their main motives for participating in crime.

Adult↗