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[Mortality due to suicide in prison].

Previous studies identified correlations between suicide in prison and socio-demographic and crime characteristics. However links between these variables were not taken into account. In this paper we use a regression model to the study of the determinants of suicide in prison in order to isolate the individual effect of each variable. We confirmed previous observations such as the increase in suicides with the increase in length of imprisonment. The sex of the individual and the nature of the crime did not correlate with suicide rate. The major risk factors for suicide were high social status and a high degree of social and family integration. These results contrast with observations on suicide outside the prison environment, for which the contrary was found.

Adolescent↗

Women as prisoners of war.

American women are increasingly becoming involved in combat-related roles. Inevitably, our country will have several killed and taken prisoner. No National Academy of Science/National Research Council or VA study has ever been undertaken to examine the chronic sequelae of the experiences undergone by these captured women. This paper examines the after-effects of 3.5 years of incarceration on the 79 American women taken prisoner by the Japanese in the Philippines during World War II. Emphasis is given to their living conditions in a prisoner-of-war camp and their resulting long-term disabilities. Comparison of data reported in this paper with those of several epidemiological studies of male survivors of Philippine camps allows several novel points to be made. Overall, half of the women had a service-connected disability, exactly like the men. Furthermore, although the average degree of service-connected disability, 37%, is the same as that of the men, not one of the women in this study was service-connected for tuberculosis or peptic ulcer disease. This is a major finding, since, compared to age-matched combat controls, the men had a higher post-repatriation death rate for the first 7 years due to tuberculosis; likewise, peptic ulcer disease is so common in the male survivors that it is a presumptive service-connected disability.

Female↗

HIV/AIDS education and prevention programs for adults in prisons and jails and juveniles in confinement facilities--United States, 1994.

By the end of 1994, at least 4588 adult inmates of U.S. prisons and jails had died as a result of acquired immunodeficiency syndrome (AIDS), and during 1994, at least 5279 adult inmates with AIDS were incarcerated in prisons and jails (1). Periodically conducted national surveys instituted in 1985 (2) and sponsored by the U.S. Department of Justice's National Institute of Justice (NIJ) and CDC have documented the prevalence of human immunodeficiency virus (HIV)/AIDS and the incidence of sexually transmitted diseases (STDs) among adult inmates and confined juveniles*. In addition, these surveys have enabled an assessment of HIV/AIDS education and prevention programs in prisons and jails for adults and confinement facilities for juveniles. This report presents findings from the eighth survey, conducted in 1994, which indicate the need to increase HIV/AIDS education and prevention services among adult inmates and confined juveniles.

Adolescent↗

Religiosity, criminality and types of offences of Jewish male prisoners.

The study examined whether the percentage of religious criminals was lower than the percentage of religious people in the population and whether the types of crimes committed by religious prison inmates differed from those committed by non-religious inmates. The 193 religious criminals studied consisted of all the religious male prisoners in the men's prisons in Israel. The percentage of religious criminals (3.7%) was found to be far below the percentage of religious people in the population (about 20%). In general both groups committed the same types of crimes. The exceptions were that religious criminals committed more sex and white-collar crimes and less security crimes than non-religious criminals.

Adult↗

Parent education for mothers in prison.

The over 26,700 mothers in U.S. prisons are a nursing concern. Incarceration disrupts families and affects mothers, children, and caregivers alike. Outcomes of prison parenting programs include improved self-esteem, behavioral expectations, empathy, discipline, family roles, relationships, and a commitment to avoid substance abuse and reincarceration, all beneficial to families and society. Nurses can voice support for prison policies that support the mother-child relationship and can help to meet the needs both of children whose mothers are incarcerated and women who were previously incarcerated.

Child↗

Prison and the role of the forensic mental health nurse.

Medium secure units (MSUs) have developed a range of nursing services for mentally disordered offenders (MDOs) within controlled environments. This paper examines the potential for such nursing services to be offered to the prison service, in order that prisons can provide a level of mental health nursing that equates with the best practice found in the NHS. A number of key reports are reviewed, with examples on how MSUs could help in interventions against self-harm, suicide prevention, forensic nurse therapy and clinical supervision. An account of how nurses in MSUs and prison health care centres could work collaboratively in developing these initiatives is provided. Finally, a brief case report is given on the treatment of one client with post-traumatic stress disorder.

Forensic Medicine↗

Tuberculosis and HIV infection in new inmates in Federal Bureau of Prisons facilities.

A significant change in the manner in which medical data were managed in the Federal Bureau of Prisons (BOP) occurred in calendar year 1992 (CY 92). Prior to CY 92, all BOP medical data were stored only as hard copy medical records. Beginning with CY 92, medical records data for all inmates have been transcribed to magnetic tape using the BOP SENTRY system. This study was an initial attempt to determine if this innovation would permit the development of meaningful infectious diseases data on BOP inmates. Our objective was to define the prevalence of tuberculosis (TB) skin test positivity, active TB, and HIV infection in new BOP inmates in CY 92 and to compare the new inmate population with the total BOP 1992 prisoner population. This initial study is important for two reasons: (1) the BOP SENTRY system for demographic and medical data was found to be a feasible tool for disease surveillance purposes; and (2) the 1992 new inmate population had much greater prevalences of purified protein derivative positivity, active TB, and HIV infection compared to the total BOP population. These findings may signal an increase in serious infectious diseases in BOP prisoners.

AIDS Serodiagnosis↗

Psychiatry behind the walls: mental health services in jails and prisons.

Throughout his professional career, Karl Menninger emphasized the importance of understanding criminal behavior and societal responses to such behavior. He focused on the need for more humane approaches within the criminal justice system. This article focuses on the current needs and anticipated directions for psychiatric services in prisons and jails, including comprehensive systems approaches that can facilitate better treatment and decrease repeat offenses. With the growing number of individuals being incarcerated in jails and prisons, and with higher percentages needing mental health services, it is important that effective mental health services be designed and implemented. Services should provide quality interventions and treatments for the inmates, must take into account and be respectful of the security needs of the facility, and must deal sensitively and thoughtfully with the stresses and factors that contribute to burnout among the professional staff and security officials. In this way, we can achieve part of Karl Menninger's dictum to provide better care for those who are unfortunate enough to have their behavior result in their being incarcerated in jails and prisons.

Crime↗

[High percentage of isolated anti-HBc-positive persons among prisoners].

PURPOSE: Is the result "isolated Anti-HBc" higher among prisoners than in the normal population and can testing for HBV-DNA clarify the results? PATIENTS AND METHODS: In Berlin, 519 prisoners were serologically tested in 1994 for hepatitis-B and -C because of intravenous drug abuse and alcohol disease or signs of hepatitis. Beside virus antigen and antibodies, HBV-DNA was also measured by hybridisation technique or PCR. RESULTS: 50.3% of all individuals showed markers of hepatitis-B and 36.8% of hepatitis-C. 19.2% of persons with hepatitis B markers were positive for anti HBc only, i.e. more than twice as many than in the normal population. 90% of the isolated anti-HBc-positive Persons were also anti-HCV positive, which is nearly double the number of individuals with other patterns of HBV markers. Half of them were tested for HBV-DNA. Whereas the hybridisation technique failed to detect HBV-DNA, 36% of sera were found positive by HBV-PCR. CONCLUSION: This study shows again that the result "anti-HBc alone" is relatively frequent especially among prisoners. This pattern often seems associated with concurrent HCV-infection and in one third of the cases correlated with a chronic hepatitis-B. The result of an isolated anti-HBc should therefore always lead to further testing of anti-HCV and HBV-DNA by PCR.

Berlin↗

Hidden cases of leprosy (in prison)

Leprosy survey conducted in eight prisons in seven districts of Bihar State revealed a prevalence of 13.3 per 1000 which was 12 times more than the recorded prevalence of leprosy in the State. Thus this finding supports the view that prisons could form a hyperendemic pocket for leprosy. Regular NLEP services need to be extended to the inmates of the prisons.

Drug Therapy, Combination↗

Evaluating privilege requests from mentally ill prisoners.

Psychiatrists working in prisons are frequently presented with inmate requests for special privileges and living arrangements. Although recommendations to reduce stress are often indicated for seriously mentally ill prisoners, the injudicious use of special privileges can interfere with treatment and with the functioning and security of the prison environment. Guidelines are suggested for evaluating privilege requests that include exploring alternatives to granting requests; reserving privileges primarily for individuals with serious mental disorders; relying upon objective findings; and utilizing a multidisciplinary decision-making process.

Forensic Psychiatry↗

Natural selection of memory-one strategies for the iterated prisoner's dilemma.

In the iterated Prisoner's Dilemma, mutually cooperative behavior can become established through Darwinian natural selection. In simulated interactions of stochastic memory-one strategies for the Iterated Prisoner's Dilemma, Nowak and Sigmund discovered that cooperative agents using a Pavlov (Win-Stay Lose-Switch) type strategy eventually dominate a random population. This emergence follows more directly from a deterministic dynamical system based on differential reproductive success or natural selection. When restricted to an environment of memory-one agents interacting in iterated Prisoner's Dilemma games with a 1% noise level, the Pavlov agent is the only cooperative strategy and one of very few others that cannot be invaded by a similar strategy. Pavlov agents are trusting but no suckers. They will exploit weakness but repent if punished for cheating.

Animals↗

Evolutionary stability in the n-person iterated prisoner's dilemma.

The iterated prisoner's dilemma game has been used extensively in the study of the evolution of cooperative behaviours in social and biological systems. The concept of evolutionary stability provides a useful tool to analyse strategies for playing the game. Most results on evolutionary stability, however, are based on the 2-person iterated prisoner's dilemma game. This paper extends the results in the 2-person game and shows that no finite mixture of pure strategies in the n-person iterated prisoner's dilemma game can be evolutionarily stable, where n > 2. The paper also shows that evolutionary stability can be achieved if mistakes are allowed in the n-person game.

Animals↗

Evolutionary dynamics of the continuous iterated prisoner's dilemma.

The iterated prisoner's dilemma (IPD) has been widely used in the biological and social sciences to model dyadic cooperation. While most of this work has focused on the discrete prisoner's dilemma, in which actors choose between cooperation and defection, there has been some analysis of the continuous IPD, in which actors can choose any level of cooperation from zero to one. Here, we analyse a model of the continuous IPD with a limited strategy set, and show that a generous strategy achieves the maximum possible payoff against its own type. While this strategy is stable in a neighborhood of the equilibrium point, the equilibrium point itself is always vulnerable to invasion by uncooperative strategies, and hence subject to eventual destabilization. The presence of noise or errors has no effect on this result. Instead, generosity is favored because of its role in increasing contributions to the most efficient level, rather than in counteracting the corrosiveness of noise. Computer simulation using a single-locus infinite alleles Gaussian mutation model suggest that outcomes ranging from a stable cooperative polymorphism to complete collapse of cooperation are possible depending on the magnitude of the mutational variance. Also, making the cost of helping a convex function of the amount of help provided makes it more difficult for cooperative strategies to invade a non-cooperative equilibrium, and for the cooperative equilibrium to resist destabilization by non-cooperative strategies. Finally, we demonstrate that a much greater degree of assortment is required to destabilize a non-cooperative equilibrium in the continuous IPD than in the discrete IPD. The continuous model outlined here suggests that incremental amounts of cooperation lead to rapid decay of cooperation and thus even a large degree of assortment will not be sufficient to allow cooperation to increase when cooperators are rare. The extreme degree of assortment required to destabilize the non-cooperative equilibrium, as well as the instability of the cooperative equilibrium, may help explain why cooperation in Prisoner's Dilemmas is so rare in nature.

Altruism↗

Individual differences in game motivation as moderators of preprogrammed strategy effects in prisoner's dilemma.

The impact of three programmed strategies (tit-for-tat, 100% cooperation, and 100% defection) on cooperation level in the Prisoner's Dilemma game is examined as a function of the subject's motivational orientation (cooperative, competitive, or individualistic). Motivational orientation was assessed on the basis of each subject's choices across four classes of decomposed games. Following this assessment, subject's played 30 trials of Prisoner's dilemma in matrix form against one of the above-mentioned strategies. Results were wholly consistent with predictions, showing that (a) cooperatively oriented subjects cooperate with a tit-for-tat and a 100% cooperative strategy, but defect against a 100% defecting strategy, (b) competitive subjects defect against all three strategies; and (c) individualistic subjects defect against both 100% cooperative and 100% defective strategies, but they cooperate with a tit-for-tat strategy. It appears reasonable to conclude that the outcomes of a Prisoner's Dilemma have affectively different meaning (i.e., values) for subjects of differing orientations, and that subjects of all three orientations adopt strategies that effectively maximize their particular type of reward in the game.

Adolescent↗

Human cooperation in the simultaneous and the alternating Prisoner's Dilemma: Pavlov versus Generous Tit-for-Tat.

The iterated Prisoner's Dilemma has become the paradigm for the evolution of cooperation among egoists. Since Axelrod's classic computer tournaments and Nowak and Sigmund's extensive simulations of evolution, we know that natural selection can favor cooperative strategies in the Prisoner's Dilemma. According to recent developments of theory the last champion strategy of "win--stay, lose--shift" ("Pavlov") is the winner only if the players act simultaneously. In the more natural situation of players alternating the roles of donor and recipient a strategy of "Generous Tit-for-Tat" wins computer simulations of short-term memory strategies. We show here by experiments with humans that cooperation dominated in both the simultaneous and the alternating Prisoner's Dilemma. Subjects were consistent in their strategies: 30% adopted a Generous Tit-for-Tat-like strategy, whereas 70% used a Pavlovian strategy in both the alternating and the simultaneous game. As predicted for unconditional strategies, Pavlovian players appeared to be more successful in the simultaneous game whereas Generous Tit-for-Tat-like players achieved higher payoffs in the alternating game. However, the Pavlovian players were smarter than predicted: they suffered less from defectors and exploited cooperators more readily. Humans appear to cooperate either with a Generous Tit-for-Tat-like strategy or with a strategy that appreciates Pavlov's advantages but minimizes its handicaps.

Journal Article↗

Orbital "shanking": a unique prison injury.

The purpose of this paper is to describe orbitocranial penetration due to "shanking", a common mode of assault in prison facilities. We report the case of a prisoner who presented with orbital apex syndrome 5 days after an assault. He died 9 days after surgical removal of the "shank" due to a presumed ruptured traumatic aneurysm. Physicians who evaluate prisoners must maintain a high index of suspicion for penetrating injuries. The entrance site is often inconspicuous and the history may be limited in this unique population.

Journal Article↗

Hospice in prison: the Louisiana State Penitentiary Hospice Program.

This article by the hospice case manager and inmate volunteer coordinator at the Louisiana State Penitentiary (LSP) hospice program describes the program's major features, how it was started and is sustained within the confines and culture of prison life, and how the challenges to implementing a hospice program within a maximum security prison continue to be met. Recommendations are offered for undertaking a hospice initiative in a correctional facility. The LSP Hospice Program was honored in May 2000 with the Circle of Life Award from the American Hospital Association. This article is excerpted from a thematic issue, "Hospice in Prison," Volume 2, Number 3, 2000 of the online journal, Innovations in End-of-Life Care at http://www.edc.org/lastacts/

Journal Article↗