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PubMed1991

Cruel and unusual punishment: the health care of women in prison.

Nationally, the number of female prison inmates--although small compared with the number of male inmates--is on the upswing. Since correctional facilities are legally mandated under the eighth amendment to provide inmates with their constitutional right to health care, innovative methods of delivering that care will have to be devised within a current system that is neither funded nor prepared to design and dispense such programs. The most frequent medical problems among incarcerated women are drug/alcohol addiction, gynecological diseases, and exacerbation of chronic health problems, particularly hypertension, diabetes and epilepsy. The prison health care system is also being faced with management of an increasing number of pregnant and postpartal inmates. Health needs of this group include basic health care, teaching, counseling and supportive care--services that can be appropriately provided by nurse practitioners and other health care providers.

Child↗
PubMedDate not supplied

Coinfection with tuberculosis and HIV-1 in male prison inmates.

An association between past exposure to tuberculosis (TB) and infection with human immunodeficiency virus type 1 (HIV-1) was investigated using a case-control design among a 6-week sample of 698 male inmates consecutively admitted to the Maryland State prison system. Based on Mantoux testing and measurement of anti-HIV-1, we found a positive but not significant association between HIV-1 and TB infection (odds ratio 2.4, 95 percent confidence interval 0.9-6.3). The power of the study to detect an association of this magnitude was 0.57. Of the entire intake sample, 1.3 percent were found to be coinfected with TB and HIV-1. Some misclassification may have been present due to anergy or latent HIV-1 infection. The elevated risk of TB in coinfected inmates, coupled with the study results, suggest that the inmate screening process on entry to the prison should be modified to improve identification of coinfected people. Specifically, anergy testing should be added to the admission screening procedure, and appropriate voluntary anonymous HIV-1 antibody testing should be more widely available to inmates.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Fatalities in west Austrian prisons].

The purpose of this study is to review 23 causes of death that have occurred in Western-Austrian prisons from 1974 to 1989. The majority of them (11 cases) were due to suicides. Among 9 cases of natural death there was a 25 years old man, who died of an unknown purulent meningoencephalitis. Two drunken prisoners had not been supervised and therefore died of alcohol poisoning. In one case the police jail physician did not recognize an epidural hematoma.

Adult↗
PubMed1990

Prison mental health services: results of a national survey of standards, resources, administrative structure, and litigation.

The formation of adequate mental health systems within prisons has accelerated as a result of successful class action lawsuits. Our recent national survey questioned all state correctional departments about the existence of standards in each system, compliance with such standards, prevalence of class action lawsuits involving the issue of providing adequate mental health services for inmates, issues related to consent decrees, available mental health resources within the correctional system, and the administrative structure of the mental health system. Our purpose was to identify those factors correlated with certified class action lawsuits involving issues related to mental health services. Twenty-one states were involved in such litigation. Only the presence of psychiatric hospitals operated by the department of corrections correlated with the presence of certified class action lawsuits involving mental health services. Prison systems larger than 15,000 inmates were at higher risk for such litigation. Smaller systems having psychiatric hospitals run by the state mental health agency appeared to be at less risk for such litigation.

Jurisprudence↗
PubMed1978

The use of benzodiazepines in prison populations.

Experience with the use of tranquilizing drugs in the control of anxiety and in attempts at behavior modification, prompted a controlled study in the use of the benzodiazepines at the Utah state prison. It appeared that the benefits derived from the administration of these drugs in prisoner control were nearly outweighed by the frequent appearance of paradoxical rage reactions and increase in hostility and aggressive tendencies in these individuals. A double blind, cohort, prospective, randomized study was set up comparing Valium and Serax in their antianxiety qualities and their tendency to produce increased aggression and paradoxical rage reactions. Guidelines are proposed for the use of benzodiazepines and Serax is suggested as a superior drug to Valium for this purpose if indeed a tranquilizer of this type is indicated.

Aggression↗
PubMed1989

Legal aspects of medical treatment of prisoners and detainees.

This paper deals with certain basic aspects of the medical treatment of detainees and prisoners. Emphasis is placed on the requirement that the responsible doctor should have the fullest possible degree of professional discretion. The rules pertaining to professional confidentiality are not suspended in the prison situation. The question as to whether a doctor should work in a situation which in general is not ethically acceptable to him is discussed. Reference is made to the Declaration of Tokyo and South African positive law is examined.

Confidentiality↗
PubMed1989

The psychology and actions of rapists interned in the Kawagoe Juvenile Prison compared with rapists in Tokyo.

The study of the psychology of rapists reveals information which could facilitate the re-orientation of juvenile offenders in prison. The subjects of this study were sixty criminals incarcerated as rapists in the Kawagoe Juvenile Prison at the end of 1985. Questionnaires and various psychological tests (including the Rozenweig Picture--Frustration method) were used to examine their state of mind. Information concerning 173 rape cases referred to the section of Criminal Identification in 1985 was obtained from the Tokyo Metropolitan Police and used for comparison.

Adolescent↗
PubMed1989

Increasing incidence of tuberculosis in a prison inmate population. Association with HIV infection.

The incidence of tuberculosis (TB) among inmates of the New York State prison system increased from 15.4 per 100,000 in 1976 through 1978 to 105.5 per 100,000 in 1986. Matching of TB and acquired immunodeficiency syndrome registries indicated that the majority (56%) of inmates with TB reported in 1985 and 1986 had acquired immunodeficiency syndrome or human immunodeficiency virus infection; none were known to be human immunodeficiency virus seronegative. A case-control study examined 59 inmates with TB reported from 1984 through 1986 and 59 matched control inmates without TB. Inmates who reported street drug use were more likely to develop TB: odds ratio, 9.7; 95% confidence interval, 2.8 to 33.6 and odds ratio, 7.3; 95% confidence interval, 0.9 to 59.3 by unconditional and conditional logistic regression analyses, respectively. Although the majority of cases are thought to be due to reactivation of latent infection, phage typing of 16 Mycobacterium tuberculosis cultures suggested the possibility of inmate-to-inmate transmission in at least one cluster of three cases. It is of crucial importance that TB control measures be reinforced in the prison setting to counter the increased risk created by human immunodeficiency virus infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Medical care behind bars: Maryland prison system.

The inmate population in the Maryland prison system has increased dramatically over the past 10 years due to changes in sentencing by the courts. At the same time, costs of inmate health care have increased markedly following court cases mandating adequate care, an amelioration of prior inadequate standards of care. The unique demographic and disease risk characteristics of inmates predispose them to a distinct set of health problems. The state is legally obligated to provide health care to individuals sentenced to confinement in state prisons. It is often the first care these individuals have received in many years.

Adolescent↗
PubMed1988

Ethical responsibilities of health professionals in caring for detainees and prisoners.

The provision of humane and effective health care for prisoners presents formidable challenges. The practical and ethical problems encountered are even greater in the provision of such care for detainees under a State of Emergency. The extent to which these challenges are faced and met reflect the level of civilisation of a society, the ethical integrity of prison medical services and the degree of support they receive from their colleagues and professional associations. The need to recognise these dilemmas, to discuss them openly and to seek humane solutions, including the abolition of detention without trial, are ongoing challenges for our society, in which the legal and medical professions can and should provide leadership.

Attitude of Health Personnel↗
PubMed1988

State prison clergy counselor role self-perceptions.

The effectiveness of state prison clergy counselors is, in part, due to the function of the individuals in their fulfillment of roles. The following research was conducted to find out the specific variables associated with state prison clergy counselor role self-perceptions. It examined those variables considered most important to the clergy counselors in self-perceptions based on role expectations and role performance. Results indicated self-perceived variables of pastoral, advisor, reality, insight, and development, respectively.

Clergy↗
PubMed1986

[Seroepidemiologic case finding in HTLV III infection, lues and HBV in a prison].

We report serological screening of 1217 prisoners for HTLV III antibodies, HBV markers and lues tests. The prevalence for HTLV III Abs on the whole of prisoners controlled is 30.8%, among the drug-users is 60.7%, with a relative risk (RR) of 1.18 between males and females in this group. It is been observed a significant association between aspecific positivity to VDRL and HTLV III Abs in the serum.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Analysis of a patient population of the neurologic-psychiatric admission department of a central prison hospital].

This article represents an attempt to analyse the multivarious and problematic groups of neurological and psychiatric inpatients admitted to a central hospital for prisoners in Baden-Württemberg. This special ward for such patients is unique in its character in the entire Federal Republic of Germany. Patients are differentiated according to diagnosis, length of stay, duration of imprisonment, reason for referral, number of patients referred, and kind of treatment. The four most strongly represented groups of diagnosis consist of the patients with psychogenic reactions, drug addiction, endogenous psychoses and psychopathies. These differ from one another according to treatment regimen, reasons for referral, and mode of hospitalisation. Statistics are given reflecting the problems of non-German, mentally abnormal prisoners and of their suicidal or para-suicidal actions.

Alcoholism↗
PubMed1978

[Aspect of the prisoner's psychological universe].

This paper deals with an aspect of inmate's psychology. One of us is consultant psychiatrist in a jail. According to his experience, the behaviour of the prisoners appears to be very regressive. Inmates chiefly complain of digestive pains. They put a great emphasis on food, nourishment and drinking. That regression to the oral phase explains an unconscious will of staying in jail: It is rather frequent, for example, to see prisoners, who are about to recover their freedom, attempting a ridiculous and futile escape, with, as only result, one more year in jail. Obviously they want, through this absurd acting out, to keep living their childish and regressive way of life.

Acting Out↗
PubMed1980

Viral hepatitis among prisoners in Norway.

The present survey reveals high frequencies of hepatitis B surface antigen and antibody in criminals committed to prison in Norway compared to the general population. The high rate of antigen carriers and the intramural supply of illicit drugs constitute a threat to fellow prisoners regarding viral hepatitis as well as drug addiction.

Adolescent↗
PubMed1995

Orthopedic injuries experienced by U.S. prisoners of war during Operation Desert Storm: a descriptive analysis.

U.S. prisoners of war from Operation Desert Storm suffered significant orthopedic injuries. The repatriated prisoners of war (RPOWs) have been medically evaluated over a 3-year period with orthopedic follow-up. A significant proportion of the musculoskeletal injuries were located around the neck and spine, shoulder, and upper extremity. Aircraft ejection was the cause of the majority of these injuries. Lower extremity injuries after ejection, aside from the knee, were not reported. Flail injuries of the lower extremities were absent as well. These results were examined with reference to Vietnam RPOW data.

Adult↗
PubMed1995

[Intestinal parasitoses in the prison population in the Madrid area (1991-1993)].

BACKGROUND: Intestinal parasitoses are frequent in populations in tropical and subtropical areas, HIV infection has favoured an increase in the prevalence of some of these parasitoses . Both conditions concur in innate populations. The aim of this study was to determine the prevalence and clinical characteristics of the intestinal parasitosis in a penitentiary population from the Madrid area. METHODS: On the basis of the data from the Laboratory of Clinical Microbiology in the Hospital General Penitenciario, patients with the diagnosis of intestinal parasitosis were retrospectively reviewed. The study period covered 29 months (from 1/8/91 to 31/12/93). Samples were taken from patients admitted to, and attended, in the outpatient area of this hospital in addition to those held in dependents prisons. Processing was done by direct macroscopic and microscopic visualization (400x) of the sediment obtained by the formol-ether concentration method (Ritchie). Modified Ziehl staining was carried out. Demographic, clinical-evolutive and microbiologic data of the patients were analyzed. RESULTS: One thousand two hundred eighty-one samples corresponding to 1,033 patients were studied 131 (10.2%) positives corresponding to 96 (9.3%) patients were observed. 88.5% (n = 85) were males. The mean age was 31.2 years (CI 95%: 29.3-32.9). The patients were from Europe in 39.7% of the cases (Spain: 94%), Africa 28.9% and Latin America 28.9%. Twenty-five patients were HIV+ (46%) with a mean CD4 count of 160/mm3 (CI 95%: 65-255) and 29 were HIV-. Globally, the most frequently found parasites were uncinaria (22%), Giardia lamblia (21%) and Cryptosporidium parvum (20%). One case of intestinal capillariasis was diagnosed. Fifteen mixed parasitoses (15.6%) were observed and the most frequent association was Trichuris trichiura and uncinaria in 8 patients (5 HIV+ and 3 unknown HIV). Clinical manifestations were present in 63.7% (42/66) of the patients with diarrhea being the most frequent (25 cases). In patients in whom the clinical evolution could be evaluated, it was favorable in most of the cases except in those with Cryptosporidium parasitosis. CONCLUSIONS: Intestinal parasites are of relevance within a prison population, presenting some differences to the intestinal parasites observed in a general population. The most frequently observed parasite was uncinaria in HIV- patients and Cryptosporidium parvum in HIV+ patients. Mixed parasitosis was not infrequent (15.6%). 25% of the intestinal parasitosis are asymptomatic. When symptomatology does exist, diarrhea is the most common clinical manifestation. The clinical evolution is usually favourable with the exception of some cases of diarrhea by Cryptosporidium in severely immunosuppressed HIV+ patients.

AIDS-Related Opportunistic Infections↗