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At least 19 recordsLinked to original sources
PubMed1999

Prisoners' views about the drugs problem in prisons, and the new Prison Service drug strategy.

Three hundred and seventy-five out of 575 prisoners (222/299 drug users and 153/267 non-users) who responded to a self-completion health care questionnaire at two prisons in 1997 commented on drugs in prisons. One hundred and forty-eight out of 176 responses expressed negative opinions about mandatory drugs testing (MDT), and 107 said that MDT promoted switching to or increased use of heroin/hard drugs'. Sixty-two prisoners suggested that more help/counselling was needed for drug users, 52 segregation of drug users/drug-free wings, and 50 more security on visits/in corridors after medication. The new Prison Service drug strategy has revised random MDT. It targets those who supply drugs, and supports those who want to stop using drugs, and accords with prisoners' views about the heroin problem in prisons.

Attitude to Health↗
PubMed2002

Prisons and prisoners: some observations, comments and ethical reflections based on a visit to a prison hospital in the Ukrainian Republic.

The Republic of the Ukraine has a huge prison population and a large prison health care system. Like all other public services in that country it is lacking in sufficient funds to operate adequately and with due respect to the human rights of the prisoners and its health care employees. This report and observations are based on my knowledge of the Ukrainian health care system and a visit to a Ukrainian prison hospital. It includes some ethical reflections stemming from this experience. Although problem-solving exercises can often help to point to areas of potential intervention that could ameliorate a troublesome situation, in this case prison health care conditions cannot be substituted for economic growth, political stability or increased awareness of societal moral obligations.

Ethics, Medical↗
PubMed1997

Harm reduction measures and injecting inside prison versus mandatory drugs testing: results of a cross sectional anonymous questionnaire survey. The European Commission Network on HIV Infection and Hepatitis in Prison.

OBJECTIVES: (a) To determine both the frequency of injecting inside prison and use of sterilising tablets to clean needles in the previous four weeks; (b) to assess the efficiency of random mandatory drugs testing at detecting prisoners who inject heroin inside prison; (c) to determine the percentage of prisoners who had been offered vaccination against hepatitis B. DESIGN: Cross sectional willing anonymous salivary HIV surveillance linked to a self completion risk factor questionnaire. SETTING: Lowmoss prison, Glasgow, and Aberdeen prison on 11 and 30 October 1996. SUBJECTS: 293 (94%) of all 312 inmates at Lowmoss and 146 (93%) of all 157 at Aberdeen, resulting in 286 and 143 valid questionnaires. MAIN OUTCOME MEASURES: Frequency of injecting inside prison in the previous four weeks by injector inmates who had been in prison for at least four weeks. RESULTS: 116 (41%) Lowmoss and 53 (37%) Aberdeen prisoners had a history of injecting drug use but only 4% of inmates (17/395; 95% confidence interval 2% to 6%) had ever been offered vaccination against hepatitis B. 42 Lowmoss prisoners (estimated 207 injections and 258 uses of sterilising tablets) and 31 Aberdeen prisoners (229 injections, 221 uses) had injected inside prison in the previous four weeks. The prisons together held 112 injector inmates who had been in prison for more than four weeks, of whom 57 (51%; 42% to 60%) had injected in prison in the past four weeks; their estimated mean number of injections was 6.0 (SD 5.7). Prisoners injecting heroin six times in four weeks will test positive in random mandatory drugs testing on at most 18 days out of 28. CONCLUSIONS: Sterilising tablets and hepatitis B vaccination should be offered to all prisoners. Random mandatory drugs testing seriously underestimates injector inmates' harm reduction needs.

Cross-Sectional Studies↗
PubMed2004

Mental health in prison populations. A review--with special emphasis on a study of Danish prisoners on remand.

OBJECTIVE: To review the literature on mental health and psychiatric morbidity in prison populations and relate findings to a Danish study on remand prisoners. METHOD: The literature is reviewed and subdivided in the following section: validity of psychometrics in prison populations, prevalence of psychiatric disorders prior to imprisonment, incidence of psychiatric disorders during imprisonment, psychopathy related to psychiatric comorbidity, dependence syndromes with special emphasis on different administrations of heroin use (smoke vs. injection). The results are compared with a longitudinal Danish study on remand prisoners in either solitary confinement (SC) or non-SC. RESULTS: Many factors must be taken into consideration when dealing with prisoners and mental health, e.g. international differences, the prison setting, demographics and methodological issues. The prison populations in general are increasing worldwide. Psychometrics may perform differently in prison populations compared with general populations with the General Health Questionnaire-28 having a low validity in remand prisoners. Psychiatric morbidity including schizophrenia is higher and perhaps increasing in prison populations compared with general populations with dependence syndromes being the most frequent disorders. The early phase of imprisonment is a vulnerable period with a moderately high incidence of adjustment disorders and twice the incidence in SC compared with non-SC. Prevalence of psychopathy is lower in European than North American prisons. Medium to high scores of psychopathy is related to higher psychiatric comorbidity. Opioid dependence is the most frequent drug disorder with subjects using injection representing a more dysfunctional group than subjects using smoke administration. Many mentally ill prisoners remain undetected and undertreated. CONCLUSION: There is a growing population of mentally ill prisoners being insufficiently detected and treated.

Adult↗
PubMed2002

Drug use and initiation in prison: results from a national prison survey in England and Wales.

AIMS: To investigate heroin and cocaine use in a sample of British prisoners, and to explore the characteristics of inmates who use these drugs for the first time while in prison. DESIGN, PARTICIPANTS: A cross-sectional survey of all prisons in England and Wales conducted as part of a major national study of psychiatric morbidity. A total of 3142 prisoners (88.2% of those selected) completed a structured interviewer-administered questionnaire. MEASUREMENTS: Interview measures of personal demographics, social history, psychiatric morbidity and drug use. Personality disorders were diagnosed via the Structured Clinical Interview for DSM-IV (SCID-II) and neurotic symptoms were assessed using the revised Clinical Interview Schedule (CIS-R). FINDINGS: More than 60% of the heroin users and cannabis users reported that they had used these drugs in prison compared with less than a quarter of the life-time cocaine users. More than a quarter of the heroin users reported that they had initiated use of this drug in prison. The extent of an individual's experience of prison was related more consistently to heroin and/or cocaine use in and out of prison than other personal background, social history or psychiatric variables assessed. CONCLUSIONS: The findings indicate that prisons are a high-risk environment for heroin and other drug initiation and use. Although related to drug use, psychiatric variables were not generally associated with initiation in prison, which was dominated by prison exposure. There is a need to explore ways of reducing heroin initiation in prison as part of a broader risk-prevention strategy.

Adolescent↗
PubMed1998

Relationship of prison life style to blood pressure, serum lipids and obesity in women prisoners in Japan.

This prospective study of female prison inmates assessed the effects of prison labour life style on the blood pressure (BP), serum lipids, and body mass index of pre- and postmenopausal female prisoners. This study was carried out in the largest women's prison, located in a town in the North East of Japan. The prison serves a reasonably large community. Three hundred and twelve premenopausal female prisoners and 88 postmenopausal female prisoners in a women's prison participated in this study. Weight and height were measured to calculate the body mass index, and systolic and diastolic blood pressure were measured with a sphygmomanometer. Serum samples were collected for serum lipid estimations. Base-line data of two groups were compared by unpaired t-test, and changes in these data from the initial values were tested by paired t-test. From our limited data, both the pre- and postmenopausal female prisoners showed decreases in systolic and diastolic pressure, total cholesterol, triglycerides, LDL-cholesterol, and body mass index. Both also showed increases in HDL-cholesterol. Given that almost all the women in this prison had the same labour life style, the findings of this study suggest that BP, the serum lipids concentration and obesity can be changed effectively by prison labour life, but are less readily changed in postmenopausal than in premenopausal women.

Adult↗
PubMedDate not supplied

[The mental health of new prisoners or of those monitored in French prisons with "services medicopsychologiques regionaux" (SMPR, Regional Medical and Psychological Departments)].

In France, the prevalence of psychiatric disorders has never been studied, despite the fact that such disorders are a major public health problem in prisons. Through the Services Medico-Psychologiques Regionaux (SMPR, Regional Medical and Psychological Departments), the psychiatric disorders of new prisoners, as well as the mental pathologies of the prisoners monitored by these services, have been analysed. All subjects arriving in prison during the month of June 2001, as well as all those monitored during the same period, were surveyed by means of a questionnaire that assessed the symptoms present on arrival in prison and the mental pathologies of the prisoners being monitored. Most of the new prisoners were male (94%). They were relatively young (31 years on average) and had severe problems with social insertion (12% were homeless). There were psychiatric symptoms in 40%, largely disorders associated with addiction or anxiety. The prisoners monitored by the SMPR were older and included more women, but the socio-economic characteristics were similar to those of the new arrivals. Personality disorders represented 34% of the diagnoses, a quarter of the prisoners being monitored suffered from mental disorders associated with the use of toxic substances, 12% suffered from neurotic or anxiety disorders, 8% had a psychotic pathology and 7% mood disorders. Psychiatric disorders are very common in new prisoners and the mental pathology of the subjects monitored by the SMPR is very specific.

Adolescent↗
PubMed2003

Drug-resistant tuberculosis among prisoners of three prisons in Bangkok and the vicinity.

The purpose of this study was to determine the prevalence of drug-resistant tuberculosis and some factors associated with drug resistance among prisoners of three prisons in Bangkok and the vicinity. Susceptibility testing to four first-line antituberculous drugs was performed on 165 M. tuberculosis strains isolated from prisoners of three prisons including Klongprem Central (KC) prison, Bangkwang Central (BC) prison and the Correctional Institution (CI) for Male Drug Addicts. Of 165 smear positive tuberculosis (TB) cases with drugs susceptibility results, resistance to one or more drugs was 49.7 per cent. Resistance to one, two, three, and four drugs was 20.0, 13.3, 4.2 and 12.1 per cent, respectively. Multidrug resistant tuberculosis (MDR-TB) was 18.8 per cent. Patients classified as primary and acquired drug resistant were 6.7 and 50.0 per cent. The primary drug resistance to one or more drugs among prisoners at KC, BC and CI were 42.5, 36.4 and 53.9 per cent, respectively and MDR-TB were 8.2, 3.0, and 7.7 per cent, respectively. Of several factors analyzed in the present study, only a history of previous TB treatment was significantly associated with drug resistance (p < 0.05). In conclusion, the results indicate the high prevalence of drug-resistant tuberculosis and the seriousness of the TB problem in prisons. The public health sector and prison authorities should work in close collaboration and co-ordination to continue improving TB case detection. Directly Observed Treatment Short course (DOTS) is highly recommended. Moreover, discharged prisoners with tuberculosis should be appropriately referred to hospitals or TB control centers.

Adult↗
PubMed2004

Assault in prison and assault in prison psychiatric treatment.

Studies have described measures associated with assault in the community, but few have identified measures associated with assault in prison or prison psychiatric treatment. In this study, prison assault histories and assaults while in prison psychiatric treatment for 222 randomly selected male inmates were evaluated. Using record reviews, interviews, neuropsychological, Rorschach, and psychopathy measures, risk factors for assault in prison and in prison psychiatric treatment were identified. Youth Authority placement, inhalant use, antisocial lifestyle, neurological injury, neuropsychological impairment, and higher PCL-R Factor II ratings were associated with assault in prison. Absence of major mental disorder, neurological impairment, or psychotic thinking, but presence of psychopathy was associated with assault in prison psychiatric treatment. In identifying risk for violence, the importance of (1) the context in which violence occurs; (2) the need for clear admission criteria for prison psychiatric treatment; and (3) the need to develop risk assessments that are specific to prison environments are emphasized.

Adolescent↗
PubMed1996

Prison life and the blood pressure of the inmates of a developing community prison.

The blood pressure (BP) of the inmates of a developing community prison was assessed. The inmates of the all-male prison were interviewed as regards medical and diet history, alcohol and smoking habit, use of hard drugs, salt intake and duration of prison confinement and had their BP measured. Sixty-two low social class males were similarly assessed as controls. Eighty-one of the 84 inmates consented. Systolic BP (SBP) ranged from 80-150 mm Hg (mean 115.1 +/- 1.7) for prisoners and 80 to 140 mm Hg (mean 107.5 +/- 1.6) for controls (P < 0.05); diastolic BP (DBP) from 50-110 mm Hg (mean 74.1 +/- 1.3) and 45-90 mm Hg (mean 68.8 +/- 1.6) respectively (P < 0.05). Twelve (14.8%) of the prisoners had DBP > or = 85 mm Hg compared to three (4.8%) of controls (P = 0.05). The prisoners have been in confinement for 1 to 790 days. Both SBP and DBP increased with duration of confinement (r = 0.26 P = 0.02 and 0.22 P = 0.057 respectively). The prevalence of "hard' drug abuse, cigarette smoking and alcohol consumption was quite high among prisoners (34.6%, 66.7% and 77.8% respectively). The study suggests that both SBP and DBP are higher in the prisoners compared to controls and appear to increase with duration of prison confinement. This might in part be related to certain stressful factors associated with prison life and possibly substance abuse.

Adolescent↗
PubMedDate not supplied

[Seroprevalence of hepatitis C virus infection at the time of entry to prison in the prison population in the north-east of Spain].

BACKGROUND: Spanish prisons have a high number of inmates whose behaviour puts them at risk of being infected by hepatitis C virus (HCV). The object of this study was to establish the prevalence of this infection and its associated factors in the prison population of the north-east of Spain. METHODS: Inmates in seven prisons in the north-east of Spain were studied. Socio-demographic and prison variables were gathered, as well as risk factors for infection by HCV. Antibodies against HCV were determined (EIA and INNO-LIA HCV III), Hepatitis B virus (VHB) (EIA), and human immunodeficiency virus (HIV) (EIA and Western-Blott). The analysis of associated factors was based on logistic regression. RESULTS: Of the total number of inmates studied, 47.9% presented HCV antibodies. There was greater prevalence in the case of the following: UDVP (89.6%); those who shared needles (94%); those infected by HIV (92.7%); carriers of Australia antigen (65.1%) and antibodies to the HBV core antigen (79.8%); those who had been in prison before (60.9%); unmarried men (54.8%); gypsies (52%); unqualified workers (50.4%); those who had no basic school qualifications (50.9%); those with tattoos (66.7%); and those with a background of self-inflicted injuries (79.3%). In the logistic regression analysis the variables associated to infection by HCV were: UDVP (OR = 33.3; I.C. 95% = 25-50), HBcAc (+) (OR = 4.1; I.C. 95% = 1.1-5.3), age (OR = 0.98; I.C. 95% = 0.96-1.00), months in prison (OR = 1.011; I.C. 95% = 1.004-1.019) and a background of previous prison sentences (OR = 2.3; I.C. 95% = 1.5-3.6). CONCLUSIONS: The prevalence of infection by HCV in prison inmates is very high. It is therefore recommended that preventive measures be increased (harm reduction programmes) and that clinical and analysis protocols be drawn up for those infected and for treatment in cases of chronic active hepatitis in order to control this serious public health problem.

Adult↗
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↗
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↗