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At least 19 recordsLinked to original sources

Prison homosexuality and its effect on post-prison sexual behavior.

Although there has grown up to a considerable literature on sex experiences in prison, little has been written on the post-prison behavioral patterns of those who, voluntarily or involuntarily, become initiated into homosexuality while incarcerated. In the light of the considerable number of prisoners and ex-prisoners in the original Kinsey sample, it is possible that the Institute for Sex Research might have in its files material that would shed light on this problem. To date, nothing has been forthcoming. In one of the few references to the subject, Kirkham (1972, p. 42) suggests that sexual experiences in prison may have permanent effects on the lives of some of the participants: "Can such men return to conventional heterosexual lives after release, or has the experience of being forced into acts of passive homosexuality been so traumatic as to preclude the resumption of sexual relations with members of the opposite sex?" In a search for an answer to his question, the present paper studies ex-prisoners whose initiation into homosexuality occurred during prison.

Age Factors

A survey of university-prison collaboration and computerized tracking systems in prisons.

It is conservatively estimated that 8 percent of inmates in U.S. prisons have significant psychiatric impairment. Correctional mental health systems are often unable to provide adequate treatment to such inmates because of staff recruitment problems. Collaboration between universities and departments of corrections can help solve recruitment problems, and needs assessment studies and computerized tracking systems can help obtain needed resources. A national survey collected data on collaborations between universities and corrections departments and on needs assessment and computerized tracking systems in prisons. Results indicated that such collaborations exist in more than half of state prison systems. Of 42 states responding, only ten states reported having systemwide computerized tracking systems, but others are in the process of developing such systems. Two-thirds of the correctional mental health systems did not have an ongoing needs assessment program.

Antisocial Personality Disorder

Mass gastric examinations of prisoners at Miyagi Prison in Japan.

Mass examinations of the stomach were carried out on 79 convicts over 40 years of age confined in the Miyagi Prison, Japan. Of the 79 subjects, 11.9% were found to need detailed examination of the stomach which disclosed gastric polyp in one case and scar from gastric ulceration in one. None was found to have carcinoma of the stomach. Complaints of symptoms were obviously more frequent with the convicts as compared with a control group. There was not, however, a significant depression in efficiency of this group examination by photofluorography, as compared with the usual gastric mass examination on general inhabitants.

Adult

The place of medicine in the American prison: ethical issues in the treatment of offenders.

In Britain doctors and others concerned with the treatment of offenders in prison may consult the Butler Report (see Focus, pp 157) and specialist journals, but these sources are concerned with the system in Britain only. In America the situation is different, both in organization and in certain attitudes. Dr Peter L Sissons has therefore provided a companion article to that of Dr Paul Bowden (page 163) describing the various medical issues in prisons. The main difference between the treatment of offenders in prisons in America and in Britain lies in the nature of the federal system which means that each state may operate a different system in a variety of prisons and prison medical services are as various. Nationally, the prison systems are 'structured to treat and cure the offender'. Therefore it follows that the prison medical officer is only one of the professionals concerned with this 'cure' of the offender. This principle also applies to any form of research: medical research in prisons is part of a programme which covers a wide field of social and judicial research. The prison medical officer (where there is one) has of course to look after sick prisoners, and the American idea of 'cure' is also expressed in the need for more corrective surgery where, for example, it is necessary to remove physical impediments to social rehabilitation. But a doctor is only found on the staff of those institutions which are large: in the smaller prisons there may be only first-aid facilities, and no specially appointed doctor in the community. Moreover medicines are often dispensed by medical auxiliaries who are sometimes prisoners themselves. Finally, in America prisoners are regularly invited to volunteer as subjects for medical and social research for which they are paid. In short, although it is hoped to 'cure' a prisoner he is a criminal first and a patient second.

Ethics, Medical

Anonymous HIV surveillance in Saughton Prison, Edinburgh.

OBJECTIVES: To estimate the prevalence of HIV by anonymous saliva testing in Her Majesty's Prison, Saughton (Saughton Prison), Edinburgh, UK. To elicit linked anonymous risk factor information from which to estimate risk scores for those who had taken an HIV blood test and, among drug injectors, for those who were HIV-1-antibody-positive on saliva testing. SETTING: Saughton Prison on 15 and 16 August 1991; HIV Immunology and Regional Virus Laboratories, Edinburgh, and the Medical Research Council Biostatistics Unit, Cambridge, UK. PARTICIPANTS: Male inmates (378 out of a total of 499) of Saughton Prison. MAIN OUTCOME MEASURES: Answers to a brief questionnaire about age, usual residence, present and past custodial sentences, drug injecting and sexual behaviour prior to and in prison, HIV testing and history of acute hepatitis. HIV-1-antibody status was established by saliva testing. RESULTS: Eighteen per cent of participants were injecting drug users (IDU), of whom approximately one-half (47%) had injected while inside prison. Ninety men (26%), including 40 (14%) of 278 participants who had never injected drugs and 77% of IDU participants, had taken an HIV blood test. Nine per cent of all participants and 35% of IDU participants had had an acute attack of hepatitis. Forty-one (62%) of 66 IDU had been imprisoned five or more times before their current prison sentence. After taking account of region of residence, injecting drug history and acute hepatitis, aspects of sentencing and sexual behaviour were not determinants of those who had been tested for HIV. On the study days, 18 out of 499 (3.6%) participants were known to prison medical officers to be HIV-infected. Following saliva testing, HIV prevalence was 17 out of 375 (4.5%) inmates tested. All 17 had at some time 'taken the blood test for HIV' and all had injected non-medically prescribed drugs. Edinburgh residence, age 26-30 years, have injected in prison and having first injected before 1983 all contributed to the risk score for whether an IDU was HIV-1-antibody-positive on saliva testing. CONCLUSIONS: Documented HIV prevalence in saliva was 4.5%, which--assuming no volunteer bias (as supported by questionnaire returns)--suggests that actual HIV prevalence was 25% greater than revealed to Saughton's prison medical service. All 17 inmates who were HIV-1-antibody-positive on saliva testing had injected non-medically prescribed drugs. The high reported frequency by inmates of injecting in prison highlights the urgent requirement for drug reduction and rehabilitation programmes for injecting inmates. Linked anonymous voluntary HIV testing of saliva can provide valuable information about HIV prevalence for the planning of prison resources and policy.

Adult

The impact of HIV disease on an Irish prison population.

Between January 1987 and January 1991, 168 known HIV-infected prisoners have been incarcerated in Dublin's Mountjoy prison. This figure constitutes 16.6% of the total HIV-infected population in the Republic of Ireland over the same period. One hundred and forty-one (84%) of these prisoners have attended the Department of Genitourinary Medicine, St James's Hospital, Dublin. This group displayed considerable morbidity from HIV-related disease. Respiratory tract infection was the most frequent complication seen. Much additional morbidity was directly attributable to intravenous drug use. A survey of a representative group of inmates revealed that 64.7% were diagnosed HIV-positive in prison. The mean length of time spent incarcerated since the diagnosis of HIV infection was 38.9 months. Twenty-nine of 34 individuals who answered a questionnaire were imprisoned for drug-related crimes and 32 of 34 prisoners admitted to parenteral drug use within the prison. As the HIV epidemic unfolds in Dublin, increasing numbers of prisoners with symptomatic HIV disease will spend time incarcerated in Mountjoy prison. This will pose a considerable burden on prison and hospital medical services alike.

Acquired Immunodeficiency Syndrome

[Rheumatic complaints and diseases in ex-prisoners of war in Croatia in 1991. A review of medical prognosis for work capacity].

The results are presented of an examination of the locomotor system in 48 ex-prisoners of war, previously maltreated in prison camps in Serbia and occupied areas of Croatia. They were part of a group of 508 prisoners of war, examined in the Clinic for Infectious Diseases in Zagreb. They were all male, aged 33.9 +/- 11.56 years, in whom, after the first medical examination a rheumatological examination was indicated because of disorders of the locomotor system. Only 16.7% of the subjects had not been physically maltreated. Blows to the lumbo-sacral spine were the most frequent (43.7%), shoulders (33.4%) and the head (27.0%). Earlier rheumatic disorders were reported by 41.7% of the ex prisoners, and during the examination in our Rheumatological clinic 70.8%. In 21% of the ex-prisoners the rheumatological disorders started as a direct consequence of maltreatment in the prison camps. In one of the ex-prisoners acquisition of ankylosis spondylitis occurred and in another uric arthritis. In 50% of the ex-prisoners a marked reduction in work ability was confirmed. Disability retirement was proposed for two ex-prisoners. Optimal health treatment is discussed and medical prognosis of work ability.

Adolescent

A study of 128 deaths in New York City correctional facilities (1971-1976): implications for prisoner health care.

During a 5 1/2 year period, January, 1971 through July, 1976, 128 deaths occurred in New York City. The epidemiology of prisoner deaths including suicide was examined in a large incarcerated population. Each death was categorized according to the International Classification of Diseases. The mean age of the prisoner death was 34 years. Only 3 deaths occurred among females. Ethnic distribution of these deaths was similar to the prison population. Deaths of prisoners fell into 2 categories: external causes (suicide, accidents, homicide, legal intervention) and nonviolent causes. External causes accounted for 71 deaths. The leading cause of death was suicide, accounting for 52 deaths. Suicides occurred in all time periods of incarceration. The highest rate was in the 35 to 44 year age group. History of drug or alcohol abuse was reported by 69 per cent of the suicides. One-third of the prisoners committing suicides had histories of previous attempts or previous mental hospitalizations. Except for 2 individuals, the method was hanging. For the most part, prisoners at risk for suicide exhibited a common pattern and were identifiable. During the last 2 1/2 years of the study period, deaths were reviewed by a prisoner death committee. Deficiencies of care in deaths of nonviolent causation were categorized as "provider," "corrections," or "system." The most common deficiency in care was delay in hospitalization of prisoners requiring care.

Adolescent

Prisoner subjects and drug testing.

Objections to prison research are based more often on opposition to the evils of prison life than to unethical practices and to the memories of atrocities committed in the name of science in Nazi prison camps during World War II. The National Commission's pronouncements on prison research specifically illustrate this general phenomenon. Having decided that research on prisoners can be performed ethically, and having learned that most prisoner volunteers bitterly resent being deprived of the opportunity to participate in research, the Commission has nevertheless stipulated prison conditions that cannot realistically be met and thus has de facto eliminated such research. The most serious potential loss is the elimination of the unique facility in Lexington, Kentucky--the Addiction Research Center. Predicting the addiction liability of drugs is not likely to be feasible in any nonprison setting, so that the addiction potential of new marketed drugs will be established in the future as it was in the past--by trial-and-error in patients, who will become the unwilling, uninformed research subjects in this area.

Ethics, Medical

[Prisons following reform. Current status and prospects].

The Author has examined the period successive to July 1975, namely, from the approval of the new prison System to the present day, highlighting the manifold negative aspects due to the incomplete application of the reform and not neglecting to review also the positive aspects of the regulations applied. The Author laid special stress on the distorted interpretations given to some different regulations of the System and on the ensuing wrong procedure that has been established, whose correction represents the only way not only towards a proper application of the reforming law, but also for preventing the most serious risk the reform is liable to run; that of being made the object of revisions and abrogations that might ultimately change their nature and jeopardise their objectives. The Author reviews the practical consequences of both the erroneous interpretations of the law and of its misapplications, dwelling on Article 30 in the first place, which has prompted some to define the law the "reform of leaves". Also examined was the problem of the special prisons, the usefulness of which is confirmed by the Author, who upholds the view that they must function in full observance of the regulations, for reasons of equity and opportuneness. From the rehabilitation treatment angle, the prison work, the participation of the extramural community, the "leasure time", the assistance after release. Still in the framework of his critical approach as to the prison reality, the Author illustrates the situation of the health service, and reviews the positive points that have been achieved in the implementation of some reform institutions, with special regard to the new disciplinary approach and its satisfactory results that have already been statistically observed. More adequate talks and correspondence by letter or through the telephone, a better compensation for the prison work, the convict representation in some sectors of intramural life, the measures as an alternative to enprisonment, all these actions represent the practical results of the reform achieved so far in a rather satisfactory way. After dealing with the figure of the surveillance judge, of the director and of the military personnel of prisons, setting forth observations and proposals to enhance their work, the Author declares, by way of conclusion, that he is fully convinced that the reform will ultimately attain its important targets, laying stress on the fact that the good will and the contribution of all those who are called upon to participate in its realization, may prove instrumental in shortening the period of time required for making the reform fully operative.

Criminal Law

Characteristics of state prisoners who demonstrate severe adjustment problems.

Hypothesis was tested that prison inmates who present serious disciplinary problems during incarceration that result in human injury, threat to personal safety, or extensive property damage also will tend to show a history of significant societal maladjustment as compared to prisoners who do not demonstrate adjustment problems. Societal maladjustment was defined to include significant problems in education, marriage, military service, and job stability. This project was an effort to present a picture of the types individuals who cause what generally are considered to be the more severe prison disturbances. The social and relevant background areas were investigated of 50 male state prison inmates who had committed serious acting-out infractions. The same background data were checked on 50 inmates who demonstrated good prison adjustment within the same time period. When background data were analyzed carefully, a trend was discovered that indicated that prisoners who create serious trouble while confined also tend to have significant histories of social failures. The results are interpreted as in favor of the hypothesis.

Adolescent

The contractual model for prison health care.

In New York City, the Department of Health is responsible for providing health services to 8 correctional facilities which receive 60,000 admissions annually. A large component of this prison health system is a contract with Montefiore Hospital, a voluntary institution, to provide medical services to the population on Rikers Island, a penal complex. This contractual agreement is unique in that an operating entity, Monefiore Hospital, has agreed to provide a "package" of health services to a defined prisoner population. The City agreed to reimbruse to the Hospital for the three year term of the contract, a total amount not to exceed +11.7 million. Because of delays in renovation of the prison facilities, for the majority of the period of the three year contract, only two prisons were served via the contractual route. Since 1973, the program has provided a range of services including screening of new prisoners, primary, emergency, infirmary and limited speciality care. Major improvements in laboratory and radiology services were implemented. The early experience with this program indicates that in this setting the contractual model possesses a number of distinct advantages over the direct delivery of prison health services. Disadvantages include a significantly higher cost.

Delivery of Health Care

Life events and prisoners.

This study explores retrospectively the relationship of the accumulation of life events as it relates to prison incarceration and extends further the concept that coping with increasing environmental changes results in a variety of overt behaviors. The prison sample comprised 176 male inmates of a federal prison (McNeil Island, Washington) and a state penitentiary (Walla Walla, Washington). Life change scores were derived from the Schedule of Recent Experience (SRE). There was an escalation of annual life change scores of prisoners, indicating the mounting frequency of occurrence of life events prior to incarceration. The SRE may have value in the prediction of socially deviant behavior as with health changes. Variables seen as influencing life change scores were race, age, and education. Analyses of life event frequencies as compared to a normative group indicated that prisoners have evolved a coping life-style that reflects antisocial and criminal behavior.

Adult

Prison health and medical education.

Prison health has long been neglected as an area of serivice by organized medicine and a site for clinical education by health science centers. The University of New Mexico Health Science Center offers an elective, weekly clinical experience for preclinical medical students, senior nursing students, and senior pharmacy students at a prison facility in need of medical services. Students' reaction to the prison experience was strongly positive. Most developed empathy toward the inmates and a greater understanding of prison health problems. Inmates rated the student service highly and requested its continuation. This community health education experience has provided a noncontractual model of a university-prison health alliance.

Ambulatory Care Facilities