Análise da vacinação contra Covid-19 na população privada de liberdade: estudo ecológico / Covid-19 vaccination analysis in the population deprived of liberty: an ecological study / Análisis de la vacunación contra el Covid-19 en la población privada de libertad: estudio ecológico

Objetivo: analisar o cenário de vacinação contra Covid-19 na população privada de liberdade em um estado do Nordeste brasileiro. Método: estudo do tipo observacional e ecológico, com os dados extraídos do Sistema de informações penitenciário brasileiro e dos boletins publicados pelo Conselho Nacional de Justiça, referentes a outubro de 2021 a junho de 2022, submetidos à análise estatística descritiva, por meio de frequências absolutas e relativas. Resultados: verificou-se que, entre 4.345 pessoas privadas de liberdade com a primeira dose de vacinação contra Covid-19, apenas 573 possuíam a segnda dose e nenhuma a terceira dose. Conclusão: evidenciou-se que, apesar da vacinação ser um benefício, ainda é um grande desafio para ser implementada para a população privada de liberdade, visto que, mesmo sendo considerados grupos prioritários, o acesso a esse direito foi prejudicado para esses indivíduos.

Objective: to analyze the Covid-19 vaccination scenario in the population deprived of liberty in a state in the Brazilian Northeast. Method: observational and ecological study, with data extracted from the Brazilian Penitentiary Information System and the bulletins published by the National Council of Justice, referring to October 2021 to June 2022, submitted to descriptive statistical analysis, using absolute and relative frequencies. Results: it was found that of the 4,345 people deprived of their liberty who had received the first dose of Covid-19 vaccination, only 573 had received the second dose and none had received the third dose. Conclusion: it was evident that, although vaccination is a benefit, it is still a major challenge to implement it for the population deprived of their liberty, since even though they are considered priority groups, access to this right has been hampered for these individuals.

Objetivo: analizar el escenario de vacunación contra el Covid-19 en la población privada de libertad en un estado del Nordeste brasileño. Método: estudio observacional y ecológico, con datos extraídos del Sistema de Información Penitenciaria de Brasil y boletines publicados por el Consejo Nacional de Justicia, correspondientes al periodo entre octubre de 2021 y junio de 2022, sometidos a análisis estadístico descriptivo, utilizando frecuencias absolutas y relativas. Resultados: se encontró que, de las 4.345 personas privadas de libertad con la primera dosis de la vacuna contra el Covid-19, solo 573 contaban con la segunda dosis y ninguna tenía la tercera dosis. Conclusión: se observó que, pese a que la vacunación es un beneficio, sigue siendo un gran desafío implementarla para la población privada de libertad, ya que, si bien se los consideran grupos prioritarios, el acceso a este derecho se vio afectado para estos individuos.

The utilization of provider-initiated testing counselling services for citizens at risk of HIV/aids at the polyclinic of class IIA Abepura penitentiary in Papua province.

Objective: To analyse the factors related to the use of provider-initiated test and counselling services for inmates at high risk of HIV /AIDS. METHODS: This descriptive cross-sectional study was conducted at the Polyclinic of Class IIA Abepura Correctional Institution, Papua Province, Indonesia, from November to December 2020, and involved 140 inmates, of age 18 years or older selected by simple random sampling technique, at high risk of HIV after obtaining informed consent. All had been tested for HIV status were fluent in Indonesian and willing to participate in the study. The use of provider-initiated testing and counselling services was recorded in 112 (80%) cases. Data were collected using a structured questionnaire exploring aspects related to testing and counselling. Data were analysed using SPSS v.21. RESULTS: The association between use of provider-initiated testing and counselling services and acceptance of HIV/AIDSrelated stigma and discrimination was significant (odds ratio=20.781; p<0.001). The association between use of provider-initiated testing and counselling services was also significant with belief in its usefulness (odds ratio=12.372; p<0.001), family and institutional support (odds ratio = 9.993; p<0.001), need for services (odds ratio = 6.587; p<0.001), and knowledge of services (odds ratio = 6.130; p<0.001). Conclusion: It is essential to build a cross-programme collaboration between health workers and security officers in the form of regular counselling to reduce the stigma and discrimination among inmates.

The Effect of Empathy Training on Bullying Behavior in Juvenile Prisoners: A Quasi Experiment.

Purpose: The purpose of this study was to determine the effect of empathy training on bullying behavior in juvenile prisoners at the Bandung City Special Development Institute for Children. Methods: This study used a quantitative method with a quasi-experimental design with pre and post-test with control group. The sampling technique used purposive sampling and obtained a sample of 100 respondents (50 intervention group and 50 control group). Empathy training was conducted for 3 months as many as 4 sessions consisting of education, role play, watching movies, and reflection. Data collection used the Indonesian version of the Olweus Bully/Victim Questionnaire. Univariate analysis used mean, min-max, and standard deviation values. Bivariate analysis used Wilcoxon test and Mann-Whitney test. Results: The results showed that in the intervention group, most respondents had high bullying behavior before the intervention (70%) and had low bullying behavior after the intervention (64%). In the control group, most respondents showed a high level of bullying behavior (80%) at pre-test and had high level of bullying behavior (78%) at post-test. The results of the Wilcoxon test showed ap value of <0.001, indicating that there was a significant effect on reducing bullying behavior in prisoners in LPKA Bandung City after being given empathy training. The results of the Mann-Whitney test showed a value of p<0.001 which means that there is a difference in the level of bullying behavior between the control and intervention groups. Conclusion: Empathy training is a recommendation for community nurses in Bandung City Special Development Institute for Children to implement community-based nursing interventions in preventing bullying in children and adolescents, especially adolescents in prison.

Correctional Transgender Policy in Canada's Federal Prison System.

Since December 2017, Canada's federal correctional system provides prisoners the opportunity to be assigned to living units according to their self-identified gender. Still organized around sex, conceptually and spatially, prison policies and procedures surrounding transgender prisoners require navigation to adhere to the rights of all prisoners. Based on interviews conducted between October 2019 and October 2021 with 74 correctional officers (COs) from the Canadian federal prison system, we discuss how correctional officers view and operationalize Canada's transgender policy to understand its unintended consequences for both prisoners and prison staff. Unintended consequences revolve around the potential risk for prisoner victimization, prisoner pregnancy, lack of adequate housing, strip search complications, officers' fear of being labeled transphobic, and uncertainty and discretion; all having effects on staff wellness. The policy, although well-intended, may potentially compromise prisoner safety, making correctional work even more stressful.

Understanding weight gain in female prisoners.

PURPOSE: The purpose of the study is to investigate female prisoners' perspectives on why they gain weight while in prison. DESIGN/METHODOLOGY/APPROACH: A qualitative design was used with semi-structured interviews with six females currently residing in a prison in the south of England. FINDINGS: Analysis of the data generated three themes relating to the reasons why women gain weight in prison. These were labelled as "The only thing you haven't got to ask permission for is your food, it's just handed to you", "If you've been stripped of the things that make you happy, or that you are addicted to, eating can soothe you" and "prison can make you take better care of your health". ORIGINALITY/VALUE: The results identify perceived reasons why women gain weight in prison uniquely from the female prisoner perspective. The implications of the research identify the need for systemic change throughout different prison departments to enable women to maintain a healthy weight during their custodial sentence.

Predictors of Suicidal Behavior in a Sample of Incarcerated Individuals.

INTRODUCTION: Incarcerated individuals exhibit higher suicide rates compared to the general population. Investigating risk factors aids in developing effective public policies and interventions. The goal of this study was to assess and analyze factors predicting both suicidal thoughts and suicide attempts in a population of male incarcerated individuals who engage in the use of multiple psychoactive substances. METHODS: A cross-sectional observational study was conducted. A total of 174 male individuals deprived of liberty participated in the study, all of whom were serving a closed regime sentence during the data collection steps. Participants were assessed with the following instruments: the "Addiction Severity Index" (ASI-6) and the "Barratt Impulsiveness Scale" (BIS-11). RESULTS: Amongst our sample, prevalences of 36.7% in suicidal ideation and of 16.0% in suicide attempts were found. Impulsivity (OR = 1.098, 95% CI: 1.008 - 1.197), social support (OR = 0.281, 95% CI: 0.085 - 0.925), witnessing someone being killed or beaten (OR = 5.173, 95% CI: 2.143 - 12.486), cigarette use (OR = 3.309, 95% CI: 1.063 - 10.293), and cocaine use (OR = 2.678, 95% CI: 1.040 - 6.897) were also found to be associated with suicidal ideation. No significant associations were found between drug use and suicide attempts. CONCLUSION: A high prevalence of suicidal behaviors was observed in the study's sample, with findings demonstrating that impulsivity moderately differentiates the groups 'with' and 'without' suicidal ideation. Traumatic life events and substance use were also associated with suicide ideation, while social support was established as a protective factor for it.

The relationship of social contacts with prisoners' mental health: a systematic review.

OBJECTIVES: Prisoners' common mental disorders (CMDs) and their social contacts are a complex and significant concern. We have systematically investigated the relationship between social contacts (i.e. perceived, and objective social support, and loneliness) and prisoners' mental health. STUDY DESIGN: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). METHODS: A protocol was developed and registered in PROSPERO (CRD42023372942). A search strategy was applied across four databases (namely MEDLINE [via OVID SP], APA PsycINFO, Scopus, and Web of Science). The quality assessment entailed the critical appraisal skills program (CASP) Checklist for cohort studies. The data were presented through a narrative synthesis. RESULTS: After screening, 32 studies that fulfilled the inclusion criteria were included in this review. Most were cross-sectional (k = 27), while five had a longitudinal design. The total number of study participants was 10,613. The majority of the studies reported negative correlations between perceived and objective social support and symptoms of common mental disorders (CMDs), specifically, depression, anxiety, and post-traumatic stress disorder (PTSD). The included studies appeared to indicate a correlation between loneliness and PTSD symptoms. CONCLUSIONS: The lack of social support was linked to the development or exacerbation of CMDs in prisoners. Initiatives, such as reducing visitation barriers and providing access to technology for remote communication, can assist prisoners in strengthening their support systems and enhancing their opportunities for reintegration into society.

Receipt of medications for opioid use disorder before and after incarceration in Massachusetts State prisons, 2014-2019.

BACKGROUND: Little is known about how use patterns of medications for opioid use disorder (MOUDs) evolve from pre-incarceration to post-incarceration among incarcerated individuals with opioid use disorder. This article describes pre- and post-incarceration MOUD receipt during a period when naltrexone was the only type of MOUD offered in a state prison system, the Massachusetts Department of Correction (MADOC). METHODS: A retrospective cohort study of individuals with opioid use disorder who had an incarceration episode in MADOC during January 2015 to March 2019. The data source was the Massachusetts Public Health Data Warehouse, a multi-sector data platform that links individual-level data from multiple statewide datasets. We described patterns of MOUD receipt during the four weeks prior to and after an incarceration episode. Multivariable logistic regression models characterized predictors of post-incarceration MOUD receipt. RESULTS: In the male sample (n=691 incarcerations), from the pre- to post-incarceration periods, receipt of buprenorphine increased (14.3 % to 18.3 %), naltrexone increased (5.0 % to 10.5 %), and methadone decreased (4.7 % to 1.7 %). Similarly, in the female sample (n=892 incarcerations), from the pre- to post-incarceration periods, receipt of buprenorphine increased (10.3 % to 12.3 %, naltrexone increased (4.5 % to 9.3 %), and methadone decreased (5.0 % to 2.9 %). Much of the post-release naltrexone receipt occurred among participants in MADOC's pre-release naltrexone program. CONCLUSIONS: MOUD receipt was low but increased slightly in the post-incarceration period. This change was driven by increases in buprenorphine and naltrexone and despite decreases in methadone.

Global prevalence and predictors of scabies among prisoners: systematic review and meta-analysis.

INTRODUCTION: Scabies is a widespread issue in prisons due to overcrowded living conditions and limited healthcare resources. A recent study published in the Journal of Infection and Public Health discovered that the prevalence of scabies varies greatly among prisoners in different regions and facilities. This review aimed to determine the global prevalence and predictors of scabies among prisoners by conducting a systematic review and meta-analysis. METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist to report the findings of our systematic review and meta-analysis. Relevant databases including PubMed, Cochrane Library, ScienceDirect, and other grey literature databases were used to search and retrieve articles. The study included both published and unpublished research written in English languages for studies reporting the prevalence of human scabies among prisoners. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis. RESULTS: The review included 7 studies involving 1, 309,323 prisoners. All included studies involved cross-sectional study design. The prevalence of scabies among prisoners ranges from 0.72% in Italy to 41.01% in Cameroon. The global pooled prevalence of human scabies among prisoners was found to be 6.57% (95% CI; 2.16-19.94). According to subgroup analysis, the overall prevalence of scabies among African prisoners was 19.55% (95% CI; 9.44-40.45), while the prevalence among prisoners outside of Africa was 1.57% (95% CI; 0.77-3.19). The length of time spent in prison, sharing of clothing or beds, and hygiene practices were found to be factors that were significantly associated with the likelihood of prisoners developing human scabies. CONCLUSION: The overall prevalence of human scabies is high among prisoners worldwide. Prisoners who spent more time in prison shared clothing or beds, and had poor hygiene practices were more likely to develop human scabies. Thus, efforts should be made by policymakers and program administrators to decrease the prevalence of scabies in prisons. The protocol for this systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews with registration number CRD42024516064.

Knowledge, practice, and infection status of prisoners toward dermatomycosis: a study in Nepal.

Background: Dermatophytosis, commonly known as tinea, poses a significant public health concern worldwide, especially in environments with poor hygiene and overcrowding, such as prisons. Despite its prevalence and impact on quality of life, there is a lack of research on the knowledge and hygiene practices regarding dermatophytosis among prisoners, particularly in Nepal. Objective: The study aimed to assess prisoners' knowledge, hygiene practice and infection status regarding dermatophytosis in Central Prison, Nepal. Methods: A descriptive cross-sectional study with a sample size of 184 respondents was designed to collect data using a validated pre-tested questionnaire from September 2023 to January 2024. The collected data was then analyzed using IBM SPSS version 21. Knowledge and hygiene practices were measured on an eight and 11-point scale and rated as poor (≤4) and sound (>4), bad (≤6), and good (>6), respectively. Summary data were presented by descriptive, while Chi-square and logistic regression were used for inferential statistics at p < 0.05. Results: The findings revealed moderate knowledge among prisoners regarding dermatophytosis, with significant gaps in understanding its spread and prevention. While most prisoners recognized the importance of treatment, there were misconceptions about the inevitability of contracting dermatophytosis and the role of personal hygiene. Conclusion: Despite good knowledge levels, adherence to recommended hygiene practices was suboptimal, highlighting the need for targeted interventions. The study underscores the importance of addressing knowledge gaps, changing attitudes, and promoting hygienic practices to mitigate the burden of dermatophytosis among prisoners.

Healthy prison cultures: factors influencing male prisoners' engagement in exercise and subsequent healthy behaviours.

PURPOSE: The purpose of this paper is to identify the factors which influence male prisoners' motivation for, and engagement in, exercise and subsequent healthy behaviours. DESIGN/METHODOLOGY/APPROACH: The first authors conducted 20 semi-structured interviews with male prisoners inside an English medium-security male prison. Interviews were recorded and transcribed, themes were identified using thematic analysis and a critical realist perspective applied to understand objective processes behind prisoners' experiences and shared meanings of exercise and engaging in healthy behaviours in prison. FINDINGS: Emerging themes indicate that in the context of healthy behaviours male prisoners aspired to a masculine ideal that was characterised by a culture of either adaptive behaviours, or maladaptive behaviours. The former fostered an adaptive exercise culture which promoted psychological well-being through an autonomy-supportive environment, consequently internalising motivation and minimising perceived barriers to engaging in healthy behaviours. Conversely, a culture of maladaptive behaviours fostered a maladaptive exercise culture which led to negative psychological well-being, underpinned by external forms of motivation which emphasised barriers to engaging in healthy behaviours. PRACTICAL IMPLICATIONS: Findings emphasise the need for prisons to promote an internal perceived locus of control for male prisoners when engaging in healthy behaviours. ORIGINALITY/VALUE: The authors adopt a rare interdisciplinary approach combining a psychological theory of motivation and criminological perspectives of prison culture to understand how best to minimise the impact of prisons as an institution on the psychological well-being of male prisoners.

Factors associated with non-treatment for long-term illness among incarcerated individuals.

PURPOSE: The prison population is seldom studied and often overlooked in many countries despite their vulnerability to long-term illness. This study aims to explore the factors associated with the non-treatment for long-term illnesses among incarcerated individuals. DESIGN/METHODOLOGY/APPROACH: This study is a cross-sectional analysis. The authors conducted a secondary data analysis using information collected in the Peruvian census of incarcerated individuals. The study population consisted of incarcerated individuals diagnosed with a long-term illness. To evaluate the factors associated with non-treatment, the authors used a Poisson regression model. FINDINGS: The authors included 12,512 incarcerated individuals (age: 40.9 ± 13.1 years), and 39% of them did not receive treatment for their long-term illness. The authors observed that non-treatment was statistically associated with gender, age, having children, use of the Spanish language, sexual identity, judicial situation, penitentiary location, discrimination inside the penitentiary and health insurance before incarceration. However, only having children (prevalence ratio [PR]: 1.11, confidence interval [CI]95% 1.03-1.19), using the Spanish language (PR: 1.15, CI95%: 1.01-1.31), being in a penitentiary not in Lima (PR: 1.11, CI95%: 1.06-1.17) and perceiving discrimination inside the penitentiary (PR: 1.12, CI95% 1.06-1.18) increased the prevalence of non-treatment. ORIGINALITY/VALUE: Identifying the factors associated with non-treatment will allow us to implement measures for prioritizing groups and developing strategies for the evaluation, close follow-up of their health and management of comorbidities.

Extent and patterns of drug use in prison in Burkina Faso: findings from a cross-sectional study in central prison of Ouagadougou.

PURPOSE: Drug use in prisons remains a public health concern because it is often the place of drug initiation. The purpose of this study was to analyze the drug use in prison in Burkina Faso. DESIGN/METHODOLOGY/APPROACH: We conducted cross-sectional study in the prison of Ouagadougou. The adult prisoners (male and female) incarcerated for more than one month at the largest prison of Burkina Faso were included in the study. Participants were selected using a systematic random sampling. Data were collected from October 28 to November 26, 2018. The face-to-face interviews were conducted in the prison grounds. Logistic multivariate regression was used to identify factors associated with in prison drug use. All analysis was done using Stata. FINDINGS: A total of 379 prisoners were included in this study. Approximately one-third inmates (32.71%; n = 124) experienced illicit drug in lifetime. Nearly one-third (28.76%; n = 109) of the prisoners were drug users before incarceration and 11.87% (n = 45) used drug inside the prison, of which 33.33% (n = 15) initiated drug use in the prison. Cannabis was the first drug used by the prisoners (71.11%) followed by tramadol (62.22%), diazepam (13.33%) and cocaine (2.22%). Four prisoners (3.63%) had reported Heroin use before incarceration. Cannabis was mainly smoked. Tramadol, diazepam and amphetamines were swallowed or mixed with food. Cocaine is smoked and snorted. Case of injection of cocaine and heroin was reported before incarceration. Main factors independently associated with drug use in prison is drug use before prison and young age of inmates. Indeed, inmates who had reported drug use before prison had 4.01 time {adjusted odd ratio (AOR: 4.01 [95% CI: 1.91-8.41])} higher odds to use drug in prison. RESEARCH LIMITATIONS/IMPLICATIONS: To conduct the interviews in the prison grounds could be a limitation due to social desirability bias. Indeed, the prisoners may understate drug use in prison for the fear of likely additional sentence. Availability of biological tests for drug markers might help addressed this bias. Nevertheless, the findings of this study should help to plan effective drug use prevention and care programs for prisoners. PRACTICAL IMPLICATIONS: The actions must include the implementation of a medical and psychological care in continuum of healthcare system in Burkina Faso. This system should include screening at entry and adequate health and psychological care in prison for drug users for an effective control of drugs use in prison. SOCIAL IMPLICATIONS: Most of these drug users in prison have a low level of education and are unemployed. Education activities and training on occupational activities to prepare drug users for a successful social reintegration less dependent on drugs is essential. This study can be a basis to explore more possibilities and find out what is available to help those with substance use disorder, manage these cases in prison and prevent relapse on release. ORIGINALITY/VALUE: To the best of the authors' knowledge, this study is the first study on drug use in prison in Burkina Faso. It indicates that the repressive strategy against drug use seems ineffective because former users continue their consumption inside and also new users are initiated to use drugs in prison.

Prevalence of skin diseases among elderly prisoners in Taiwan: an examination of skin health in prison.

BACKGROUND: Although prisoner health is a topic of significant importance, it has received limited attention in epidemiological studies, likely due to challenges in obtaining data. Therefore, this study aimed to investigate the prevalence of skin diseases among elderly prisoners in Taiwan. METHODS: We examined the presence of skin diseases in 2215 elderly prisoners based on the International Classification of Diseases, 9th revision Clinical Modification (ICD-9-CM). Additionally, the most common types of skin diseases among elderly prisoners in Taiwan were identified. RESULTS: The prevalence of skin diseases among prisoners was estimated to be 55.03%. Elderly men prisoners exhibited a higher prevalence of skin diseases than the women prisoners. The most common skin diseases observed were as follows: contact dermatitis and other forms of eczema; pruritus and related conditions; cellulitis and abscesses; and urticaria. CONCLUSION: Skin diseases were identified in more than half of the elderly prisoners. The overall quality of life of elderly prisoners can be improved by addressing their skin health, which would contribute to the fulfilment of their basic human rights. CLINICAL TRIALS NUMBER: NA.

The full spectrum of clinical stages of psychosis at prison entry: prevalence and concurrent validity of symptom screening.

PURPOSE: Despite the high rates of psychotic disorders amongst people in prison, current prison mental health screening approaches have not included assessment of the full psychosis spectrum to capture those at-risk of an emerging psychosis as well as those with established illness nor assessed the concurrent validity of psychosis symptom screening. METHODS: Using a clinical staging approach to establish the prevalence of Ultra High Risk (UHR), first episode of psychosis (FEP) and established psychosis (EP) groups, 291 adults entering custody in two prison reception centres in NSW completed a two-stage (screening and validation) interview process. The Comprehensive Assessment of At-Risk Mental States (CAARMS) was used to determine the clinical stages of psychosis and concurrent validity of symptom screening in identifying individuals on the psychosis spectrum was formally assessed. RESULTS: Amongst men and women entering prison, almost one quarter (24.1%) met UHR criteria, 5.1% met the FEP threshold and 10.6% had an established psychosis. Those on the psychosis spectrum reported greater disadvantage across sociodemographic and justice factors. The presence of perceptual disturbance and paranoid beliefs emerged as the two best screening items for identifying those with an underlying psychosis spectrum illness. CONCLUSION: The prevalence of psychosis spectrum illness, including the UHR state, amongst those entering prison is high. Current prison mental health approaches should include screening for the presence of perceptual disturbances and paranoid beliefs to improve the detection of psychosis spectrum illness.

A model of care for Aboriginal and Torres Strait Islander prisoner health and wellbeing in South Australia.

PURPOSE: Aboriginal and Torres Strait Islander (Aboriginal) people are overrepresented in Australian prisons, where they experience complex health needs. A model of care was designed to respond to the broad needs of the Aboriginal prisoner population within the nine adult prisons across South Australia. The purpose of this paper is to describe the methods and findings of the Model of Care for Aboriginal and Torres Strait Islander Prisoner Health and Wellbeing for South Australia. DESIGN/METHODOLOGY/APPROACH: The project used a qualitative mixed-method approach, including a rapid review of relevant literature, stakeholder consultations and key stakeholder workshop. The project was overseen by a Stakeholder Reference Group, which met monthly to ensure that the specific needs of project partners, stakeholders and Aboriginal communities were appropriately incorporated into the planning and management of the project and to facilitate access to relevant information and key informants. FINDINGS: The model of care for Aboriginal prisoner health and wellbeing is designed to be holistic, person-centred and underpinned by the provision of culturally appropriate care. It recognises that Aboriginal prisoners are members of communities both inside and outside of prison. It notes the unique needs of remanded and sentenced prisoners and differing needs by gender. SOCIAL IMPLICATIONS: Supporting the health and wellbeing of Indigenous prison populations can improve health outcomes, community health and reduce recidivism. ORIGINALITY/VALUE: Only one other model of care for Aboriginal prisoner health exists in Australia, an Aboriginal Community Controlled Health Organisation-initiated in-reach model of care in one prison in one jurisdiction. The South Australian model of care presents principles that are applicable across all jurisdictions and provides a framework that could be adapted to support Indigenous peoples in diverse prison settings.

Complexities of midwifery care delivered to perinatal women in prison: A qualitative study.

PURPOSE: To provide insight into the challenges faced by imprisoned perinatal women in accessing appropriate information, support, and care and the importance of the midwife's role in this context. METHOD: This paper draws on two studies conducted in one United Kingdom (UK) women's prison over two separate time points (2019, 2021). In both qualitative evaluative studies that were descriptive in nature, semi-structured interviews were conducted with perinatal women and professionals involved in their care. PARTICIPANTS: 17 women participated across the two qualitative studies, six were pregnant, nine were on the Mother and Baby Unit (MBU) and two had given birth in the last 12 months but were not on the MBU. 12 professionals participated across the two studies. RESULTS: The studies highlight the specific challenges that perinatal women in prison face compared to their community counterparts in being able to access reliable information on pregnancy, birth, and parenting; having access to appropriate and reliable peer support and mental health support not only in terms of provision but also in terms of accessibility; and in being able to advocate for themselves or having people that can advocate for them. CONCLUSION: These challenges arguably heighten the importance of, as well as the pressure on the midwife in this context. The authors therefore highlight the need for consideration of three factors for midwifery in this context: (1) Resourcing (2) Information provision to, and information sharing between, midwives to increase awareness of challenges faced by this cohort, and (3) Strengthening the midwife's position to support and advocate for women's perinatal mental health in prison.

The hunger strike in prison: bioethical and medico-legal insights arising from a recent opinion of the Italian national bioethics committee.

This contribution addresses some bioethical and medico-legal issues of the opinion formulated by the Italian National Bioethics Committee (CNB) in response to the dilemma between the State's duty to protect the life and health of the prisoner entrusted to its care and the prisoner's right to exercise his freedom of expression. The prisoner hunger strike is a form of protest frequently encountered in prison and it is a form of communication but also a language used by the prisoner in order to provoke changes in the prison condition. There are no rules in the prison regulations, nor in the laws governing the legal status of prisoners, that allow the conscious will of the capable and informed subject to be opposed and forced nutrition to be carried out. However, this can in no manner make therapeutic abandonment legitimate: the medical doctor should promote every action to support the patient. In the recent opinion formulated by the CNB it was remarked how self-determination is a central concept in human rights and refers to an individual's ability to make autonomous and free decisions about his or her life and body.

The relationship between risk and prevention awareness of infectious diseases and health literacy among prisoners.

OBJECTIVE: This study aimed to explore the intricate relationship between the health literacy and the awareness of risks and prevention awareness of infection disease among prisoners. STUDY DESIGN: A cross-sectional descriptive study was conducted among 1350 prisoners at an L Type Closed Penal Execution Institution in Turkey, using comprehensive criteria to ensure the inclusion of a diverse participant pool. METHOD: Data was collected via face-to-face interviews using the "personal information form," "health literacy scale (HLS)," and "communicable diseases risk awareness and protection Scale (CDRAPS)." Both scales exhibited high reliability. Statistical analyses, including Pearson correlation and linear regression, were conducted to evaluate the relationships between the dimensions of these scales. RESULTS: The study was completed with 1031 prisoners. The participants' mean age was 38.65 with a majority being single (69.2%) and high school graduates (46.3%). A weak positive correlation (r = 0.448, P = 0.000) was observed between the CDRAPS (mean score 135.98 ± 24.00) and the HLS (mean score 89.85 ± 22.30), indicating health literacy explained a 20% variance in communicable diseases risk awareness and prevention. Furthermore, a significant relationship was established considering multiple variables including age, marital and educational status, family health personnel presence, smoking and alcohol use, and comorbidities, showing a combined effect on disease risk awareness and prevention (R2 = 0.203, ß = 0.458, P = 0.000). CONCLUSION: These findings highlight the importance for governments and policy makers to implement preventive and educational programs that are focused on public health, aiming to increase prisoners' health literacy and awareness of infectious diseases.

The Present State of Housing and Treatment of Transgender Incarcerated Persons.

The care and housing of transgender (TGD) incarcerated persons is a complex concern that is growing because of the increased recognition and diagnosis of gender dysphoria in society. To remain current in this evolving landscape, there have been updates to federal manuals and state guidelines regarding the medical care and housing of the TGD population. Since the publication by Glezer and colleagues in 2013, there has not been a comprehensive overview of current federal and state guidelines, and legal and other considerations on this topic. We provide an update with special consideration given to housing practices, safety, and access to care. A review of the literature shows that the World Professional Association for Transgender Health (WPATH) standards and Prison Rape Elimination Act (PREA) requirements are not uniformly implemented and enforced on a state level. In fact, some states have policies that are in direct conflict with federal requirements. The safety and equitable treatment of both TGD and cisgender populations is an important topic that merits attention. As new challenges emerge, an increase in federal enforcement and consistency is needed to ensure the humane treatment and protection of TGD inmates.