Patient Perceptions of Hepatitis C Screening and Diagnosis While in a County Jail.

Prior research in the Santa Clara County (SCC) Jail showed that knowledge of hepatitis C virus (HCV), perception of risk, and perceived coercion impacted participation in routine HCV screening; however, the experiences of patients undergoing screening were not assessed. The purpose of the study was to understand patient perceptions of undergoing routine viral hepatitis screening and receiving a diagnosis of HCV while incarcerated. A qualitative design was employed using semi-structured interviews of individuals newly diagnosed with HCV via routine screening in the SCC Jail between March and November 2023. The data were analyzed using thematic analysis. Of the 15 participants, most were within the 35 to 44 (47%) and 25 to 34 (40%) age ranges, were White or Caucasian (47%), and all were male. Nine themes emerged: (1) risk perception as a motivator for testing, (2) testing convenience to maintain health, (3) minimal to no prior testing experience, (4) mixed experiences testing in the jail, (5) negative to neutral reactions to HCV diagnosis, (6) intrinsic motivation to get treated, (7) basic HCV knowledge after diagnosis, (8) seamless treatment experience in the jail, and (9) barriers to continuing care upon release. The HCV screening process, including disclosure, education, and treatment initiation, was positively received among participants.

Hepatitis C Virus Care Cascade by Race/Ethnicity in a Statewide Correctional Population, 2019-2023.

IMPORTANCE: Hepatitis C virus (HCV) care cascade data by race/ethnicity for US correctional populations are sparse. OBJECTIVE: To evaluate the HCV care cascade by race/ethnicity for a state correctional population. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used Connecticut Department of Correction data for incarcerated individuals tested, diagnosed, and treated for chronic HCV infection with direct-acting antivirals (DAAs) from 2019 to 2023. MAIN OUTCOMES AND MEASURES: HCV care cascade outcomes, including testing, treatment, and cure rates, were compared by race/ethnicity. Poisson regression was used to estimate prevalence ratios (PRs), with adjustment for demographic and legal status factors. RESULTS: A total of 24,867 patients tested for HCV (88.9% men, mean (SD) age 35.6 (11.8), 32.7% White, 37.9% Black, 28.4% Hispanic, 0.6% Asian, 0.4% American Indian/Alaska Native (AIAN), 34.7% sentenced ≥ 1 year). Both HCV exposure and chronic HCV were highest for White (27.1% and 15.2%) and lowest for Black individuals (4.6% and 2.6%) (P < 0.01, for both outcomes). While incarcerated, 63.2% of chronic HCV patients started DAAs, and treatment rates did not significantly differ by race/ethnicity (P > 0.05). For those treated and having post-treatment lab data available, cure rates were 98.8% or better for all racial/ethnic groups (P > 0.05). In the adjusted regression analyses, HCV treatment initiation was lower for those sentenced < 1 year (PR, 0.76; 95% CI, 0.67-0.87) and unsentenced (PR, 0.85; 95% CI, 0.80-0.91) than those sentenced ≥ 1 year. The adjusted prevalence of advanced fibrosis stage/activity grade was not significantly associated with race/ethnicity. CONCLUSIONS: In this cohort study, less than two-thirds of chronic HCV patients initiated DAA treatment during their incarceration, and for those with available data, nearly all were cured. While there were disparities in HCV exposure and chronic HCV infection, significant racial/ethnic differences were not observed for treatment initiation or cure rates. Further efforts are needed to increase HCV treatment, especially for patients with shorter incarceration periods.

Depression among inmates of Gandaki Province, Nepal: a cross-sectional study.

INTRODUCTION: Depression is a pervasive mental health condition that affects individuals across various demographic categories, including imprisoned adults. The prevalence of mental health problems among inmates worldwide is considerably higher than in the general population, and it is estimated that 11% of inmates have significant mental disorders, such as anxiety and depression. This study aimed to find out the prevalence of depression and factors associated with it among the prisoners of Gandaki Province, Nepal. METHODS: A descriptive cross-sectional study was conducted among the inmates in Gandaki Province, Nepal. Data were collected from 223 inmates, who were recruited through systematic random sampling from eight district-level prisons. The Beck Depression Inventory-II was used to measure depression, with the cumulated score dichotomized into depressed and not-depressed categories. Additionally, a structured questionnaire was employed to capture socio-demographic and imprisonment-related variables. Bivariate and multivariable logistic regressions were performed to examine the factors associated with depression. RESULTS: Findings revealed that 18.8% of the inmates exhibited symptoms of depression. Inmates with health problems [(adjusted odds ratio (aOR) = 2.39], suicide ideation during imprisonment (aOR = 4.37), and attempted suicide before imprisonment (aOR = 7.97) had a statistically significant relationship with depression. This study revealed a notable prevalence of depression among incarcerated individuals in the Gandaki Province of Nepal. CONCLUSION: The findings imply a crucial need for psychosocial and rehabilitative interventions to enhance inmates' mental health and overall well-being.

Wastewater threshold as an indicator of COVID-19 cases in correctional facilities for public health response: A modeling study.

Although prison facilities are not fully isolated from the communities in which they are located, most of the population is confined and requires high levels of health vigilance and protection. This study aimed to examine the dynamic relationship between facility-level wastewater viral concentrations and the probability of at least one positive COVID-19 case within the facility. The study period was from January 11, 2021 to May 8, 2023. Wastewater samples were collected and analyzed for SARS-CoV-2 (N1) and pepper mild mottle virus (PMMoV) three times weekly across 14 prison facilities in Kentucky (USA). Positive clinical case reports were also provided. A hierarchical Bayesian facility-level temporal model with a latent lagged process was developed. We modeled facility-specific SARS-CoV-2 (N1) normalized by the PMMoV wastewater concentration ratio threshold associated with at least one COVID-19 clinical case at an 80 % probability. The threshold differed among facilities. Across the 14 facilities, our model demonstrates a mean capture rate of 94.95 % via the N1/PMMoV ratio threshold with pts≥0.5. However, as the pts threshold was set higher, such as at ≥0.9, the mean capture rate of the model was reduced to 60 %. This robust performance underscores the effectiveness of the model for accurately detecting the presence of positive COVID-19 cases among incarcerated people. The findings of this study provide a facility-specific threshold model for public health response based on frequent wastewater surveillance.

The Americans with Disabilities Act and Medication Assisted Treatment in Correctional Settings.

Studies estimate that least 65% of people incarcerated in the United States have Substance Use Disorder (SUD). Medication Assisted Treatment (MAT) is a proven effective treatment for Opioid Use Disorder (OUD). MAT reduces the number of people who die each year from OUD by fifty percent and ninety percent of individuals in recovery maintain sobriety after two years. Title II of the Americans with Disabilities Act (ADA) covers the programs and services provided by state and local governments including correctional facilities. Under the ADA, correctional facilities must make reasonable modification to policies and practice to allow inmates in recovery to have access to MAT. In this article, we discuss how the ADA applies to correctional facilities and the impact that MAT has for people who have OUD.

Prisoners' perceptions and satisfaction with telepsychiatry services in Greece.

Telepsychiatry is an effective tool to support and provide mental health services to prison inmates. In Greece, telepsychiatry was formally applied in two correctional facilities in 2018. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation. The sample consisted of 100 male inmates with a multicultural background and prior experience with both methods of services provision. The data were obtained through a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and another Participant Satisfaction Questionnaire to assess satisfaction with telepsychiatric services. The results have shown a higher level of satisfaction with telepsychiatry compared to face-to-face care. Statistically significant improvements (all p-values <0.001) were noted in: waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behaviour of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry has proved to be an acceptable way of approaching and supporting inmates in Greece, with most of the participants expressing high acceptance, satisfaction, and preference rates. Implications for additional research and further development of telepsychiatry are discussed.

Health Belief Model to Assess Mpox Knowledge, Attitudes, and Practices among Residents and Staff, Cook County Jail, Illinois, USA, July-August 2022.

In summer 2022, a case of mpox was confirmed in a resident at the Cook County Jail (CCJ) in Chicago, Illinois, USA. We conducted in-depth interviews with CCJ residents and staff to assess mpox knowledge, attitudes, and practices; hygiene and cleaning practices; and risk behaviors. We characterized findings by using health belief model constructs. CCJ residents and staff perceived increased mpox susceptibility but were unsure about infection severity; they were motivated to protect themselves but reported limited mpox knowledge as a barrier and desired clear communication to inform preventive actions. Residents expressed low self-efficacy to protect themselves because of contextual factors, including perceived limited access to cleaning, disinfecting, and hygiene items. Our findings suggest correctional facilities can support disease prevention by providing actionable and tailored messages; educating residents and staff about risk and vaccination options; and ensuring access to and training for hygiene, cleaning, and disinfecting supplies.

HIV Care Continuum and Preexposure Prophylaxis Program in Federal Bureau of Prisons, United States.

In 2019, the US Department of Health and Human Services launched the Ending the HIV Epidemic in the US initiative (EHE) with the goal of reducing new HIV infections by 90% by 2030. This initiative identifies 4 pillars (diagnose, treat, prevent, and respond) to address the HIV epidemic in the United States. To advance the EHE goals, the Federal Bureau of Prisons (FBOP) has implemented interventions at all points of the HIV care continuum. The FBOP has addressed the EHE pillar of prevention through implementing preexposure prophylaxis, developing a strategy to decrease the risk of new HIV infection, and providing guidance to FBOP healthcare providers. This article describes the implementation of programs to improve the HIV care continuum and end the epidemic of HIV within the FBOP including a review of methodology to implement an HIV preexposure prophylaxis program.

Screening for Chlamydia and Gonorrhea in Youth Correctional Facilities, Utah, USA.

We reviewed data obtained in October 2021-May 2023 from youth who reported a history of sexual activity upon admission to 1 of 12 juvenile justice facilities in Utah, USA, that offered screening for Chlamydia trachomatis and Neisseria gonorrhoeae. Urinalysis revealed C. trachomatis positivity of 10.77%, N. gonorrhoeae positivity of 1.08%, and coinfection C. trachomatis N. gonorrhoeae) of 0.90%. Prevalence of infection was similar for youths in rural and urban facilities. A total of 12.01% of those identifying as male and 14.01% of those identifying as female tested positive for C. trachomatis, N. gonorrhoeae, or coinfection. Of young adults who tested positive, 74.65% received their results while incarcerated, all of whom accepted treatment. Our research underscores the feasibility of providing prompt C. trachomatis/N. gonorrhoeae screening and treatment in juvenile correctional facilities. The pervasiveness of infection emphasizes the urgent need for early identification and treatment for C. trachomatis and N. gonorrhoeae in incarcerated youth nationwide.

Lessons Learned from Cross-Systems Approach to COVID-19 Pandemic Response in Juvenile Justice System, Colorado, USA.

The global COVID-19 pandemic illustrates the importance of a close partnership between public health and juvenile justice systems when responding to communicable diseases. Many setting-specific obstacles must be navigated to respond effectively to limit disease transmission and negative health outcomes while maintaining necessary services for youth in confinement facilities. The response requires multidisciplinary expertise and collaboration to address unique considerations. Public health mitigation strategies must balance the risk for disease against the negative effects of restrictions. Key aspects of the COVID-19 response in the juvenile justice system of Colorado, USA, involved establishing robust communication and data reporting infrastructures, building a multidisciplinary response team, adapting existing infection prevention guidelines, and focusing on a whole-person health approach to infection prevention. We examine lessons learned and offer recommendations on pandemic emergency response planning and managing a statewide public health emergency in youth confinement settings that ensure ongoing readiness.

Lessons Learned from Public Health and State Prison Collaborations during COVID-19 Pandemic and Multifacility Tuberculosis Outbreak, Washington, USA.

The large COVID-19 outbreaks in prisons in the Washington (USA) State Department of Corrections (WADOC) system during 2020 highlighted the need for a new public health approach to prevent and control COVID-19 transmission in the system's 12 facilities. WADOC and the Washington State Department of Health (WADOH) responded by strengthening partnerships through dedicated corrections-focused public health staff, improving cross-agency outbreak response coordination, implementing and developing corrections-specific public health guidance, and establishing collaborative data systems. The preexisting partnerships and trust between WADOC and WADOH, strengthened during the COVID-19 response, laid the foundation for a collaborative response during late 2021 to the largest tuberculosis outbreak in Washington State in the past 20 years. We describe challenges of a multiagency collaboration during 2 outbreak responses, as well as approaches to address those challenges, and share lessons learned for future communicable disease outbreak responses in correctional settings.

Candida auris in US Correctional Facilities.

Candida auris is an emerging fungal pathogen that typically affects patients in healthcare settings. Data on C. auris cases in correctional facilities are limited but are needed to guide public health recommendations. We describe cases and challenges of providing care for 13 patients who were transferred to correctional facilities during January 2020-December 2022 after having a positive C. auris specimen. All patients had positive specimens identified while receiving inpatient care at healthcare facilities in geographic areas with high C. auris prevalence. Correctional facilities reported challenges managing patients and implementing prevention measures; those challenges varied by whether patients were housed in prison medical units or general population units. Although rarely reported, C. auris cases in persons who are incarcerated may occur, particularly in persons with known risk factors. Measures to manage cases and prevent C. auris spread in correctional facilities should address setting-specific challenges in healthcare and nonhealthcare correctional environments.

Development and Evaluation of Surveillance System for Identifying Jail-Associated COVID-19 Cases in Minnesota, USA, 2022.

Confinement facilities are high-risk settings for the spread of infectious disease, necessitating timely surveillance to inform public health action. To identify jail-associated COVID-19 cases from electronic laboratory reports maintained in the Minnesota Electronic Disease Surveillance System (MEDSS), Minnesota, USA, the Minnesota Department of Health developed a surveillance system that used keyword and address matching (KAM). The KAM system used a SAS program (SAS Institute Inc., https://www.sas.com) and an automated program within MEDSS to identify confinement keywords and addresses. To evaluate KAM, we matched jail booking data from the Minnesota Statewide Supervision System by full name and birthdate to the MEDSS records of adults with COVID-19 for 2022. The KAM system identified 2,212 cases in persons detained in jail; sensitivity was 92.40% and specificity was 99.95%. The success of KAM demonstrates its potential to be applied to other diseases and congregate-living settings for real-time surveillance without added reporting burden.

Improving adolescent sleep in long-term Juvenile correctional settings: case examples with clinical, research, and policy implications.

Poor sleep during adolescence is a public health concern that may be especially important to address among youth in juvenile correctional facilities, who tend to experience greater mental health challenges, substance use disorders, and traumatic stress exposure. However, evidence for addressing sleep in correctional settings is limited. Using de-identified composite clinical cases, this paper describes challenges and opportunities for addressing sleep disorders (i.e. insomnia) and promoting sleep health (i.e. improving duration, regularity, and behaviors) among adolescents in long-term juvenile correctional facilities. These clinical cases highlight common presenting problems and underscore the need for integrated sleep and mental health interventions as well as adaptations to enhance feasibility and efficacy of behavioral sleep treatment and sleep health promotion in juvenile correctional contexts. We conclude by summarizing clinical, research, and policy implications for addressing adolescent sleep problems and promoting sleep health and well-being in these contexts.

Youth Incarceration in Adult Facilities and Mental Health in Early Adulthood.

PURPOSE: To examine the relationship between youth incarceration in adult correctional facilities and mental health in early adulthood. METHODS: We analyzed nationally representative data from 1997 through 2019 (N = 8,961) using the National Longitudinal Survey of Youth 1997. An ordinary least squares regression model using inverse probability weights was used to assess the influence of youth incarceration in an adult facility on average mental health scores from age 18 to 37. RESULTS: Respondents incarcerated in an adult facility as a youth had poorer average mental health than those not held in adult prisons or jails over the course of the study period. Those incarcerated for longer in adult facilities also exhibited more mental health symptoms. DISCUSSION: Young people incarcerated in adult correctional facilities experience poorer long-term mental health related to depression and anxiety in early adulthood.

The State of Mental Health Services for Incarcerated Adults in Ontario: A Scoping Review.

Individuals with mental illness are significantly overrepresented in the Canadian justice system. Given the high rate of mental illness among individuals who are incarcerated, correctional facilities must implement accessible and effective mental health resources. This not only improves their health and well-being but also contributes to their rehabilitation efforts. However, evidence suggests that the care provided in prisons is inadequate. This scoping review asks, "What is known about the access and quality of mental health care services for adults who are incarcerated in Ontario?" Mental health care services included non-acute interventions and care that is provided in the institution. This scoping review followed the PRISMA Extension for Scoping Reviews methodology. Databases searched include MedLINE, EMBASE, CINAHL, PsycINFO, Criminal Justice Abstracts, JSTOR, Google Scholar, and the grey literature. The search yielded 354 titles and abstracts of which 16 met the inclusion criteria. Conducted from 2010-2022, the 16 studies included qualitative, quantitative, and mixed methods. Common themes that were identified related to segregation, mental health assessments, medication prescribing and access, opioid agonist therapy, psychiatric service access, systemic and institutional barriers, mental health perception, and the need for collaboration. Despite the significant demand for mental health care in Ontario correctional facilities, limitations to quality care are evident. Such limitations intersect and are then exacerbated, resulting in poor mental health care provision among the incarcerated population. More research is warranted regarding the access, quality, and efficiency of mental health care in Ontario prisons, and how factors including ethnicity, gender, and prison classification (provincial vs. federal) may influence mental health care and its outcomes.

Incidence of hepatitis C virus infection in the prison setting: The SToP-C study.

People in prison are at high risk of HCV given high injecting drug use prevalence. This study evaluated HCV incidence and associated injecting drug use characteristics in prison. The SToP-C study enrolled people incarcerated in four Australian prisons. Participants were tested for HCV at enrolment and then every 3-6 months (October-2014 to November-2019). Participants eligible for this analysis included those at-risk of HCV primary infection (anti-HCV negative) or re-infection (anti-HCV positive, HCV RNA negative) with follow-up assessment. A total of 1643 eligible participants were included in analyses (82% male; median age 33 years; 30% injected drugs in prison; 1818 person-years of follow-up). Overall HCV incidence was 6.11/100 person-years (95%CI: 5.07-7.35), with higher rate of re-infection (9.34/100 person-years; 95%CI: 7.15-12.19) than primary infection (4.60/100 person-years; 95%CI: 3.56-5.96). In total population (n = 1643), HCV risk was significantly higher among participants injecting drugs in prison [vs. no injecting; adjusted hazard ratio (aHR): 10.55, 95%CI: 5.88-18.92), and those who were released and re-incarcerated during follow-up (vs. remained incarcerated; aHR: 1.60, 95%CI: 1.03-2.49). Among participants who injected recently (during past month, n = 321), HCV risk was reduced among those receiving high-dosage opioid agonist therapy (OAT), i.e. methadone ≥60 mg/day or buprenorphine ≥16 mg/day, (vs. no OAT, aHR: 0.11, 95%CI: 0.02-0.80) and increased among those sharing needles/syringes without consistent use of disinfectant to clean injecting equipment (vs. no sharing, HR: 4.60, 95%CI: 1.35-15.66). This study demonstrated high HCV transmission risk in prison, particularly among people injecting drugs. High-dosage OAT was protective, but improved OAT coverage and needle/syringe programmes to reduce sharing injecting equipment are required.

COVID-19 nas prisões: validação de um inquérito de conhecimento, atitude e prática / COVID-19 en las cárceles: validación de un estudio de conocimiento, actitud y práctica / COVID-19 in prisons: validity of a knowledge, attitude and practice survey

Resumo Objetivo Validar um inquérito de conhecimento, atitude e prática sobre medidas preventivas da COVID-19 para os funcionários do sistema penitenciário, fundamentado na teoria ambientalista. Métodos Estudo metodológico desenvolvido em quatro etapas: estabelecimento da estrutura conceitual, elaboração do instrumento, validação do conteúdo por juízes e avaliação da aparência pelo público-alvo. O conteúdo de cada item foi validado quanto a objetividade, clareza e relevância. A aparência do inquérito foi avaliada quanto ao objetivo, a organização, ao estilo da escrita e a motivação. Utilizou-se o coeficiente de validação de conteúdo para avaliar a concordância entre os juízes e entre o público-alvo. Os dados foram analisados por meio de distribuições brutas, percentuais, medidas de posição e de dispersão. O índice alfa de Cronbach foi utilizado para analisar a consistência das avaliações dos juízes e do público-alvo. Resultados Quanto ao conteúdo e a aparência, os requisitos avaliados obtiveram concordância superior a 0,9. Na avaliação da consistência, obteve-se índice alfa de Cronbach > 0,9 e > 0,7, quanto ao conteúdo e à aparência, respectivamente, indicando que juízes e público-alvo tenderam a fazer avaliações similares. Conclusão O inquérito apresentou validade de conteúdo e aparência para a coleta de dados referentes a conhecimento, atitude e prática sobre prevenção da COVID-19, para os funcionários do sistema penitenciário, indicando que poderá contribuir para o planejamento e a avaliação de ações de educação em saúde.

Resumen Objetivo Validar un estudio de conocimiento, actitud y práctica sobre medidas preventivas de COVID-19 para los empleados del sistema penitenciario, fundamentado en la teoría ambientalista. Métodos Estudio metodológico llevado a cabo en cuatro etapas: establecimiento de la estructura conceptual, elaboración del instrumento, validación del contenido por jueces y evaluación de la apariencia por el público destinatario. Se validó el contenido de cada ítem respecto a la objetividad, claridad y relevancia. Se evaluó la apariencia del estudio respecto al objetivo, la organización, el estilo de escritura y la motivación. Se utilizó el coeficiente de validez de contenido para evaluar la concordancia entre los jueces y entre el público destinatario. Los datos se analizaron mediante distribuciones brutas, porcentajes, medidas de posición y de dispersión. Se utilizó el índice alfa de Cronbach para analizar la consistencia de las evaluaciones de los jueces y del público destinatario. Resultados Respecto al contenido y a la apariencia, los requisitos evaluados obtuvieron concordancia superior a 0,9. En la evaluación de la consistencia, se obtuvo un índice alfa de Cronbach > 0,9 respecto al contenido y > 0,7 respecto a la apariencia, lo que indica la tendencia de los jueces y del público destinatario a realizar evaluaciones similares. Conclusión El estudio presentó validez de contenido y apariencia para la recopilación de datos referentes a conocimiento, actitud y práctica sobre prevención de COVID-19 para empleados del sistema penitenciario, lo que indica que podrá contribuir a la planificación y evaluación de acciones de educación para la salud.

Abstract Objective To validate a knowledge, attitude and practice survey on preventive measures against COVID-19 for penitentiary system staff based on environmental theory. Methods This is a methodological study developed in four stages: conceptual structure establishment; instrument elaboration; content validity by judges; and appearance assessment by the target audience. The content of each item was validated for objectivity, clarity and relevance. Survey appearance was assessed regarding objective, organization, writing style and motivation. Content validity coefficient was used to assess agreement among judges and the target audience. Data were analyzed using gross distributions, percentages, position and dispersion measures. Cronbach's alpha index was used to analyze the consistency of judges' and target audience's assessments. Results Regarding content and appearance, the assessed requirements achieved agreement greater than 0.9. In consistency assessment, a Cronbach's alpha index > 0.9 and > 0.7 was obtained for content and appearance, respectively, indicating that judges and target audiences tended to make similar assessments. Conclusion The survey presented content and appearance validity for collecting data regarding knowledge, attitude and practice regarding COVID-19 prevention for penitentiary system staff, indicating that it could contribute to health education action planning and assessment.

Formação da identidade profissional de enfermeiros para o trabalho no sistema prisional / Development of the professional identity of nurses to work in the prisonal system / Formación de la identidad profesional de los enfermeros para trabajar en el sistema penitenciario

Objetivo:analisar elementos motivadores da construção da identidade profissional de enfermeiros do sistema prisional. Método: estudo histórico-social, qualitativo, sob o método de triangulação de fontes orais e documentais coletados de maio a dezembro de 2020, iluminado pelo referencial foucaultiano. Protocolo de pesquisa aprovado pelo Comitê de Ética e Pesquisa da instituição signatária. Resultados: a realização de concurso público para o sistema prisional foi motivada pela aquisição de estabilidade. Os enfermeiros concursados eram despreparados para cuidar de pessoas presas. A disciplina e os poderes exercidos pelos guardas e presos surpreenderam estes enfermeiros, que precisaram se adaptar ao sistema num contexto social marcado pela violência urbana. Considerações finais: destaca-se, na construção da identidade destes profissionais, a capacidade para contornar medos e inseguranças, exercício de poder disciplinar e normatização do cuidado para o enfrentamento do cotidiano do trabalho. Emerge a necessidade de capacitação de enfermeiros nesta área na formação profissional(AU)

Objective: to analyze elements that motivate the construction of the professional identity of nurses in the prison system. Method: historical-social, qualitative study, under the method of triangulation of oral and documental sources collected from May to December 2020, illuminated by the Foucaultian reference. Approved by the Ethics and Research Committee. Results: the holding of a public tender for the prison system was motivated by the acquisition of stability. The registered nurses were unprepared to take care of prisoners. The discipline and powers exercised by guards and prisoners surprised these nurses, who had to adapt to the system in a social context marked by urban violence. Final considerations: in the construction of the identity of these professionals, the ability to overcome fears and insecurities, exercising disciplinary Power and standardizing care for coping with daily work is highlighted. The need to train nurses in thisarea in professional training emerges(AU)

Objetivo: analizar elementos que motivan la construcción de la identidad profesional de las enfermeras en el sistema penitenciario. Método: estudio histórico-social, cualitativo, iluminado por el referente foucaultiano, que utiliza el método de triangulación de fuentes orales y documentales recolectadas de mayo a 20 de diciembre. El Comité de Ética en Investigación de la institución firmante aprobó el protocolo de investigación. Resultados: la realización de un concurso público para el sistema penitenciario estuvo motivada por la adquisición de estabilidad. Los enfermeros aprobados por ese concurso público no estaban preparados para cuidar a los presos. La disciplina y los poderes que ejercían los guardias y presos sorprendieron a estos enfermeros, que debieron adaptarse al sistema en un contexto social marcado por la violencia urbana. Consideraciones finales: en la construcción de la identidad de estos profesionales se destaca la capacidad de superación de miedos e inseguridades, ejercicio de poder disciplinario y estandarización de los cuidados para hacer frente al cotidiano del trabajo. Surge la necesidad de capacitar a enfermeros en esta área en la formación profesional(AU)

Accuracy of Rapid Antigen Screening Tests for SARS-CoV-2 Infection at Correctional Facilities in Korea: March - May 2022.

BACKGROUND: The number of confirmed cases of individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increased rapidly due to the Omicron variant. Correctional facilities are vulnerable to infectious diseases, and they introduced rapid antigen tests (RATs) to allow for early detection and rapid response. We aimed to evaluate the diagnostic performance and usefulness of SARS-CoV-2 RATs in newly incarcerated people. MATERIALS AND METHODS: We conducted a cross-sectional study at correctional facilities in Korea from 9 March to 22 May 2022. The study population was newly incarcerated people who were divided into two groups. In one group, 799 paired SARS-CoV-2 RATs and real-time polymerase chain reaction (RT-PCR) were conducted simultaneously in 522 individuals in March 2022. In the other group, 4,034 paired RATs and RT-PCR consecutively in 4,034 participants; only individuals with negative RATs results underwent RT-PCR from April to May 2022. We analyzed data using descriptive statistics and a logistic regression model. RESULTS: Among the 799 specimens in March, RT-PCR was positive in 72 (9.0%), and among the 4,034 specimens in April - May 2022, RT-PCR was positive in 40 (1.0%). Overall, the RATs had a sensitivity of 58.3%, specificity of 100.0%, positive predictive value (PPV) of 100.0%, and negative predictive value (NPV) of 96.0%. Asymptomatic individuals constituted 98.2% of the study group, and symptomatic individuals 1.8%. In asymptomatic cases, the sensitivity of RATs was 52.5%, specificity was 100.0%, PPV was 100.0%, and NPV was 96.3%. In symptomatic cases, the sensitivity of RATs was 84.6%, specificity was 100.0%, PPV was 100.0%, and NPV was 33.3%. Sensitivity (P = 0.034) and NPV (P = 0.004) differed significantly according to the presence and absence of symptoms, and the F1 score was the highest at 0.9 in symptomatic individuals in March. There was a positive linear trend in the proportion of false-negative RATs in newly incarcerated people following the weekly incidence of SARS-CoV-2 (P = 0.033). The best-associated predictors of RATs for SARS-CoV-2 infection involved symptoms, timing of sample collection, and repeat testing. CONCLUSION: Sensitivity and NPV significantly depend on whether symptoms are present, and the percentage of false negatives is correlated with the incidence. Thus, using RATs should be adjusted according to the presence or absence of symptoms and the incidence of SARS-CoV-2 infection in the community. RATs could be a useful screening tool as an effective first-line countermeasure because they can rapidly identify infectious patients and minimize SARS-CoV-2 transmission in correctional facilities.